Zur Lebensqualität Bypass-operierter Patienten in der kardiologischen Akutversorgung und ihre Einstellungen zu verschiedenen Rehabilitationsoptionen

Die Lebensqualität von Koronarpatienten hängt nicht nur vom Erfolg der Akutversorgung, sondern auch von der sich anschließenden Rehabilitationsphase ab. In der vorliegenden Arbeit wurden 74 Patienten nach Bypass-Operation mittels Fragebogen noch auf der Akutstation nach der Beurteilung verschiedener Reha-Formen (stationär, teilstationär, ambulant) im Hinblick auf eine mögliche Anschlussheilbehandlung, sowie zu ihrer momentanen Befindlichkeit und verschiedenen psychosozialen Faktoren befragt. Im direkten Vergleich wird die stationäre Rehabilitation als die günstigste Form mit dem Vorteil einer professionellen medizinischen Behandlung gesehen. Haupteinwand gegen ambulante Maßnahmen ist die Belastung durch tägliche An- und Abreise. In Diskrepanz zum hohen Prozentsatz psychischer Beschwerden waren 3/4 der Befragten mit ihrer momentanen Lebenssituation sehr zufrieden, wobei hinsichtlich der zukünftigen Krankheitsentwicklung das eigene Verhalten als bedeutendster Faktor festgestellt wurde

Variation of Pollutant Levels in Vegetables: A Case Study of

There is growing public concern over the illegal cultivation of vegetables on soils amended with sewage sludge or irrigated with mixtures of sewage and sewage sludge. Effluents and wastewater from Bidii in Kitale treatment plant are used by vegetable farmers for the irrigation of their vegetables during dry season. These effluents may contain some toxic pollutants which bioaccumulate along the food chain. Moreover the uptake of such toxic metals by vegetables is governed by their availability and concentration in the soil. Therefore such vegetables may accumulate pollutants in excessive amount in their various parts. This may ultimately, adversely affect humans and other species that depend on such crops for food, hence the need to evaluate the variation of pollutant levels in vegetables samples in these areas. Samples of spinach and kales and top soils (0-20) cm were collected from the vegetable farms of Bidii and Taito area as control point. Random sample collections were made five (5) times during the period from the two plots between October to December 2012. The vegetables samples were dried in an oven at 80°C for 72 h. The dry samples were crushed in a mortar  and pestle and the resulting powder digested by weighing 1.0 g of oven-dried ground and sieved (<1 mm) into an acid-washed porcelain crucible and placed in furnace for 4 hours at 500°C. The crucibles were removed and cooled. The weighed vegetable samples were transferred to 300 ml digesting flasks and then 27 ml of a mixture of HNO3 and concentrated H2SO4 were added to the sample. The mixture was heated on a hot plate for about half an hour until brown fumes disappeared. The mixture was cooled, and 3 ml of percloric acid were carefully added and then heating continued until white fumes disappeared. The digested sample was filtered into a 100 ml volumetric flask and made up to volume with de-ionized water. Soil samples were digested using aqua regia and 1.0 g of the soil sample was placed in a flask and 6 ml of concentrated nitric acid (HNO3) was added first before adding 18 ml of concentrated HCl. The mixture was then heated until a clear digest was obtained. The digest was then cooled and a few drops of water were added before filtering. The filtrate was then diluted with de-ionized water to 100 ml. The concentrations of heavy metals which include, Cu, Zn, Cr, and Pb, were determined using atomic absorption spectrophotometer (AAS). Levels of some anions (nitrate and phosphate were determined using Spectroscan 30 UV-Vis spectrophotometer. The results revealed that Cr and Pb had the highest concentrations, while Cu had the lowest in the leafy vegetables studied. The order of heavy metals was found to be Zn>Pb>Cr>Cu in soils while Pb>Zn>Cr>Cu in vegetables. The concentration of NO3- ranged between 2.176 mg/kg to 3.202 mg/kg while PO43- 2.897 mg/kg to 3.342 mg/kg in vegetables. Levels of NO3- in soils were 1.88 mg/kg to 2.06 mg/kg while PO43- had 4.66 mg/kg to 4.99 mg/kg. The vegetables from Bidii area contained much higher concentrations than those from Taito area. The levels of Cr and Pb in vegetables exceeded WHO Maximum Limit (0.05 mg/kg for Cr and 0.3 mg/kg for Pb). The variation in the parameters determined were found to be statistically significant (p<0.05) as determined by one way ANOVA. Key words: copper, lead, chromium, zinc, nitrates, phosphates, polluted soils, vegetables

