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Subarachnoid hemorrhage (SAH) is an acute cerebrovascular event with profound effects on the central nervous system and several other organs, and is defined by bleeding into the subarachnoid space between the arachnoid layer and pia mater. SAH occurs with an incidence of 2–22.5 per 100,000 [1,2]. The highest reported incidences of aneurysmal SAH (aSAH) come from Japan and Finland and occur at a rate of 16–22.5 per 100,000 per year. In the United States, SAH occurs at approximately 6 per 100,000, or a total of 18,000 events per year. The incidence of aSAH peaks in the 55–60-year-old age group. Additionally, subarachnoid hemorrhage is a consequence of traumatic brain injury in 12–53%, which corresponds to approximately 240,000 persons per year in the United States.
Instruments measuring caregiver reactions usually disregard positive aspects, and focus predominately on home care. The Caregiver Reaction Assessment (CRA) scale is an exception. Until now, no German version has been available. We translated the instrument to German (G-CRA) and evaluated its psychometric properties and feasibility.
Face-to-face interviews with 234 informal caregivers of persons with dementia were performed. Half of the persons with dementia (n = 118) had been recently admitted to institutional long-term care (iLTC); the remainder (n = 116) lived at home. Exploratory factor analysis (EFA) was performed. Subscales were inter-correlated and further correlated with the Zarit Burden Interview (ZBI), the General Health Questionnaire (GHQ-12), and the EuroQuol (EQ-5D). Internal consistency was measured (Cronbach's α), and interviewers (n = 9) appraised feasibility. The time needed to apply the scale was measured in 20 interviews.
The EFA yielded six factors (Kaiser criterion), but a scree plot supported the five dimensions of the original version that explained 56.2% of variance. Low-to-moderate subscales’ inter-correlation was revealed. Highest correlation (r = 0.5) was found between impact on health and impact on daily schedule, indicating slight overlap. Criterion validity was supported by reasonable correlations between subscales and ZBI and GHQ-12 (r = −0.21–0.71). Subscale impact on health was negatively correlated with the EQ-5D. The internal consistency was sufficient (α = 0.67 − 0.78). Interviewers judged the G-CRA to be appropriate. Completion took 6.50 min (median value).
Our results suggest that the G-CRA is sufficiently valid and internally reliable. The instrument is applicable in home care and iLTC as well as in the transitional phase.
Over the last decades, high-throughput screening (HTS) of small molecule libraries has developed into a very powerful tool for drug discovery. Although HTS capabilities initially were developed almost exclusively in the domain of pharmaceutical and biotech commercial ventures, they have more recently become available in academia. The Molecular Library Initiative of the National Institutes of Health (NIH) is one example that HTS has established itself as a routine technology in biomedical research .
The popularity of HTS is due to rapid developments in four different areas:
Robotic systems. Once exotic and expensive, robotic systems and automatic liquid handling have become more affordable and easier to operate. Turnkey systems are available for the most common applications.
Chemical libraries. Chemical libraries are becoming more readily available and affordable to the scientific community in academia and industry. Even large compound libraries, such as the one developed for the above-mentioned Molecular Library Initiative, are accessible to the general scientific community.
Plate reader platforms. Reader platforms have undergone rapid development over the last two decades. As of today, high-speed microplate readers are available to very rapidly scan microplates in the 96-, 384-, and 1536-well formats or even higher densities. Automated confocal and conventional microscopes and other image-based reader platforms have evolved at an astonishing speed. Sophisticated image-based readers and corresponding image recognition and analysis software have led to the development of complex, high-content cell-based assays.
Detection technologies. A whole array of luminescence-based technologies have been developed and commercialized over the last few years. Among those are fluorescent proteins, high-yield fluorochromes, and luminescence substrates.
