<p>Anhörigas närvaro vid avancerad hjärtlungräddning (A-HLR) har på senare år varit ett internationellt diskuterat ämne. Flera undersökningar har gjorts som undersökt anhörigas syn på sin egen närvaro vid denna akuta vårdsituation. Dessa studier har visat att anhöriga i stor utsträckning önskar få möjlighet att närvara vid en A-HLR situation. Av denna anledning var det av intresse att studera akutsjuksköterskors syn på detta. Syftet med studien var att undersöka och jämföra attityder och erfarenheter av anhörigas närvaro vid A-HLR hos sjuksköterskor inom ambulanssjukvården, akutmottagningen och hjärtintensivvårdsavdelning. Studien bygger på en enkätundersökning som lämnats till samtliga sjuksköterskor på dessa enheter (n=101). Data har analyserats statistiskt med chitvåtest samt Fishers exakta test. I resultatet framkommer tydligt att ambulanssjuksköterskorna är de sjuksköterskor som har mest erfarenhet av anhörigas närvaro under A-HLR. De är också den grupp sjuksköterskor i denna jämförelse som ser mest positivt på att anhöriga finns närvarande. För övrigt är de den grupp som i minst utsträckning aktivt kan välja att utesluta anhörigas närvaro i jämförelse med slutenvårdsarbetande sjuksköterskor. Då tidigare forskning visar att anhöriga önskar och bör ges möjligheten att närvara vid A-HLR situationen kan resultatet av denna studie leda till mer strukturerade utbildningsinsatser för akutsjuksköterskan.</p>

This study examines the organization of the village society in Benestad, in southern Sweden, during the period from 1886 to 1928. The study focuses on the commonly owned resources in the village and how the landowners there came together and shared the resources. By studying the records of the societies’ meetings, and in particular the cases that concerns the common resources, a categorization has been done.   The results of the study show that the landowners in Benestad shared pasture lands, milk carriage and other resources with one another. Overall, the village society had a strong organization with at least two yearly meetings about the commonly owned resources. Not everyone was however welcomed to the meetings and the wives and children had to trust their housemaster to also consider their interests. By comparing the results with Elinor Ostrom’s theory of eight design principles that unites all stabile institutions that handle commonly owned resources, one can say that the village society in Benestad was a stabile establishment. In fact, the society is still active - even if the landowners nowadays deal with other matters than those of the milk carriage.

The aim of the study was to look at the psychomotor skills in cardiopulmonary resuscitation and relate the results to sex, age and type of training. Place of training had three different categories: training at Finnish Red Cross (FRC) courses for general public, training at workplace or training at both places. The study was conducted on 310 trainees on different first aid courses and events in Finland. The psychomotor skills were evaluated by observation with help of a CPR evaluation standardized checklist with 11 moments. Age showed to have an impact on the skills. Age groups 20, 30 and 40 performed the skills better than the age group 50 and above. To explain the difference with anxiety is not likely, as 41.1 % of the trainees informed not to be afraid in a real situation and only 27.8% answered to be or did not know if they would be afraid. More likely the difference can be explained by self confidence to act as well as by the fact that different age groups need different teaching methods. Repeating has also a big role with the competence. Trainees with health care background or active at FRC succeeded to get better results. They also managed better with the essential moments like calling for help and opening the airways. Obvious is that those with 3-6 passed first aid courses managed to get better results than those with 0-2 courses. Motivation to have skills in CPR have an impact when comparing the skills and place where you got the training. All 11 moments right had 43.8% of the trainees who got their training at a FRC course, and 28.0% of those who were trained at workplace. Same difference can be shown when comparing skills with the essential moment, opening the airways. Out of the trainees at FRC courses 89.9% performed it right and 62.7% of trainees at courses at workplaces. When evaluating the skills it is just not enough to look at the right moments, but as well at the crucial, life saving, measures. In order to save more lives by CPR training an essential factor in the training is confidence to intervene in the event as well as repetition together with different teaching methods for different target groups. CPR skill tests are an important tool for the future development of the quality of the teachers. / <p>ISBN 91-7997-096-6</p>

