Processing of Dielectric Materials and Metals with ps Laserpulses

Since industrial suited ps laser systems are available, the cold ablation with ultrashort laser pulses is of huge interest when high requirements concerning accuracy, surface roughness and heat affected zone are demanded. Interesting applications lie within the fields of surface and 3-d structuring of metals, semiconductors (especially flexible solar cells) and dielectric materials with direct and induced processes. For a profitable industrial use of this technology high process efficiency is required which is confirmed by the development of the corresponding systems towards high average powers up to several 10 W. Beside the pulse duration, which is given by the laser system, the user has a wide variety of parameters, e.g. fluence, repetition rate, wavelength and marking speed, to optimize structuring processes. For a given average power there exist optimal laser parameters to achieve a maximal volume ablation rate. To take benefit of this maximum ablation rate, to simultaneously prevent harmful effects (particle shielding, surface melting) and to achieve the requirements concerning surface quality and accuracy, adapted structuring strategies have to be used. This can lead to equipment needs of the beam guiding system which are often not accomplishable and therefore to the demand for new technologies which have to be developed

Support My Spine ASAP. A Rural Tele-health care model for patients being managed with a Thoracic Lumbar Sacral Orthotic (TLSO).

U ovom diplomskom radu definirana je i ispitana nova metoda kratkoročne prognoze valnih visina iz podataka brzine vjetra tzv. metoda ekvivalentnog trajanja. Metoda je bazirana na jednadžbama danim u EM 1110-2-1100 (Part II) Chapter II-2 “Meteorology and Wave Climate”. Projektiranje pomorskih građevina gotovo uvijek zahtijeva prognozu određenih parametara valova. To je prognoziranje često vrlo komplicirano te zahtijeva suradnju projektanta i inženjera specijaliziranog za izradu kompleksnih numeričkih modela. U nekim situacijama poželjno je procijeniti značajne valne visine koje se mogu pojaviti na nekom prostoru na jednostavan, jeftin i brz način. U svrhu istraživanja u ovome radu analizirane su valne situacije na dvije lokacije, u Riječkom zaljevu te kod mjesta Rukavac na otoku Visu. Uspoređujući izmjerene valne visine u trenutku pojave maksimalne brzine i valne visine dobivene proračunom, utvrđeno je da metoda ekvivalentnog trajanja bazirana na jednadžbama danim u EM 1110-2-1100 (Part II) Chapter II-2 “Meteorology and Wave Climate” značajno podcjenjuje vrijednosti značajnih valnih visina. U ovom radu ispitano je 17 valnih situacija te su na njima testirane dvije modifikacije bazne metode ekvivalentnog trajanja. Rezultati dviju modifikacije su vrijednosti značajnih valnih visina i perioda značajno bliže izmjerenim vrijednostima, odnosno vrijednostima dobivenim iz globalnog modela.A research study has been conducted to estimate significant wave heights and wave periods for wind-generated waves using the new equivalent duration method based on the equations from EM 1110-2-1100 (Part II) Chapter II-2 “Meteorology and Wave Climate”. Designing maritime structures almost always requires wave hindcasting and forecasting. In some cases it is desirable to estimate significant wave heights and periods in a simple, inexpensive and quick way without complex, numerical models or expensive software. For the purpose of this research study, wind-wave situations on two locations have been analysed. The first one in the Rijeka bay area and the second one close to Rukavac on the island of Vis. Comparing the measured and calculated significant wave heights in the moment of maximum wind speed, it has been noticed that the equivalent duration method based on the equations from EM 1110-21100 (Part II) Chapter II-2 “Meteorology and Wave Climate” underestimates the values of calculated wave heights. In this research study two new modifications of the basic method, on 17 wind-wave situations, have been tested. The results show that the values of calculated significant wave heights and wave periods in the moment of maximum wind speed are closer to the measured values

Support My Spine ASAP. A Rural Tele-health care model for patients being managed with a Thoracic Lumbar Sacral Orthotic (TLSO).

