553 research outputs found
Використання купажованого жиру у технології варених ковбас
У результаті проведеної роботи нами знайдено технологічне рішення використання купажу свинячого жиру з гірчичною олією для подовження терміну зберігання варених ковбас. Використання купажованого жиру підвищує стійкість фаршу до окислювального псування та покращує біологічну цінность продукту за рахунок кращої збалансованості жирнокислотного складу. Термін зберігання таких ковбас подовжується з 5 до 7 днів без погіршення функціонально-технологічних показників готового продукту
Ergonomic assessment of the posture of surgeons performing endoscopic transurethral resections in urology
<p>Abstract</p> <p>Background</p> <p>During transurethral endoscopic prostate and bladder operations the influence of an ergonomic redesign of the arrangement of the operation equipment - including the introduction of a video-assisted resection method ('monitor endoscopy') instead of directly viewing onto the operation area via the endoscope ('direct endoscopy') - was studied with respect to the postures of the surgeons.</p> <p>Methods</p> <p>Postures were analysed on the basis of video recordings of the surgeons performed in the operation theatre during live operations and subsequent visual posture estimation executed by an observer. In particular, head, trunk and arm positions were assigned to posture categories according to a newly developed posture classification schema. 10 urological operations with direct endoscopy and 9 with monitor endoscopy were included.</p> <p>Results</p> <p>Application of direct endoscopy coincides with distinct lateral and sagittal trunk and head inclinations, trunk torsion and strong forearm and upper arm elevations of the surgeons whereas operations with monitor endoscopy were performed with an almost upright head and trunk and hanging arms. The disadvantageous postures observed during direct endoscopy are mainly caused by the necessity to hold the endoscope continuously in close contact with the eye.</p> <p>Conclusion</p> <p>From an ergonomic point of view, application of the video-assisted resection method should be preferred in transurethral endoscopic operations in order to prevent awkward postures of the surgeons and to limit muscular strain and fatigue. Furthermore, the application of the monitor method enables the use of a chair equipped with back support and armrests and benefits the reduction of postural stress.</p
Independent Supported Housing vs institutional housing rehabilitation settings for non-homeless individuals with severe mental illness - longitudinal results from an observational study.
BACKGROUND
Most individuals with severe mental illness (SMI) strongly prefer independent living over living in an institution. Independent Supported Housing (ISH) provides housing rehabilitation for persons with SMI in their accommodations. However, most individuals who need housing rehabilitation live in institutional housing settings (housing rehabilitation as usual: HAU). We investigated which housing rehabilitation setting is effective on which variable in the long term to support service users to form an informed preference for either housing rehabilitation setting.
METHODS
We conducted a two-year longitudinal observational non-inferiority study to test the effectiveness of ISH in improving participants' social inclusion, quality of life, emotional social support, capabilities, symptom severity, functioning, service utilisation and costs. Participants were assessed at baseline and after six, twelve, and 24 months. Mixed effects models were computed to test between-group and within-group effects.
RESULTS
The study included 83 participants in ISH (n = 31) and HAU (n = 52) housing rehabilitation settings with a mean age of 36.2 years. Most participants were male (64%) and had a primary psychotic or schizophrenic (35%) or an affective diagnosis (24%). During the study, ISH participants significantly improved their quality of life (β = 0.54; 95% CI: 0.26 to 0.82), symptoms (β = -0.32; 95% CI: -0.60 to -0.03), and capabilities (β = 4.46; 95% CI: 0.14 to 8.77) and decreased psychiatric hospitalisations (p = 0.04). HAU participants improved their quality of life (β = 0.40; 95% CI: 0.12 to 0.69). Housing and rehabilitation support costs were almost half with ISH than with HAU.
CONCLUSION
ISH has been shown to be much less expensive than HAU and was associated with several improvements like reduced psychiatric hospitalisations and improved quality of life. Therefore, our findings strongly argue for a preference-driven provision of housing rehabilitation services and to end the institutionalisation of persons with SMI.