Bakgrund: I Sverige drabbas ungefär 5000 patienter årligen av plötsligt hjärtstopp på våra sjukhus: Hjärtstopp behandlas med hjärt-lungräddning (HLR). Sjuksköterskan är ofta den som upptäcker patienter med hjärtstopp, och den som utbildar i HLR. Syfte: Syftet var att beskriva nya alternativ till den traditionella metoden för HLR-utbildning. Metod: Examensarbetet är gjord som en litteraturöversikt och inkluderar elva vetenskapliga artiklar. Litteratursökningar gjordes i databaserna Pubmed, Cinahl och SveMed. Resultat: Tre olika nya typer av HLR utbildning identifierades; användandet av en simulatordocka som ger datorbaserad återkoppling eller ljudbaserad återkoppling, videoinspelning med självreflektion samt interaktiva datorspel. Metodiken som använde simulatordockor med datoråterkoppling och ljudbaserad återkoppling gav bäst utvecklingsresultat på värden som bröstkompressioner och inblåsningar. Diskussion: Ett optimalt HLR utbildning scenario består av fyra komponenter. Dessa komponenter består av; simuleringsdockor som ger feedback via ljudspår och datorprogram, videoinspelning på den individuella sjuksköterskans insats, interaktiva datorspel samt att sjuksköterskor undervisar sjuksköterskor för bästa möjliga HLR insats. Slutsats: För att vårdpersonal, framförallt sjuksköterskor, ska kunna optimera sina insatser vid HLR-situationer, bör de nyare metoderna för utbildning göras tillgänglig i både grundutbildningen till sjuksköterska och även för verksamma sjuksköterskor. / Background: In Sweden approximately 5000 patients suffer from sudden cardiac arrest in our hospitals every year. Cardiac arrest is treated with cardiopulmonary resuscitation (CPR). Nurses are often those who come across patients with cardiac arrest, and also those who teach CPR. Purpose: The purpose of this paper was to describe new alternatives to the traditional methods for teaching CPR. Method: This examination paper is designed as a literature review, and includes eleven scientific articles. The literature search was made in the databases Pubmed, Cinahl and SveMed. Result: Three different types of new CPR educations were identified; the use of simulation equipment which gives computer based feedback or audio feedback, video recordings with self-reflection, and interactive computer games. Discussion: An optimal CPR education scenario consists of four components; Simulation equipment which gives feedback by audio and computer programs, video recording of the individual nurses contribution, interactive computer games and also nurses who educates nurse for the best CPR effort. Conclusion: In order to optimize healthcare professionals, especially nurse contribution to CPR scenarios, should the new educational types be made available in both the basic education for nurses and also for active working nurses.

Thesis (M.S.)--University of Michigan, 1997. / Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 1997. / Includes bibliographical references.

Introduction: This dissertation thesis aims to describe microcirculatory changes in cardiac arrest setting and to assess the impact of circulatory supports (i.e. mechanical chest compressions and extracorporeal membrane oxygenation (ECMO)) on tissue microcirculation. Methods and results: Two separate studies were designed. Microcirculation was monitored sublingually by a recent Sidestream Dark Field (SDF) technique and its parameters were evaluated offline, separately for small (of diameter ≤ 20µm) and other vessels. In order to monitor microcirculation during cardiac arrest (CA) and resuscitation (CPR) an experimental pig model was used; eighteen pigs were commenced to 3 minutes of untreated CA and subsequent 5 minutes of mechanical CPR. During CA the microcirculatory parameters deteriorated, in CPR they improved and reached 59 - 85 % of the prearrest values. The microcirculatory variables correlated neither to parameters of systemic circulation (mean arterial blood pressure and carotid blood flow) nor to lactate. In the second, clinical, study the sublingual microcirculation was monitored 29 (± 17) hours after the CA onset in 15 patients, who were after unsuccessful conventional CPR rescued by ECMO. In comparison to healthy (sex and age matched) volunteers, the patients showed mild but...

