Liquid vapor equilibrium in nucleate and film boiling

Liquid vapor equilibrium data were obtained for several solutions and azeotropes under both nucleate and film boiling. The data were invariant between the two boiling regimes indicating that both nucleate and film boiling are equilibrium vaporizations rather than either diffusional or bulk vaporizations. Boiling heat transfer versus temperature data were taken in nucleate and film boiling for the solutions and azeotropes and for several pure liquids. The critical heat flux for methyl alcohol-benzene solutions rose sharply at first and then more moderately with increasing alcohol concentration. The critical heat flux was pratically constant regardless of concentration in ethyl alcohol-benzene solutions. Photographs of nucleate and film boiling were taken to illustrate the differences between the two boiling regimes. The photographs were consistant with previously published work

An Exploration of the Dilemmas Encountered by Staff Working in Paediatric Palliative Care

This study examined the experience of clinical staff working in paediatric palliative care (PPC). The involvement of parents in the provision of care alongside professionals and differences in interpreting a child’s condition and palliative status by parents, professionals and the children themselves are likely to impact on decision-making and may result in challenges and conflicts of interests. Dilemmas arising from the interplay of potentially opposing perspectives are likely to cause tension and make it difficult for staff to know how to proceed. However, insufficient attention has been paid to understanding staff’s experience of these dilemmas. The aims of this study were to explore the dilemmas encountered by staff in PPC. Particular attention was paid to how staff coped and made sense of these dilemmas and whether they drew on any held beliefs, values or other frameworks to facilitate coping or sense making. Actual and desired systems of support which facilitated coping were also explored. The study employed a qualitative methodology. Semi-structured interviews were conducted with nine members of staff and data derived from the interviews was analysed using Interpretative Phenomenological Analysis. Four super-ordinate themes were developed: ‘Dilemmas: Familiar Yet Uncomfortable’, ‘Greater Perspective on Life’, ‘Moving between the Professional and Personal’ and ‘Sharing the Burden’. Participants frequently encountered dilemmas in their practice. Building long-term relationships with families provided unique insights into families’ lives which participants experienced as enriching through a greater appreciation of their own lives and which helped them to cope. Staff drew on aspects of both their personal and professional identity to help them make sense of dilemmas. They valued a number of support systems including peer support, managerial support and supervision to help them cope and identified ways of achieving greater cohesion. The findings are discussed in relation to the literature and implications for future research and clinical practice were considered

Schmerzerfassung in der postoperativen Schmerztherapie: psychometrische Qualität von QUIPS und PAIN OUT