TRIAL REGISTRATION
The study was registered on December 04, 2018, at ClinicalTrials.gov (NCT03815604)
Independent Supported Housing for non-homeless individuals with severe mental illness: Comparison of two effectiveness studies using a randomised controlled and an observational study design
Background: No randomised controlled study (RCT) on the effectiveness of Independent Supported Housing (ISH) vs. housing as usual (HAU) settings for non-homeless individuals with severe mental illness (SMI) has been conducted to date because of limited feasibility. Alternative designs, such as observational studies, might be suitable for providing adequate evidence if well conducted. To test this hypothesis, this article reports on a prospective, direct comparison of the designs of two parallel studies in this field.
Methods: A two-centre, parallel-group non-inferiority effectiveness study was conducted at two locations in Switzerland using identical instruments and clinical hypotheses. One centre applied an RCT design and the other an observational study (OS) design with propensity score methods (ClinicalTrials.gov: NCT03815604). The comparability of the two study centres was investigated in terms of participants, procedures, and outcomes. The primary outcome was social inclusion and the secondary outcomes were quality of life and psychiatric symptoms.
Results: The study included 141 participants (RCT: n = 58; OS: n = 83). Within one year, 27% study dropouts occurred (RCT: 34%; OS: 22%). A similar balance of sample characteristics was achieved in the RCT and the OS using propensity score methods (inverse probability of treatment weighting). After one year, ISH was non-inferior to the control condition regarding social inclusion (mean differences [95% CI]) in the RCT (6.28 [–0.08 to 13.35]) and the OS (2.24 [–2.30 to 6.77]) and showed no significant differences in quality of life (RCT: 0.12 [–0.52 to 0.75]; OS: 0.16 [–0.26 to 0.58]) and symptoms (RCT: –0.18 [–0.75 to 0.40]; OS: 0.21 [–0.17 to 0.60]) in both study centres. However, strong and persistent preferences for ISH in the RCT control group reduced participants’ willingness to participate. Because of several limitations in the RCT, the results of the RCT and the OS are not comparable.
Conclusion: Participants were comparable in both study sites. However, there were significant problems in conducting the RCT because of strong preferences for ISH. The OS with propensity score methods provided results of more stable groups of participants and revealed balanced samples and valid outcome analysis. Our results do not support further investment in RCTs in this field
Independent Supported Housing Versus Institutionalised Residential Rehabilitation for Individuals with Severe Mental Illness: A Survey of Attitudes and Working Conditions Among Mental Healthcare Professionals.
Despite widespread support for Independent Supported Housing (ISH) interventions, psychiatric housing rehabilitation still commonly takes place in residential care facilities (RCFs). This study compares preferences, attitudes and working conditions of mental healthcare professionals (MHCPs) in ISH and RCFs using an online survey. The survey included setting preferences, stress and strain at work, recovery attitudes, stigmatisation, and factors experienced as particularly important or obstructive in housing rehabilitation. Data were analysed using quantitative and qualitative approaches. Of the 112 participating MHCPs, 37% worked in ISH and 63% in RCFs. Professionals' education, work-related demands and influence at work were higher in ISH, stigmatising attitudes were higher in RCFs. MHCPs in both settings endorsed ISH. The support process was seen as particularly important whereas stigmatisation, regulatory and political requirements were seen as obstructive for successful housing rehabilitation. Results indicate that social inclusion of individuals with severe mental illness is seldom feasible without professional support
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Observation of direction instability in a fiber ring laser
We report on the observation of a new phenomenon occurring in a fiber ring laser. This phenomenon is about the transition from an initially bidirectional emission of a reciprocal fiber ring laser to a unidirectional emission at a certain pump power threshold. In addition, the final direction is not predefined but appears to be randomly chosen every time the threshold is exceeded. Therefore, we term this new phenomenon direction instability. Furthermore, we provide a first discussion of how the instability threshold is influenced by the length and the loss of the cavity. We show that the threshold follows a power times length scaling, indicating a nonlinear origin
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