Отношение членов реанимационной бригады и сопровождающих пациента лиц к присутствию родственников пациента первой степени родства во время сердечно-легочной реанимации в отделениях неотложной помощи

The presence of the patient’s family at their bedside during cardiopulmonary resuscitation (CPR) is one of the challenging issues that has been frequently taken into consideration. Considering the importance of this topic. The objective of the present study was conducted to determine the attitude of the CPR team members and the patient’s companions toward the presence of the patient’s first-degree relatives during CPR.Materials and methods. The descriptive-analytical cross-sectional study was conducted on 100 CPR team members of two University Hospitals and 120 near relatives of patients undergoing CPR in 2021. The data were collected by the researcher-made questionnaire and depression, anxiety, stress scale (DASS) during CPR. The collected data were analyzed by SPSS (version 22) statistical software.Results. From the perspective of both the CPR team members and the patient’s companions, the highest mean response was related to the fact that it would be better for the patient to agree on the presence or absence of their family before hospitalization and whether they have favorable conditions. The attitude toward the presence of the patient’s family during CPR was statistically significantly associated with the companions’ gender (p < 0.05) and with the experience of work and participation in CPR of the CPR team members (p < 0.05).Conclusion. Taking into account the different opinions of the CPR team members and the patient’s relatives about the presence of family during resuscitation, additional studies with a large sample size should be carried out.Присутствие семьи пациента у его постели во время проведения сердечно-легочной реанимации (СЛР) является одним из вопросов, привлекающих внимание. Настоящее исследование было проведено с целью определения отношения членов реанимационной бригады и сопровождающих пациента лиц к присутствию родственников пациента первой степени родства во время проведения СЛР.Материалы и методы. Описательно-аналитическое перекрестное исследование проведено в 2 университетских больницах с участием 100 членов команд, проводящих СЛР, и 120 близких родственников пациентов, которым проводили СЛР в 2021 г. Данные были собраны с помощью разработанного исследователем опросника и шкалы стресса, тревоги и депрессии (DASS) во время СЛР. Собранные данные были проанализированы с помощью статистического программного обеспечения SPSS (версия 22).Результаты. С точки зрения как членов команды, проводящей СЛР, так и близких пациента, наиболее значимым был вопрос о том, что самому пациенту было бы лучше договориться о присутствии или отсутствии своей семьи еще до момента госпитализации и выяснить, насколько для этого созданы благоприятные условия. Отношение к присутствию семьи пациента во время СЛР было статистически значимо связано с полом сопровождающего (р < 0,05) и с опытом работы и участия в СЛР членов реанимационной бригады (р < 0,05).Вывод. Учитывая различные мнения членов команды, проводящей СЛР, и близких пациента относительно присутствия семьи во время реанимации, следует провести дополнительные исследования с большим объемом выборки

Assessment of the durability performance of fiber-cement sheets

According to standards, the durability performance of fiber-cement sheets must be evaluated by comparing the modulus of rupture (MOR) before and after durability tests (freeze-thaw, soak-dry, and warm water) are completed. This paper investigated the MOR of two different fiber-cement sheets samples before and after durability tests as well as its ductility and toughness. Results showed no significant difference between the MOR of control specimens and that of the specimens submitted to durability tests except in the case of the freezing and thawing test where after 100 cycles, a 7–9% decrease was observed. The differences between the MOR of the control specimens and that of the specimens submitted to durability tests were negligible and acceptable in accordance to the requirements of the standard. However, toughness and ductility decreased considerably in specimens of sample 1 by 25, 35, and 15%, respectively, when exposed to soak-dry (25 and 50 cycles) and warm water conditions. In turn, the reduction in toughness and ductility for specimens of sample 2 exposed to soak-dry (50 cycles) and warm water conditions were of 40 and 7%, respectively. The results of this investigation suggest that ductility and toughness should also be considered to assess the durability performance of fiber-cement sheets

