Post-operative nausea and/or vomiting (PONV/POV) are among the biggest problems occurring in the paediatric recovery room and in the course of the following post-operative period. Apart from pain and ...emergence delirium, PONV is one of the main causes of post-operative discomfort in children. The DGAI Scientific Working Group on Paediatric Anaesthesia already worked out recommendations for the prevention and treatment of PONV in children years ago. These recommendations have now been revised by a team of experts, the current literature has been reviewed, and evidence-based core recommendations have been consented. Key elements of the new recommendations consist of effective individual measures for prevention and therapy, next to the implementation of a fixed dual prophylaxis in the clinical routine applicable to all children ≥ 3 years of age.
Modern monument conservation aims to foster the public's perception of cultural heritage. To support this aim, we developed a mobile, location-aware information system that draws the visitor's ...attention to historic sites of interest and provides location-dependent multimedia information. We call the system mobiDENK, which is the acronym for mobile monuments in German: "mobile Denkmaler". Essentially, the mobiDENK application runs on a personal digital assistant (PDA) with an integrated global positioning system (GPS) receiver. By locating the user and showing position and path on an interactive map, mobiDENK offers visual navigation support. As the user casually tours an area, mobiDENK provides location-based multimedia information about points of interest (POIs) along the way, such as monuments and significant historical sites. MobiDENK is one application of the highly modular, flexible Niccimon system architecture that we developed for rapid mobile application development. The project's aim is to provide the public with mobile, location-based multimedia information about significant cultural sites in Lower Saxony.
We present a novel context acquisition and management middleware for mobile phones based on Qt (C++ based cross-plattform API) for S60 called mSense. In our middleware, sensor nodes encapsulate ...platform level APIs for seamlessly accessing hardware sensors, simulated sensors or web services. Aggregators (channels) combine information from other nodes to generate new knowledge. For example, GPS, accelerometer and compass could be combined to provide a more accurate inertial sensor node. The output is supplied via a native interface or broadcasted through web services.
Clinical studies have been inconclusive about the effectiveness of N95 respirators and medical masks in preventing health care personnel (HCP) from acquiring workplace viral respiratory infections.
...To compare the effect of N95 respirators vs medical masks for prevention of influenza and other viral respiratory infections among HCP.
A cluster randomized pragmatic effectiveness study conducted at 137 outpatient study sites at 7 US medical centers between September 2011 and May 2015, with final follow-up in June 2016. Each year for 4 years, during the 12-week period of peak viral respiratory illness, pairs of outpatient sites (clusters) within each center were matched and randomly assigned to the N95 respirator or medical mask groups.
Overall, 1993 participants in 189 clusters were randomly assigned to wear N95 respirators (2512 HCP-seasons of observation) and 2058 in 191 clusters were randomly assigned to wear medical masks (2668 HCP-seasons) when near patients with respiratory illness.
The primary outcome was the incidence of laboratory-confirmed influenza. Secondary outcomes included incidence of acute respiratory illness, laboratory-detected respiratory infections, laboratory-confirmed respiratory illness, and influenzalike illness. Adherence to interventions was assessed.
Among 2862 randomized participants (mean SD age, 43 11.5 years; 2369 82.8%) women), 2371 completed the study and accounted for 5180 HCP-seasons. There were 207 laboratory-confirmed influenza infection events (8.2% of HCP-seasons) in the N95 respirator group and 193 (7.2% of HCP-seasons) in the medical mask group (difference, 1.0%, 95% CI, -0.5% to 2.5%; P = .18) (adjusted odds ratio OR, 1.18 95% CI, 0.95-1.45). There were 1556 acute respiratory illness events in the respirator group vs 1711 in the mask group (difference, -21.9 per 1000 HCP-seasons 95% CI, -48.2 to 4.4; P = .10); 679 laboratory-detected respiratory infections in the respirator group vs 745 in the mask group (difference, -8.9 per 1000 HCP-seasons, 95% CI, -33.3 to 15.4; P = .47); 371 laboratory-confirmed respiratory illness events in the respirator group vs 417 in the mask group (difference, -8.6 per 1000 HCP-seasons 95% CI, -28.2 to 10.9; P = .39); and 128 influenzalike illness events in the respirator group vs 166 in the mask group (difference, -11.3 per 1000 HCP-seasons 95% CI, -23.8 to 1.3; P = .08). In the respirator group, 89.4% of participants reported "always" or "sometimes" wearing their assigned devices vs 90.2% in the mask group.
Among outpatient health care personnel, N95 respirators vs medical masks as worn by participants in this trial resulted in no significant difference in the incidence of laboratory-confirmed influenza.
ClinicalTrials.gov Identifier: NCT01249625.
Purpose of Review
Co-occurring substance use disorders (SUDs) are highly common in individuals with psychiatric illnesses. Individuals with comorbid psychiatric illness and SUDs may experience poorer ...mental health and decreased treatment efficacy. However, there are no FDA-approved treatments for co-occurring substance use and psychiatric disorders. Repetitive transcranial magnetic stimulation (rTMS), a form of non-invasive brain stimulation that uses an electromagnetic field to change brain activity and behavior, may be a promising treatment for co-occurring disorders. A comprehensive literature search of PubMed, MEDLINE, and Google Scholar databases was conducted, and records were manually reviewed to include all studies testing the effects of rTMS for co-occurring SUDs.
Recent Findings
Eleven studies met our inclusion criteria. The majority (7/11) assessed rTMS for the treatment of schizophrenia and co-occurring substance use, and the remaining three studies assessed rTMS for the treatment of SUDs in mood and anxiety disorders. Potential neural circuitry targets for the treatment of co-occurring substance use and post-traumatic stress disorder, anxiety disorder, and bipolar disorder are discussed. We identify future directions and considerations for rTMS treatment and research. Namely, we recommend identification of novel treatment targets, the use of pragmatic treatment approaches, the evaluation of rTMS for substance withdrawal, the evaluation of state dependence as a predictor of treatment efficacy, the use of neurobiological measurements to identify underlying neural circuitry, and the assessment of individual predictors of rTMS treatment response.
Summary
There is preliminary evidence suggesting rTMS may be effective to treat co-occurring disorders, but additional research is needed.
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