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro Tecnológico. Programa de Pós-Graduação em Engenharia de Produção. / Made available in DSpace on 2012-10-21T00:35:00Z (GMT). No. of bitstreams: 1 224424.pdf: 769035 bytes, checksum: 42f6783c9f52f4fa938c9baafa6c2bb0 (MD5) / O presente estudo foi desenvolvido com o objetivo de propor um conjunto de medidas que possibilitem a utilização da Cédula de Produto Rural (CPR) e dos mecanismos de futuros e opções como instrumentos para obtenção de financiamento e redução de risco de variação de preço de café. Assim, foram pesquisados produtores de café, agências do Banco do Brasil e Sindicato Rural, localizados na região norte do Estado do Paraná, no período agrícola de 2001/2002. Para tanto, comparou-se o custo da CPR com outras alternativas de crédito (recursos do CDI, crédito oficial e crédito pessoal), além de se dimensionar o efeito do custo financeiro do aval na taxa efetiva das CPRs Produto. Outro aspecto abordado é a utilização dos instrumentos de mercados futuros e opções para comercialização da safra. Assim, foram apresentados exemplos de operações pertinentes àqueles mercados, como alternativas de fixação de preços de café. Como resultado da pesquisa, a CPR produto, apesar de fixar preço antecipadamente, apresentou grande variação de taxas efetivas de juros, as quais chegaram até 121,69% ao ano, o que é proibitivo para o segmento agrícola. Quanto à CPR financeira, esta apresentou custos na faixa de 25% ao ano, isto é, muito superiores quando comparadas ao crédito oficial de 9,5% ao ano, mostrando-se viável apenas para aqueles produtores com maior produtividade, através de plantio adensado. O crédito pessoal, apesar de raramente utilizado pelo produtor, mostrou-se a pior das alternativas apresentando taxas de juros na ordem de 166% ao ano. Quando associados CPR e os mecanismos de futuros e de opções, os resultados apresentados demonstraram que o produtor ao utilizar estes instrumentos pode obter melhor desempenho, em relação ao processo tradicional de custeio e venda da safra, em termos de financiamento e proteção de variação de risco de preço. Como resultado do estudo, são sugeridas medidas visando a melhoria do modelo de financiamento e da proteção de preços hoje praticados, com enfoque nos seguintes aspectos: manutenção da taxa de financiamento a 9,5% ao ano para a cafeicultura; financiamento dos ajustes nas operações de venda a futuro e financiamento dos prêmios das opções de venda; reavaliação da taxa de aval em CPR; vinculação de parte da produção financiada a operações de trava de preço via futuro e opções; seguro de performance que proporcione emissão de CPR a custos menores e, por último, a criação de um fundo de commodities lastreado em CPRs, em que a venda do produto esteja acertada através de mercado futuro ou de opções.

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro Tecnológico. Programa de Pós-Graduação em Engenharia de Produção. / Made available in DSpace on 2012-10-19T11:02:57Z (GMT). No. of bitstreams: 0Bitstream added on 2014-09-25T20:10:07Z : No. of bitstreams: 1 186854.pdf: 7383174 bytes, checksum: 6ebed90befe8ecdeca019db5c8bfba77 (MD5) / Este trabalho teve por objetivo principal analisar as formas de comercialização utilizadas pelos sojicultores da Região Oeste do Paraná e apontar meios alternativos, que propiciem aumento de segurança e de margem de retorno da commodity soja. Foram levantados dados relativos aos preços obtidos e o volume comercializado, no período de 1995 a 2000, através dos instrumentos tradicionais, Mercados a Termo, Mercados Futuros, CPR, CPRF e Leilão Eletrônico. As conclusões extraídas do trabalho apontam que a grande maioria dos produtores de soja ainda utiliza os meios tradicionais de comercialização, mercado físico, soja-verde e sistema de troca. Aponta como alternativa de financiamento os seguintes meios: a CPR, a CPRF, o Leilão Eletrônico e as Salas de Agronegócios. De acordo com os resultados de simulações, com taxas que remuneram a poupança ou o crédito pessoal, o produtor que utilizou Cédula de Produto Rural (CPR) para financiar a produção e a comercialização de soja teve vantagem em 40% das observações. Pelo critério da média mensal, no período de 1995 a 2000, os melhores meses para o sojicultor vender a soja foram: dezembro; novembro; setembro e outubro. Enquanto que os piores foram: abril e maio; março; junho, julho e agosto. Adicionalmente o trabalho aponta os benefícios que a mudança nos meios atuais de comercialização pode trazer ao produtor e descreve os passos que devem ser seguidos para utilização dos modernos meios de financiamento e comercialização da commodity soja.

The thesis deals with an overview of the history of First Aid, focusing on the development of cardiopulmonary resuscitation. It is a historical-comparative work of theoretical nature. The intention is to map the knowledge and experience that can be used effectively to develop and study the issue. When writing a thesis, an analysis of the available literature, both historical and contemporary, foreign and Czech, was used. Articles from professional periodicals and monographs were searched. The work was, for the sake of completeness, supplemented with period pictures and diagrams. The introduction justifies the choice of the topic and depicts the current state of knowledge in the field of First Aid. The next chapter explains the basic concepts which are important for orientation in the issue. Following a historical study First Aid aimed at developments providing cardiopulmonary resuscitation. The chapter is divided into subchapters describing the chronology of events to present recommendations for resuscitation and First Aid, so called CPR Guidelines 2015. The last chapter deals with the basic legal minimum. The outcome of this work is an extremely comprehensive overview of mapping the formation and development of First Aid from its history to current recommendations for resuscitation. This thesis...