Does the use of cardiopulmonary resuscitation feedback devices improve the quality of chest compressions performed by doctors? A prospective, randomized, cross-over simulation study

Background: The aim of the study was to compare the quality of chest compressions (CCs) carried out with and without the use of the TrueCPR device during simulated cardiopulmonary resuscitations conducted by trainee doctors. Methods: The study was a prospective, randomized, cross-over simulation study. The study involved 65 trainee doctors who were tasked with performing a 2-min cycle of uninterrupted CCs under conditions of a simulated cardiopulmonary resuscitation of adults. CC were carried out in two scenarios: with and without TrueCPR chest compression support. Participants did not have experience in the use of CCs prior to this study. Results: The depth of compressions in regard to CC techniques were varied by 45 mm (IQR 43–48) for manual CC and 53 mm (IQR 51–55) for the TrueCPR device (p < 0.001). The incidence of CCs with and without TrueCPR was: 112 (IQR 103–113) vs. 129 (IQR 122–135) compressions (p = 0.002). The degree of complete chest relaxation with the TrueCPR device was 95% (IQR 76–99) and without the device, 33% (IQR 29–38) (p < 0.001). Conclusions: In the simulation study performed, the use of the TrueCPR device resulted in a significant improvement in the quality of CCs in relation to frequency and depth of CCs and correctness of chest relaxation

In vivo MRI of the human finger at 7 T

PURPOSE: To demonstrate a dedicated setup for ultrahigh resolution MR imaging of the human finger in vivo. METHODS: A radiofrequency coil was designed for optimized signal homogeneity and sensitivity in the finger at ultrahigh magnetic field strength (7 T), providing high measurement sensitivity. Imaging sequences (2D turbo-spin echo (TSE) and 3D magnetization-prepared rapid acquisition gradient echo (MPRAGE)) were adapted for high spatial resolution and good contrast of different tissues in the finger, while keeping acquisition time below 10 minutes. Data was postprocessed to display finger structures in three dimensions. RESULTS: 3D MPRAGE data with isotropic resolution of 200 µm, along with 2D TSE images with in-plane resolutions of 58 × 78 µm2 and 100 × 97 µm2 , allowed clear identification of various anatomical features such as bone and bone marrow, tendons and annular ligaments, cartilage, arteries and veins, nerves, and Pacinian corpuscles. CONCLUSION: Using this dedicated finger coil at 7 T, together with adapted acquisition sequences, it is possible to depict the internal structures of the human finger in vivo within patient-compatible measurement time. It may serve as a tool for diagnosis and treatment monitoring in pathologies ranging from inflammatory or erosive joint diseases to injuries of tendons and ligaments to nervous or vascular disorders in the finger. Magn Reson Med 79:588-592, 2018. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited

The Energy Spectrum of TeV Gamma-Rays from the Crab Nebula as measured by the HEGRA system of imaging air Cherenkov telescopes

The Crab Nebula has been observed by the HEGRA (High-Energy Gamma-Ray Astronomy) stereoscopic system of imaging air Cherenkov telescopes (IACTs) for a total of about 200 hrs during two observational campaigns: from September 1997 to March 1998 and from August 1998 to April 1999. The recent detailed studies of system performance give an energy threshold and an energy resolution for gamma-rays of 500 GeV and ~ 18%, respectively. The Crab energy spectrum was measured with the HEGRA IACT system in a very broad energy range up to 20 TeV, using observations at zenith angles up to 65 degrees. The Crab data can be fitted in the energy range from 1 to 20 TeV by a simple power-law, which yields dJg/dE = (2.79+/-0.02 +/- 0.5) 10^{-7} E^{-2.59 +/- 0.03 +/- 0.05}, ph m^{-2} s^{-1} TeV^{-1} The Crab Nebula energy spectrum, as measured with the HEGRA IACT system, agrees within 15% in the absolute scale and within 0.1 units in the power law index with the latest measurements by the Whipple, CANGAROO and CAT groups, consistent within the statistical and systematic errors quoted by the experiments. The pure power-law spectrum of TeV gamma-rays from the Crab Nebula constrains the physics parameters of the nebula environment as well as the models of photon emission.Comment: to appear in ApJ, 29 pages, 6 figure

Exploring the success factors of hybrid micro-enterprises

This research explores hybrid micro-entrepreneurs’ founding motivations and the transformation of those motivations into visions of success, by applying multiple criteria decision analysis (MCDA). We find that entrepreneurs of hybrid micro-enterprises are driven mostly by noneconomic goals and that those influence their vision of success. The success framework consists of seven indicators (training, professional development, marketing, management, external factors, infrastructures, and organizational aspects). Human capital is perceived as the most important for success – translating the professional motivations for founding. Reversely, external factors, which are usually considered crucial to attain legitimacy, are perceived the least important factors. Given the findings, are hybrid micro-entrepreneurs ready to succeed?info:eu-repo/semantics/publishedVersio

'Asking the right question'. A comparison of two approaches to gathering data on 'herbals' use in survey based studies

