Ecohydrology: An Integrative Sustainability Science

The dynamic of the water cycle in catchments is determined by climate, geology, geomorphology, plant cover ad modified by agriculture, urbanisation, industrial development and hydroengineering infrastructure. Up until the end of the 20th century, water management was dominated by a mechanistic approach, focused on the elimination of threats such as floods and droughts and providing resources for the society with little to no regard for the impact this approach had on the ecosystem. Highlighting of water as a key driver of ecosystem dynamics, and further ecohydrology which highlights water/biota interactions from molecular to catchment scale provide a new perspective, new tools and new systemic solutions for enhancement of catchment sustainability potential WBSRCE (consisting of 5 elements: Water, Biodiversity, Ecosystem Services for Society, Resilience and Culture and Education)

Type 2 diabetes as a modifier of fibrin clot properties in patients with coronary artery disease

Altered fibrin clot structure has been reported both in patients with coronary artery disease (CAD) and those with type 2 diabetes mellitus (DM2). The aim of the present study was to evaluate plasma fibrin clot permeability and susceptibility to lysis in patients with DM2 and CAD. We studied 132 consecutive CAD patients, including 67 subjects with DM2, scheduled for elective coronary artery bypass grafting surgery. Ex vivo plasma fibrin clot permeability (K(s)) and lysis time (t(50%)) induced by 1 μg/mL recombinant tissue plasminogen activator (tPA), along with plasma levels of plasminogen activator inhibitor-1 (PAI-1), thrombin activatable fibrinolysis inhibitor (TAFI), tPA, von Willebrand factor (vWF), P-selectin, soluble CD40 ligand (sCD40L), were measured. Diabetic and non-diabetic patients did not differ in regard to demographics and remaining cardiovascular risk factors. Concomitant DM2 was associated with higher glucose (+24.3 %, p < 0.001), fibrinogen (+9.0 %, p = 0.037), PAI-1 (+58.7 %, p < 0.001), tPA (+24.0 %, p < 0.001) and P-selectin (+12.2 %, p < 0.001). Compared with the non-diabetic group, the CAD patients with DM2 had lower K(s) (-6.1 %, p = 0.02) and prolonged t(50%) (+5.1 %, p = 0.04). Multiple regression analysis of the whole study group showed that vWF, PAI-1, fibrinogen and DM2 were the independent predictors of t(50%) (R(2) = 0.58, p < 0.001), while only vWF was an independent predictor of K(s) (R(2) = 0.22, p < 0.001). This study indicates that DM2 is potent enough to unfavorably affect plasma fibrin clot characteristics despite abnormal clot phenotype typically observed in CAD. Of note, platelet and endothelial markers appear to contribute to fibrin clot properties in CAD concomitant with DM2

Analysis of the quality of chest compressions during resuscitation in an understaffed team — randomised crossover manikin study

INTRODUCTION: According to the chain of survival, chest compressions (CCs) are crucial in every cardiac arrest patient. It is very challenging to provide high-quality resuscitation in a two-paramedic team. The task of an automatic chest compression device (ACCD) is to relieve the rescuer and improve the quality of CCs. Its influence on the quality of the whole resuscitation as well as the survival of patients is still subject to discussion worldwide. This study aimed to assess the quality of CCs during resuscitation in a two-paramedic team using ACCD.  MATERIAL AND METHODS: This research was designed as a prospective, randomised, cross-over, high-fidelity simulation study. Fifty-two double paramedic teams took part in the research. The role of the participants was to conduct full advanced resuscitation in a human patient’s simulator. Each team provided resuscitation twice. Once with an ACCD and once using manual compressions. Chest compression quality parameters, as well as chest compression fraction (CCF), were measured.  RESULTS : Statistically significant differences were found between manual and automated compressions in: mean depth (48 ± 4 mm vs. 56 ± 3 mm, p &lt; 0.0001), mean rate (117 ± 9 mm vs. 103 ± 1 mm, p &lt; 0.0001), percentage of CC with correct depth (46 ± 25 vs. 87 ± 13, p &lt; 0.0001), rate (72 ± 22 vs. 96 ± 4, p &lt; 0.0001), and recoil (55 ± 23 vs. 89 ± 13, p &lt; 0.0001). CCF was also higher when the ACCD was used (74 ± 7% vs. 83 ± 2%, p &lt; 0.0001).  CONCLUSIONS: The use of an ACCD increases the quality of compressions by improving CCF, chest recoil, and the percentage of compressions performed with adherence to guidelines.

