Aggression against medical personnel in perception of nursery students : tool suggestion

Agresja pacjentów i ich rodzin stanowi poważny problem w pracy personelu medycznego. Agresja powoduje wiele psychologicznych reakcji: od poczucia winy przez lęk do złości i wściekłości. Efekt długofalowy stanowi pogorszenie jakości opieki zdrowotnej powiązane z wypaleniem zawodowym personelu. Celem pracy była adaptacja skali IMPACS, służącej do oceny konsekwencji agresji wobec pielęgniarek. Badaniem objęto 102 studentki III roku pielęgniarstwa. Narzędzie badawcze stanowiła adaptacja skali IMPACS. W celu uzyskania polskiej wersji narzędzia zastosowano metodę eksploracyjnej analizy czynnikowej. Przedstawiono dwa warianty analizy - trzy- i dwuczynnikowe. W badaniu wykazano różnice w rozbieżnościach pomiędzy oryginalną wersją skali i uzyskaną w badaniach. Wskazuje to na różnice w postrzeganiu agresji i jej konsekwencji w zależności od wpływu kultury i miejsca pracy.Aggression of patients and their families poses a serious problem in the work of medical personnel. Violence in relationships causes a number of psychological reactions of carers: from a sense of guilt through fear to anger and rage. A long-term effect is a decline in health care quality connected with occupational burnout of the personnel. The aim of the research was adaptation of the IMPACS scale: a tool for evaluation of the consequences of aggression towards nurses. The research covered 102 students of nursery. The research tool used in the research was adaptation of IMPACS scale. In order to obtain the scales of the Polish version of the tool, the exploratory factor analysis method was used. Two variants of the analysis results were demonstrated, i.e. with three and two factors. The study demonstrates the divergence between the original version and the one developed as a result of the present research. It means that the perception and consequences of aggression depend on the influence of culture and workplace

Inhibition of thrombin generation by simvastatin and lack of additive effects of aspirin in patients with marked hypercholesterolemia

AbstractOBJECTIVESTo assess the effects of aspirin compared with simvastatin on thrombin generation in hypercholesterolemic men, and to establish whether the reduction of elevated blood cholesterol by simvastatin would affect the action of aspirin on thrombin formation.BACKGROUNDAspirin inhibits thrombin formation, but its performance is blunted in hypercholesterolemia. By virtue of altering lipid profile, statins could be expected to influence thrombin generation.METHODSThirty-three men, aged 34 to 61 years, with minimal or no clinical symptoms, serum total cholesterol >6.5 mmol/liter and serum triglycerides <4.6 mmol/liter, completed the study consisting of three treatment phases. First, they received 300 mg of aspirin daily for two weeks (phase I), which was then replaced by simvastatin at the average dose of 24 mg/d for three months (phase II). In phase III, aspirin, 300 mg/day, was added for two weeks to simvastatin, the dose of which remained unchanged. Thrombin generation was assessed: 1) in vivo, by measuring levels of fibrinopeptide A (FPA) and prothrombin fragment 1+2 (F1+2) in venous blood; and 2) ex vivo, by monitoring the rates of increase of FPA and F1+2 in blood emerging from standardized skin incisions of a forearm. A mathematical model was used to describe the kinetics of thrombin formation at the site of microvascular injury.RESULTSTwo-week treatment with aspirin had no effect on thrombin markers in vivo, while ex vivo it depressed the total amount of thrombin formed, though not the reaction rate. After simvastatin treatment, serum cholesterol decreased by 31% and LDL cholesterol by 42%, while thrombin generation became markedly depressed. In venous blood, FPA was significantly reduced. Concomitantly, the initial thrombin concentration and total amount of thrombin generated decreased significantly. Addition of aspirin to simvastatin (phase III) had no further effect on any of these parameters.CONCLUSIONSIn men with hypercholesterolemia, lowering serum cholesterol level by a three-month simvastatin treatment is accompanied by a marked reduction of thrombin generation both at basal conditions in venous blood and after activation of hemostasis by microvascular injury. Once blood cholesterol became reduced, adding aspirin to simvastatin did not enhance dampening of thrombin formation