Space-occupying lesions such as tumours, intracranial haematomas and abscesses are the most common indications for supratentorial surgery. Anaesthesia management is directed towards haemodynamic stability, facilitation of electrophysiological monitoring, and provision of optimal operative conditions and a rapid, high-quality recovery. The aim of pre-operative assessment is to identify potential anaesthetic problems and coexisting medical conditions, quantify risk and plan perioperative care. The assessment of the neurosurgical patient is identical to that of other patient groups but must additionally include a complete neurological assessment. Neuroanaesthesia is a specialty where the knowledge and skill of the anaesthetist affects both the operative field and ultimate outcome for the patient. Awake craniotomy allows the intraoperative assessment of a patient's neurological status and the identification of safe resection margins during epilepsy surgery and excision of space-occupying lesions in eloquent cortex, as well as the accurate localization of electrodes for deep brain stimulation.
To increase and sustain hospital-wide compliance with hand hygiene through a long-term ongoing multidimensional improvement program emphasizing behavioral factors.
Quasi-experimental short study (August 2000-November 2001) and descriptive time series (April 2003-December 2006).
A 450-bed teaching tertiary-care hospital.
An initial intervention bundle was introduced in pilot locations that addressed cognitive behavioral factors, which included access to alcohol sanitizer, education, and ongoing audit and feedback. The bundle was subsequently disseminated hospital-wide, along with a novel approach focused on behavior modification through positive reinforcement and annually changing incentives.
A total of 36,123 hand hygiene opportunities involving all categories of healthcare workers from 12 inpatient units were observed from October 2000 to October 2006. The rate of compliance with hand hygiene significantly improved after the intervention in 2 cohorts over the first year (from 40% to 64% of opportunities and from 34% to 49% of opportunities; P< .001, compared with the control group). Mean compliance rates ranged from 19% to 41% of 4174 opportunities (at baseline), increased to the highest levels of 73%–84% of 6,420 opportunities 2 years after hospital-wide dissemination, and remained improved at 59%–81% of 4,990 opportunities during year 6 of the program.
This interventional cohort study used a behavioral change approach and is one of the earliest and largest institution-wide programs promoting alcohol sanitizer from the United States that has shown significant and sustained improvements in hand hygiene compliance. This creative campaign used ongoing frequent audit and feedback with novel use of immediate positive reinforcement at an acceptable cost to the institution.
The frequency of selection of functional groups and plant species by free-ranging cattle foraging in a diverse environment and its changes during the dry and the following prehumid seasons were investigated using direct observations and bite counting. The study was conducted at two sites in the Bolivian–Tucuman montane forests in southern Bolivia, by including datasets of a total of 16 animals. Across both study sites and the entire observation period (May to October/November), the cattle were found to select a broad spectrum of plant species from different functional groups. However, just a limited number of species made up a considerable contribution to overall plant selection. The functional group of the graminoids was selected most frequently, but their contribution to plant selection decreased significantly from 63.5% of total bites in May to 15.9% in September/October, in accordance with a decrease in availability. Selection of woody plants (shrubs and tree parts, the latter mainly in the form of leaf litter and fruits) increased with time, reaching its peak at the beginning of the prehumid season, while the herbs showed a curvilinear pattern of selection which was highest in August. Plant species belonging to the functional groups of ferns, climbers and epiphytes were also selected by the cattle, but generally at low relative proportions. Plant selection might be influenced by temporal differences in nutritional quality and availability of the preferred plant species and functional groups. Sampling behaviour seems to be the most likely reason for the inclusion of a broad range of plant species with overall low contribution to plant selection.
The influence of Si-doping on the growth and material characteristics of InAs nanowires deposited by metal-organic vapor phase epitaxy (MOVPE) was investigated. It was observed that above a certain partial pressure ratio, doping has an influence on the morphology. The nanowires exhibit better uniformity but lower height vs. diameter aspect ratio as the supply of the dopant increases. It was consistantly found that the specific conductance of the nanowires also increases. Moreover the electrical measurements showed a transition from semiconducting to metallic behavior in the case of highly doped nanowires.