Ergonomia pracy w karetce pogotowia ratunkowego : opinie ratowników medycznych

Wprowadzenie. Ergonomia miejsca pracy jest tematyka budzącą już od wielu tak rosnącezainteresowanie. Dużą aktualność tematyki skłoniła mnie do podjęcia badan własnych. Cel badań. Celem pracy jest przestawienie opinii ratowników medycznych w zakresie ergonomicznych warunków pracy wewnątrz karetki pogotowia ratunkowego. Materiał i metody. Badaniom prospektywnym poddana grupa 50 (48 mężczyzn oraz 2 kobiety) w wieku od 25 do 65 lat ratowników medycznych. Badania ankietowe, bezpośrednie przeprowadzono w okresie od 1 stycznia 2015 do 30 maja 2015. Ankietę oparto na liście kontrolnej K. F. H. Murrella zawierającej 11 pytań-problemów. Wyniki i wnioski. Przeprowadzone badania pozwoliły stwierdzić, że 74% respondentów uważało, że podczas pracy wewnątrz karetki pogotowia ratunkowego mogą w sposób optymalny wykorzystywać posiadane umiejętności. 48% badanych wskazało, że urządzenia, jakie znajdują się w karetce są dostosowane do czynności, jakie wykonuje ratownik. 90% badanych ratowników medycznych jest zdania , że wnętrze karetki zostało zaprojektowane z myślą o przyszłych użytkownikach. Dla ratowników pracujących wewnątrz karetki najważniejszym kanałem komunikacji jest kanał słuchowy. Jednakowa liczba respondentów jest zdania , że najlepszym systemem łączności wewnątrz karetki jest : intercom – takiego zdania było 37% badanych i łączność głosowa- ten sposób komunikacji preferowało 37% badanych. 80% ankietowanych ratowników podkreśla, że łączność w karetce pogotowia powinna być przede wszystkim słowna. 72% badanych skarżyła się, że łączność słowna w karetce może być zakłócana przez hałas. Wszyscy badani ratownicy medyczni wskazują, że wymagania fizyczne bądź umysłowe, jakie powstają podczas wykonywania pracy w karetce pogotowia mogą prowadzić do nadmiernego przeciążenia ratownika. Wśród wielu postulatów zgłaszanych przez ankietowanych, mogących poprawić pracę wewnątrz karetki pogotowia ratunkowego dominowały dwa podstawowe: nowoczesny sprzęt i zapewnienie optymalnej liczby członków w zespole.Introduction. Workplace ergonomics has been a topic of increasing interest for many years. The ever-greater importance of this issue has encouraged the authors to pursue their own research. Aim of the study. The purpose of the study is to present the opinion of paramedics related to the ergonomics of work aboard an ambulance. Materials and methods. A group of 50 paramedics (48 men and 2 women) aged from 25 to 65 were suspected to a prospective study.The survey was conducted directly in the period from 1 January 2015 to 30 May 2015. It was based on the checklist by K. F. H. Murrell comprising 11 problem questions. Results and conclusions. The study conducted made it possible to conclude that 74% of the respondents believed that during work in an ambulance they could make optimum use of their skills. 48% of the people surveyed indicated that the equipment in the ambulance was adapted to the tasks carried out by the paramedics. 90% of the paramedics surveyed believed that the ambulance’s interior has been designed with future users in mind. The auditory channel is the most important communication channel for paramedics working on the ambulance. The same numbers of respondents were of the opinion that the best communication system inside the ambulance was intercom – such was the conviction of 37% of respondents, and voice communication – this method was preferred by 37% of those surveyed. 80% of the paramedics questioned emphasized that verbal communication especially should be used in the ambulance. 72% of the surveyed complained that verbal communication in the ambulance may be disturbed by noise. All the paramedics surveyed pointed out that both the physical or mental demands arising during work in the ambulance may lead to the paramedic becoming overburdened. Among the suggestions put forward by the surveyed, which could improve work in the ambulance, the following two were predominant: modern equipment and an optimum number of team members

Impact of microsatellite status in early-onset colonic cancer

Background The molecular profile of early-onset colonic cancer is undefined. This study evaluated clinicopathological features and oncological outcomes of young patients with colonic cancer according to microsatellite status. Methods Anonymized data from an international collaboration were analysed. Criteria for inclusion were patients younger than 50 years diagnosed with stage I-III colonic cancer that was surgically resected. Clinicopathological features, microsatellite status, and disease-specific outcomes were evaluated. Results A total of 650 patients fulfilled the criteria for inclusion. Microsatellite instability (MSI) was identified in 170 (26.2 per cent), whereas 480 had microsatellite-stable (MSS) tumours (relative risk of MSI 2.5 compared with older patients). MSI was associated with a family history of colorectal cancer and lesions in the proximal colon. The proportions with pathological node-positive disease (45.9 versus 45.6 per cent; P = 1.000) and tumour budding (20.3 versus 20.5 per cent; P = 1.000) were similar in the two groups. Patients with MSI tumours were more likely to have BRAF (22.5 versus 6.9 per cent; P < 0.001) and KRAS (40.0 versus 24.2 per cent; P = 0.006) mutations, and a hereditary cancer syndrome (30.0 versus 5.0 per cent; P < 0.001; relative risk 6). Five-year disease-free survival rates in the MSI group were 95.0, 92.0, and 80.0 per cent for patients with stage I, II, and III tumours, compared with 88.0, 88.0, and 65.0 per cent in the MSS group (P = 0.753, P = 0.487, and P = 0.105 respectively). Conclusion Patients with early-onset colonic cancer have a high risk of MSI and defined genetic conditions. Those with MSI tumours have more adverse pathology (budding, KRAS/BRAF mutations, and nodal metastases) than older patients with MSI cancers. Data on 650 patients aged less than 50 years diagnosed with stage I-III colonic cancer and undergoing surgery with curative intent were collected, and the impact of microsatellite instability (MSI) on clinicopathological features and disease-specific outcomes was assessed. Patients with early-onset disease had a high risk of MSI and defined genetic conditions. Those with MSI tumours had more adverse pathology (budding, KRAS/BRAF mutations, and nodal metastases) than older patients with MSI cancers

