Ricehansen5651

Background In the Netherlands, people with severe cognitive deficits due to Korsakoff syndrome are generally admitted to a specialized nursing home. Professional caregivers experience that these residents are often not aware of their deficits, and consequently, their willingness to accept care is relatively low. However, these residents need permanent support when performing daily tasks due to severe cognitive deficits. The combination of objective care needs and low subjective responsiveness makes caring for people with Korsakoff syndrome a complex undertaking. It is unknown how professional caregivers deal with this complex task and how they manage the associated ethical challenges. Objectives The aim of this study was to explore the professional caregivers' perspectives on good care for residents with Korsakoff syndrome. Methods A qualitative study design was used. Data were collected via semi-structured interviews. The Framework Method was used for the thematic analyses of the interview data. Participantse the practitioners' reflection on their own ideas about good care for people with Korsakoff syndrome.The Woven EndoBridge Device (WEB) is efficient and safe in the treatment of wide-neck bifurcation intracranial aneurysms. A crucial step in operative planning is establishing the appropriate dimension of the device, and there are limitations to the therapeutic solutions provided by WEBs. We describe a case of a right middle cerebral artery bifurcation wide-neck aneurysm treated with WEB. After the initial deployment of a WEB proven oversized, we substituted it with a smaller one that presented immediate post-detachment intra-aneurysmal tilt probably resulting from undersizing. The 24-h angiographic control identified a partial displacement of the device in the superior middle cerebral artery branch. We describe rescue techniques with review of the literature and our treatment strategy, including effort to reposition the device followed by stent deployment. The treatment was electively completed by the coil-through technique. The post-detachment WEB tilt should be considered an unstable position and treated either by removal of the device or with adjunctive implants. Each WEB size adapts to a range of aneurysmal height and width. This range is not always the same for each specific WEB dimension, based on the table provided by the manufacturer. This eventually predisposes to a different behavior of different WEB sizes regarding the modification of the device's height in relation to the modification of the diameter after deployment.Customer-facing train crew members have to follow strict procedures to guarantee that trains are safe and run on time. They are also responsible for revenue protection and customer care. Human factors and ergonomics research are instrumental to understand the safety-critical aspects and improve work. We bring user experience research and personas to describe how train crew perceive their routines and how new technology may impact them. We conducted 7 hours of interviews and 30 hours of shadowing observations with the train crew (N = 22) to provide an understanding of who are they and to define their experiences. We present the crew's current routines and created two personas to represent them. One is slightly reluctant to adopt the proposed technology, whereas the other is more accepting. Results indicate how such technology may affect crew work ergonomics and experiences, and suggest which valuable aspects should be maintained, for example the positive interactions with passengers. Practitioner summary This study investigated the work routines of the customer-facing train crew. Interviews and shadowing were conducted with 22 crew from a large operator in the UK. Personas were created to represent them. Results show their preferred activities and how these would be affected by the introduction of new technology. Abbreviations CH; customer host (onboard catering staff); DOO driver-only operation; ETA estimated time of arrival; PTI platform-train interface; TM train manager (onboard customer-facing authority); UCD user-centred design; UX user experience.Background Rivaroxaban 2.5mg twice daily plus aspirin 100mg reduced the risk of cardiovascular events as compared to aspirin monotherapy in the COMPASS (Cardiovascular Outcomes for People Using Anticoagulation Strategies) trial but increased the risk of major bleedings. Analysis of net clinical benefit (NCB) is of key clinical relevance and represents an integrated measure of overall patient outcome. Methods The current pre-specified analysis was performed to assess the NCB of adding rivaroxaban 2.5mg twice daily to aspirin monotherapy in patients with chronic vascular disease in the COMPASS study cohort (intention-to treat study population), with a specific focus on high-risk subgroups. The pre-defined NCB outcome was the composite of cardiovascular death, stroke, myocardial infarction, fatal bleeding, or symptomatic bleeding into a critical organ. Results A lower number of NCB adverse outcomes was observed with rivaroxaban 2.5mg twice daily + ASA vs. ASA alone (Hazard Ratio (HR) 0.80, 95% Confidence Intervaequent and with less clinical impact. The NCB was particularly favorable in high-risk subgroups and those with multiple risk characteristics. Clinical Trial Registration URL https//www.clinicaltrials.gov. Unique identifier NCT01776424.Objective Urinary retention caused by bladder clots can be frustrating because such blood clots are difficult to remove. We established a novel technique in which hydrogen peroxide is applied to evacuate bladder clots. Methods In this single-center retrospective study, we evaluated 31 patients with retention of blood clots in the bladder who underwent emergency evacuation using hydrogen peroxide. Results The patients comprised 17 men and 14 women with mean age of 61.2 years (range, 42-82 years). Hydrogen peroxide solution and a 20-Fr three-cavity Foley catheter with large-diameter side holes were used for manual bladder irrigation in all patients. The bladder blood clots were successfully removed in 27 patients. Selleckchem ONO-7475 The remaining four patients could not tolerate the symptoms of urinary retention and had to resort to surgery. Conclusion Hydrogen peroxide solution for manual bladder irrigation can improve the efficiency of bladder blood clot evacuation. This is a simple and effective option for managing bladder clot retention.