Impact of arterial procedures on coagulation and fibrinolysis : a pilot study

Abstract Objective: The main goal of our study was to assess the impact of vascular procedures on the activity of hemostatic and fibrinolytic pathways. Methods: We enrolled 38 patients with ≥ 45 years old undergoing surgery for abdominal aortic aneurysm or peripheral artery disease under general or regional anesthesia and who were hospitalized at least one night after the procedure. Patients undergoing carotid artery surgery and those who had acute bypass graft thrombosis, cancer, renal failure defined as estimated glomerular filtration rate < 30 ml/min/1.73m2, venous thromboembolism three months prior to surgery, or acute infection were excluded from the study. We measured levels of markers of hemostasis (factor VIII, von Willebrand factor:ristocetin cofactor [vWF:CoR], antithrombin), fibrinolysis (D-dimer, tissue plasminogen activator [tPA], plasmin-antiplasmin complexes), and soluble cluster of differentiation 40 ligand (sCD40L) before and 6-12h after vascular procedure. Results: Significant differences between preoperative and postoperative levels of factor VIII (158.0 vs. 103.3, P<0.001), antithrombin (92.1 vs. 74.8, P<0.001), D-dimer (938.0 vs. 2406.0, P=0.005), tPA (10.1 vs. 12.8, P=0.002), and sCD40L (9092.9 vs. 1249.6, P<0.001) were observed. There were no significant differences between pre- and postoperative levels of vWF:CoR (140.6 vs. 162.8, P=0.17) and plasmin-antiplasmin complexes (749.6 vs. 863.7, P=0.21). Conclusion: Vascular surgery leads to significant alterations in hemostatic and fibrinolytic systems. However, the direction of these changes in both pathways remains unclear and seems to be different depending on the type of surgery. A study utilizing dynamic methods of coagulation and fibrinolysis assessment performed on a larger population is warranted

Novel Venetin-1 nanoparticle from earthworm coelomic fluid as a promising agent for the treatment of non-small cell lung cancer

The present research shows the antitumor activity of a protein-polysaccharide complex Venetin-1 obtained from the coelomic fluid of Dendrobaena veneta earthworms against A549 cancer cells. The investigations are a continuation of experiments on the antitumor activity of coelomic fluid obtained from this species. The Venetin-1 nanoparticle was obtained after thermal treatment of the coelomic fluid, separation from coelomocytes, filtration, and lyophilization. The preparation showed a selective effect on cancer cells, whereas normal cells were unaffected. Venetin-1 was effective against the lung cancer cells at doses of 31.3 and 62.5 µg/ml, and the results were imaged using light microscopy and scanning electron microscopy (SEM). The cells died mainly via the apoptosis pathway. Necrotic cells appeared sporadically in the microscopic view. SEM imaging revealed complete destruction of the A549 cells after the incubation with Venetin-1. The atomic force microscopy (AFM) analyses showed changes in the topography, peak force error images, and Young’s modulus (elasticity) of the A549 cells after the incubation with Venetin-1. The transmission electron cryomicroscopy (Cryo-TEM) analysis indicated a polymeric nature of the analyzed preparation. The samples of Venetin-1 showed a very homogeneous size profile with the microparticle size of approximately 58.23 nm. A significant decrease in Venetin-1 binding to sphingomyelin was observed. Venetin-1 lost its pore-forming activity or deactivation of the pore-forming activity occurred. This confirms the absence of hemolytic capacity of Venetin-1 towards red blood cells. The conducted analyses show the suitability of the obtained complex for biomedical research. The next step will consist in analyses of the effect of Venetin-1 on the immune system in mice

The character of superflous man in russian literature from the second half of 19th century

Zbędny człowiek to bohater literacki, który pojawił się w literaturze rosyjskiej po upadku powstania dekabrystów. Charakteryzował się wielkimi możliwościami intelektualnymi, wrażliwością, miał ogromne aspiracje. A jednak nie był zdolny do czynu, ponosił porażkę. Nazwa tego pokolenia liberalnej szlachty, którego młodość przypada na lata trzydzieste-czterdzieste XIX w., wzięła się od tytułu opowiadania Iwana Turgieniewa - "Dziennik człowieka niepotrzebnego" i jest, jak się wydaje, dość trafna. Należy jednak zastanowić się, co sprawiło, że ludzie, którzy mieli możliwości, by być przewodnikami dla społeczeństwa, inicjować pewne przemiany, nie byli stanie - jak ujął to A. Walicki - zaokrąglić swojego istnienia. Autor pracy analizuje trzy utwory, w których pojawia sie postać zbędnego człowieka: "Rudina" I. Turgieniewa, "Obłomowa" I. Gonczarowa oraz "Biesy" F. Dostojewskiego. W każdym z dzieł postać ta jest przedstawiona nieco inaczej - Rudin jest idealistą, który do końca próbuje czegoś dokonać. Obłomow to człowiek zbędny w pełnym tego słowa znaczeniu- leniwy, a przez to wycofany. W "Biesach" z kolei można zobaczyć jak potoczyły się losy ludzi lat czterdziestych. Dostojewski stwierdza, że ich życie nie było tak bezowocne, jak mogło się wydawać. W pracy poruszony zostaje ponadto wątek sporu pomiędzy zbędnym ludźmi, a raznozyńcami, którzy starali się przejąć rząd dusz, gdy tylko były ku temu korzystne warunki polityczne. Co łączy bohaterów omawianych utworów? Dlaczego ich los potoczył się tak, a nie inaczej? Na te właśnie pytania niniejsza praca stara się przynieść odpowiedzi.The Superflous Man is a literary concept which appeared in the russian literature after Decambrist Revolt ended. It can be characterized as highly intelectual, sensitive and aspiring. Still, he was unable to act. This liberal gentry generation, who lived their youths in thirties and forties of XIX century, took their name from Iwan Turgenev's short story "The Diary of The Superflous Man" and this indeed seems to be accurate. The author analyzes three pieces in which that character appears: I. Turgenev's "Rudin", I. Goncharov's "Oblomov" and "Demons" by F. Dostoevsky. What do the characters in question have in common? What were their fates and could they be different? This paper is aimed at searching for the answers for the above questions

