Optical cements for interferometric applications

The wave front distortion introduced by optical cements is important in interferometric applications. We describe here tests performed to characterize two common cements, Epo-Tek 301 and Norland Optical Adhesive 61

Testing the GRACE follow-on triple mirror assembly

We report on the successful testing of the GRACE follow-on triple mirror assembly (TMA) prototype. This component serves to route the laser beam in a proposed follow-on mission to the Gravity Recovery and Climate Explorer (GRACE) mission, containing an optical instrument for space-based distance measurement between satellites. As part of this, the TMA has to meet a set of stringent requirements on both the optical and mechanical properties. The purpose of the TMA prototype testing is to establish the feasibility of the design, materials choice and fabrication techniques. Here we report on co-alignment testing of this device to the arc second (5 μrad) level and thermal alignment stability testing to 1 μ rad {{K}-1}

Complications of Peripherally Inserted Central Venous Catheters: A Retrospective Cohort Study

Background and Aim The use of venous catheters is a widespread practice, especially in oncological and oncohematological units. The objective of this study was to evaluate the complications associated with peripherally inserted central catheters (PICCs) in a cohort of patients. Materials and Methods In this retrospective cohort study, we included all patient carrying PICCs (n = 603) inserted at our institute between October 2010 and December 2013. The main variables collected were medical diagnosis, catheter care, location, duration of catheterization, reasons for catheter removal, complications, and nursing care. Complications were classified as infection, thrombosis, phlebitis, migration, edema, and/or ecchymosis. Results All patients were treated according to the same “nursing care” protocol. The incidence rate of complications was two cases per 1000 days of catheter duration. The most relevant complications were infection and thrombosis, both with an incidence of 0.17 cases per 1000 days of the total catheterization period. The total average duration of catheterization was 170 days [SD 6.06]. Additionally to “end of treatment” (48.42%) and “exitus”, (22.53%) the most frequent cause of removal was migration (displacement towards the exterior) of the catheter (5.80%). Conclusions PICCs are safe devices that allow the administration of long-term treatment and preserve the integrity of the venous system of the patient. Proper care of the catheter is very important to improve the quality life of patients with oncologic and hematologic conditions. Therefore, correct training of professionals and patients as well as following the latest scientific recommendations are particularly relevant

Comparisons of silicone and polyurethane Peripherally Inserted Central Catheter post insertion complications

Background; Peripherally inserted central catheters (PICC) are increasing in popularity in healthcare systems around the world. Positive patient satisfaction and clear fiscal savings combined with perceived low insertion and post insertion complication rates when compared to other options have secured the popularity of PICC in health care systems around the world. However little quality evidence is available to PICC inserters with regards to the safest catheter choice in order to produce the lowest levels of post insertion complications both in general adult populations as well as specific patient groups. Research question; Is the make of the PICC catheter (silicone or polyurethane) selected by nurse inserters a primary influence in patients experiencing post insertion complications? Data Analysis- Descriptive statistics were used to present demographic findings in both phases of the study. Phase One results were graphically portrayed, while Phase Two data was entered into the computer program SPSS (version 24). For Phase Two comparisons of post insertion complication rates and varying factors of both PICC type were analysed with Pearson chi test, categorical regression, two sample independent t-test, nonparametric binomial test and ANOVA. Methods; To address this research question a two phase study guided by the Gearing framework was undertaken in a Medical Imaging department of a large public hospital in Far North Queensland, Australia. The Gearing framework is a retrospective chart audit research design that comprises nine steps including: conception of the research, literature review, proposal development, data abstraction, development of protocols for data abstraction, chart audit tool, sample, ethical considerations and pilot. Phase One of the study comprised steps 1 and 2 in the Gearing framework. Consistent with the Gearing framework the literature review is presented as systematic review, and forms part of the data collection process. Phase Two encompassed steps 3 to 9 of the Gearing framework and the chart audit process. Using the tool developed in steps 1 to 9 a total of 379 charts were accessed and data recorded on 295 of these on a secure electronic device. Data collected included; demographic data, patient status, reason for insertion and reason for removal of PICC. Results; Phase One, the systematic literature review, found a large variance in reported post insertion complications from 8 to 50% of all PICC inserted. Both silicone and polyurethane PICC showed similar overall rates of post insertion complication however with closer examination strengths and weaknesses in each PICC type were noted. These finding were used to inform Phase Two of the study. Of the 295 PICC insertions included in Phase Two, 141 were silicone PICC and 154 polyurethane PICC. Various patient groups were contained within the sample including: inpatient (142), outpatient (80) and transitional (73). Reason for requiring a PICC identified 102 oncology patients, 164 requiring intravenous antibiotics and 29 requiring other types medications. Reasons for removal of catheter varied from no complication/ completion of therapy (67.8%), infection (11.2%), migration (5.8%), deceased (4.7%), occlusion (3.7%), thrombus (2.7%), breakage (2.7%), phlebitis (0.3%) and upgrade to triple lumen catheter (0.3%). Overall the number of lumens the PICC contained (p=.001) was shown to be a predictor of removal due to post insertion complications. Categorical regression showed that oncology, not the catheter type, (Beta 0.253, p=.083), to be the strongest predictor of complications. Conclusions; PICC remain a safe and reliable form of medium to long-term intravenous access across PICC types, patient groups and for all patient types. The greatest predictors of post insertion complications were number of lumens and oncology patient groups. The emerging trend of health facilities to transition inpatients to outpatients in the community with PICC insitu was shown to be a safe practice with similar post insertion complication levels to inpatients

