Assessment of the exposure of nurses from Emergency Departments to aggressive behavior of patients

INTRODUCTION: A large number of patients and their families waiting for help in ED, deteriorating health, high levels of stress and a recent sudden event, such as an accident, assault, life or health threaten the patient’s anxiety, fear or fright that may result in irrational or violent behavior. These behaviors may be a threat to both the patient and the environment. This work aims to determine the exposure of nursing staff employed in ED for aggression on the part of patients.  METHODS: The research was carried out in the Masovian Province, in the Prague Hospital in Warsaw, in the Brodnowski Mazowieckie Hospital in Warsaw and in the Independent Public Health Care Team in Minsk Mazowiecki, from January to March 2018. The study was attended by 50 nurses working in ED.  RESULTS: According to the surveys carried out, nursing Staff in ED meets with the aggression of patients very often, ie at least once every few days — this is confirmed by as many as 60% of the respondents. For frequent contact with aggressive patients (ie on average once a week) indicates 28% of respondents, and the remaining 12% contact aggressive patients on average once a month. The most frequent type of aggres- sion manifested by ED patients is verbal aggression — 68% of respondents contact it. 22% indicate physical aggression directed to nursing staff, and 10% for physical aggression but directed to objects.  CONCLUSIONS: In conclusion, our data indicate that: (1) Aggression of patients in ED is a very frequent phenomenon, and the level of high personnel exposure — aggression is recorded at least once every few days. There is no clear relationship between the increase in the number of aggressive patients on certain days of the week or the time of day, although there is a tendency to note such cases on weekends and at night; (2) The most common type of aggression undertaken by ED patients is verbal aggression manifested in insults, insults, shouting, threats and intimidation; 

An experimental assessment on a diesel engine powered by blends of waste-plastic-derived pyrolysis oil with diesel

The utilization of plastic solid wastes for sustainable energy production is a crucial aspect of the circular economy. This study focuses on pyrolysis as an effective method to convert this feedstock into renewable drop-in fuel. To achieve this, it is essential to have a comprehensive understanding of feedstock composition, pyrolysis process parameters, and the physicochemical characteristics of the resulting fuel, all correlated with engine combustion parameters. Considering this full value chain, this study provides the first unbiased and up-to-date benchmark of polypropylene and polystyrene pyrolysis oils (PPO and PSO) produced in an industrial-grade batch reactor. The pyrolysis process was optimized to achieve ultra-high liquid yield levels of 92% for PPO and 98% for PSO with minimum energy consumption. After post-processing, blending with diesel, and normative fuel analytics, combustion/emission tests involving 20 species preceded under fully controllable conditions using a state-of-the-art single-cylinder research engine. The fuel analysis results revealed significant disparities between the properties of PPO and PSO. PPO exhibited a diverse carbon structure, resulting in very low density and high volatility. On the other hand, PSO was predominantly composed of aromatics, leading to low viscosity and poor auto-ignition properties. Engine tests showed that PPO blends exhibited combustion characteristics similar to diesel, while PSO blends exhibited significant differences, particularly during the premixed combustion stage attributed to pilot injection. Following the combustion response, the addition of PPO had minimal impact on emissions, while PSO acted as an emission enhancer, resulting in over twofold increase in particulate matter at high loads. Consequently, PSO showed elevated carbon monoxide and hydrocarbon emissions due to the higher contribution of aromatics. Ultimately, this study challenges the prevailing perception of plastic-derived fuels as “dirty”. By implementing feedstock segregation to minimize polystyrene content, it is possible to achieve a fossil substitute level of 40% while meeting all emission and safety regulations for diesel engines with a minimum economic burden.© 2023 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/bync/4.0/).fi=vertaisarvioitu|en=peerReviewed

Total antioxidant status (TAS) in childhood cancer survivors

Total antioxidant status (TAS), and the influence of treatment and correlation between TAS and parametersinvolved in metabolic syndrome (MS) in pediatric cancer survivors were evaluated. One hundred childrenand adolescents were studied. Twenty-five survivors received radiotherapy, 12 were obese or overweight.Additionally, we analyzed TAS in eight children with acute lymphoblastic leukemia (ALL) at diagnosis andduring treatment after remission induction. The control group consisted of 22 healthy children. Serum concentrationsof TAS, glucose, cholesterol, HDL-cholesterol, triglycerides, fibrinogen and insulin were measured. Incancer survivors, independently of diagnosis and kind of treatment (radiotherapy anthracyclines administration),the mean serum TAS did not differ significantly from the control group. No correlations were observedwith age at the time of diagnosis or interval after the end of treatment. TAS values did not correlate with traits ofthe metabolic syndrome. In a group of eight patients with ALL at diagnosis and after induction of remission,TAS values were lower than in the control and cancer survivor groups. Antioxidant status was not found to bedeteriorated in children after anticancer treatment, irrespective of diagnosis or kind of treatment, which mightindicate sufficient antioxidant prevention. However, the possibility of the development of MS and cardiovasculardisease in adulthood indicates the need for future studies.Total antioxidant status (TAS), and the influence of treatment and correlation between TAS and parametersinvolved in metabolic syndrome (MS) in pediatric cancer survivors were evaluated. One hundred childrenand adolescents were studied. Twenty-five survivors received radiotherapy, 12 were obese or overweight.Additionally, we analyzed TAS in eight children with acute lymphoblastic leukemia (ALL) at diagnosis andduring treatment after remission induction. The control group consisted of 22 healthy children. Serum concentrationsof TAS, glucose, cholesterol, HDL-cholesterol, triglycerides, fibrinogen and insulin were measured. Incancer survivors, independently of diagnosis and kind of treatment (radiotherapy anthracyclines administration),the mean serum TAS did not differ significantly from the control group. No correlations were observedwith age at the time of diagnosis or interval after the end of treatment. TAS values did not correlate with traits ofthe metabolic syndrome. In a group of eight patients with ALL at diagnosis and after induction of remission,TAS values were lower than in the control and cancer survivor groups. Antioxidant status was not found to bedeteriorated in children after anticancer treatment, irrespective of diagnosis or kind of treatment, which mightindicate sufficient antioxidant prevention. However, the possibility of the development of MS and cardiovasculardisease in adulthood indicates the need for future studies