Evaluation of adhesion in polymeric fibre reinforced cementitious composites

In this study adhesion of some polymeric fibres to a cement matrix was evaluated both by a theoretical and by an experimental approach. In common methods adhesion of the fibres to the cementitious materials is determined by pull-out test. This test evaluates the energy failure during the fibre drawing out. This paper analyzes the adhesion theory for fibre reinforced cementitious composites to separate the share of the chemical and mechanical adhesion expressing new parameters, which are effective in the adhesion behaviour. Explanations about how the different fibres, matrix properties, test factors and environmental conditions can affect the adhesion results are given. It was found that for fibre/cement composites the fracture energy due to the interfacial interactions is for several orders of magnitude smaller that the polymeric fibre losses function. By employing adhesion theory, fibre/cement interac- tions are better described by a simple relationship of their surface free energy. Determination of the loss function (energy dissipation) leads us to predict the fibre behaviour in the cement matrix and the selection of the appropriate reinforcement

Cementitious composites reinforced with polypropylene, nylon and polyacrylonitile fibres

This paper compares the adhesion strength between three polymeric fibres (polypropylene (PP), nylon66 (N66) and polyacrylonitrile (PAN)) embedded in a cement paste. The specimens were prepared at a water to cement ratio (w/c) of 0.5, and tested after 7, 14 and 28 curing days. It was found that although the adhesion between the polymeric fibres to the cement matrix is an important factor, the energy absorption capacity or energy dissipation ability of the fibres plays a more important role in the improvement of the cementitious composites fracture toughness. Scanning electron micrographs was used to characterize the fibres surface before and after the Pullout tests

Influence of acrylic fibers geometry on the mechanical performance of fiber-cement composites

This article analyses the influence of acrylic fibers shape on the flexural behavior of cement composite. The fibers differ in their cross-sectional shapes due to the spinning process (wet-spun and dry-spun). The fibers were characterized by optical microscopy, and the shape factors were calculated on the basis of their geometric characteristics. Results showed that both types of acrylic fiber remarkably improved the flexural performance of the composites. Wet-spun acrylic fibers lead to high flexural strength and toughness. It was found that by increasing the fibers’ shape factor by a factor of 10%, flexural strength and toughness increase to 26% and 23%, respectively

Scottish and Newcastle antiemetic pre-treatment for paracetamol poisoning study (SNAP)

BACKGROUND: Paracetamol (acetaminophen) poisoning remains the commonest cause of acute liver injury in Europe and North America. The intravenous (IV) N-acetylcysteine (NAC) regimen introduced in the 1970s has continued effectively unchanged. This involves 3 different infusion regimens (dose and time) lasting over 20 hours. The same weight-related dose of NAC is used irrespective of paracetamol dose. Complications include frequent nausea and vomiting, anaphylactoid reactions and dosing errors. We designed a randomised controlled study investigating the efficacy of antiemetic pre-treatment (ondansetron) using standard NAC and a modified, shorter, regimen. METHODS/DESIGN: We designed a double-blind trial using a 2 × 2 factorial design involving four parallel groups. Pre-treatment with ondansetron 4 mg IV was compared against placebo on nausea and vomiting following the standard (20.25 h) regimen, or a novel 12 h NAC regimen in paracetamol poisoning. Each delivered 300 mg/kg bodyweight NAC. Randomisation was stratified on: paracetamol dose, perceived risk factors, and time to presentation. The primary outcome was the incidence of nausea and vomiting following NAC. In addition the frequency of anaphylactoid reactions and end of treatment liver function documented. Where clinically necessary further doses of NAC were administered as per standard UK protocols at the end of the first antidote course. DISCUSSION: This study is primarily designed to test the efficacy of prophylactic anti-emetic therapy with ondansetron, but is the first attempt to formally examine new methods of administering IV NAC in paracetamol overdose. We anticipate, from volunteer studies, that nausea and vomiting will be less frequent with the new NAC regimen. In addition as anaphylactoid response appears related to plasma concentrations of both NAC and paracetamol anaphylactoid reactions should be less likely. This study is not powered to assess the relative efficacy of the two NAC regimens, however it will give useful information to power future studies. As the first formal randomised clinical trial in this patient group in over 30 years this study will also provide information to support further studies in patients in paracetamol overdose, particularly, when linked with modern novel biomarkers of liver damage, patients at different toxicity risk. TRIAL REGISTRATION: EudraCT number 2009-017800-10, ClinicalTrials.gov IdentifierNCT0105027