Comparisons of silicone and polyurethane Peripherally Inserted Central Catheter post insertion complications

Background; Peripherally inserted central catheters (PICC) are increasing in popularity in healthcare systems around the world. Positive patient satisfaction and clear fiscal savings combined with perceived low insertion and post insertion complication rates when compared to other options have secured the popularity of PICC in health care systems around the world. However little quality evidence is available to PICC inserters with regards to the safest catheter choice in order to produce the lowest levels of post insertion complications both in general adult populations as well as specific patient groups. Research question; Is the make of the PICC catheter (silicone or polyurethane) selected by nurse inserters a primary influence in patients experiencing post insertion complications? Data Analysis- Descriptive statistics were used to present demographic findings in both phases of the study. Phase One results were graphically portrayed, while Phase Two data was entered into the computer program SPSS (version 24). For Phase Two comparisons of post insertion complication rates and varying factors of both PICC type were analysed with Pearson chi test, categorical regression, two sample independent t-test, nonparametric binomial test and ANOVA. Methods; To address this research question a two phase study guided by the Gearing framework was undertaken in a Medical Imaging department of a large public hospital in Far North Queensland, Australia. The Gearing framework is a retrospective chart audit research design that comprises nine steps including: conception of the research, literature review, proposal development, data abstraction, development of protocols for data abstraction, chart audit tool, sample, ethical considerations and pilot. Phase One of the study comprised steps 1 and 2 in the Gearing framework. Consistent with the Gearing framework the literature review is presented as systematic review, and forms part of the data collection process. Phase Two encompassed steps 3 to 9 of the Gearing framework and the chart audit process. Using the tool developed in steps 1 to 9 a total of 379 charts were accessed and data recorded on 295 of these on a secure electronic device. Data collected included; demographic data, patient status, reason for insertion and reason for removal of PICC. Results; Phase One, the systematic literature review, found a large variance in reported post insertion complications from 8 to 50% of all PICC inserted. Both silicone and polyurethane PICC showed similar overall rates of post insertion complication however with closer examination strengths and weaknesses in each PICC type were noted. These finding were used to inform Phase Two of the study. Of the 295 PICC insertions included in Phase Two, 141 were silicone PICC and 154 polyurethane PICC. Various patient groups were contained within the sample including: inpatient (142), outpatient (80) and transitional (73). Reason for requiring a PICC identified 102 oncology patients, 164 requiring intravenous antibiotics and 29 requiring other types medications. Reasons for removal of catheter varied from no complication/ completion of therapy (67.8%), infection (11.2%), migration (5.8%), deceased (4.7%), occlusion (3.7%), thrombus (2.7%), breakage (2.7%), phlebitis (0.3%) and upgrade to triple lumen catheter (0.3%). Overall the number of lumens the PICC contained (p=.001) was shown to be a predictor of removal due to post insertion complications. Categorical regression showed that oncology, not the catheter type, (Beta 0.253, p=.083), to be the strongest predictor of complications. Conclusions; PICC remain a safe and reliable form of medium to long-term intravenous access across PICC types, patient groups and for all patient types. The greatest predictors of post insertion complications were number of lumens and oncology patient groups. The emerging trend of health facilities to transition inpatients to outpatients in the community with PICC insitu was shown to be a safe practice with similar post insertion complication levels to inpatients

A comparison of silicone and polyurethane PICC lines and postinsertion complication rates : a systematic review /

Purpose: To determine post-insertion complication rate for peripherally inserted central catheters (PICCs), in particular the difference between silicone and polyurethane lines in general population groups as well as oncology and non-oncology patient groups. Methods: A systematic review of prospective and retrospective studies in the English language between January 2000 and October 2013 focusing on post-insertion complication rates for PICCs in the adult population. Joanna Briggs Institute tools were used to extract data from the final 19 articles with information collated relating tocatheter type, patient type, overall complication rate, rates of infection, occlusion, dislodgment, phlebitis, thrombus and rupture. Results: Overall, the PICCs complication rates ranged from 8 to 50%. Although both lines saw similar overall rates upon closer observation, the strengths and weaknesses of both lines are shown. Polyurethane PICC lines were found to provide lower rates of infection, dislodgment, thrombus and rupture complications. Mixed results were found with catheter line occlusions, overall averages showing polyurethane lines slightly higher rates than silicone. Oncology patients however saw opposite results. Phlebitis rates saw the largest division among the postinsertion complication rates, with 6.7% more phlebitis in the general patient group and 14.5% in the oncology group more for those with polyurethane PICC lines compared with the silicone. Conclusions: Both silicone and polyurethane PICC lines exhibit nearly identical overall average post-insertion compilation rates; however, it is the type of complications experienced that differ. Overall, oncology patients can expect to experience higher levels of post-insertion complications