Die fünf für die vorliegende Dissertation ausgewählten Arbeiten gruppieren sich um die Fragen der psychometrischen Qualität zweier zur Schmerzerfassung in der postoperativen Schmerztherapie verwendeten Fragebogen und der klinischen Relevanz dieser Verfahren. Die Arbeiten sind in den Kontext des deutschen QUIPS-Projektes und des EU-geförderten PAIN OUT Projektes eingebettet. Manuskript 1 befasst sich mit der psychometrischen Qualität des QUIPS-Outcome Bogens, eines multidimensionalen Fragebogeninstrument zur Erfassung von Akutschmerz im postoperativen Bereich. Die erste vorläufige Überprüfung seiner psychometrischen Güte erbrachte zufrieden stellende Ergebnisse. Die Manuskripte 2 und 3 widmen sich der vertieften Analyse ausgewählter psychometrischer Eigenschaften des QUIPS-Outcome-Bogens. Manuskript 2 stellt einen direkten Vergleich an zwischen zwei Item-Antwortformaten, der Numerischen Rating Skala (NRS) und dichotomen Ja/Nein-Antworten. Beide Antwortarten erreichen vergleichbare Test-Retest-Reliabilität und Validität. Die Frage nach der externen Validität von drei Items zu Funktionseinschränkungen durch Schmerzen und damit die Frage nach der klinischen Relevanz dieser Items im jeweiligen chirurgischen Setting wird in Manuskript 3 thematisiert. Die Weiterführung von QUIPS auf internationaler Ebene geschieht durch das PAIN OUT Projekt. Neben der Möglichkeit für Feedback und Benchmarking steht in PAIN OUT der Aufbau eines internationalen Schmerzregisters mit der zuverlässigen Erfassung patientenzentrierter Ergebnisdaten im Zentrum. Im Pilotprojekt mit 14 Partnern in 13 Ländern auf vier Kontinenten konnte die Umsetzbarkeit der Projektidee in diesem internationalen Setting bestätigt werden (Manuskript 4). Die Überprüfung der Gütekriterien des in PAIN OUT verwendete IPO (International Pain Outcomes Questionnaire) ist Gegenstand von Manuskript 5. Die gute psychometrische Qualität des IPO, die an 9.727 Patienten in Europa und Israel getestet werden konnte, bildet eine solide Ausgangsbasis für die weltweite Einführung dieses Fragebogeninstrumentes. Gegenwärtig wird der IPO in Europa, Süd-Ost-Asien, Afrika und den USA verwendet. Der Aufbau eines weltweiten Schmerzregisters unter Verwendung eines einheitlichen Outcome-Fragebogens bietet eine Fülle von Möglichkeiten im Bereich der Qualitätsverbesserung wie auch zusätzliche Forschungsperspektiven im Bereich der Schmerzforschung. Mit dem weiteren Ausbau von PAIN OUT stünde erstmals ein internationales Schmerzregister zur Verfügung, welches die Bearbeitung umfassender Fragestellungen ermöglicht. Die zuverlässige und einheitliche Erfassung von Ergebnisdaten aus Patientensicht stellt dabei einen wichtigen Baustein dar, zu dem die vorgelegte Arbeit einen Beitrag zu leisten versucht.The five manuscripts presented in this work are dealing with the clinical relevance and psychometric quality of two questionnaires for assessing acute postoperative pain. All manuscripts evolved in the context of the German QUIPS project and the EU-funded PAIN OUT project. Manuscript 1 is concerned with the psychometric features of the QUIPSOutcome-Questionnaire, a multi-dimensional questionnaire for acute postoperative pain. The preliminary evaluation of its reliability and validity showed satisfactory results. Manuscript 2 and 3 address in-depth analysis of selected psychometric elements of the QUIPS-Outcome-Questionnaire. Manuscript 2 compares two answer formats (Numeric Rating Scale - NRS and binary yes/no answers). Both answer forms achieve comparable test-retest-reliability and validity. External validity of three items on functional interference due to pain is the subject of manuscript 3. The proof of external validity helps to assess the clinical relevance of these items depending on the specific postoperative setting of a certain surgical discipline. QUIPS is continued and expanded on an international level as PAIN OUT project. The main objective of PAIN OUT is the development of an international acute pain registry that provides feedback and benchmarking based on reliable patient outcome data. A pilot project including 14 partners in 13 countries on four continents proved the feasibility of the concept (manuscript 4). In manuscript 5 we report on the psychometric quality of the International Pain Outcomes Questionnaire (IPO) which is used in PAIN OUT. The very satisfactory reliability and validity, which was tested on 9,727 patients in Europe and Israel, provides a solid platform for the international introduction of the project. Currently the IPO is used in Europe, South-East-Asia, Africa and the US. Setting up a worldwide registry provides plenty of new opportunities in pain research as well as means for quality assurance. The reliable and standardised collection of patient-centred outcome data is one important element of such a registry. The submitted work tries to contribute to this objective

Family witnessed resuscitation - experience and attitudes of German intensive care nurses.

To explore German intensive care nurses' experiences and attitudes toward family witnessed resuscitation (FWR). The subject of FWR has fuelled much controversy among health professionals. Typically studies involving European critical and cardiac nurses' under-represent the perspective of individual countries. Arguably research exploring the experiences and attitudes of nurses by country may expand understanding and embrace cultural values. Descriptive survey. Three hundred and ninety-four German intensive care nurses attending a conference were invited to complete a 36-item questionnaire on their experiences and attitudes towards FWR. Participants were also invited to share, in writing, other thoughts relevant to the study. Data was analysed using descriptive statistics. A total of 166 (42.1%) questionnaires were returned completed. Seventy participants had experiences with family members being present and for 46 (65.7%) these were negative. Participants (68%) did not agree that family members should have the option to be with loved ones during resuscitation. Over half (56.0%) were concerned that family presence may adversely influence staff performance during resuscitation procedures. There was a lack of certainty about the outcomes of the practice, although 61% agreed that family presence could facilitate better understanding among relatives. Qualitative responses where characterized by four broad themes relating to individualized decision-making, supporting families, threats of violence and family involvement. German intensive care nurses have guarded attitudes towards FWR because of their experiences and concerns for the well-being of relatives and staff. Introducing this topic within nursing curricula, as part of resuscitation training and by wider professional debate will help challenge and resolve practitioner concerns and objections. Health professionals have anxieties about possible consequences of FWR, strategies involving education and simulation training may improve attitudes

