Analytical solution of the Poiseuille flow of a De Kee viscoplastic fluid

We provide an explicit analytical solution of the planar Poiseuille flow of a viscoplastic fluid governed by the constitutive equation proposed by De Kee and Turcotte (Chem. Eng. Commun. 6 (1980) 273-282). Formulae for the velocity and the flow rate are derived, making use of the Lambert W function. It is shown that a solution does not always exist because the flow curve is bounded from above and hence the rheological model can accommodate stresses only up to a certain limit. In fact, the flow curve reaches a peak at a critical shear rate, beyond which it exhibits a negative slope, giving rise to unstable solutions

Exploring Nurses' Perceptions of Medication Error Risk Factors: Findings From a Sequential Qualitative Study

A focus group study was conducted to explore nurses' perceptions of medication administration error associated factors in two medical wards of a tertiary hospital. Nurses were invited to participate in focus group discussions. Thematic analysis was employed and identified four themes: professional practice environment related factors, person-related factors, drug-related factors, and processes and procedures. Staffing, interruptions, system failures, insufficient leadership, and patient acuity were perceived as risk factors for medication errors. The findings of this study complement the findings of an observational study which investigated medication administration errors in the same setting. Although some findings were similar, important risk factors were identified only through focus group discussions with nurses. Nurses' perceptions of factors influencing medication administration errors provide important considerations in addressing factors that contribute to errors and for improving patient safety

Implementation of Guidelines for the Management of Arterial Hypertension. The Impulsion Study

This study assessed the effects of a pilot best practice implementation enhancement program on the control of hypertension. We enrolled 697 consecutive known hypertensive patients with other vascular risk factors but free from overt vascular disease. There was no “control” group because it was considered unethical to deprive high-risk patients from “best medical treatment”. Following a baseline visit, previously trained physicians aimed to improve adherence to lifestyle measures and drug treatment for hypertension and other vascular risk factors. Both at baseline and at study completion (after 6 months), a 1-page form was completed showing if patients achieved treatment targets. If not, the reasons why were recorded. This program enhanced compliance with lifestyle measures and increased the use of evidence-based medication. There was a substantial increase in the number of patients who achieved treatment targets for blood pressure (p<0.0001) and other vascular risk factors. In non-diabetic patients (n=585), estimated vascular risk (PROCAM risk engine) was significantly reduced by 41% (p<0.0001). There was also a 12% reduction in vascular risk according to the Framingham risk engine but this did not achieve significance (p=0.07). In conclusion, this is the first study to increase adherence to multiple interventions in hypertensive patients on an outpatient basis, both in primary care and teaching hospitals. Simple, relatively low cost measures (e.g. educating physicians and patients, distributing printed guidelines/brochures and completing a 1-page form) motivated both physicians and patients to achieve multiple treatment goals. Further work is needed to establish if the improvement observed is sustained. [ClinicalTrials.gov NCT00416611]

Europe-wide expansion and eradication of multidrug-resistant Neisseria gonorrhoeae lineages: a genomic surveillance study

