A multi-center study on the attitudes of Malaysian emergency health care staff towards allowing family presence during resuscitation of adult patients

BACKGROUND The practice of allowing family members to witness on-going active resuscitation has been gaining ground in many developed countries since it was first introduced in the early 1990s. In many Asian countries, the acceptability of this practice has not been well studied. AIM We conducted a multi-center questionnaire study to determine the attitudes of health care professionals in Malaysia towards family presence to witness ongoing medical procedures during resuscitation. METHODS Using a bilingual questionnaire (in Malay and English language), we asked our respondents about their attitudes towards allowing family presence (FP) as well as their actual experience of requests from families to be allowed to witness resuscitations. Multiple logistic regression was used to analyze the association between the many variables and a positive attitude towards FP. RESULTS Out of 300 health care professionals who received forms, 270 responded (a 90% response rate). Generally only 15.8% of our respondents agreed to allow relatives to witness resuscitations, although more than twice the number (38.5%) agreed that relatives do have a right to be around during resuscitation. Health care providers are significantly more likely to allow FP if the procedures are perceived as likely to be successful (e.g., intravenous cannulation and blood taking as compared to chest tube insertion). Doctors were more than twice as likely as paramedics to agree to FP (p-value = 0.002). This is probably due to the Malaysian work culture in our health care systems in which paramedics usually adopt a 'follow-the-leader' attitude in their daily practice. CONCLUSION The concept of allowing FP is not well accepted among our Malaysian health care providers

Simulation of ALD chemistry of (nBu3P)2Cu(acac) and Cu(acac)2 precursors on Ta(110) surface

We have used density functional theory to investigate copper oxides atomic layer deposition on a Ta(110) surface using (nBu3P)2Cu(acac) (nBu = n-butyl, acac = acetylacetonate) with wet oxygen and Cu(acac)2 with ozone. A thermodynamic analysis was performed to evaluate the stability of precursors and to predict the equilibrium compositions between the gas-phase species and surface. We find that the (nBu3P)2Cu(acac) precursor prefers to dissociate in the gas-phase, while Cu(acac)2 favors to decompose on the Ta surface. However, the self-dissociation of (nBu3P)Cu(acac) complex requires a high temperature and pressure, which prevents the undesired disproportionation reaction. We show that the incomplete (by releasing CO and CH4) and complete (by releasing CO2 and H2O) combustion reactions are the most likely mechanisms during the Cu precursor and ozone/wet oxygen pulses, respectively

Computationally efficient simulation method for conductivity modeling of 2D-based conductors

Macroscopic materials made of two-dimensional components such as flakes of graphene or transition metal dichalcogenides represent a material class with great potential for large-scale applications. Depending on the structure, they can inherit the exceptional properties of the nanoscale building blocks while developing new features on the macroscopic scale. Supported by theoretical considerations and finite element analysis, we developed a network simulation method to model 2D-based electrical conductors. Here, we systematically explain the technical and methodological details of our approach, using the example of graphene-based conductor materials. Apart from the raw material properties, we discuss the importance of homogeneity and internal structure of the material. Our findings are supported by finite element analysis. We demonstrate the application of our method by studying the intricate interaction of several material parameters and the resulting effect on the macroscopic network. Finally, we provide guidelines for adapting our method to different physical situations

Simulation of nanostructures for sensor and circuit applications

The simulation of nanostructures for sensor and circuit applications requires new concepts, namely electronic structure calculations based on the atomic configuration of the involved materials. We give a short overview of the available concepts. Semi-empirical methods and the density functional theory are highlighted. The concepts are illustrated by several examples. Presenting results obtained from metal nanowires, CNT-metal-contacts and strained CNTs, we demonstrate that electronic structure calculations based on quantum theory are essential for an adequate simulation of nanostructures

Detection of the Low Density Lipoprotein Receptor Gene Pvuii Intron 15 Polymorphism Using the Polymerase Chain Reaction: Association With Plasma Lipid Traits in Healthy Men and Women

We have used anchored PCR to amplify and sequence 1400bp of the 15th intron of the Low Density Lipoprotein (LDL) receptor gene, and have determined oligonucleotides and conditions for the genotyping of the previously reported Pvull polymorphism. The cutting site (CAGCTG) is created by the transition of a CpG to a TpG within the sequence CAGCCG at a position roughly 600bp 5' from the splice acceptor site of exon 16. Genotype was determined in three populationbased samples of healthy individuals. In a group of 318 men and women from Iceland the frequencies of the Intron-15 T (cutting) allele was 0.23 (95% CI, 0.19-0.28) and was similar in men and women. In two groups of men from England (n=385) and Scotland (n=320), the frequency was similar, being 0.23 (0.19-0.27) and 0.25 (0.22-0.28) respectively. Individuals who were homozygous for the T allele had lower levels oftotal-cholesterol triglycerides and apolipoprotein B, than those with other genotypes, and in the combined group of UK men this effect reached statistical significance; compared to the CIC group, the TIT group had 6% lower cholesterol (p=0.02) and 15% lower triglycerides (p=0.03). The lowering effect associated with the TIT genotype was greater in men who were in the lowest terti Ie of body mass index (<25kg/m2) and for the trait of apoB levels, this genotype x obesity interaction was statistically significant (p=0.01). We thus confirm the association between this allele and lower levels of plasma lipid levels previously reported. The availability of a PCR-based method to detect this polymorphism will facilitate further investigation of the impact of LDL-receptor gene variation in determining lipid levels

Detection of the low density lipoprotein receptor gene PvuII intron 15 polymorphism using the polymerase chain reaction: association with plasma lipid traits in healthy men and women

We have used anchored PCR to amplify and sequence 1400bp of the 15th intron of the Low Density Lipoprotein (LDL) receptor gene, and have determined oligonucleotides and conditions for the genotyping of the previously reported Pvull polymorphism. The cutting site (CAGCTG) is created by the transition of a CpG to a TpG within the sequence CAGCCG at a position roughly 600bp 5' from the splice acceptor site of exon 16. Genotype was determined in three populationbased samples of healthy individuals. In a group of 318 men and women from Iceland the frequencies of the Intron-15 T (cutting) allele was 0.23 (95% CI, 0.19-0.28) and was similar in men and women. In two groups of men from England (n=385) and Scotland (n=320), the frequency was similar, being 0.23 (0.19-0.27) and 0.25 (0.22-0.28) respectively. Individuals who were homozygous for the T allele had lower levels oftotal-cholesterol triglycerides and apolipoprotein B, than those with other genotypes, and in the combined group of UK men this effect reached statistical significance; compared to the CIC group, the TIT group had 6% lower cholesterol (p=0.02) and 15% lower triglycerides (p=0.03). The lowering effect associated with the TIT genotype was greater in men who were in the lowest terti Ie of body mass index (<25kg/m2) and for the trait of apoB levels, this genotype x obesity interaction was statistically significant (p=0.01). We thus confirm the association between this allele and lower levels of plasma lipid levels previously reported. The availability of a PCR-based method to detect this polymorphism will facilitate further investigation of the impact of LDL-receptor gene variation in determining lipid levels