Assessment of total cardiovascular risk according to SCORE scale in patients with metabolic syndrome

Wstęp. Zespół metaboliczny (ZM) określa się jako współistnienie czynników ryzyka chorób układu krążenia. Przyjmuje się, że osoby z ZM mają wyższe ryzyko wystąpienia ostrych incydentów wieńcowych. Cel pracy. Celem pracy jest odpowiedź na pytanie, czy na podstawie skali SCORE w wiarygodny sposób ocenia się podwyższone ryzyko zgonu z przyczyny sercowo-naczyniowej u osób z ZM. Materiał i metody. Ryzyko według tabeli SCORE oceniono u 81 pacjentów hospitalizowanych na Oddziale Chorób Wewnętrznych, Zaburzeń Metabolicznych i Nadciśnienia Tętniczego. Pacjenci byli w wieku 35&#8211;70 lat (55,8 &#177; 9,1); 43,2% stanowiły kobiety, a 56,8% mężczyźni. Spośród całej grupy u 59 osób na podstawie kryteriów według IDF z 2005 roku stwierdzono ZM. Pacjenci bez ZM w liczbie 22 stanowili grupę kontrolną. Wyniki. Nie wykazano statystycznie istotnej różnicy między ryzykiem SCORE w obu grupach; 71,2% pacjentów z ZM miało niskie (< 5%) ryzyko SCORE, a 28,8% wysokie (&ge; 5%). Podobnie przedstawiało się ryzyko w grupie kontrolnej: 72,7% (niskie), 27,3% (wysokie) &#8212; test chi2 Yatesa p = 0,8884. Grupa badana i kontrolna nie różniły się pod względem wieku, płci, palenia tytoniu i stężenia cholesterolu całkowitego oraz cholesterolu frakcji LDL. Wnioski. Z zebranych danych wynika, że większość pacjentów z ZM ma niskie ryzyko SCORE. Zespół metaboliczny jest jedną z tych sytuacji klinicznych, w których ryzyko może być wyższe niż oszacowane na podstawie SCORE. Otyłość brzuszna, nieprawidłowa glikemia na czczo, zmniejszone stężenie cholesterolu frakcji HDL i zwiększone TAG to kryteria ZM nieuwzględnione w ocenie SCORE. Pacjentów z ZM należy traktować indywidualnie, a SCORE jako dodatkowe narzędzie w pracy lekarza, które nie powinno jednak zastępować całościowej i dokładnej oceny lekarskiej.Introduction. Metabolic syndrome (MS) is defined as coexistence of risk factors for cardiovascular disease. It is estimated that people with MS are more likely to undergo acute coronary events. Aim of the study. The aim of the research is to answer whether SCORE is a good method of assessing the risk of death due to cardiovascular cause among patients with MS. Material and methods. The potential risk was estimated on the basis of SCORE among 81 patients hospitalized in the Ward of Internal Medicine, Metabolic Disorders and Hypertension. On the basis of IDF 2005 criteria it turned out that there are 59 patients with MS. The remaining group of 22 patients accounted for control group. Results. According to statistics there was no relevant difference of SCORE risk between both groups. When it comes to the group of patients with MS 71.2% of them faced low risk (< 5%), whereas 28.8% of patients showed high risk (&ge; 5%). The similar results were among patients from control group: 72.7% (low risk) and 27.3% (high risk) &#8212; &chi;2Yates&#8217;s test-p value = 0,8884. Both groups were the same in terms of age, sex, smoking habit and total cholesterol. Conclusions. The gathered data shows that the majority of patients with MS had a low risk of SCORE. MS is one of the clinical situations in which the risk may be higher than the one estimated on the SCORE. The criteria of MS which were not taken into account in assessment of SCORE involve: obesity, hyperglycemia, reduced HDL and increased TAG. Patients with MS need to be treated individually and the SCORE result ought not to replace reasonable medical assessment

