Safety climate perceived by pre-hospital emergency care personnel—an international cross-sectional study

IntroductionImproving patient safety is one of the most critical components of modern healthcare. Emergency medical services (EMS) are, by nature, a challenging environment for ensuring patient safety. It is fast-paced, physically dangerous, and highly stressful, requiring rapid decision-making and action. This can create risks not only for patients but also for employees. We assessed variations in perceptions of safety culture in prehospital emergency care among an international sample of paramedics and nurses.MethodsThe Emergency Medical Services Safety Attitudes Questionnaire (EMS-SAQ) was used for the study. The instrument measures six domains of safety culture in the workplace: teamwork climate, job satisfaction, safety climate, working conditions, stress recognition, and perceptions of management. A total of 1,128 EMS from 9 countries participated in this study.ResultsSafety Climate was 81.32/100 (SD 6.90), Teamwork Climate 84.14/100 (SD 8.74), Perceptions of Management 76.30/100 (SD 10.54), Stress Recognition 89.86/100 (SD 5.70), Working Conditions 81.07/100 (SD 9.75), and Job Satisfaction 70.71/100 (SD 7.21). There was significant variation in safety culture scores across countries for teamwork climate (TWC), working conditions (WC), and job satisfaction (JS). Among the individual variables (age, gender, level of education, and work experience), variations in safety culture scores were unaffected by age, gender, or work experience. Organizational characteristics: employment status and position type were linked to significant variations in safety culture domain scores.ConclusionParticipants’ perceptions of the patient safety climate were not particularly satisfactory, confirming that there is still a need to develop a culture of patient safety in prehospital emergency care

New arylpiperazine derivatives with antidepressant-like activity containing isonicotinic and picolinic nuclei: evidence for serotonergic system involvement

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Endovascular treatment of acute ischemic stroke – Own experience

Objective Presentation of the own experience in the treatment of ischemic stroke using endovascular methods of simultaneous evaluation of their effectiveness and safety. Materials and methods The retrospective study involved a group of 18 patients hospitalized in 2005–2012 who were treated with intraarterial thrombolysis and mechanical thrombectomy. Overall there were 24 procedures performed. The investigated group consisted of seven (38.89%) women and 11 (61.11%) men. The average age of the patients was 60 years (SD±17, median – 60 years). Results In 62.50% of cases (n=15) the effect of revascularization has been achieved and another 12.50% of cases (n=3) recanalization was achieved only partially. Only in 25% of procedures (n=6) failed to achieve recanalization of the artery (TICI≤1). The highest percentage of recanalized arteries were obtained by following the procedure of thrombolysis targeted – 69.24% (TICI≥2b). In the case of mechanical thrombectomy total patency (TICI≥2b) was 54.55%. The average duration of treatment (operation) is 157min. After 30 days successful result of the neurological status was achieved in 57.14% of patients (n=8). Full return to independent functioning as defined within 3 months after the surgery (mRS≤2) reached 57.14% of patients (n=8). Conclusion Studies suggest that endovascular techniques are effective and safe in the treatment of ischemic stroke. Greater efficiency is characterized by intraarterial thrombolysis. Patients who were treated endovascular improved significantly

Biliary duct obstruction treatment with aid of percutaneous transhepatic biliary drainage