BACKGROUND:Over the last decade academic interest in the prevalence and nature of herbal medicines use by pregnant women has increased significantly. Such data are usually collected by means of an administered questionnaire survey, however a key methodological limitation using this approach is the need to clearly define the scope of 'herbals' to be investigated. The majority of published studies in this area neither define 'herbals' nor provide a detailed checklist naming specific 'herbals' and CAM modalities, which limits inter-study comparison, generalisability and the potential for meta-analyses. The aim of this study was to compare the self-reported use of herbs, herbal medicines and herbal products using two different approaches implemented in succession. METHODS:Cross-sectional questionnaire surveys of women attending for their mid-trimester scan or attending the postnatal unit following live birth at the Royal Aberdeen Maternity Hospital, North-East Scotland. The questionnaire utilised two approaches to collect data on 'herbals' use, a single closed yes/no answer to the question "have you used herbs, herbal medicines and herbal products in the last three months"; and a request to tick which of a list of 40 'herbals' they had used in the same time period. RESULTS:A total of 889 responses were obtained of which 4.3% (38) answered 'yes' to herbal use via the closed question. However, using the checklist 39% (350) of respondents reported the use of one or more specific 'herbals' (p<0.0001). The 312 respondents who reported 'no' to 'herbals' use via the closed question but "yes" via the checklist consumed a total of 20 different 'herbals' (median 1, interquartile range 1-2, range 1-6). CONCLUSIONS:This study demonstrates that the use of a single closed question asking about the use of 'herbals', as frequently reported in published studies, may not yield valid data resulting in a gross underestimation of actual use

Perspectives and attitudes of breastfeeding women using herbal galactagogues during breastfeeding: a qualitative study

Some herbal galactagogues have gained reputation and recognition by the public and health professionals as alternative approaches to increase breast milk supply. This study explores the perspectives and attitudes of breastfeeding women towards the use of herbal galactagogues while breastfeeding, their experiences, and why and how they have chosen an alternative option over conventional treatments to enhance breastfeeding performance. This exploratory research was conducted through in-depth semi-structured interviews with women living in Perth, Western Australia, who were using one or more herbal galactagogues during breastfeeding. Purposeful and subsequent snowball sampling methods were employed to recruit participants. All interviews, facilitated by an interview guide, were audio-recorded, then transcribed verbatim. Thematic analysis was used to analyse qualitative data to construct themes and subthemes.The perspectives and attitudes of the 20 participants are classified under three main headings: i) use of herbal medicines during breastfeeding, ii) available herbal medicines resources, and iii) level of breastfeeding support received. Throughout the interviews, participants described how their perseverance and determination to breastfeed, as well as concerns over breastfed infants’ safety with conventional treatments, influenced their choice of therapy. A sense of self-efficacy and autonomy over their own health needs was seen as influential to their confidence level, supported self-empowerment and provided reassurance throughout the breastfeeding journey. There was also a desire for more evidence-based information and expectations of health professionals to provide credible and reliable information regarding the use of herbal medicines during breastfeeding. This study has enhanced our understanding of the perspectives and attitudes of breastfeeding women towards the use of herbal medicines, in particular galactagogues, while breastfeeding. The positive attitudes of breastfeeding women identified in this study highlight the need for further research into evaluating the safety and efficacy of commonly used herbal galactagogues, whilst the negative views on breastfeeding education should be taken into consideration when implementing or improving breastfeeding-related health policies

Medicine is patriarchal, but alternative medicine is not the answer

Women are over-represented within alternative medicine, both as consumers and as service providers. In this paper, I show that the appeal of alternative medicine to women relates to the neglect of women’s health needs within scientific medicine. This is concerning because alternative medicine is severely limited in its therapeutic effects; therefore, those who choose alternative therapies are liable to experience inadequate healthcare. I argue that while many patients seek greater autonomy in alternative medicine, the absence of an evidence base and plausible mechanisms of action leaves patients unable to realize meaningful autonomy. This seems morally troubling, especially given that the neglect of women’s needs within scientific medicine seems to contribute to preferences for alternative medicine. I conclude that the liberatory credentials of alternative medicine should be questioned and make recommendations to render scientific medicine better able to meet the needs of typical alternative medicine consumers

A dual continuum model of the reasons for use of complementary health approaches among overweight and obese adults: Findings from the 2012 NHIS

Background: Obese and overweight individuals have greater illness and disease burden, but previous findings from the 2002 National Health Interview Survey (NHIS) suggest that they are no more likely to use complementary health approaches (CHA) than those of normal weight. The current study investigates the relationship between weight status and CHA use, and among CHA users, examines differences in reasons for use by weight status. We propose and test a Dual Continuum Model of Motivations for Use of CHA to examine differences in reasons for use by weight status. Method: Participants were drawn from the 2012 NHIS, a nationally representative sample of civilian, non-institutionalized US adults (N = 34,525). Weight status was operationalized by body mass index. CHA use was measured in the past year and was categorized into alternative providers, products, and practices. Among CHA users (N = 9,307) factors associated with use were categorized as health enhancing or health reactive. Results: Logistic regression showed overweight and obese individuals were less likely to use alternative providers, products, and practices than normal weight. Multinomial logit regression showed some support that overweight and obese adults were less likely than normal weight persons to use CHA for health-enhancing reasons, and more likely to use for health reactive reasons. Conclusions: Despite greater health burden, overweight and obese adults are underutilizing CHA, including modalities that can be helpful for health management. The Dual Continuum Model of CHA Motivations shows promise for explicating the diversity of reasons for CHA use among adults at risk for health problems