Urinary Neutrophil Gelatinase-Associated Lipocalin Is Complementary to Albuminuria in Diagnosis of Early-Stage Diabetic Kidney Disease in Type 2 Diabetes

Background. Two clinical phenotypes of diabetic kidney disease (DKD) have been reported, that is, with or without increased albuminuria. The aim of study was to assess the usefulness of urinary neutrophil gelatinase-associated lipocalin (uNGAL) for the early diagnosis of DKD in the type 2 diabetes mellitus (T2DM). Methods. The study group consisted of 123 patients with T2DM (mean age 62 ± 14 years), with urine albumin/creatinine ratio (uACR) 39.64 µg/g, 13 (54%) did not have markedly increased albuminuria. Women with T2DM had higher uNCR than men (p<0.001), without difference in uACR (p=0.09). uNCR in T2DM patients correlated significantly with HbA1c. Sex, total cholesterol, and uACR were independent predictors of uNCR above 39.64 µg/g. Conclusions. Increased uNGAL and uNCR may indicate early tubular damage, associated with dyslipidemia and worse diabetes control, especially in females with T2DM

Zarządzanie jakością życia w wieku senioralnym: uczestnictwo w Klubach Seniora jako forma zapobiegania depresji

The article was written by me and my students from the Faculty of Psychology and Humanities Academy of Krakow. Senior Clubs are a very good example of social capital as a network of social relationships between individuals who trust each other and have a reciprocal. People in the network tend to mutually support each other, help and exchange important information. Thanks to the participation in the Senior Clubs can contribute actively to prevent a serious threat occurring at the senior age, which is depression. According to the WHO, it is the fourth most serious health problem in the world, which are often the source of a signifi cant deterioration in mental functioning, physical and social disability, and suicide attempts. Depression in the elderly is more dependent on environmental factors than younger people. While younger people family burden found in about 80% in the elderly is at about 44%. This means that the depression at the senior age is much more driven by the social rather than biological factors compared with younger age groups. This also means that it is easier to prevent and treat using these social factors. One of the main causes of depression in the elderly is the depletion interaction with the environment, and reduced activity. Therefore, it is important to stimulate the activation of such persons, thereby reducing the risk of depression. Recent psychological research indicates a strong relationship of friendship with happiness and the length and quality of life. Friendship improves happiness through the creation of social support and a sense of belonging. The aim of our research presented in this article was to test the hypothesis that individuals who actively participate in the Senior Club are less depressed than those who do not participate. Our team conducted empirical research presented in this paper, allowed to confi rm this hypothesis. Activity in the Senior Club provides activities, involvement and support of mental health, which may signifi cantly prevent the development of depression. Of course, it is also probably the case that those who are already at risk of suffering from depression or her less likely to participate in the activities of the Senior Citizens Clubs. It is often associated with passivity, apathy and withdrawal from the social environment, and so often associated with symptoms of depression. However, even in such a situation, the primary treatment, usually bringing more interest in the world and people should encourage such people to actively participate in senior clubs. It is then treated as a kind of social therapy. Social and cultural activity in old age is a factor in increasing the quality of life, serving mental and physical health, increasing the level of happiness and reducing the level of suffering

Influence of gestational diabetes mellitus on outcomes of preinduced labour with dinoprostone vaginal insert

Objectives: The aim of this study was to evaluate the effectiveness of labour preinduction using a dinoprostone vaginal insert in patients with gestational diabetes mellitus versus patients undergoing labour induction for other causes. The second aim of the study was to compare perinatal outcomes in both groups. Material and methods: The study has a retrospective character, conducted in 2019–2021 in a tertiary reference hospital. The following endpoints were assumed for the analysis: natural childbirth, birth occurring within 12 hours of dinoprostone administration and neonatal outcomes. Furthermore, indications of a Caesarean section were analysed. Results: The percentage of natural childbirths was similar in both groups. Furthermore, in both groups, over 80% of patients gave birth within less than 12 hours following dinoprostone administration. Neonatal outcomes (body weight, Apgar score) did not differ statistically. Analysing indications for a Caesarean section, failure in the progress of labour was an indication in 39.5% of cases in the control group, 29.4% of cases in gestational diabetes mellitus (GDM), and 50% of cases in diabetes mellitus (DM). The risk of foetal asphyxia was an indication in 55.8% of cases in the control group, 35.3% of cases in GDM and 50% of cases in DM. Ineffective labour induction — no induction of the contractile function was an indication for a C-section in 4.7% of cases in the control group and 35.3% of cases in GDM; no cases were noted in DM (p = 0.024). Conclusions: The study demonstrated that patients undergoing labour induction due to GDM using a dinoprostone vaginal insert did not differ in terms of labour duration, oxytocin administration compared to patients undergoing labour induction for other causes. Furthermore, the same rate of Caesarean sections was found in the study group; however, these groups differ in terms of indications, including risk of foetal asphyxia (35.3% vs 55.8%), failure in the progress of labour (29.4% vs 39.5%), and no active labour (1.8% vs 1.5%). The neonatal Apgar score at 1.5 and 10 minutes after birth was similar in both groups