1,341 research outputs found

    Crazy Horse

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    Fiction by Ronald Cor

    The Window

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    Non-fiction by Ronald Cor

    The Friend of Man

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    Fiction by Ronald Cor

    The Muddled Mr. Middlesworth

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    Fiction by Ronald Cor

    Outcomes of Family Presence During Resuscitation (FPDR) in the Acute Care Setting: A Review of the Literature

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    Family Presence During Resuscitation (FPDR) remains controversial and is not consistently implemented during resuscitation events or invasive procedures. Evidence has demonstrated positive outcomes produced by implementation of FPDR; such as, decreased rates of post-traumatic stress symptoms, decreased symptoms of anxiety, and depressive symptoms were not significantly different. Unfortunately, use of FPDR in the acute care setting is not widely accepted or readily implemented. The primary purpose of this integrative literature review is to evaluate the use of FPDR in the acute care setting. The secondary purpose is to evaluate the health care professional\u27s level of perceived value associated with the outcome of having family present during resuscitation. A systematic literature search was conducted using multiple databases for relevant articles in the English language between 2006 to 2017, including Cumulative Index to Nursing and Allied Health Literature (CINAHL), Educational Resources Information Center (ERIC), Elton B. Stephens Co. Host (Ebsco Host), Medical Literature On-line (Medline), Psychological Information Database (PsychINFO), and PubMed. Search terms included \u27family presence during resuscitation\u27, \u27family presence\u27, \u27pediatrics\u27, \u27nurse perceptions\u27, and \u27perceptions\u27. Ten of the nineteen articles suggest the use of FPDR leads to positive outcomes such as decreased post-traumatic symptoms, and decreased anxiety for family members. The use of FPDR can enhance family members\u27 understanding of resuscitation efforts and involves them in their loved one\u27s care. This integrative review indicates the implementation of FPDR can provide benefits for family members of those undergoing CPR and invasive procedures; although the perceptions of the healthcare team remain the barrier to its use

    Dosimetric impact of gastrointestinal air column in radiation treatment of pancreatic cancer

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    OBJECTIVE: Dosimetric evaluation of air column in gastrointestinal (GI) structures in intensity modulated radiation therapy (IMRT) of pancreatic cancer. METHODS: Nine sequential patients were retrospectively chosen for dosimetric analysis of air column in the GI apparatus in pancreatic cancer using cone beam CT (CBCT). The four-dimensional CT (4DCT) was used for target and organs at risk (OARs) and non-coplanar IMRT was used for treatment. Once a week, these patients underwent CBCT for air filling, isocentre verification and dose calculations retrospectively. RESULTS: Abdominal air column variation was as great as ±80% between weekly CBCT and 4DCT. Even with such a large air column in the treatment path for pancreatic cancer, changes in anteroposterior dimension were minimal (2.8%). Using IMRT, variations in air column did not correlate dosimetrically with large changes in target volume. An average dosimetric deviation of mere -3.3% and a maximum of -5.5% was observed. CONCLUSION: CBCT revealed large air column in GI structures; however, its impact is minimal for target coverage. Because of the inherent advantage of segmentation in IMRT, where only a small fraction of a given beam passes through the air column, this technique might have an advantage over 3DCRT in treating upper GI malignancies where the daily air column can have significant impact. Advances in knowledge: Radiation treatment of pancreatic cancer has significant challenges due to positioning, imaging of soft tissues and variability of air column in bowels. The dosimetric impact of variable air column is retrospectively studied using CBCT. Even though, the volume of air column changes by ± 80%, its dosimetric impact in IMRT is minimum
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