Variation of Pollutant Levels in Vegetables: A Case Study of

There is growing public concern over the illegal cultivation of vegetables on soils amended with sewage sludge or irrigated with mixtures of sewage and sewage sludge. Effluents and wastewater from Bidii in Kitale treatment plant are used by vegetable farmers for the irrigation of their vegetables during dry season. These effluents may contain some toxic pollutants which bioaccumulate along the food chain. Moreover the uptake of such toxic metals by vegetables is governed by their availability and concentration in the soil. Therefore such vegetables may accumulate pollutants in excessive amount in their various parts. This may ultimately, adversely affect humans and other species that depend on such crops for food, hence the need to evaluate the variation of pollutant levels in vegetables samples in these areas. Samples of spinach and kales and top soils (0-20) cm were collected from the vegetable farms of Bidii and Taito area as control point. Random sample collections were made five (5) times during the period from the two plots between October to December 2012. The vegetables samples were dried in an oven at 80°C for 72 h. The dry samples were crushed in a mortar  and pestle and the resulting powder digested by weighing 1.0 g of oven-dried ground and sieved (<1 mm) into an acid-washed porcelain crucible and placed in furnace for 4 hours at 500°C. The crucibles were removed and cooled. The weighed vegetable samples were transferred to 300 ml digesting flasks and then 27 ml of a mixture of HNO3 and concentrated H2SO4 were added to the sample. The mixture was heated on a hot plate for about half an hour until brown fumes disappeared. The mixture was cooled, and 3 ml of percloric acid were carefully added and then heating continued until white fumes disappeared. The digested sample was filtered into a 100 ml volumetric flask and made up to volume with de-ionized water. Soil samples were digested using aqua regia and 1.0 g of the soil sample was placed in a flask and 6 ml of concentrated nitric acid (HNO3) was added first before adding 18 ml of concentrated HCl. The mixture was then heated until a clear digest was obtained. The digest was then cooled and a few drops of water were added before filtering. The filtrate was then diluted with de-ionized water to 100 ml. The concentrations of heavy metals which include, Cu, Zn, Cr, and Pb, were determined using atomic absorption spectrophotometer (AAS). Levels of some anions (nitrate and phosphate were determined using Spectroscan 30 UV-Vis spectrophotometer. The results revealed that Cr and Pb had the highest concentrations, while Cu had the lowest in the leafy vegetables studied. The order of heavy metals was found to be Zn>Pb>Cr>Cu in soils while Pb>Zn>Cr>Cu in vegetables. The concentration of NO3- ranged between 2.176 mg/kg to 3.202 mg/kg while PO43- 2.897 mg/kg to 3.342 mg/kg in vegetables. Levels of NO3- in soils were 1.88 mg/kg to 2.06 mg/kg while PO43- had 4.66 mg/kg to 4.99 mg/kg. The vegetables from Bidii area contained much higher concentrations than those from Taito area. The levels of Cr and Pb in vegetables exceeded WHO Maximum Limit (0.05 mg/kg for Cr and 0.3 mg/kg for Pb). The variation in the parameters determined were found to be statistically significant (p<0.05) as determined by one way ANOVA. Key words: copper, lead, chromium, zinc, nitrates, phosphates, polluted soils, vegetables

Mejoramiento de los procesos en el quirófano mediante la aplicación de la metodología Lean de Toyota

ResumenEl sector de la atención en salud está necesitando un cambio fundamental a fin de mejorar significativamente los resultados y limitar al mismo tiempo los costos. Los métodos Lean desarrollados inicialmente en la industria manufacturera han demostrado mejorar realmente la calidad, la productividad y la seguridad, a la vez que permiten utilizar menos recursos en la gestión de la salud. Estas herramientas, prácticas gerenciales y filosofías se han adaptado con éxito en los servicios de cirugía del SC. Pueden transformar el sistema y la cultura mediante el compromiso del personal de asistencia para el desarrollo de un servicio que mejora continuamente y permite obtener mejores resultados clínicos duraderos.AbstractHealthcare is in need of fundamental change if we are going to make significant improvements in outcomes while limiting costs. Lean methods, initially developed in the manufacturing industry, have been shown to deliver real improvements in quality, productivity, and safety while using fewer resources in healthcare service settings. These tools, management practices and philosophies have been successfully adapted in operative services at SC. They can transform your system and culture through engagement of frontline staff into a continuously improving service with real and sustainable enhancements in clinical outcomes

Optimizing infrared to near infrared upconversion quantum yield of β-NaYF₄:Er³⁺ in fluoropolymer matrix for photovoltaic devices