Assessment of Chest Compression Quality — a systematic review

INTRODUCTION: High-quality chest compression (CC) is a crucial factor that determines the survival of cardiac arrest patients. Adequate quality should be featured by appropriate compression rate and depth, and full chest recoil after each compression. The ranges are strictly determined in Resuscitation Guidelines. All these parameters are interdependent. Currently, there is a need to find or develop a universal index that will enable the definition and determination of the overall quality of CCs.  MATERIAL AND METHODS: A systematic review of the MEDLINE, EMBASE, COCHRANE, and GOOGLE SCHOLAR databases was performed. The authors aimed to find papers in which the quality of CC was assessed. The extracted information included measurement of the CC quality in a direct and objective manner — by analysing the depth, rate, and recoil of CC, position of the hands, duty cycle, and indirectly by evaluating chest compression fraction (CCF). Papers describing the quality of CC based on a combination of various components of the CC quality were selected for analysis.  RESULTS: In total 1604 publications were obtained. Among them, 21 articles satisfied the search criteria. In most of the papers, it was suggested that compressions should have been considered as correct when they met simultaneously all quality criteria. Only three papers presented any mathematical formula that could have been used for further comparisons.  CONCLUSIONS: Although many proposals have been developed, no single, universal, and commonly accepted indicator of resuscitation quality has been so far designed and subsequently applied. Further work on this subject is warranted and strongly recommended.

Phenomena connected with autobiographical memory during genogram session on the course of family therapy

W artykule przedstawione jest wykorzystanie techniki genogramu podczas sesji rodzinnych dla rekonstruowania pamięci autobiograficznej. Opisane są niektóre procesy pamięci autobiograficznej: zapamiętywanie, odpamiętywanie, zmienność wspomnień i ich reinterpretowanie, a także zjawisko wzajemnego wpływu osób pozostających w bliskiej relacji na treść ich wspomnień. Przedstawione są zjawiska występujące podczas analizy genogramu, m.in. grupowe ustalanie wspomnień, społecznie współdzielone zapominanie wybranych informacji, prozdrowotna reinterpretacja wspomnień.The aim of the presented paper is to describe the mechanisms of autobiographical memory, especially processes such as memorizing, memory retrieval and reinterpreting memories, which may be useful in work of family therapists during genogram sessions. The changeability of the content of memories, especially when an original event is transformed during its memorization and retrieval, are presented. It is also shown how these processes can facilitate healthy reinterpretation of the elements of the memories. Autobiographical memory is an unstable and flexible phenomenon and the records of past events change over time. If family therapists take it into consideration, they create a new space for the therapists-families interactions. Patients may believe that what they reminiscent are the real events and give them an obvious interpretation, although the psychological knowledge indicates that this interpretation is already adapted to the auditorium of listeners. A genogram session presents a unique opportunity to modify the way patients interpret important events from the past. A new, more “friendly” way of how each partner understands his or her past fosters more mature explanation of present and past behaviour. Family therapists may benefit from taking into consideration memories as a fluid matter, which is not a reliable record of past events but rather a result of reflection of the relational and cognitive processes that occurred in the past, and is still in progress during a genogram session. This could be supported by therapists when they create a good alliance with the family, invite everyone to share memories about families of origin, or stimulate the dialogue about these memories

Use of video laryngoscopes by inexperienced personnel in difficult intubations

The current gold standard in securing airway patency remains to be endotracheal intubation. It is the only method, which allows for nearly 100% protection of the bronchial tree from aspiration of gastric contents as well as providing the most ideal circumstances for control of ventilation parameters. Endotracheal intu- bation, although in many aspects superior to other methods of securing airways, can only be performed by skilled and experienced personnel in ideal conditions. An example of such conditions are in an operating room in the preoperative period when an anesthesiologist is able to proficiently perform the task with all of the tools and equipment needed at hand. However, in many situations, especially in emergencies, such ideal conditions are difficult or impossible to achieve. One of the many reasons behind this is often the lack of experienced personnel at the scene of an emergency. Another significant difficulty arises from trauma patients who must maintain an immobilized cervical spine, as well as those patients who are undergoing active cardiopulmonary resuscitation when providing high quality chest compressions is the highest priority. Therefore, it seems reasonable to look for the methods which on one hand will secure an airway with a tube inserted directly into the larynx, and on the other hand will make the procedure more accessible to less expe- rienced personnel by maintaining the proper patient safety throughout the whole procedure. A noteworthy method, which achieves this goal, is the use of the video laryngoscopes for endotracheal intubation. The participation in a short introductory training, regarding the use of the device itself, is sufficient to allow for the efficient intubation. The parameters which can be used to compare these different intubation methods include the ease of use, the rate of effectiveness of the first intubation trial as well as the total time needed for the procedure. The authors of this article attempt to compare classic laryngoscopes to video-assisted laryngoscopes. 

