Modern approach to the treatment of stage IV decubitus ulcers

Objective a retrospective assessment of the bedsores' features, the optimization of treatment tactics, evaluation of long-term treatment results. Material and methods.The study group included 38 patients with stage IV decubitus ulcers according to the classification of AHCPR localized in the sacral region, the area of the ischial tuberosity and the greater trochanter. Results.We determined the critical time intervals for the decubitus ulcers occurrence. It has been found that in most patients bedsores are remaining for a long period of time. The modern complex methods for the IV stage decubitus ulcers treatment with the plastics of the soft tissue defects revealed their reliably higher effectiveness. Conclusion.The formation of bedsores most often occurs during the first month after the injury and three years after the injury. The treatment of patients with this pathology should be comprehensive and carried out in the well-equipped purulent surgery department by the specialists experienced in treating such patients. The plastic surgery by displaced blood-supplying flaps contributes to success in the treatment of stage IV bedsores

Nurses' experiences of what in the work situation contributes to stress, burnout and exhaustion : A literature review

Bakgrund: Stress är vanligt förekommande i sjuksköterskeyrket och kan även leda till utbrändhet och utmattning. Sjuksköterskor arbetar under högt tempo med stort ansvar. Även nära relation med patienter ingår i sjuksköterskeyrket. Ohälsosam arbetsmiljö kan både påverka sjuksköterskors hälsa och patientsäkerheten och kan därmed leda till allvarliga konsekvenser. Syfte: Är att beskriva sjuksköterskors erfarenheter av vad i arbetssituationen som medverkar till stress, utbrändhet och utmattning. Metod: Metoden som användes var en litteraturöversikt där både kvalitativa och kvantitativa artiklar ingår. Resultat: Ur analysen framkom två huvudkategorier; Känslor av otillräcklighet och Brister i omgivande organisation med nio underkategorier. Konklusion: Sammanfattningsvis tenderar upplevelse av stress, utbrändhet och utmattning hos sjuksköterskor förekomma i flera länder. För att sjuksköterskor ska kunna må bra på sina arbeten krävs att verksamheten åtgärdar problemen som framkommit

Family leadership and environmental sustainability: a case of the single fathers in Russia

Nowadays, the traditional perception of the family is changing. However, understanding children preferences and shaping their views of the world still remain the key prerequisites for the environmental sustainability. The purpose of the article is to analyze models of single fatherhood, to study the motivation and structure of factors that determine the involved fatherhood making, the specifics of mother’s and parent family’s influence on the paternal practices implementation. Our research testifies to the fact that single fathers tend to become family leaders and undertake responsibility related to childcare in the context of transforming marital and family relations as well as facing global environmental issues. The results of the study show that single fatherhood is usually a forced situation caused by death or severe illness of the mother, her deviant behavior and leaving the family, deprivation of parental rights, divorce consequences, long-term separation of spouses, use of modern reproductive technologies of surrogacy. It is concluded that the scenarios of the single fatherhood becoming – planned or casual – are associated with the cause of the child appearance in the family. The significant differences are found in the social and cultural capital of the single fathers which might have different impacts on the level of environmental education they can pass on to their children

Postoperative bone defects’ reconstruction in patients with focal form of chronic post-traumatic osteomyelitis

A prospective comparative analysis, i.e. the results of treatment of 68 patients, was carried out. The focal form of chronic post-traumatic osteomyelitis of the distal third of the tibia was focused. All patients were subjected to surgical debridement of the osteomyelitic focus on the variant of osteonecrectomy, followed by myoplastic reconstruction of the formed bone defect with chopped autologous muscle. In 30 patients, the traditional method of myoplastic reconstruction was used, and in 38 patients, the improved one. We added autologous Platelet-Rich Plasma (hereinafter - PRP) to the muscle graft before placing it into the bone defect. After filling in the defect, we sutured a Resorbable Collagen Membrane (hereinafter - RCM) to its edges in order to seal the defect and additionally fix the muscle graft. The dynamics of changes in the structure and the rate of fixation of the muscle graft to the walls of the bone cavity, the duration of the local inflammatory response, the duration of hospitalization, short-term outcomes, and long-term results of treatment in the comparison groups were evaluated

New procedure for the simulation of belowground competition can improve the performance of forest simulation models

The major part of existing models of belowground competition in mixed forest stands is limited in explaining the spatial distribution of roots as a response to competitive pressure from neighbours and heterogeneity of soil properties. We are presenting a new spatially explicit and multi-layered discrete model of belowground competition, RootInt (ROOTs INTake). It describes spatial distribution of belowground biomass and allows simulation of competition between trees for soil nutrients. The tree-specific area of root zone is calculated on the basis of stem diameter, with site-specific modifiers to account for the effect of soil fertility and moisture. The shape of root zone is dependent on the amount of available nitrogen in the current cell, distance between this cell and the stem base, and the mass of roots of other plants. RootInt was incorporated into ecosystem model EFIMOD to refine the existing description of belowground competition in forest stands with multiple cohorts and tree species. The results of simulation showed that bringing more complexity into structure of stand (including initial spatial locations of trees, species composition and age structure, vertical structure of canopy) resulted in higher spatial variation in competition intensity, as well as in higher rates of resource uptake. This indicates that stands with complex canopy structure had high plasticity in their root systems and were adapted to intensive competition for soil resources.201