Uvod: Etični konflikt predstavlja resen poklicni problem. Medicinske sestre so na svojem delovnem mestu čedalje bolj obremenjene, še posebej v intenzivnih enotah, kjer je delo z življenjsko ...ogroženimi pacienti posebej težavno in je pojavnost etičnih konfliktov toliko večja. Namen je bil ugotoviti stopnjo izpostavljenosti etičnim konfliktom med medicinskimi sestrami v intenzivni enoti.Metode: Izvedena je bila kvantitativna presečna opazovalna raziskava. Vanjo je bilo vključenih 97 medicinskih sester, zaposlenih v intenzivnih enotah ene bolnišnice. Podatki so bili zbrani s pomočjo vprašalnika in statistično obdelani z uporabo univariatne statistike.Rezultati: Raziskava je pokazala, da so medicinske sestre v intenzivnih enotah zmerno izpostavljene etičnim konfliktom (x = 138,85, s = 89,08). Najpogosteje doživljajo etični konflikt ob situacijah, ko primanjkuje virov,ki zdravstvenemu timu omogočajo upoštevanje etičnih smernic za delovanje (x = 14,11, s = 9,13). Najmanj so izpostavljene etičnim konfliktom, ko je treba v okviru kliničnega preizkušanja dajati zdravila in pri tem ne prejmejo vseh potrebnih informacij, ki so po njihovem mnenju potrebne za izvajanje te naloge (x = 2,25, s = 3,70).Diskusija in zaključek: Pri pojavnosti stopnje etičnega konflikta pri medicinskih sestrah je bilo ugotovljeno, da se srečujejo s konflikti, ki so rahlo problematični in precej problematični. Največji etični konflikt se pojavi pri pomanjkanju časa za upoštevanje etičnih smernic za delovanje, kar kaže, da je medicinskih sester premalo za kakovostno oskrbo pacientov.
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NUK, ODKLJ, UL, UM, UPUK, VSZLJ
This work is focused on a quantitative procedure for estimating the generally unfavourable effects that incorrectly drilled holes, characterized by the initial clearance between a rivet and a hole, ...have on the fatigue life of riveted joints. The solution is based on an analytical approach using the stress-severity-factor concept. An experimental programme with riveted-joint specimens characterized by low-load transfer factors was realized in the Czech Aerospace Research Centre (VZLU) test lab under constant amplitude loading. The holes for rivet joints with 4-mm diameters were prepared with the clearance in a range of 0.0–0.16 mm. Force-controlled riveting was applied using a constant pressure force to form the driven head. To prevent fretting events between the joined parts, their anodized contact surfaces were lubricated with MOLYKA, plastic grease with molybdenum disulphide and graphite. The experimental data showed that the load-transfer factor and the fatigue life depend on the initial clearance between a rivet and a hole. The presented procedure introduced the hole-filling factor, integrated in the stress-severity-factor concept as a function of the initial clearance between a rivet and a hole.
Heart failure is common in the nursing home population and presents many diagnostic and therapeutic challenges. Point-of-care ultrasonography is a bedside method that can be used to assess volume ...status more reliably than clinical examination. This trial was conceived to test whether point-of-care ultrasonography-guided management improves heart failure outcomes among nursing home residents.
Nursing home residents with heart failure will be enrolled in a multi-centre, prospective, randomised controlled trial. Residents will first be screened for heart failure. Patients with heart failure will be randomised in 1:1 fashion into two groups. Nursing home physicians will adjust diuretic therapy according to volume status for six months. Point-of-care ultrasonography will be used in the test group and clinical examination in the control group. The primary endpoint will be heart failure deterioration, defined as a composite of any of the following four events: the need for an intravenous diuretic application, the need for an emergency service intervention, the need for unplanned hospitalisation for non-injury causes, or death from whatever cause.
The expected prevalence of heart failure among nursing home residents is above 10%. Point-of-care ultrasonography-guided heart failure management will reduce the number of deteriorations of heart failure in the nursing home population.
This study will explore the usefulness of point-of-care ultrasonography for heart failure management in the nursing home population.
Aim. The aim of this paper is to compare the prevalence of voice disorders and the risk factors for them in different occupations with a vocal load in Slovenia.
Methods. A meta-analysis of six ...different Slovenian studies involving teachers, physicians, salespeople, catholic priests, nurses and speech-and-language therapists (SLTs) was performed. In all six studies, similar questions about the prevalence of voice disorders and the causes for them were included.
Results. The comparison of the six studies showed that more than 82% of the 2347 included subjects had voice problems at some time during their career. The teachers were the most affected by voice problems. The prevalent cause of voice problems was the vocal load in teachers and salespeople and respiratory-tract infections in all the other occupational groups. When the occupational groups were compared, it was stated that the teachers had more voice problems and showed less care for their voices than the priests. The physicians had more voice problems and showed better consideration of vocal hygiene rules than the SLTs. The majority of all the included subjects did not receive instructions about voice care during education.
Conclusions. In order to decrease the prevalence of voice disorders in vocal professionals, a screening program is recommended before the beginning of their studies. Regular courses on voice care and proper vocal technique should be obligatory for all professional voice users during their career. The inclusion of dysphonia in the list of occupational diseases should be considered in Slovenia as it is in some European countries.
Cilj. Primerjati prevalenco glasovnih motenj in dejavnikov tveganja za njihov nastanek pri različnih poklicih v Sloveniji.
Metode. Narejena je bila meta analiza šestih različnih raziskav v Sloveniji, ki so vključevale zdravnike, učitelje, prodajalce, duhovnike, medicinske sestre in logopede. V vseh študijah so bili uporabljeni podobni vprašalniki, ki so zajemali vprašanja o pojavu glasovnih motenj in razlogih zanje.
Rezultati. Primerjava raziskav je pokazala, da je 82% od 2.347 vključenih že imelo glasovne težave v svoji karieri. Največ težav z glasom so imeli učitelji. Glavni vzrok hripavosti pri učiteljih in prodajalcih je bila glasovna obremenitev, pri preostalih poklicih pa akutne respiratorne okužbe. Primerjava poklicev je pokazala, da imajo učitelji več glasovnih težav kot duhovniki, manj tudi skrbijo za svoj glas. Primerjava zdravnikov in logopedov je pokazala, da imajo zdravniki več glasovnih motenj, čeprav bolje skrbijo za svoj glas. Večina vprašanih ni dobila navodil glede skrbi in rabe glasu med svojim študijem.
Zaključki. Za zmanjšanje pojava glasovnih motenj bi bili potrebni presejalni pregledi kandidatov za poklice z glasovno obremenitvijo še pred začetkom študija. Poklicni govorniki bi se morali tudi med opravljanjem svojega poklica dodatno izobraževati o skrbi za glas in pravilni vokalni tehniki. Glasovne motnje bi morali vključiti v seznam poklicnih bolezni, tako kot je to urejeno že ponekod v Evropi.
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