Устройства на основе фотонных кристаллов

Рассмотрены физико-технические особенности фотонных кристаллов. Представлен обзор конструкций и характеристик устройств на их основе

The PRCI study: design of a randomized clinical trial to evaluate a coping intervention for medical waiting periods used by women undergoing a fertility treatment

Background: Many medical situations necessitate a stressful period of waiting for potentially threatening test results. The medical waiting period is often associated with negative anticipatory anxiety and rumination about the outcome of treatment. Few evidence-based self-help coping interventions are available to assist individuals manage these periods. Theory and research suggest that positive reappraisal coping strategies may be particularly useful for this type of unpredictable and uncontrollable stressful context. The objective of this study is to investigate the effects of a Positive Reappraisal Coping Intervention (PRCI) on psychological well-being of women waiting for the outcome of their fertility treatment cycle. Methods/Design: In a three-armed randomized controlled trial, the effectiveness of the PRCI will be tested. Consecutive patients undergoing in vitro fertilisation in a Dutch university hospital and meeting selection criteria will be invited to participate. Those who agree will be randomized to one of three experimental groups (N=372). The PRCI Intervention group will receive the intervention that comprises an explanatory leaflet and the 10 statements designed to promote positive reappraisal coping, to be read at least once in the morning, once in the evening. To capture the general impact of PRCI on psychological wellbeing patients will complete questionnaires before the waiting period (pre-intervention), on day ten of the 14-day waiting period (intervention) and six weeks after the start of the waiting period (post-intervention). To capture the specific effects of the PRCI during the waiting period, patients will also be asked to monitor daily their emotions and reactions during the 14-day waiting period. The primary outcome is general anxiety, measured by the Hospital Anxiety and Depression Scale. Secondary outcomes are positive and negative emotions during the waiting period, depression, quality of life, coping and treatment outcome. During recruitment for the RCT it was decided to add a fourth non-randomized group, a PRCI Control group that received the PRCI and completed the questionnaires but did not complete daily monitoring. Discussion: Positive reappraisal is one of the few ways of coping that has been shown to be associated with increased wellbeing during unpredictable and uncontrollable situations like medical waiting periods. A simple evidence based self-help intervention could facilitate coping during this common medical situation. This RCT study will evaluate the value of a self-help coping intervention designed for medical waiting periods in women undergoing fertility treatment. Trial registration: The study is registered at the Clinical Tials.gov (NCT01701011)

Is cranial molding preventable in preterm infants? A systematic literature review of the effectiveness of interventions

Aims: A systematic review of published studies was conducted to study the evidence supporting interventions to prevent or reduce cranial molding of the preterm infant in Neonatal Intensive Care Units. Background: Incidence of cranial molding has increased over recent decades. Cranial molding is identified as a contributor for negative physical and psychosocial developmental effects. Design and Method: A systematic literature review and critical appraisal according to the Cochrane Collaboration Center assessment criteria was performed. Results: Eight intervention studies meeting the inclusion criteria were identified. Most studies used the anterior-posterior: bi-parietal ratio as measurement of cranial molding. One multicenter quasi-experimental intervention study showed that infants who received regular repositioning had a statistically significant reduction of bilateral head flattening compared to infants who did not receive this intervention. Other studies had either methodological weaknesses or showed no effect for the intervention studied. Conclusion: Evidence is poor and restricted to one intervention; regular body repositioning. More well-designed randomized studies are needed to confirm the effect of regular head and body positioning

The impact of a self-administered coping intervention on emotional wellbeing in women awaiting the outcome of IVF treatment: a randomised controlled trial

STUDY QUESTION What is the effect of the positive reappraisal coping intervention (PRCI) on anxiety in women awaiting the outcome of an IVF/ICSI cycle? SUMMARY ANSWER Women reported significantly more anxiety during the waiting period than before treatment, but the use of the PRCI did not significantly reduce anxiety during the waiting period. WHAT IS KNOWN ALREADY Waiting for the outcome of IVF/ICSI treatment after embryo transfer is one of the most stressful periods of fertility treatments. At present, no evidence-based coping interventions are available to assist women though this waiting period. The PRCI has been designed to address this unmet need by promoting positive reappraisal coping. STUDY DESIGN, SIZE, DURATION A three-armed randomized controlled trail (RCT) was designed to evaluate the PRCI in women undergoing IVF/ICSI. Data were collected between October 2010 and June 2012. A total of 377 participants were randomized to receive either the PRCI and emotional monitoring, emotional monitoring only, or routine care. Only the PRCI-monitoring group received the coping intervention, comprising an explanatory leaflet and ten statements to be read at least once in the morning and once in the evening. PARTICIPANT, MATERIALS, SETTING, METHODS To capture the general impact of the PRCI, all three groups completed questionnaires at three time points: just before the waiting period (time 1: stimulation phase), on Day 10 of the 14-day waiting period (time 2: waiting period) and 6 weeks after the start of the waiting period (time 3: 6-week follow-up). In addition, to capture the specific impacts of the PRCI on the days of the waiting period, the PRCI-monitoring group and the monitoring-control group also rated their emotions and reactions daily, for the 14-day waiting period. MAIN RESULTS AND THE ROLE OF CHANCE Of the women who agreed to participate and who met eligibility criteria, 377 were randomized. All study participants reported significantly more anxiety and depression during the waiting period than before treatment (P < 0.001). The mean difference in anxiety between time 1 versus time 2 was 1.465 (95% CI 1.098–1.832). The mean difference in depression between time 1 versus time 2 was 0.514 (95% CI 0.215–0.813). Use of the PRCI did not significantly reduce anxiety or depression, or daily negative emotions during the waiting period. However, patients randomized to the PRCI reported significantly more positive emotions during the waiting period (P < 0.001) than the monitoring-control group, and reported the intervention to be easy to use, and as having a positive psychological effect. No significant differences were found between the groups in treatment outcome. LIMITATIONS, REASONS FOR CAUTION The lack of difference observed in the present study for anxiety levels between the PRCI and the monitoring-control group could have been due to the effects of monitoring itself or its ability to attenuate or obscure the effects of the PRCI intervention in unknown ways. A randomized group of women who used only the PRCI without daily monitoring would provide more insight. WIDER IMPLICATIONS OF THE FINDINGS The PRCI was shown to help women reinterpret the demands of the waiting period in a more positive way. These results are consistent with previous studies showing that positive reappraisal coping is a useful strategy for unpredictable and uncontrollable situations represented by a medical waiting period. This simple low cost self-help coping intervention increases positive affect during the waiting period in an IVF/ICSI treatment

