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

Education for sustainable development (ESD): the turn away from ‘environment’ in environmental education?

This article explores the implications of the shift of environmental education (EE) towards education for sustainable development (ESD) in the context of environmental ethics. While plural perspectives on ESD are encouraged both by practitioners and researchers of EE, there is also a danger that such pluralism may sustain dominant political ideologies and consolidated corporate power that obscure environmental concerns. Encouraging plural interpretations of ESD may in fact lead ecologically ill-informed teachers and students acculturated by the dominant neo-liberal ideology to underprivilege ecocentric perspective. It is argued that ESD, with its focus on human welfare, equality, rights and fair distribution of resources is a radical departure from the aim of EE set out by the Belgrade Charter as well as a distinct turn towards anthropocentrically biased education. This article has two aims: to demonstrate the importance of environmental ethics for EE in general and ESD in particular and to argue in favour of a return to instrumentalism, based on the twinned assumptions that the environmental problems are severe and that education of ecologically minded students could help their resolution

Why are migrant students better off in certain types of educational systems or schools than in others?

The main research question of this paper is the combined estimation of the effects of educational systems, school composition, track level, and country of origin on the educational achievement of 15-year-old migrant students. We focus specifically on the effects of socioeconomic and ethnic background on achievement scores and the extent to which these effects are affected by characteristics of the school, track, or educational system in which these students are enrolled. In doing so, we examine the ‘sorting’ mechanisms of schools and tracks in highly stratified, moderately stratified, and comprehensive education systems. We use data from the 2006 Programme for International Student Assessment (PISA) wave. Compared with previous research in this area, the paper’s main contribution is that we explicitly include the tracks-within-school level as a separate unit of analyses, which leads to less biased results concerning the effects of educational system characteristics. The results highlight the importance of including factors of track level and school composition in the debate surrounding educational inequality of opportunity for students in different education contexts. The findings clearly indicate that the effects of educational system characteristics are flawed if the analysis only uses a country- and a student level and ignores the tracks-within-school level characteristics. From a policy perspective, the most important finding is that educational systems are neither uniformly ‘good’ nor ‘bad’, but they can result in different consequences for different migrant groups. Some migrant groups are better off in comprehensive systems, while others are better off in moderately stratified systems

Towards a new image processing system at Wendelstein 7-X: From spatial calibration to characterization of thermal events

Wendelstein 7-X (W7-X) is the most advanced fusion experiment in the stellarator line and is aimed at proving that the stellarator concept is suitable for a fusion reactor. One of the most important issues for fusion reactors is the monitoring of plasma facing components when exposed to very high heat loads, through the use of visible and infrared (IR) cameras. In this paper, a new image processing system for the analysis of the strike lines on the inboard limiters from the first W7-X experimental campaign is presented. This system builds a model of the IR cameras through the use of spatial calibration techniques, helping to characterize the strike lines by using the information given by real spatial coordinates of each pixel. The characterization of the strike lines is made in terms of position, size, and shape, after projecting the camera image in a 2D grid which tries to preserve the curvilinear surface distances between points. The description of the strike-line shape is made by means of the Fourier Descriptors

Forward modeling of collective Thomson scattering for Wendelstein 7-X plasmas: Electrostatic approximation

In this paper, we present a method for numerical computation of collective Thomson scattering (CTS). We developed a forward model, eCTS, in the electrostatic approximation and benchmarked it against a full electromagnetic model. Differences between the electrostatic and the electromagnetic models are discussed. The sensitivity of the results to the ion temperature and the plasma composition is demonstrated. We integrated the model into the Bayesian data analysis framework Minerva and used it for the analysis of noisy synthetic data sets produced by a full electromagnetic model. It is shown that eCTS can be used for the inference of the bulk ion temperature. The model has been used to infer the bulk ion temperature from the first CTS measurements on Wendelstein 7-X

Experimental confirmation of efficient island divertor operation and successful neoclassical transport optimization in Wendelstein 7-X

We present recent highlights from the most recent operation phases of Wendelstein 7-X, the most advanced stellarator in the world. Stable detachment with good particle exhaust, low impurity content, and energy confinement times exceeding 100 ms, have been maintained for tens of seconds. Pellet fueling allows for plasma phases with reduced ion-temperature-gradient turbulence, and during such phases, the overall confinement is so good (energy confinement times often exceeding 200 ms) that the attained density and temperature profiles would not have been possible in less optimized devices, since they would have had neoclassical transport losses exceeding the heating applied in W7-X. This provides proof that the reduction of neoclassical transport through magnetic field optimization is successful. W7-X plasmas generally show good impurity screening and high plasma purity, but there is evidence of longer impurity confinement times during turbulence-suppressed phases.EC/H2020/633053/EU/Implementation of activities described in the Roadmap to Fusion during Horizon 2020 through a Joint programme of the members of the EUROfusion consortium/ EUROfusio

The weight-watcher service and its lightweight implementation

This paper presents the weight-watcher service. This service aims at providing resource consumption measurements and estimations for software executing on resource-constrained devices. By using the weight-watcher, software components can continuously adapt and optimize their quality of service with respect to resource availability. The interface of the service is composed of a profiler and a predictor. We present an implementation that is lightweight in terms of CPU and memory. We also performed various experiments that convey (a) the tradeoff between the memory consumption of the service and the accuracy of the prediction, as well as (b) a maximum overhead of 10% on the execution speed of the VM for the profiler to provide accurate measurements

Managing new oral anticoagulants in the perioperative and intensive care unit setting

Managing patients in the perioperative setting receiving novel oral anticoagulation agents for thromboprophylaxis or stroke prevention with atrial fibrillation is an important consideration for clinicians. The novel oral anticoagulation agents include direct Factor Xa inhibitors rivaroxaban and apixaban, and the direct thrombin inhibitor dabigatran. In elective surgery, discontinuing their use is important, but renal function must also be considered because elimination is highly dependent on renal elimination. If bleeding occurs in patients who have received these agents, common principles of bleeding management as with any anticoagulant (including the known principles for warfarin) should be considered. This review summarizes the available data regarding the management of bleeding with novel oral anticoagulation agents. Hemodialysis is a therapeutic option for dabigatran-related bleeding, while in vitro studies showed that prothrombin complex concentrates are reported to be useful for rivaroxaban-related bleeding. Additional clinical studies are needed to determine the best method for reversal of the novel oral anticoagulation agents when bleeding occurs. Copyright © 2013, the American Society of Anesthesiologists, Inc.SCOPUS: re.jinfo:eu-repo/semantics/publishe