Kontrola, tehnologija i mehanizam djelovanja izloženosti prašini i plinovima na plućnu funkciju

In an earlier investigation, a major temporary effect on the lung function was determined, with a spirometer, in stevedoors on a ro-ro-ship exposed to diesel exhausts from trucks during a work shift. In the present study all the trucks used aboard were equipped with especially designed micro-filters mounted on the exhaust pipes. When the filter was in use, no significant effect on the lung function was measured. The removal of the particulate fraction of the exhausts by filtering modified, or possibly eliminated, the effect observed earlier. In designing an indicator of the biological effects of diesel exhausts the particle fraction should be taken into consideration.U prijašnjem istraživanju nađen je značajan prolazni učinak ispušnih plinova kamiona na plućnu funkciju radnika za vrijeme smjene. U sadašnjem istraživanju svi kamioni imali su specijalne mikro filtre pričvršćene na ispušne cijevi. Pri upotrebi filtara nije primijećeno značajno djelovanje ispušnih plinova na plućnu funkciju. Uklanjanje određenog dijela plinova promijenilo je ili sasvim eliminiralo djelovanje koje je prije primijećeno. Stoga bi pri stvaranju indikatora za biološko djelovanje osobitu pažnju trebalo obratiti na tu frakciju ispušnih plinova dizel-goriva

Factors associated with medication adherence in older patients: A systematic review

OBJECTIVE: Medication adherence is a major challenge in the treatment of older patients; however, they are under‐represented in research. We undertook a systematic review focused on older patients to assess the reasons underlying non‐adherence in this population. METHODS: We searched multiple electronic databases for studies reporting reasons for non‐adherence to medication regimens in patients aged 75 years and over. Our results were not limited to specific diseases, health‐care settings, or geographical locations. The quality of eligible studies was assessed using the Newcastle‐Ottawa Scale. A narrative synthesis of findings was performed. RESULTS: A total of 25 publications were included, all of which were in community settings. Frequent medication review and knowledge regarding the purpose of the medication were positively associated with adherence. Factors associated with poor adherence were multimorbidity, cognitive impairment, complex regimens with multiple prescribing physicians, and problems with drug storage or formulation. CONCLUSION: These findings suggest that interventions to improve adherence could focus on medication review aimed at simplifying regimens and educating patients about their treatment. Groups with poor adherence that may benefit most from such a model include patients with multiple comorbidities and cognitive impairment

Nurse prescribing of medicines in Western European and Anglo-Saxon countries: a systematic review of the literature

<p>Abstract</p> <p>Background</p> <p>A growing number of countries are introducing some form of nurse prescribing. However, international reviews concerning nurse prescribing are scarce and lack a systematic and theoretical approach. The aim of this review was twofold: firstly, to gain insight into the scientific and professional literature describing the extent to and the ways in which nurse prescribing has been realised or is being introduced in Western European and Anglo-Saxon countries; secondly, to identify possible mechanisms underlying the introduction and organisation of nurse prescribing on the basis of Abbott's theory on the division of professional labor.</p> <p>Methods</p> <p>A comprehensive search of six literature databases and seven websites was performed without any limitation as to date of publication, language or country. Additionally, experts in the field of nurse prescribing were consulted. A three stage inclusion process, consisting of initial sifting, more detailed selection and checking full-text publications, was performed independently by pairs of reviewers. Data were synthesized using narrative and tabular methods.</p> <p>Results</p> <p>One hundred and twenty-four publications met the inclusion criteria. So far, seven Western European and Anglo-Saxon countries have implemented nurse prescribing of medicines, viz., Australia, Canada, Ireland, New Zealand, Sweden, the UK and the USA. The Netherlands and Spain are in the process of introducing nurse prescribing. A diversity of external and internal forces has led to the introduction of nurse prescribing internationally. The legal, educational and organizational conditions under which nurses prescribe medicines vary considerably between countries; from situations where nurses prescribe independently to situations in which prescribing by nurses is only allowed under strict conditions and supervision of physicians.</p> <p>Conclusions</p> <p>Differences between countries are reflected in the jurisdictional settlements between the nursing and medical professions concerning prescribing. In some countries, nurses share (full) jurisdiction with the medical profession, whereas in other countries nurses prescribe in a subordinate position. In most countries the jurisdiction over prescribing remains predominantly with the medical profession. There seems to be a mechanism linking the jurisdictional settlements between professions with the forces that led to the introduction of nurse prescribing. Forces focussing on efficiency appear to lead to more extensive prescribing rights.</p