Research of Microstructure of Molybden Doped Weldings of Oil and Gas Pipelines

Still existing scientific, technical and technological developments to improve the quality of welded joints of metal pipe structures contain contradictions and uncertainty about the effects of alloying elements, such as molybdenum, mechanical and visco plastic properties, as well as metallographic component joints. All this indicates the need for a systematic study of these problems for the development of rational metallurgical and technological measures to significantly improve the technological and corrosion-mechanical properties of weld metal. Metallographic studies, using laboratory equipment with high identifying ability, found that the doping of weld metal with molybdenum in the amount of 0.2-0.4% causes fragmentation of ferrite-pearlite structure, including carbides Mn and Fe, and also reduces the number and size of non-metallic inclusions – sulfides, oxides and silicates. Moreover, non-metallic inclusions have a dispersed appearance, which promotes plasticization of the structure, which directly increases the viscous-plastic characteristics and resistance of the metal joints to crack formation. Based on the results of metallographic research, the optimum content in the weld metal of the alloyed element – molybdenum, which is 0.2-0.4%, is determined

Identification of Galaxy-Galaxy Strong Lens Candidates in the DECam Local Volume Exploration Survey Using Machine Learning

We perform a search for galaxy-galaxy strong lens systems using a convolutional neural network (CNN) applied to imaging data from the first public data release of the DECam Local Volume Exploration Survey, which contains 1/4520 million astronomical sources covering 1/44000 deg2 of the southern sky to a 5σ point-source depth of g = 24.3, r = 23.9, i = 23.3, and z = 22.8 mag. Following the methodology of similar searches using Dark Energy Camera data, we apply color and magnitude cuts to select a catalog of 1/411 million extended astronomical sources. After scoring with our CNN, the highest-scoring 50,000 images were visually inspected and assigned a score on a scale from 0 (not a lens) to 3 (very probable lens). We present a list of 581 strong lens candidates, 562 of which are previously unreported. We categorize our candidates using their human-assigned scores, resulting in 55 Grade A candidates, 149 Grade B candidates, and 377 Grade C candidates. We additionally highlight eight potential quadruply lensed quasars from this sample. Due to the location of our search footprint in the northern Galactic cap (b > 10 deg) and southern celestial hemisphere (decl. < 0 deg), our candidate list has little overlap with other existing ground-based searches. Where our search footprint does overlap with other searches, we find a significant number of high-quality candidates that were previously unidentified, indicating a degree of orthogonality in our methodology. We report properties of our candidates including apparent magnitude and Einstein radius estimated from the image separation

The DECam Local Volume Exploration Survey Data Release 2

We present the second public data release (DR2) from the DECam Local Volume Exploration survey (DELVE). DELVE DR2 combines new DECam observations with archival DECam data from the Dark Energy Survey, the DECam Legacy Survey, and other DECam community programs. DELVE DR2 consists of similar to 160,000 exposures that cover >21,000 deg(2) of the high-Galactic-latitude ( divide b divide > 10 degrees) sky in four broadband optical/near-infrared filters (g, r, i, z). DELVE DR2 provides point-source and automatic aperture photometry for similar to 2.5 billion astronomical sources with a median 5 sigma point-source depth of g = 24.3, r = 23.9, i = 23.5, and z = 22.8 mag. A region of similar to 17,000 deg(2) has been imaged in all four filters, providing four-band photometric measurements for similar to 618 million astronomical sources. DELVE DR2 covers more than 4 times the area of the previous DELVE data release and contains roughly 5 times as many astronomical objects. DELVE DR2 is publicly available via the NOIRLab Astro Data Lab science platform

Characteristics of Early-Onset vs Late-Onset Colorectal Cancer: A Review.

The incidence of early-onset colorectal cancer (younger than 50 years) is rising globally, the reasons for which are unclear. It appears to represent a unique disease process with different clinical, pathological, and molecular characteristics compared with late-onset colorectal cancer. Data on oncological outcomes are limited, and sensitivity to conventional neoadjuvant and adjuvant therapy regimens appear to be unknown. The purpose of this review is to summarize the available literature on early-onset colorectal cancer. Within the next decade, it is estimated that 1 in 10 colon cancers and 1 in 4 rectal cancers will be diagnosed in adults younger than 50 years. Potential risk factors include a Westernized diet, obesity, antibiotic usage, and alterations in the gut microbiome. Although genetic predisposition plays a role, most cases are sporadic. The full spectrum of germline and somatic sequence variations implicated remains unknown. Younger patients typically present with descending colonic or rectal cancer, advanced disease stage, and unfavorable histopathological features. Despite being more likely to receive neoadjuvant and adjuvant therapy, patients with early-onset disease demonstrate comparable oncological outcomes with their older counterparts. The clinicopathological features, underlying molecular profiles, and drivers of early-onset colorectal cancer differ from those of late-onset disease. Standardized, age-specific preventive, screening, diagnostic, and therapeutic strategies are required to optimize outcomes