Was können Pflegende zur Reduktion unnötiger Kathetertage beitragen : Eine Analyse pflegegeleiteter Strategien zur Verhinderung unnötiger Kathetertage und den damit verbundenen katheterassoziierten harnwegsinfektionen bei Erwachsenen im Akutspital

Hintergrund: In der Schweiz erhält jede(r) vierte Patient(in) während des Spitalaufenthaltes einen Dauerkatheter (DK). Trotz bestmöglicher DK-Pflege erhöht jeder zusätzliche Kathetertag das Risiko einer katheterassoziierten Harnwegs-infektion (CAUTI) um 3-10%. Ziel: Anhand der Fragestellung soll herausgefunden werden, welche pflegerischen Interventionen bei Erwachsenen im Akutspital unnötige Kathetertage verhindern und damit verbundene katheterassoziierte Harnwegsinfektionen (CAUTIs) reduzieren können. In dieser Arbeit werden pflegerische Strategien zur Evaluation der DK-Notwendigkeit aufgelistet und miteinander verglichen. Methode: Es wurde eine Literaturrecherche in den Datenbanken CINAHL, Medline, Pubmed und Cochrane Library durchgeführt. Die relevante Literatur wurde analysiert und bezüglich ihrer Güte eingeschätzt. Ergebnisse: Die Evidenz zeigt einen positiven Effekt verschiedener pflegerischer Strategien zur Evaluation der DK-Notwendigkeit auf die Reduktion von Kathetertagen, von einer CAUTI-Reduktion wird teilweise berichtet. Schlussfolgerungen: In der Literatur wird empfohlen, Pflegende in die Evaluation der DK-Notwendigkeit miteinzubeziehen, um den DK-Gebrauch zu reduzieren. Es sollte im Akutspital eine pflegerische Strategie verfolgt werden, um das Bewusstsein bezüglich DK-Gebrauchs zu erhöhen. Die Auseinandersetzung mit der Literatur zeigt, dass eine Kombination mehrerer pflegerischer Strategien zur DK-Evaluation sinnvoll wäre. So beispielsweise ein pflegegeleitetes DK-Protokoll in Kombination mit Edukation

Efficiency increase in carbon dioxide refrigeration technology with parallel compression

In this article, we will review the comparison between a CO2 refrigeration system with a parallel compressor and a conventional carbon dioxide refrigeration machine. In order to carry out the comparison, a numerical model has been generated showing a good correlation to experimental data obtained with a fully instrumented test rig machine. We can determine under which conditions an increase in the energy efficiency ratio (EER) of 10% and more can be expected with a parallel compression system. The results will help users to decide upon economically viable refrigeration systems, depending on the operational conditions of the machine. In usual operating conditions, the achievable increase in the EER by the parallel compressor has been determined; furthermore, it showed that a low evaporation temperature and a high temperature at the outlet of the gas cooler have a positive effect on the parallel compression circuit. With respect to the intermediate pressure, an optimum can be specified at low evaporation temperatures

Solar ultraviolet protection provided by human head hair

The solar erythemal UV irradiances through human hair and the protection from UV provided by human head hair have been investigated for a solar zenith angle (SZA) range of 17 to 51 degrees for the conditions of a head upright in full sun, a head upright in shade and a head in full sun tilted towards the sun. The two hair lengths investigated were 49.1+-7.1 mm for the short type and 109.5+-5.5 mm for the long type. For the head upright in full sun, the irradiances through the hair ranged from 0.75 to 1.4 SED/h for SZA less than 25 degrees and less than 0.6 SED/h in shade. The ultraviolet protection factor (UPF) ranged from approximately 5 to 17 in full sun, with the UPF increasing with higher SZA. The longer hair provided a lower UPF than the shorter hair and for the head oriented towards the sun, there was a marginally lower UPF than for the upright head. This research shows that the UV exposure limits to the scalp through hair can be exceeded within short timeframes and provides important information to assist employers to comply with Workplace Health and Safety legislation

Parity-violating elastic electron scattering and nuclear structure

We discuss parity-violating elastic electron scattering as a complementary tool in the race for more precise determinations of neutron densities in nuclei. Isovector and isoscalar densities and form factors in N > Z and N = Z stable nuclei are discussed taking Pb-208 and Si-28 as examples. Distorted wave calculations of parity-violating asymmetries are shown and are compared to the plane wave impulse approximation. The extraction of the ratio between neutron and proton monopole form factors is discussed. The isospin mixing produced by Coulomb interaction in the ground state of N = Z nuclei with Skyrme selfconsistent mean fields is also discussed.This work was supported by Ministerio de Ciencia e Innovación (Spain) under Contract FIS2008-01301. J.M.U. acknowledges support from INTAS Open Call grant No 05- 1000008-8272, and Ministerio de Ciencia e Innovación (Spain) under grants FPA-2007- 62616 and FPA-2006-07393, and UCM and Comunidad de Madrid under grant Grupo de Física Nuclear (910059).Peer reviewe