Centre for Genomic Pathogen Surveillance and the Euro-GASP study group: Sonja Pleininger, Alexander Indra, Irith De Baetselier, Wim Vanden Berghe, Blaženka Hunjak, Tatjana Nemeth Blažić, Panayiota Maikanti-Charalambous, Despo Pieridou, Hana Zákoucká, Helena Žemličková, Steen Hoffmann, Susan Cowan, Lasse Jessen Schwartz, Rita Peetso, Jevgenia Epstein, Jelena Viktorova, Ndeindo Ndeikoundam, Beatrice Bercot, Cécile Bébéar, Florence Lot, Susanne Buder, Klaus Jansen, Vivi Miriagou, Georgios Rigakos, Vasilios Raftopoulos, Eszter Balla, Mária Dudás, Lena Rós Ásmundsdóttir, Guðrún Sigmundsdóttir, Guðrún Svanborg Hauksdóttir, Thorolfur Gudnason, Aoife Colgan, Brendan Crowley, Sinéad Saab, Paola Stefanelli, Anna Carannante, Patrizia Parodi, Gatis Pakarna, Raina Nikiforova, Antra Bormane, Elina Dimina, Monique Perrin, Tamir Abdelrahman, Joël Mossong, Jean-Claude Schmit, Friedrich Mühlschlegel, Christopher Barbara, Francesca Mifsud, Alje Van Dam, Birgit Van Benthem, Maartje Visser, Ineke Linde, Hilde Kløvstad, Dominique Caugant, Beata Młynarczyk-Bonikowska, Jacinta Azevedo, Maria-José Borrego, Marina Lurdes Ramos Nascimento, Peter Pavlik, Irena Klavs, Andreja Murnik, Samo Jeverica, Tanja Kustec, Julio Vázquez Moreno, Asuncion Diaz, Raquel Abad, Inga Velicko, Magnus Unemo, Helen Fifer, Jill Shepherd, Lynsey PattersonBackground: Genomic surveillance using quality-assured whole-genome sequencing (WGS) together with epidemiological and antimicrobial resistance (AMR) data is essential to characterise the circulating Neisseria gonorrhoeae lineages and their association to patient groups (defined by demographic and epidemiological factors). In 2013, the European gonococcal population was characterised genomically for the first time. We describe the European gonococcal population in 2018 and identify emerging or vanishing lineages associated with AMR and epidemiological characteristics of patients, to elucidate recent changes in AMR and gonorrhoea epidemiology in Europe. Methods: We did WGS on 2375 gonococcal isolates from 2018 (mainly Sept 1-Nov 30) in 26 EU and EEA countries. Molecular typing and AMR determinants were extracted from quality-checked genomic data. Association analyses identified links between genomic lineages, AMR, and epidemiological data. Findings: Azithromycin-resistant N gonorrhoeae (8·0% [191/2375] in 2018) is rising in Europe due to the introduction or emergence and subsequent expansion of a novel N gonorrhoeae multi-antigen sequence typing (NG-MAST) genogroup, G12302 (132 [5·6%] of 2375; N gonorrhoeae sequence typing for antimicrobial resistance [NG-STAR] clonal complex [CC]168/63), carrying a mosaic mtrR promoter and mtrD sequence and found in 24 countries in 2018. CC63 was associated with pharyngeal infections in men who have sex with men. Susceptibility to ceftriaxone and cefixime is increasing, as the resistance-associated lineage, NG-MAST G1407 (51 [2·1%] of 2375), is progressively vanishing since 2009-10. Interpretation: Enhanced gonococcal AMR surveillance is imperative worldwide. WGS, linked to epidemiological and AMR data, is essential to elucidate the dynamics in gonorrhoea epidemiology and gonococcal populations as well as to predict AMR. When feasible, WGS should supplement the national and international AMR surveillance programmes to elucidate AMR changes over time. In the EU and EEA, increasing low-level azithromycin resistance could threaten the recommended ceftriaxone-azithromycin dual therapy, and an evidence-based clinical azithromycin resistance breakpoint is needed. Nevertheless, increasing ceftriaxone susceptibility, declining cefixime resistance, and absence of known resistance mutations for new treatments (zoliflodacin, gepotidacin) are promising.This study was supported by the European Centre for Disease Prevention and Control, the Centre for Genomic Pathogen Surveillance, the Li Ka Shing Foundation (Big Data Institute, University of Oxford), the Wellcome Genome Campus, the Foundation for Medical Research at Örebro University Hospital, and grants from Wellcome (098051 and 099202). LSB was funded by Conselleria de Sanitat Universal i Salut Pública, Generalitat Valenciana (Plan GenT CDEI-06/20-B), Valencia, Spain, and Ministry of Science, Innovation and Universities (PID2020–120113RA-I00), Spain, at the time of analysing and writing this manuscript.info:eu-repo/semantics/publishedVersio