The prevalence of glaucoma in Tehran, Iran

Purpose: To determine the prevalence of glaucoma in adults 40 years of age or older in Tehran, Iran. Methods: This stratified random-sampling cross-sectional population survey was performed on residents of Tehran, the capital of Iran, aged 40 years and older in the year 2001. Refraction, best-corrected visual acuity, slitlamp biomicroscopy, Goldmann applanation tonometry, funduscopy, and gonioscopy were performed in all subjects. Automated perimetry was performed in selected cases. Results: Out of 4418 sampled subjects, 2184 individuals (49.4) participated in the survey. Eventually data from 2160 individuals including 814 (38) male and 1346 (62) female subjects with mean age of 55.1±10.2 (range 40-92) years were analyzed. The overall prevalence of glaucoma was 1.44 (95 confidence interval, 0.94-1.94) including primary open angle glaucoma 0.46, chronic angle closure glaucoma 0.33, normal tension glaucoma 0.28, pseudoexfoliation glaucoma 0.23, and other types of glaucoma 0.14. More than 80 of affected subjects were unaware of their condition. Conclusion: The prevalence of glaucoma in adults 40 years of age or older in Tehran is 1.44, which is in the lower range reported in other populations. The large majority of cases are unaware of their condition

SaFaRI: sacral nerve stimulation versus the FENIX (TM) magnetic sphincter augmentation for adult faecal incontinence: a randomised investigation

Purpose Faecal incontinence is a physically, psychologically and socially disabling condition. NICE guidance (2007) recommends surgical intervention, including sacral nerve stimulation (SNS), after failed conservative therapies. The FENIX™ magnetic sphincter augmentation (MSA) device is a novel continence device consisting of a flexible band of interlinked titanium beads with magnetic cores that is placed around the anal canal to augment anal sphincter tone through passive attraction of the beads. Preliminary studies suggest the FENIX™ MSA is safe, but efficacy data is limited. Rigorous evaluation is required prior to widespread adoption. Method and design The SaFaRI trial is a National Institute of Health Research (NIHR) Health Technology Assessment (HTA)-funded UK multi-site, parallel group, randomised controlled, unblinded trial that will investigate the use of the FENIX™ MSA, as compared to SNS, for adult faecal incontinence resistant to conservative management. Twenty sites across the UK, experienced in the treatment of faecal incontinence, will recruit 350 patients randomised equally to receive either SNS or FENIX™ MSA. Participants will be followed-up at 2 weeks post-surgery and at 6, 12 and 18months post-randomisation. The primary endpoint is success, as defined by device in use and ≥50 % improvement in the Cleveland Clinic Incontinence Score (CCIS) at 18 months post-randomisation. Secondary endpoints include complications, quality of life and cost effectiveness. Discussion SaFaRI will rigorously evaluate a new technology for faecal incontinence, the FENIX™ MSA, allowing its safe and controlled introduction into current clinical practice. These results will inform the future surgical management of adult faecal incontinence

Continence technologies whitepaper: Informing new engineering science research

Advances in healthcare technology for continence have historically been limited compared to other areas of medicine, reflecting the complexities of the condition and social stigma which act as a barrier to participation. This whitepaper has been developed to inspire and direct the engineering science community towards research opportunities that exist for continence technologies that address unmet needs in diagnosis, treatment and long-term management. Our aim is to pinpoint key challenges and highlight related research opportunities for novel technological advances. To do so, we draw on experience and expertise from academics, clinicians, patients and patient groups linked to continence healthcare. This is presented in four areas of consideration: the clinical pathway, patient perspective, research challenges and effective innovation. In each we introduce seminal research, background information and demonstrative case-studies, before discussing their relevance to engineering science researchers who are interested in approaching this overlooked but vital area of healthcare