Protocolized Versus Nonprotocolized Weaning to Reduce the Duration of Invasive Mechanical Weaning in Neonates A Systematic Review of All Types of Studies

Mechanical ventilation is one of the most commonly used treatments in neonatology. Prolonged mechanical ventilation is associated with deleterious outcomes. To reduce the ventilation duration, weaning protocols have been developed to achieve extubation in adult and pediatric care in a safe and uniform manner. We performed a systematic review to obtain all available evidence on the effect of protocolized versus nonprotocolized weaning on the duration of invasive mechanical ventilation in critically ill neonates. The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, Web of Science, and the International Clinical Trial Registry Platform were searched until January 2018. Quantitative and qualitative studies involving neonates that investigated or described protocolized versus nonprotocolized weaning were included. Primary outcome was the difference in weaning duration. A total of 2099 potentially relevant articles were retrieved. Three stud

Evaluating the Baby@Home program: Early discharge strategies for (pre)term infants are safe and benefit health outcomes

Aim: Prolonged hospitalisation in the neonatal intensive care unit (NICU) can emotionally tax newborn infants and their families, resulting in developmental adversities and inadequate parent–infant bonding. This study aimed to assess the feasibility and value of the Baby@Home program in reducing prolonged hospital stays. Methods: This is a retrospective cohort study of 26 infants from a tertiary neonatology department, using qualitative data (gathered through interviews with parents (n = 15) and professionals (n = 5)) and quantitative data (retrieved from medical records and the Luscii application). Results: Our study included 26 newborn infants. 76% were premature, born at an average term of 35 weeks and 2 days. During the study period, all infants thrived, and only two adverse events occurred (an allergic reaction and respiratory incident necessitating readmission). Interviews were conducted based on six major themes concerning the feasibility and value of the program. Despite the challenges of application utilisation, the program's overall value was evident. Conclusion: The Baby@Home program effectively facilitated early discharge, promoted family reunification, and yielded favourable safety and health outcomes. Innovative solutions such as Baby@Home have the potential to pave the way for more sustainable and patient-centred care models

Nurses’ experiences and perspectives on aEEG monitoring in neonatal care: A qualitative study

Purpose: This study aimed to gather nurses’ experiences and perspectives regarding the amplitude-integrated electroencephalogram (aEEG) monitoring system in neonatal intensive care units (NICUs) and to explore potential avenues for future improvements. Design and Methods: This study employed a descriptive qualitative design. Semi-structured interviews were conducted with 20 nurses from the level-III NICU of a Dutch medical center. The collected interview data were analyzed using thematic analysis. Results: Seven main themes emerged: training in aEEG monitoring, proficiency in aEEG electrode placement and pattern interpretation, usual practices of using aEEG, neonatologist-nurse cooperation on aEEG, the performance of the automated seizure detection software, the usefulness of aEEG monitoring in the NICU, and feedback about the current aEEG monitoring system. Conclusions: Nurses confirmed that aEEG is a valuable tool for cerebral function monitoring in the NICU; however, improvements are necessary. For better utilization of aEEG in the NICU, it is recommended to enhance nurses’ aEEG knowledge and skills and apply state-of-art techniques to improve the monitoring system. Practice implications: To enhance the aEEG knowledge of NICU nurses, we suggest introducing structured training programs, conducting routine case-centered discussions, and creating readily available reference resources. To optimize the aEEG monitoring system, it is essential to incorporate innovative electrodes, provide remote accessibility, integrate advanced algorithms, and develop an intuitive graphical user interface

The Needs of Dutch Women During Decision-Making About Treatment for Miscarriage

Objective: To explore the needs of women during decision-making about treatment for miscarriage. Design: Descriptive qualitative design. Settings: University and teaching hospitals in the Netherlands. Participants: We selected a purposive sample of 16 women who needed treatment for miscarriage from an electronic patient file system. We ensured maximum variation by sampling in different hospitals and selecting women with different ages, numbers of children, miscarriage histories, treatment types, and educational levels. Methods: We conducted face-to-face individual, semistructured interviews and used thematic analysis to identify, analyze, and describe themes. Results: We identified one overarching theme, Decision Based on Reason and Emotion, and three related subthemes: Certainty, Information, and Support From Environment. Conclusion: Health care professionals should be aware of how women's decision-making is structured in the context of treatment choices for miscarriage, and discussion regarding treatment should address reason and emotion