The present study reports for the first time the optimization of the infrared (1523 nm) to near-infrared (980 nm) upconversion quantum yield (UC-QY) of hexagonal trivalent erbium doped sodium yttrium fluoride (β-NaYF4:Er3+) in a perfluorocyclobutane (PFCB) host matrix under monochromatic excitation. Maximum internal and external UC-QYs of 8.4% ± 0.8% and 6.5% ± 0.7%, respectively, have been achieved for 1523 nm excitation of 970 ± 43 Wm−2 for an optimum Er3+ concentration of 25 mol% and a phosphor concentration of 84.9 w/w% in the matrix. These results correspond to normalized internal and external efficiencies of 0.86 ± 0.12 cm2 W−1 and 0.67 ± 0.10 cm2 W−1, respectively. These are the highest values ever reported for β-NaYF4:Er3+ under monochromatic excitation. The special characteristics of both the UC phosphor β-NaYF4:Er3+ and the PFCB matrix give rise to this outstanding property. Detailed power and time dependent luminescence measurements reveal energy transfer upconversion as the dominant UC mechanism

Effective conductivity of composites of graded spherical particles

We have employed the first-principles approach to compute the effective response of composites of graded spherical particles of arbitrary conductivity profiles. We solve the boundary-value problem for the polarizability of the graded particles and obtain the dipole moment as well as the multipole moments. We provide a rigorous proof of an {\em ad hoc} approximate method based on the differential effective multipole moment approximation (DEMMA) in which the differential effective dipole approximation (DEDA) is a special case. The method will be applied to an exactly solvable graded profile. We show that DEDA and DEMMA are indeed exact for graded spherical particles.Comment: submitted for publication

Global Incidence and mortality of oesophageal cancer and their correlation with socioeconomic indicators temporal patterns and trends in 41 countries

Oesophageal cancers (adenocarcinomas [AC] and squamous cell carcinomas [SCC]) are characterized by high incidence/mortality in many countries. We aimed to delineate its global incidence and mortality, and studied whether socioeconomic development and its incidence rate were correlated. The age-standardized rates (ASRs) of incidence and mortality of this medical condition in 2012 for 184 nations from the GLOBOCAN database; national databases capturing incidence rates, and the WHO mortality database were examined. Their correlations with two indicators of socioeconomic development were evaluated. Joinpoint regression analysis was used to generate trends. The ratio between the ASR of AC and SCC was strongly correlated with HDI (r = 0.535 [men]; r = 0.661 [women]) and GDP (r = 0.594 [men]; r = 0.550 [women], both p < 0.001). Countries that reported the largest reduction in incidence in male included Poland (Average Annual Percent Change [AAPC] = −7.1, 95%C.I. = −12,−1.9) and Singapore (AAPC = −5.8, 95%C.I. = −9.5,−1.9), whereas for women the greatest decline was seen in Singapore (AAPC = −12.3, 95%C.I. = −17.3,−6.9) and China (AAPC = −5.6, 95%C.I. = −7.6,−3.4). The Philippines (AAPC = 4.3, 95%C.I. = 2,6.6) and Bulgaria (AAPC = 2.8, 95%C.I. = 0.5,5.1) had a significant mortality increase in men; whilst Columbia (AAPC = −6.1, 95%C.I. = −7.5,−4.6) and Slovenia (AAPC = −4.6, 95%C.I. = −7.9,−1.3) reported mortality decline in women. These findings inform individuals at increased risk for primary prevention

Ground state of a polydisperse electrorheological solid: Beyond the dipole approximation

The ground state of an electrorheological (ER) fluid has been studied based on our recently proposed dipole-induced dipole (DID) model. We obtained an analytic expression of the interaction between chains of particles which are of the same or different dielectric constants. The effects of dielectric constants on the structure formation in monodisperse and polydisperse electrorheological fluids are studied in a wide range of dielectric contrasts between the particles and the base fluid. Our results showed that the established body-centered tetragonal ground state in monodisperse ER fluids may become unstable due to a polydispersity in the particle dielectric constants. While our results agree with that of the fully multipole theory, the DID model is much simpler, which offers a basis for computer simulations in polydisperse ER fluids.Comment: Accepted for publications by Phys. Rev.

Turbulent superfluid profiles in a counterflow channel

We have developed a two-dimensional model of quantised vortices in helium II moving under the influence of applied normal fluid and superfluid in a counterflow channel. We predict superfluid and vortex-line density profiles which could be experimentally tested using recently developed visualization techniques.Comment: 3 double figures, 9 page