Robustness of common hemodynamic indicators with respect to numerical resolution in 38 middle cerebral artery aneurysms

Background: Using computational fluid dynamics (CFD) to compute the hemodynamics in cerebral aneurysms has received much attention in the last decade. The usability of these methods depends on the quality of the computations, highlighted in recent discussions. The purpose of this study is to investigate the convergence of common hemodynamic indicators with respect to numerical resolution. Methods: 38 middle cerebral artery bifurcation aneurysms were studied at two different resolutions (one comparable to most studies, and one finer). Relevant hemodynamic indicators were collected from two of the most cited studies, and were compared at the two refinements. In addition, correlation to rupture was investigated. Results: Most of the hemodynamic indicators were very well resolved at the coarser resolutions, correlating with the finest resolution with a correlation coefficient >0.95. The oscillatory shear index (OSI) had the lowest correlation coefficient of 0.83. A logarithmic Bland-Altman plot revealed noticeable variations in the proportion of the aneurysm under low shear, as well as in spatial and temporal gradients not captured by the correlation alone. Conclusion: Statistically, hemodynamic indicators agree well across the different resolutions studied here. However, there are clear outliers visible in several of the hemodynamic indicators, which suggests that special care should be taken when considering individual assessment

Exploring the experiences of being an ethnic minority student within undergraduate nurse education: A qualitative study

© 2019 The Author(s). Background: Students studying in a country where another language is spoken face multiple challenges including their ability to fully integrate with peers and academic pressures in trying to obtain an undergraduate nursing degree. The aim of the study was to explore the lived experiences of students, from varying cultural and ethnic backgrounds, undertaking an undergraduate nursing degree. Methods: The study adopted a qualitative design and eight individual semi-structured interviews were conducted. The interviews were analysed using manifest content analysis according to Graneheim and Lundman. Results: Students reported feelings of isolation and the lack of opportunities to integrate with native students within academia and practice. The need for personal support was a crucial factor that was independent of gender and students reported challenges related to both language and culture during the programme. Conclusions: Suggestions arising from this study includes appropriate support systems within academia and practice. It is imperative that universities and practice settings promote and integrate cultural awareness within academia and practice in meeting the needs of students and providing culturally appropriate nursing care, thereby providing opportunities for all students to become competent and professional practitioners