Knowledge of midwives about clinical trials

Introduction: Proper level of knowledge of midwives on the subject of clinical trials is influenced by the participant's safety and the quality of conducted clinical trials. Aim: The aim of the study was to assess midwives knowledge of clinical trials. Material and method: The study involved 105 midwives, at the age of 20–54years. The method of a diagnostic survey was used. The study was conducted in period April - December 2018 year. Results: The majority of respondents - 81% (n=85) knew the correct definition of the clinical trial. The most important benefit of clinical trials for the study group was "creating new treatment standards" (69,5%, n=74), and the greatest risk resulting from clinical trials "was" the possibility of adverse events and events "(92,4%, n=97). Conclusions: Midwives knowledge about clinical trials is on a sufficient level

Analysis of the tourist attractiveness of selected Greek islands: comparison of the Ionian Islands, the Dodecanese and Crete of the basis of the tourist attractiveness index

The tourism sector is responsible for a large part of Greece's GDP because the tourist assets of this country generate a lot of tourist traffic. The aim of the article is to compare the tourist attractiveness of the Ionian Islands, Dodecanese and Crete. This allowed for the creation of an attractiveness index. The following aspects were analyzed in detail: the number of tourist attractions, the number of hotels, the quality of these hotels, the number of airports and the number of seaports. Each of the elements was rated on a five-point scale. The region of the Ionian Islands turned out to be the most attractive for tourists. It has the most seaports and airports, so it is the most available in terms of communication. The number of attractions in the Ionian Islands is the largest among the studied areas. The number and quality of hotels is comparable to other analyzed places.The tourism sector is responsible for a large part of Greece's GDP because the tourist assets of this country generate a lot of tourist traffic. The aim of the article is to compare the tourist attractiveness of the Ionian Islands, Dodecanese and Crete. This allowed for the creation of an attractiveness index. The following aspects were analyzed in detail: the number of tourist attractions, the number of hotels, the quality of these hotels, the number of airports and the number of seaports. Each of the elements was rated on a five-point scale. The region of the Ionian Islands turned out to be the most attractive for tourists. It has the most seaports and airports, so it is the most available in terms of communication. The number of attractions in the Ionian Islands is the largest among the studied areas. The number and quality of hotels is comparable to other analyzed places

Acute Valproic Acid Intoxication: An Attempt at Estimating the Correlation Between Serum Level and Clinical Manifestations

We investigated the association between serum valproic acid (VPA) levels and clinical conditions in patients after acute intoxication with this drug. We performed a retrospective study of cases of VPA intoxications hospitalized in Toxicology Unit in Cracow in 2 years of observation. The study included 26 patients (age: 35.69 ± 12.93 years). In all patients, the VPA plasma level was higher than the therapeutic range, mean ± SD: 275.32 ± 135.97 μg/ml. About half of poisoned patients described in this report were treated with VPA prior to the poisoning. We noted four cases of mixed VPA intoxications with ethanol. Acute pulmonary failure was observed in two persons. The mean hospital stay for all patients was 4.69 days. This analysis demonstrates that increased serum VPA levels, in acute intoxication with this drug, were associated with the severity of poisoning — in PSS (P = 0.019) and in Matthews coma scale (P = 0.022), diastolic pressure (P = 0.022) and length of stay in hospital (P = 0.001). No correlation was detected between the serum VPA concentration and the heart rate and systolic blood pressure. In persons treated with VPA earlier, the course of poisoning was less severe, although these results were not statistically significant

Impact of Allura Clarity technology on radiation dose exposure during left atrial appendage closure

Background: To evaluate the impact of the Clarity IQ technology on reducing radiation risk in patients undergoing cardiac interventional radiology (IR) procedures. Material/Methods: Phantom studies were performed with two angiographic systems, FD10 Allura Xper and FD10 Allura Clarity. In the study, we performed left atrial appendage closure. Dosimetric measurements were performed with thermoluminescent dosimeters (TLD) placed inside a CIRS anthropomorphic phantom. Radiation risk was estimated based on the TLD readings and expressed as the dose absorbed by particular organs. The Mann-Whitney U test was carried out to test for significance of differences in the absorbed radiation doses between the techniques. Results: During left atrial appendage closure, the estimated dose absorbed by particular organs was lower in the case of the FD10 Allura Clarity system in comparison to the Allura Xper. In this procedure, dose reduction for particular organs ranged between 49-86%. Conclusions: Application of the FD10 Allura Clarity system resulted in a significant dose reduction, thereby leading to a significant decrease in radiation risk for patients undergoing IR procedures

Building national consensus on experiences of care

The NHS in England is measured against specific indicators that focus on ‘ensuring that people have a positive experience of care,’ yet there was a lack of organisational alignment across the new national health and care organisations regarding their understanding of what constitutes a positive experience of care. This represents a major barrier to achieving an aligned and consistent system-wide approach to improving experiences. To address the need to create national alignment in definition and approach, we worked with the Patient Experience Sub-group of the National Quality Board to develop consensus on how national organisations define ‘experience of care’ and what constitutes a good experience of care, drawing on relevant evidence and guidance. Working in collaboration, we developed a ‘Narrative’ to describe this consensus and highlight resources and examples of good practice on improving experiences of care for the wider system, including commissioners and providers, to support broader improvement and implementation efforts