Question: Does a Telehealth model of care facilitating treatment in rural hospitals for patients requiring a TLSO eliminate the need for transfer to a tertiary referral hospital? Design: Quantitative pre and post intervention design. Participants: Physiotherapists, nursing and medical staff at rural hospital pilot sites. Intervention: Pre and post intervention data collection provided patient demographics, and length of stay data around model of care implementation. Pre intervention staff surveys identified knowledge gaps informing educational packages which were provided with a mobile Telehealth link. Outcome measures: Primary: Number of patients managed under the new model of care. Secondary: Length of stay, travel distance eliminated and complications. Results: 30 patients fitted with TLSO’s and managed under this model of care to date. Length of stay has reduced from 9.14 days pre intervention to 3.8 days post intervention. Approximate savings of $6840 per patient have been identified, with over 6000kms of patient travel eliminated. No complications have occurred. Rural Physiotherapists have been successfully up skilled in managing patients requiring TLSO fitting. Conclusion: This intervention successfully created a model of care to facilitate local management of patients requiring TLSO fitting with Telehealth support from a tertiary referral hospital. Considerable savings have occurred from this model of care for patients and the health district. This model is currently being implemented district wide. Key Practice Points: Telehealth model of care can be successfully implemented to TLSO management Multidisciplinary team role is critical role in redesigning models of care Telehealth increase the efficiency of healthcare resource

Vitamin D and Its Role During Pregnancy in Attaining Optimal Health of Mother and Fetus

Despite its discovery a hundred years ago, vitamin D has emerged as one of the most controversial nutrients and prohormones of the 21st century. Its role in calcium metabolism and bone health is undisputed but its role in immune function and long-term health is debated. There are clear indicators from in vitro and animal in vivo studies that point to vitamin D’s indisputable role in both innate and adaptive immunity; however, the translation of these findings to clinical practice, including the care of the pregnant woman, has not occurred. Until recently, there has been a paucity of data from randomized controlled trials to establish clear cut beneficial effects of vitamin D supplementation during pregnancy. An overview of vitamin metabolism, states of deficiency, and the results of recent clinical trials conducted in the U.S. are presented with an emphasis on what is known and what questions remain to be answered

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Pflegerische Interventioen zur Prävention und Behandlung strahleninduzierter Dermatitis bei Mammakarzinom-Patientinnen: systematische Literaturübersicht

Die vorliegende Bachelorthesis hat den Charakter einer systematischen Literaturübersicht. Das Ziel dieser Bachelorthesis besteht im Analysieren und Ermitteln von evidenzbasierten Pflegeinterventionen zur Prävention und Behandlung von strahleninduzierter Dermatitis bei Mammakarzinom-Patientinnen. Für die Literaturanalyse wurden fünf Datenbanken auf Studien mit experimentellem oder quasi- experimentellem Design für den Zeitraum 2000-2010 abgesucht. Alle brustkrebsspezifischen Studien, die Pflegeinterventionen zur Behandlung oder Prävention von Radiodermatitis untersuchten, wurden von der Autorin auf Inhalt und methodische Qualität geprüft. Danach folgte eine tabellarische Zusammenfassung der ausgewählten Studien. Den Rahmen der Literaturübersicht bildet das Symptom Management Modell, welches eine Hilfestellung im Umgang mit Symptomen bietet. 12 Studien entsprachen den Einschlusskriterien und wurden in die Literaturübersicht integriert. Verschiedene Hautpflegeprodukte wurden untersucht, wobei Biafine® Creme, das meist genannte Produkt war. Ein aussagekräftiger Vergleich der Effekte zeichnete sich als schwierig heraus, da unterschiedliche Kontrollgruppen verwendet wurden. Trotzdem konnten Tendenzen eines signifikanten Effektes einzelner Produkte aufgezeigt werden. Der Gebrauch von Deodorants und das Waschen des Bestrahlungsfeldes während einer Radiotherapie werden empfohlen Ebenfalls die Anwendung von Calendula Salbe, Skin Save und Biafine® Creme. Beschränkte Evidenz bezüglich verminderter Hauttoxizität bestand bei Ureadin Rx® Rd, DuoDERM CGF Verband und dem reizfreien 3M Cavilon Hautschutzfilm. Alle anderen Produkte zeigten keinen signifikanten Effekt in der Prävention und Behandlung von Radiodermatitis. Die Umsetzung dieser Empfehlungen in der Praxis ist relevant, da keine allgemein gültigen Guidelines existieren und es an evidenzbasierten Studien zum Thema mangelt. Weitere Forschung bezüglich Behandlung und Prävention von Radiodermatitis bei Mammakarzinom sollte durchgeführt, Standard Pflegeprodukte geprüft und neue Produkte entwickelt werden. Auf Basis qualitativ hoher Studien und Forschungsprojekten sollten allgemein gültige Guideline