Polish Pension System in the light of selected European solutions

W chwili obecnej znaczną, nieraz wręcz dominującą częścią wydatków publicznych w krajach rozwiniętych stanowią wydatki społeczne, a w szczególności wydatki emerytalne. W dobie starzenia się społeczeństw fakt ten jest nie do przecenienia, wpływa bowiem na niekorzystną sytuację finansów publicznych. Również w Polsce zdano sobie sprawę z potrzeby wprowadzenia gruntownych zmian w przestarzałym systemie zabezpieczenie społecznego – dokonano tego w 1999 r. Na ocenę przyjętego wówczas modelu jest zapewne zbyt wcześnie, niemniej jednak warto porównać zastosowane rozwiązania z tymi, które przyjęły inne państwa europejskie. W pracy, oprócz krótkiego wprowadzenia w historię zabezpieczenia emerytalnego oraz opisania podstawowych pojęć z nim związanych, autor dokonuje analizy rozwiązań przyjętych w trzech krajach, które od zawsze wyznaczały standardy w jakości zabezpieczenia społecznego: Szwecji, Wielkiej Brytani oraz Niemczech.W rozdziale 3 opisany został polski system emerytalny: od 1918 r. aż po reformę emerytalną z roku 1999, za sprawą której Polska może poszczycić się jednym z najbardziej nowoczesnych, a przy tym „odważnych” systemów emerytalnych w Europie.Public expenses are currently, to a large extend, social expenses in developed countries, and to be precise they are focused on pension-related expenses. This seems to be crucial in the era of society ageing since the major effect is visible in unfavorable condition of public finances. It has been observed in Poland as well that the obsolete social security system requires alterations which were implemented in 1999. It seems to be too early to evaluate the afore mentioned implementations, still it might be useful to compare them with solutions proposed in other European countries. The significant fact is that the first public systems of pension schemes were created in Europe.This paper presents a short introduction to the history of pension system and deals with basic concepts related to this question. Moreover, the author analyzes the solutions accepted in three countries commonly accepted as setting standards in the quality of social security: Sweden, Great Britain and Germany. Chapter 3 focuses on polish pension system: from the moment of regaining the independence in 1918 when, apart from many other common problems, the government “inherited three legal systems which meant three pension systems being the remains of territory annexation; through pension system reform in 1999 which created one of the most modern and “bold” systems

Application of a compliant foil bearing for the thrust force estimation in the single stage radial blower

The paper presents the application of a compliant foil bearing for estimation of the thrust force in a single stage radial blower under operational conditions. The bump foil of the thrust bearing behaves as a nonlinear spring. The knowledge of the spring deflection curve allows estimation of the actual thrust force for a measured bump deflection at the given rotational speed. To acquire the deflection curve, static calibration of the axial shaft displacement sensor was performed. During the calibration, the information about voltage signals of the sensor for the given loading force was collected. The measured voltage values at different speeds and loadswere then converted into the thrust force. The results were verified by comparison to the thrust force resulting from the pressure distribution on the impeller

Trends in the treatment of idiopathic nephrotic syndrome in children based on a single-centre experience

Aim: The aim of the study was to perform a retrospective analysis of treatment modalities in children with idiopathic nephrotic syndrome, types of responses to the therapies used and adverse effects induced by the drugs based on a singlecentre experience. Material and methods: Medical histories of 146 patients (82 boys and 64 girls) diagnosed with idiopathic nephrotic syndrome and hospitalised in the Clinic of Paediatric Nephrology, Medical University of Wroclaw, between 2012 and 2016 were included in the analysis. Results: Remission was achieved in 83.6% of patients treated due to the first episode of idiopathic nephrotic syndrome, whereas primary steroid resistance was diagnosed in 16.4% of cases. During the treatment of subsequent disease recurrences, 52% of children developed steroid dependence, while secondary steroid resistance occurred in 8% of patients. Cyclosporine A was the most common second-line regimen after steroids. Alkylating agents were used as second-line therapy in 1/3 of children; however, they were not used in any of the patients at the end of the follow-up period. Although mycophenolate mofetil was used as a second-line drug in only 3 patients, it was the most common therapeutic option for subsequent relapses. Adverse effects were observed in 50.5% of children receiving steroid therapy and 58.8% of patients receiving cyclosporine A. Adverse reactions were observed in less than 1% of patients receiving alkylating agents and mycophenolate mofetil. Conclusions: Cyclosporine A was the most widely used and a safe second-line drug in the treatment of paediatric idiopathic nephrotic syndrome. Mycophenolate mofetil became an important therapeutic option and an effective alternative for cyclosporine A in the therapy of steroid-dependent idiopathic nephrotic syndrome. Appropriate selection and monitoring of therapy with new generation drugs allowed to avoid irreversible complications in most cases