Status społeczno-polityczny kobiety w Indiach na przełomie XX i XXI wieku - konflikt tradycji i prawa

Recent media reports about the loud process men accused of the brutal rape of a student started a new discussion about the position of women in Indian society. This status at the turn of the twentieth and twenty-first to a large extent still is the result of tensions caused by the clash of tradition and modernity. The aim of this research work is to show the rank of the issue of socio-political women in India at the turn of the century. Article focuses on the determinants that have shaped the contemporary Indian political system and the description of the contemporary Indian society and discuss the major social problems of India. Moreover, analyses the determinants of religious and regulating the position of women in society. The article seeks to discuss contemporary media events, and analyse the development of problem in the future

Dose and noise in abdominal computed tomography examinations

Background: Dose reduction in computed tomography (CT) examinations was an idea of the Co-rdinated Research Project (CRP) "Dose Reduction in Computed Tomography (CT) while maintaining Diagnostic Confidence", supported by the International Agency of Atomic Energy (IAEA) in the years 2003-2005. Participation in the CRP inspired the authors' attempts to elaborate a method for optimization of CT abdominal procedures allowing reduce a dose to patient with saving diagnostically satisfying image quality. The paper presents the algorithm together with clinical verification of the results of the study. Material/Methods: Two types of single-slice CT scanners were used for the investigations. The images recorded for patients undergoing routine abdomen examinations and then these obtained with modified exposure parameters were analyzed. The influence of the changed tube outputs on image quality was checked using Catphan 424 phantom. Results: As the result no statistically significant difference between the measured noise in clinical images for patients examined at routine and modified settings (within the same weight category) was observed. Conclusions: The conclusion was that at routine (screening) abdomen examinations, the dose may be reduced up to 50% with saving diagnostically satisfying image quality

Various cardio-vascular risk and new safety recommendations in the treatment of non-steroidal anti-inflammatory drugs

Niesteroidowe leki przeciwzapalne (NLPZ) należą do najczęściej przepisywanych leków na świecie. Na podstawie systematycznych przeglądów i metaanaliz ostatnich lat stwierdzono, że terapia NLPZ wiąże się ze zróżnicowanym poziomem ryzyka sercowo-naczyniowego (np. zawałem serca, niewydolnością serca lub udarem niedokrwiennym) odnotowywanego zarówno u osób z chorobami układu krążenia, jak i bez nich, leczonych NLPZ. Z badań wynika, że stosowanie diklofenaku może być przyczyną wysokiego ryzyka powikłań sercowo-naczyniowych. Zróżnicowanie klasycznych NLPZ pod względem profilu ryzyka sercowo-naczyniowego mogą wyjaśniać różnice w powinowactwie do cyklooksygenaz COX-1 i COX-2 oraz wpływ na równowagę pomiędzy syntezą prostacykliny PGI2 a tromboksanem A2. Ponadto poziom ryzyka zależy od stosowanej dawki, czasu trwania leczenia i formulacji leku. Dlatego nowe zalecenia bezpieczeństwa dla diklofenaku, które mają zminimalizować zagrożenia ze strony układu krążenia, rekomendują stosowanie leku w najniższej skutecznej dawce dziennej (< 150 mg) przez możliwie najkrótszy okres wymagany do opanowania objawów. Względnie niskie ryzyko sercowo-naczyniowe potwierdzono jedynie dla naproksenu, dlatego lek może stanowić alternatywę dla pacjentów, których leczenie NLPZ jest wskazane. Lekarze zlecający terapię lekami z grupy NLPZ powinni brać pod uwagę indywidualny profil ryzyka sercowo-naczyniowego pacjenta oraz starannie rozważyć stosunek korzyści do zagrożeń, jakie mogą wystąpić w wyniku leczenia.Non-steroidal anti-inflammatory drugs (NSAIDs) have become some of the most frequently used drugs throughout the world. Several recent systematic reviews and meta-analyses indicates, that NSAIDs are associated with variable levels of cardiovascular risk (CV) (myocardial infarction, heart failure or ischemic stroke), observed both in people with high risk of cardiovascular disease and in healthy individuals. Diclofenac is the agent most associated with an increased risk among others members of the class. Research suggests it could be related to the inhibition of COX-2, coupled with an incomplete inhibition of COX-1 and altering the prostaglandin PGI2-thromboxane TxA2 balance. The CV risk is also dose-, time- and formulation-dependent. Therefore, short duration of treatment, safe and effective daily dose (< 150 mg) of diclofenac are recommend according to new safety recommendations, which are intended to minimize the CV risk. Naproxen because of the safest cardiovascular risk profile could be an alternative, when NSAID treatment can’t be avoided. Physicians initiating any NSAIDs treatment should consider the patient’s risk profile and make an individual assessment of cardiovascular risk and carefully consider the balance between benefit and CV risk