The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study

Background: Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on time to adjuvant therapy. Methods: Consecutive women undergoing mastectomy ± IBR for breast cancer July–December, 2016 were included. Patient demographics, operative, oncological and complication data were collected. Time from last definitive cancer surgery to first adjuvant treatment for patients undergoing mastectomy ± IBR were compared and risk factors associated with delays explored. Results: A total of 2540 patients were recruited from 76 centres; 1008 (39.7%) underwent IBR (implant-only [n = 675, 26.6%]; pedicled flaps [n = 105,4.1%] and free-flaps [n = 228, 8.9%]). Complications requiring re-admission or re-operation were significantly more common in patients undergoing IBR than those receiving mastectomy. Adjuvant chemotherapy or radiotherapy was required by 1235 (48.6%) patients. No clinically significant differences were seen in time to adjuvant therapy between patient groups but major complications irrespective of surgery received were significantly associated with treatment delays. Conclusions: IBR does not result in clinically significant delays to adjuvant therapy, but post-operative complications are associated with treatment delays. Strategies to minimise complications, including careful patient selection, are required to improve outcomes for patients

TEACHERS IN THE ERA OF ACCELERATION : How the acceleration of ICT developments influences the ICT use by teachers at school

In the effort to examine the factors that impact the use of ICT by teachers, research has up until now neglected the acceleration of ICT developments as a factor that affects the successful integration of ICT in education. The technological acceleration in general has triggered significant changes at the social level, such as the acceleration of social change and the acceleration of the pace of life. This is why the study of the acceleration of ICT provides for a good theoretical framework to study the teachers and their interaction with ICT in a broader context, one that engages the environment in which a teacher functions as a teacher and a learner. This study explores the role of the acceleration of ICT as a factor that affects the use of ICT by teachers in Cyprus secondary schools. The Social Acceleration (SA) theory is used to interpret the whole situation. After examining how teachers perceive the ICT acceleration, how it affects them at school and personally as lifelong learners the results showed that ICT acceleration is not a significant factor in the use of ICT by teachers at schools in Cyprus but it still affects teachers indirectly as lifelong learners. I argue that the teachers have established a superficial relation to technology that has to do with a short-sighted vision of ICT integration which also the Ministry of Education shares. I propose that serious decisions should be made at a policy level in order to make a conscious adoption of technology, not necessarily running behind the accelerated ICT developments but exploiting the potential of ICT according to the needs of the educational system

Mental Health in Cypriot Citizens of the Rural Health Centre Kofinou

Objective: The main purpose of this study was to investigate the mental health of Cypriot citizens living in the current difficult period of economic recession. The specific objective was to investigate the different factors (gender, age, socio-economic factors, etc.) that may affect the levels of emotional distress, anxiety, and depression in patients attending the Rural Health Centre of Kofinou. Materials and Methods: The sample consisted of a total of 300 Cypriots who visited Kofinou Health Centre in the period between July and September 2015. For the middle-aged citizens, the Greek version of the Hospital Anxiety Depression Scale (HADS) was applied to 150 persons [1], while for the visiting senior citizens (aged over 65 years), the Greek version of the Geriatric Depression Scale (GDS) was used [2]. Results: HADS: A total of 150 people of average age 47 ± 11.5 years (min 23–max 64) participated in the study. Fifty-six percent were women. Seventy-seven percent stated they had a reduction in income (mean reduction 35% ± 25%) and 46.7% suffered from chronic disease. The 36.6% and 28.7% of the visitors showed moderate or severe forms of anxiety and depression, accordingly. Higher emotional distress is associated with lower educational level (b = −2.63, p &lt; 0.001), lower income (b = −1.07, p = 0.017), and the presence of a chronic disease (b = 5.45, p &lt; 0.001). The same factors are significantly associated with higher anxiety (Education: b = −1.20, p = 0.003; Income: b = −0.64, p = 0.01; Chronic disease: b = 2.82, p = 0.001). Additionally, a reduction in income (&gt;35%) is associated with increased depression (p = 0.028). GDS: 150 patients out of which 77 were women (51.3%). The average age of participants was 72 ± 5.5 years. Ninety-three (62%) participants declared a reduction in income due to the financial crisis (mean reduction 20% ± 8%), while 139 (92.7%) stated that they had chronic disease. Fifty-three participants (35.3%) thought they had symptoms of depression after the economic crisis. The women showed higher level of geriatric depression symptoms than men (b = −1.96, p = 0.005), while age is associated with higher levels of GDS (b = 0.16, p = 0.006). Conclusions: The study shows that stress levels, depression, and emotional distress are increased in specific population groups. The main variables associated with the mental health of the participants are the presence of a chronic disease, income, and level of education