Records Management im Universitätsarchiv Hamburg

Die Schriftgutverwaltung ist an der Universität Hamburg dem Universitätsarchiv angegliedert, das auch für die elektronische Aktenführung in der Präsidialverwaltung zuständig ist. Die Erstellung eines prozessorientierten Aktenplans und die Einführung eines Dokumentenmanagementsystems (DMS) in die gesamte Universität wären vorteilhaft in Sachen Zusammenarbeit, Nachvollziehbarkeit, Transparenz und Langzeitarchivierung, und würden ein ganz- und einheitliches Records Management ermöglichen.At the University of Hamburg, records management is attached to the University Archives, which is also responsible for the electronic record management in the presidential administration. The creation of a process-oriented filing plan and the introduction of a document management system (DMS) in the entire university would be advantageous in terms of teamwork, traceability, transparency and digital preservation. Also, it would enable a new, more comprehensive and uniform records management

Molecular changes in the postmortem parkinsonian brain

Parkinson disease (PD) is the second most common neurodegenerative disease after Alzheimer disease. Although PD has a relatively narrow clinical phenotype, it has become clear that its etiological basis is broad. Post-mortem brain analysis, despite its limitations, has provided invaluable insights into relevant pathogenic pathways including mitochondrial dysfunction, oxidative stress and protein homeostasis dysregulation. Identification of the genetic causes of PD followed the discovery of these abnormalities, and reinforced the importance of the biochemical defects identified post-mortem. Recent genetic studies have highlighted the mitochondrial and lysosomal areas of cell function as particularly significant in mediating the neurodegeneration of PD. Thus the careful analysis of post-mortem PD brain biochemistry remains a crucial component of research, and one that offers considerable opportunity to pursue etiological factors either by ‘reverse biochemistry’ i.e. from defective pathway to mutant gene, or by the complex interplay between pathways e.g. mitochondrial turnover by lysosomes. In this review we have documented the spectrum of biochemical defects identified in PD post-mortem brain and explored their relevance to metabolic pathways involved in neurodegeneration. We have highlighted the complex interactions between these pathways and the gene mutations causing or increasing risk for PD. These pathways are becoming a focus for the development of disease modifying therapies for PD. Parkinson's is accompanied by multiple changes in the brain that are responsible for the progression of the disease. We describe here the molecular alterations occurring in postmortem brains and classify them as: Neurotransmitters and neurotrophic factors; Lewy bodies and Parkinson's-linked genes; Transition metals, calcium and calcium-binding proteins; Inflammation; Mitochondrial abnormalities and oxidative stress; Abnormal protein removal and degradation; Apoptosis and transduction pathways

Nanoparticle-induced neuronal toxicity across placental barriers is mediated by autophagy and dependent on astrocytes

The potential for maternal nanoparticle (NP) exposures to cause developmental toxicity in the fetus without the direct passage of NPs has previously been shown, but the mechanism remained elusive. We now demonstrate that exposure of cobalt and chromium NPs to BeWo cell barriers, an in vitro model of the human placenta, triggers impairment of the autophagic flux and release of interleukin-6. This contributes to the altered differentiation of human neural progenitor cells and DNA damage in the derived neurons and astrocytes. Crucially, neuronal DNA damage is mediated by astrocytes. Inhibiting the autophagic degradation in the BeWo barrier by overexpression of the dominant-negative human ATG4BC74A significantly reduces the levels of DNA damage in astrocytes. In vivo, indirect NP toxicity in mice results in neurodevelopmental abnormalities with reactive astrogliosis and increased DNA damage in the fetal hippocampus. Our results demonstrate the potential importance of autophagy to elicit NP toxicity and the risk of indirect developmental neurotoxicity after maternal NP exposure