The significance of diet in oral contraception

W związku z rosnącą powszechnością stosowania dwuskładnikowej tabletki antykoncepcyjnej (DTA), przy jednoczesnym wzroście obaw co do działań niepożądanych jej zażywania, niniejsza publikacja ma na celu przybliżenie kwestii wpływu diety na występowanie skutków ubocznych tej formy antykoncepcji. Do działań niepożądanych powiązanych z żywieniem należy zaliczyć: choroby układu krążenia, chorobę zakrzepowo-zatorową, nadciśnienie tętnicze, zaburzenia metabolizmu węglowodanów, oraz depresję i obniżenie libido. Poszczególne funkcje, jakie mogą spełniać czynniki dietetyczne w prewencji i leczeniu wyżej wymienionych zaburzeń, to: zapobieganie chorobom układu krążenia, działanie antyagregacyjne, regulacja metabolizmu węglowodanów, właściwości przeciwdepresyjne i stymulujące poziom aktywności seksualnej, a także normalizacja masy ciała.In view of the increasing popularity of combined oral contraceptive pill (COCP) as well as the growing concerns about its safety this publication attempts to examine the influence of diet on the occurrence of side effects of this therapy. The adverse effects of COCP include cardiovascular disorders, thrombosis, hypertension, impaired carbohydrate metabolism, depression and decreased libido. Diet can have great influence to help modify above disorders by actions such as prevention of cardiovascular disease, anticoagulant effects, modification of carbohydrate metabolism, antidepressant effects, enhancement of libido as well as normalization of body weight

Powiązanie otyłości ze zmianami w funkcjonowaniu mięśnia sercowego u zdrowych, młodych mężczyzn

Introduction. Obesity among young people has increased dramatically worldwide, and the prevalence continues to increase. Studies performed in both adults and children have confirmed that abnormalities of cardiac function and autonomic nervous system are present in those with obesity and might explain at least in part the increased mortality seen in those with obesity. Materials and methods. The present study explores hemodynamic, autonomic and cardiovascular function in a cohort of well-characterized young men with obesity and compared these measures to those from a cohort of men of comparable age without obesity. Subjects underwent examination using Task Force® Monitor non-invasive assessment of the cardiovascular functions. Results. The obesity group had a significantly higher resting heart rate (74.3 ± 11.8 vs. 56.0 ± 8.9 n/min, p &lt; 0.0001), systolic (128.1 ± 9.4 vs. 114.3 ± 7.0 mm Hg, p &lt; 0.0001) and diastolic (85.1 ± 8.2 vs. 70.7 ± 6.2 mm Hg, p &lt; 0.0001) blood pressure compared to the age- and sex-matched, non-obesity group. This was coupled with significantly reduced stroke volume (81.3 ± 22.7 vs. 112.8 ± 20.3 ml, p &lt; 0.0001), cardiac output (5.9 ± 1.5 vs. 6.2 ± 1.4 l/min; p &lt; 0.0001) thoracic fluid content (28.5 ± 3.3 vs. 36.0 ± 3.3 1/Ohm, p &lt; 0.0001) and contractility parameters, index of contractility (31.7 ± 12.9 vs. 68.8 ± 16.1 1000/s, p &lt; 0.0001) and Heather index (0.1 ± 0.0 vs. 0.3 ± 0.0 1/s2, p &lt; 0.0001). Discussion. Our results confirm that obesity is associated with sub-clinical and cardiovascular abnormalities that can be identified using non-invasive measures. The differences identified in those with obesity were in young and healthy individuals. It will be important to determine whether these findings can be used to predict future clinical abnormalities.Wprowadzenie: Liczba otyłych osób wzrasta dramatycznie na całym świecie. Badania przeprowadzone wśród otyłych dorosłych i dzieci potwierdziły, że zaburzenia funkcji układu sercowo-naczyniowego i autonomicznego układu nerwowego mogą wyjaśniać podwyższone wartości współczynnika śmiertelności w tej grupie.   Materiał i metoda: W badaniach przedstawiono analizę wartości hemodynamicznych, autonomicznych i sercowo - naczyniowych w kohorcie dobrze scharakteryzowanych, młodych mężczyzn z otyłością w porównaniu do mężczyzn w podobnym wieku bez otyłości. Do badania użyto systemu Task Force Monitor.   Wyniki: Grupa osób z otyłością miała znacznie wyższe wartości tętna (74.3±11,8 vs. 56.0±8.9 n/min; p&lt;0.0001), ciśnienia skurczowego (128.1±9.4 vs. 114.3±7.0 mmHg; p&lt;0.0001) i rozkurczowego (85.1±8.2 vs. 70.7±6.2 mmHg; p&lt;0.0001) w porównaniu do grupy osób bez otyłości. Ponadto wykazano obniżone wartości objętości wyrzutowej serca (81.3±22.7 vs. 112.8±20.3 ml; p&lt;000.1), pojemności minutowej (5.9±1.5 vs. 6.2±1.4 l/min; p&lt;0.0001), zawartości płynu w klatce piersiowej (28.5±3.3 vs. 36.0±3.3 1/Ohm; p&lt;0.0001), kurczliwości mięśnia sercowego (31.7±12.9 vs. 68.8±16.1 1000/s; p&lt;0.0001) i Heather index (0.1±0.0 vs. 0.3±0.0 1/s2; p&lt;0.0001) w grupie osób z otyłością.   Wnioski: Nasze badania potwierdzają, że otyłość związana jest z zaburzeniami funkcji układu sercowo - naczyniowego, które mogą zostać zidentyfikowane na podstawie nieinwazyjnych wskaźników. Wartości te mogą mieć istotne znaczenie kliniczne, aby przewidzieć, jakiego typu zmiany w obrębie układu sercowo – naczyniowego mogą wystąpić u osób z otyłością.