Nurses’ and patients’ perceptions of caring behaviours: quantitative systematic review of comparative studies

Aim. This paper is a report of a systematic review conducted to test the hypothesis that nurses and patients perceive the concept of caring in nursing differently. Background. Caring is viewed as the central focus of nursing. However, despite its fundamental place in clinical practice, researchers and scholars have failed in reaching a common definition. This failure has led to eliciting for nebulous interpretations of the concept often leading to perplexity and opposing views between patients and nurses. Data sources. Extensive search was conducted using MEDLINE, CINAHL and EMBASE between March and May 2009 with no publishing time limit and the keywords ‘care’, ‘caring’, ‘nurse’, ‘nursing’, ‘behavio(u)rs’, ‘patient’, ‘perception’, ‘quantitative’ and ‘comparative’. Review methods. This quantitative systematic review of comparative studies followed the guidance of the Centre for Reviews and Dissemination. A seven-item ‘yes’ or ‘no’ checklist was developed and used for appraising the quality status of the selected literature. Narrative summary technique was used to report outcomes. Results. Evidence of incongruence of perceptions between patients and nurses is mainly supported by the literature. Few studies, however, report aspects of congruence. Conclusion. There is considerable evidence of the assertion that there is no congruence of perceptions between patients and nurses as regards to which behaviours are considered caring and intended caring is not always perceived as such by the patient. Further research is needed, however, to generate more knowledge on the relationship between caring behaviours, patient outcomes and health or nursing costs

Experimental study of the response of links in reinforced concrete column subjected to dynamic loads