Izlučivanje i raspodjela žive u štakora, antidoti za živu i učinci primjene žive na nesivost i plodnost u kokoši

The results of investigations of the distribution and excretion of organic and inorganic mercury compounds in albino rats and white leghorn hens conducted over a period of ten years are surveyed. The storage of mercury in eggs as well as its effects on the egg-lay-frequency and hatchability of the layed eggs have also been studied. All investigated mercury compounds were labelled with the radioactive mercury isotope 203Hg and the mercury level was measured with a scintillation technique. Since antidotes used in the treatment of mercury poisoning influence not only the excretion of mercury, but also its distribution in the body, the effects of nine antidotes on the metabolism of different mercury compounds were also investigated. The results of the survey are presented graphically.Prikazani su rezultati desetogodišnjeg istraživanja raspodjele i izlučivanja organskih i anorganskih spojeva žive na albino-štakorima i leghorn-kokošima, lstraživano je i odlaganje žive u jajima nesilica, učinci na nesivost i oplođenost jaja. Živini spojevi obilježavani su radioaktivnim izotopom 203Hg, a živa mjerena scintilacijskom tehnikom. Budući da antidoti što se primjenjuju pri otrovanju živom utječu ne samo na izlučivanje već i na raspodjelu žive u organizmu, izneseni su i rezultati učinaka devet antidota na prijetvor pojedinih živinih spojeva u organizmu pokusnih životinja

The Walls of Informationalism the threat to information as positive right; an ideology-analysis of the WTO and its agreements.

This thesis examines the ideological implications of an emerging shift in human rights-issues regarding information. As Intellectual Property becomes increasingly important to the economy of developed nations previously commonly owned or unprotected information runs a real risk of becoming privatized. The World Trade Organization and its binding agreements GATS and TRIPS are subjected to a critical ideology-analysis, with special efforts to elucidate possible effects on the public service realm and its commitment as provider of free information as a human right. The result suggests that not only does a threat to information as such a right exist, but that its ideological basis however seemingly rooted in a liberal/neoliberal context actually in its express views on information deviates from liberal/neoliberal theory in many ways, and that there are theoretical inconsistencies in that same ideology.Uppsatsnivå:

Corrosion protection of steel ships - Localized high strain failures of protective coating

The advances of corrosion protection over the last decade has been considerable due to mutual efforts of ship owners, TSCF, IMO, IACS, research institutes and paint manufacturers. Now there are well-described corrosion protection systems that give 15 years of surface protection without much maintenance work. However, there are deterioration mechanisms that are not understood. Further research efforts are needed and new understanding should be turned into procedures for implementation. Tankers and bulk carriers are designed for about 25 years. In trans-ocean trade these ships may make as few as 300-1000 voyages in the lifetime. The loading and discharge cycle ballast-cargo-ballast causes high local stresses in some bracket corners and cutouts. During the ocean voyages wave loads causes high stresses in the same spots. When stresses are superimposed the yield point of the material is frequently reached and there will be local yielding in many such places. In the paper it is shown that the steel sustains high strain better than the aged coating. Spots at risk are not systematically identified today despite the very high probability of localized failure of the coating. Once the coating has failed locally corrosion starts and accelerated crack propagation takes place in the steel for the wave-induced stresses. The paper gives a state of the art description concerning corrosion protection systems and focuses on the localized strain induced coating failures, some methods under development. In order to avoid localized cracks in the coating due to high strain followed by corrosion one should identify spots with very high strain, give the local geometry of the steel below the vulnerable coating a perfect shape for the benefit of a sustainable coating

Drug treatment of elderly : The need for changing behaviour among providers and patients