AbstractIntroductionPercutaneous Transhepatic Biliary Drainage (PTBD) is a procedure indicated in patients with non-operative lesions, when endoscopic application of prosthesis is impossible due to anatomic reasons, complications or severe general condition of patient. Most often it is a palliative procedure, aiming for live-quality improvement, although not altering prognosis of basic disease.AimThis study presents own experience in biliary drainage with the aid of percutaneous transhepatic method and simultaneous assessment of method effectiveness and safety. The aim was to assess outcomes and complications of PTBD in a large group of patients.Materials and methodIn time period 2007–2014, 167 patients hospitalized in Radiodiagnostics and Radiology Department of Clinical Hospital, were investigated retrospectively. PTBD procedure was applied to patients with biliary tract obstruction. In total 186 procedures of percutaneous drainage were applied. Average age of patients was 63.6years. Bilirubin, alkaline phosphatase and gamma-glutamyl transferase were measured before and after procedure. All data were analyzed statistically.ResultsIn examined group percutaneous drainage was successful in 90.7% interventions. In 8.1% procedures drainage application was ineffective. The most common complication during procedure was hemobilia (3.2%) and the long term complication was drain dislocation (2.7%). The mean bilirubin levels declined from 397.06μmol/l before drainage to 297.88μmol/l after drainage (p<0.05).ConclusionsPTBD is an effective method of biliary tract decompression and it is an important alternative to endoscopic drainage. This method is indicated in patients with neoplastic obstruction of biliary tract with low expected survival rate and thus is a palliative procedure

Zebrafish as a robust preclinical platform for screening plant-derived drugs with anticonvulsant properties—a review

Traditionally, selected plant sources have been explored for medicines to treat convulsions. This continues today, especially in countries with low-income rates and poor medical systems. However, in the low-income countries, plant extracts and isolated drugs are in high demand due to their good safety profiles. Preclinical studies on animal models of seizures/epilepsy have revealed the anticonvulsant and/or antiepileptogenic properties of, at least some, herb preparations or plant metabolites. Still, there is a significant number of plants known in traditional medicine that exert anticonvulsant activity but have not been evaluated on animal models. Zebrafish is recognized as a suitable in vivo model of epilepsy research and is increasingly used as a screening platform. In this review, the results of selected preclinical studies are summarized to provide credible information for the future development of effective screening methods for plant-derived antiseizure/antiepileptic therapeutics using zebrafish models. We compared zebrafish vs. rodent data to show the translational value of the former in epilepsy research. We also surveyed caveats in methodology. Finally, we proposed a pipeline for screening new anticonvulsant plant-derived drugs in zebrafish (“from tank to bedside and back again”)

Sleep Disturbances and Health Consequences Induced by the Specificity of Nurses&rsquo; Work

Introduction: Nursing staff working in a shift or night system are exposed to sleep disorders, which has a direct impact on the emergence of dangerous health consequences for them. Melatonin secretion is abnormal at night and the circadian rhythm is disturbed. The aim of the study was to assess the occurrence of sleep disorders and their consequences for the body in a group of representative nursing staff working in a shift and night system. Participants: The study was conducted among 126 nurses who are generally healthy, employed in health care facilities in the Ma&#322;opolskie voivodship. Methods: The Athens Insomnia Scale consisting of 8 test items was used to obtain research material: falling asleep, waking up at night, waking up in the morning, total sleep time, sleep quality, well-being the next day, mental and physical fitness the next day, and sleepiness during the next day. As well as an original questionnaire. Results: The research showed significant negative consequences of shift work on the health of health-care workers. The subjects noticed symptoms related to the nervous system, such as increased nervous tension 53%, lack of patience in 62% of all respondents. As many as 85% pointed to the negative impact of shift work on their family life, 82% of all respondents on social life and 56% of all respondents on sex life. The other variables were not confirmed. Conclusions: Symptoms of insomnia are common among night-work nurses

Precrash vehicle velocity determination using inverse system and tensor product of Legendre polynomials - subcompact car class

Presented paper discusses new approach to EES parameter determination in frontal car crash based on the tensor product of Legendre polynomials. In this paper Subcompact Car Class was analyzed using that method. Data that was used to perform analyses introduced in this paper was taken from National Highway Traffic Safety Administration (NHTSA) database. Such database consists of considerate number of test cases along with various information including vehicle mass, crash velocity, chassis deformation etc. New approach to the problem of determining the EES parameter was necessary due to the low accuracy of the currently used methods. Linear models used up till now for accident reconstruction show significant error as the relationship between mass, velocity and deformation cannot be well approximated with a flat plane. Proposed model produces better results, because of the nonlinear dependence of said parameters. This paper also includes a calculation example presenting a comparison of linear and nonlinear method on an actual crash test