87 σ.Στην εργασία αυτή γίνεται μελέτη της πειραματικής απόκρισης συνδετήρων σε υποστύλωμα οπλισμένου σκυροδέματος καθώς και του διαμήκους οπλισμού του, υπό δυναμική φόρτιση. Το υποστήλωμα αποτελεί μέρος ενός στοιχείου υποστυλώματος- προβόλου δοκού, που καταπονείται με μεταβαλλόμενα φορτία τόσο κατά εύρος όσο και κατά συχνότητα. Τα εφαρμοζόμενα φορτία ασκούνται στο άκρο του προβόλου. Αναλυτικά Άρχικά έγινε η κατασκευή των δοκιμίων , που ήταν σε σχεδόν πραγαμτική κλιμακα. Τα κυρίως δοκίμια αποτελούνται απο δοκό και υποστήλωμα διατομής 250mm χ 250mm και ύψος τουλάχιστον 1500 mm. Αυτά οπλίστηκαν με χάλυβα S 500s και κλωβούς συνδετήρων. Επί των κλωβών τποθετήθηκαν ηλεκτρικοί μετρητές παραμόρφωσης (strain gauges) κατάλληλα για μέταλλα. Επίσης ηλεκτρικοί μετρητές παραμόρφωσης κατάλληλοι για σκυρόδεμα, τοποθετήθηκαν σε αντοίστοιχες θέσεις της επιφάνειας σκυροδέματος, όπου με την εγκατάστηση των απαιτούμενων οργάνων και του λογισμικού είναι δυνατή η ταχεία λήψη, αποθήκευση και επεξεργασία αποτελεσμάτων. Στη συνέχεια τα κυρίως δοκίμια υποβλήθηκαν σε κρουστικά φορτία και εναλλασσόμενα φορτία συχνότητα 5-15 Hz, με αυξανόμενη ένταση έως τη τελική θραύση τους. Η όλη διαδικασία μαγνητοσκοποίθηκε ηλεκτρονικά και ταυτόχρονα υπήρξε συνεχής καταγραφή της απόκρισης των ηλεκτικών μηκηνσιομέτρων. Η επεξεργασία των αποτελεσμάτων της εργασίας αυτής αφορά μετρήσεις μικρής έντασης φορτίου,επομένως απέχουν από τη ρηγμάτωση του δοκιμίου που έγινε βέβαια σε μεγαλύτερα φορτία. Η αντοίστοιχη επεξεργασία θα γίνει από αλλους ερευνητές. Τέλος σημειώνεται ότι υπάρχει πολύ περιορισμένος αριθμός βιβλιογραφικών αναφορών σε πειραματικές μελέτες που αφορούν τη διάδοση κύματος στον εγκλάρσιο οπλισμό, καθώς και την απόκριση του σε υψηλές συχνότητες, όπως πειράματα στο Πανεπιστήμιο της California [11,12] που έχουν γίνει σε σπειρωιδή εγκάρσιο οπλισμό. Αναφέρονται επίσης αντοίστοιχες πειραμτικές διαδικασίες για την συμπεριφορά του οπλισμού σε ειδικές περιπώσεις όπως π.χ. τον βαθμό περίσφυξης [13], ή την κατανομή των τάσεων σε υπερκάλυηψ [14].In this work becomes study of experimental response of fasteners in column armed concrete as well as his armament, under dynamic charge. Column it constitutes part of element of column- joist, that loaded with altered charges so much at breadth what at frequency. The applied charges are practiced in utmost [proboloy]. Analytically Initially became the manufacture of essays, that was almost in real scale. The essays are mainly constituted by joist and [ypostiloma] cross-section 250mm h 250mm and height at least 1500 mm. These were armed with steel S 500s and cages of fasteners. On the cages electric meters of deformity (strain gauges) suitably for metals. Also electric meters of deformity suitable for concrete, were placed in [antoistoiches] places of surface of concrete, where with the installation of required bodies and software is possible the rapid reception, storage and treatment of results. Afterwards the essays were mainly submitted in impactive charges and alternating charges frequency 5-15 Hz, with increasing intensity until their final fracture. The all process recorded electronic and simultaneous existed continuous recording of response strain gauges. The treatment of results of this work concerns measurements of small intensity of charge, consequently abstains from the crack of essay that became certain in bigger charges. The treatment will become from other researchers. Finally it is marked that exists very limited number of bibliographic reports in experimental studies that concern the distribution of wave in the traverse armament, as well as his response in high frequencies, as experiments in the University of California [11,12] that have become in [speiroidi] traverse armament. Are reported also similar experiments processes for the behavior of armament in special cases as eg the degree tightening [13], or the distribution of tendencies incover [14].Γεώργιος Π. Χαραλάμπου

Analytical solution of the Poiseuille flow of a De Kee viscoplastic fluid

We provide an explicit analytical solution of the planar Poiseuille flow of a viscoplastic fluid governed by the constitutive equation proposed by De Kee and Turcotte (1980). Formulae for the velocity and the flow rate are derived, making use of the Lambert W function. It is shown that a solution does not always exist because the flow curve is bounded from above and hence the rheological model can accommodate stresses only up to a certain limit. In fact, the flow curve reaches a peak at a critical shear rate, beyond which it exhibits a negative slope, giving rise to unstable solutions