Medication-related illness is a great problem, particularly among the elderly. Elderly people use many different drugs, they have many diseases and symptoms, and also experience natural signs of aging. Altogether, the treatment of an elderly patient is complex and assessment of the appropriateness of a drug therapy is difficult. In order to make a treatment as effective as possible and to achieve the best possible health it is important that the care personnel can identify problems associated with drug treatment. Such problems, e.g. polypharmacy, may lead to non-compliance. The overall aim of this thesis was to explore the drug utilization among elderly people in order to develop methods for rational drug audits and to get a knowledge of the patient’s view on the use of drugs. In the first study, we studied drug treatment of nursing home patients who had cardiovascular diseases (heart failure, post-myocardial infarction, angina pectoris, hypertonia, or cardiac valvular disease), and assessed the effect of medication advice given. We found that intervention did not affect the cardiovascular symptoms, i.e. medication could be decreased or even disrupted with no (harmful) effect on the health of the patients. Revisions of drug treatment should therefore be practiced on a regular basis in order to decrease the risk for polypharmacy and also decrease unnecessary costs. Revisions should involve more than one class of drugs in order to be cost-effective. In the second study, we investigated the effects of withdrawing SSRI drugs for nursing home patients who had no documented diagnosis or symptoms of depression. We found that treatment with SSRI drugs in patients without a clinically major depression or anxiety disorder often was unjustified and seemed to have had no essential effect. The medication with SSRI drugs should discontinued in those patients. In the third study, the relationship among elderly people between adherence to prescribed drugs and the patient’s perception of the care and information given was explored. We found that better perceived health was related to higher adherence. Patients in the non-adherent group reported a higher consumption of drugs. Moreover, patients who felt they did not get an opportunity to ask the physicians questions were over-represented in the non-adherent group. Care-providers should therefore increase their efforts to communicate with the patients. The fourth study was designed to analyse the relationship between the attitude to drugs, general health, psychological well-being, stress coping ability, and adherence to prescribed drugs in an elderly population. We found that of the mentioned factors the number of drugs prescribed and consumed is the most important factor for adherence to a drug treatment. The higher the number of prescribed drugs, the lower the proportion of adherent patients will be. The study also showed that non-adherent patients who took too many or too few drugs possibly may be approached in a different way in order to improve their adherence to the drug treatment. Drugs are essential for a successful management of diseases. Although the prescription of a drug is well intended, its use can bring about serious consequences. It is important to reconsider medication after some period of time as the indication no longer may be valid. When a patient chooses to take a drug or not to take it, the responsibility lies with the patient, and the patient should therefore be given tools to make a rational decision. It is the care-providers who can supply the patient with these tools. The patient should be given adequate information on the possible adverse effects of drugs and be encouraged to report adverse reactions. The patient’s participation and involvement in decisions concerning his/her care and treatment is an important principle in nursing

Structural behaviour of a high tensile steel deck using trapezoidal stiffeners and dynamics of vehicle–deck interactions

As an early part of a large design and fabrication-oriented project FasdHTS funded by the GROWTH programme of the European Commission, an exotic concept ship was designed in very high tensile steel (EHS690) with the purpose of finding out consequences for design and production. The project has already produced a considerable bank of knowledge for design and shipyard production in this material. This paper presents analysis and discussions on static and dynamic behaviour of a high tensile steel deck designed with trapezoidal stiffeners. First, a finite element model of the deck structure is created. The influence of support condition for the longitudinal girders, and the contact area between the vehicle tyre and panel were analysed. The results from modal analysis of the structure under different load conditions are presented. The different load conditions comprise the unloaded and loaded deck, and the load type, i.e. cargo loads or vehicle loads (car loads or truck loads). From the frequency response analysis under harmonic excitation, it shows how the locations and numbers of cars parked on the deck influence the dynamic response of the structure. Furthermore, by studying the car–deck interaction, it is found that the effects of normal cargo loads are quite different from the vehicle loads due to the spring/damping effects of the vehicles. It is suggested that the carloads have a similar mechanism to that of tuned mass dampers. Finally, two transient analyses of the structure due to excitations transferred from deck supports and lorry braking-induced loading are performed. It is suggested that the deck structure and vehicle design could have more interactions with each other