The emergence of nanotechnology has increased the concern of exposure to nanoparticles through inhalation. Studies have examined the performance of filtering facepiece respirators against engineered nanoparticles. This has been done by the generation and dispersal of certain particles in a given size distribution, which have then been run through experimental set-ups involving Condensation Particle Counters, Scanning Mobility Particle Sizers, and high efficiency performance filters for a set flow. Published studies have shown that the respirators used do provide expected levels of filtration protection against nanometer-sized particles. However, studies have not examined or applied different types of nanoparticle samples - different particle types have differing morphologies and physical characteristics that could affect filter performance. This study has exposed NIOSH-approved N95 facepiece respirators to six different types of engineered nanoparticles: aluminum oxide, iron oxide, single-walled carbon nanotubes, synthesized diamond, silicon dioxide, and titanium dioxide. In addition, N95 respirators have not been commonly exposed to differing concentrations of an aerosol in order to observe a shift in the primary penetrating particle size and a shift in the overall size distribution. This study challenged N95 respirators to four different concentrations of sodium chloride: 0.1, 1, 10, and 50 mg/ml. Another concern is whether or not a prolonged exposure of a single respirator affects the overall performance and protection from an aerosol, especially engineered nanoparticles, since very few studies have been done regarding this matter. N95 respirators were exposed to several types of engineered nanoparticles in a respirator testing apparatus at a set flow rate, examined for penetration with an SMPS, CPC, and DMA given these conditions: differing concentrations of sodium chloride, different engineered particles, and an extended duration of exposure to both sodium chloride and 15-nm titanium dioxide. This study showed that the primary penetrating particle size through an N95 facepiece respirator does increase and shift with increasing concentrations of an aerosol; however, the overall size distribution did not seem to shift much. Penetration decreased as sodium chloride concentration increased. Different nanoparticles had differing primary penetrating particle sizes through the respirator; however, penetration of these particles was similar to one another with the exception of iron oxide which had quite a high penetration percentage. A decrease in N95 respirator performance was observed when exposed to a 1 mg/ml solution of sodium chloride, as penetration increased with prolonged exposure. However, this did not seem to be the case when the respirator was exposed to a 6.67 mg/ml suspension of 15-nm titanium dioxide, as the penetration over the extended period of time was similar to one another.

In spite of the substantial repository of literature about respirators, little is known about the practicalities of their use. The focus of this research was about the practical aspects of using respirators in New South Wales workplaces. Two self-administered postal surveys were used to assess the level of implementation of respirator programs in 1996 and 2001. After five years, six elements improved. The most improvement was seen in the area of documentation including written procedures, keeping training records, recording respirator tasks, and maintenance records. The second survey investigated respirator maintenance and found little automated cleaning. Thorough washing was scarce with more than 50% of organisations relying on moist towelettes. For the third portion of the research methodology 485 used, half facepiece reusable respirators from 36 different sites were examined to determine the most common respirator defects. Maintenance and cleaning procedures were primitive and probably inadequate. Disinfection or sanitisation was common practice indicating concern about infectious diseases. The 2001 survey found that physical inspection of respirators in the workplace usually checked for the common types of defects found in the examination of used respirators. Weight, breathing resistance, heat and tightness were reported as causes of discomfort. The key outcomes from the research were that respirator programs were poorly implemented in a group of organisations that were expected to have more expertise than most and that the most common defects could be corrected by good respirator cleaning programs. / Doctor of Philosphy (PhD)

Introduction: Non-compliance with respiratory protection programs among firefighters may put them at increased risk of injury and illness from occupational exposures during fire extinguishing activities. This research aims to characterize respiratory protection practices among Florida firefighters. This information will allow better understanding of factors that are associated with non-compliance with respiratory protection guidelines. Methods: Survey questionnaire was used to characterize Florida fire departments in this cross sectional study. Four hundred and seventy-seven surveys were administered to Florida firefighters both in person and electronically to collect information regarding firefighter knowledge and participation in their respective respiratory protection programs during the past twelve months. Survey questions were developed from the model set by the National Fire Protection Association which provides standards and regulations regarding firefighter protections. Collected data were used to produce summary statistics regarding firefighter department size, coverage area, and firefighter employment type. Further data analysis used Statistical Analysis Software to compute multinomial logistic regression analysis. Results: The 477 respondents were 91% male with a mean age 39 years old (range 21-65 years). The majority of respondents, 76%, were non-smokers, 21% former smokers, and 3% current smokers. In regards to ethnicity, respondents were 77% Caucasian, 13% Hispanic, 3% African-American, and 4% other. Most respondents were career firefighters, 97%, with less than ten years of experience, 44%, working in a fire department with at least 21 firefighters, 98%. Most respondents, 80%, had a written respiratory program in place. The most cited reason for not having implemented a written respiratory program was lack of knowledge related to the program. Multinomial logistic regression analysis of departments with response areas of at least 250,000 square miles produced a statistically significant 0.44 odds ratio for having a written respiratory program as compared to those with a less than 10,000 square miles response area. Conclusion: Additional resources need to be given to Florida fire departments to ensure that all firefighters receive adequate respiratory protection in accordance with National Fire Protection Association guidelines. There is an association between fire departments with large response areas and non-compliance with respiratory protection guidelines in regards to: having a written respiratory program, the frequency of respiratory fit testing, and the frequency of medical fitness testing. This suggests that rural fire departments need additional resources to ensure fire fighters are adequately protected. Additional research should focus on why these differences exist in the rural fire departments. Respondents stating a lack of knowledge or no requirement for a written respiratory program suggest that future efforts should focus on respiratory protection education and training.

Name: : The difference of consumption of a medium being inhaled between a man and a woman at the same level of endurance in scuba diving. Goals: The primary goal of this work, is to determine if and how is the amount of the inhaled medium depending on the gender of the divers. Compare the consumption between men and women while being faced with the same amount of stress, meaning during a united profile of a dive, try to maximize the decrease of the influence of stress factors. Confirm or deny the hypothesis that men show higher values of the inhaled medium. Methods: The theoretical part of this paper, was created based on the research of the appropriate literature. To obtain all the data, there was used the method of experiments, the results were then analyzed, compared and than statistically evaluated using the Students T- test. Probandi (n=10+10) took part in a 30 minute long and 20 meters deep dive in Bořená hora, during which their consumption of the inhaled medium was recorded every 5 seconds using a special underwater computer with a probe. Results: It was found out that men, during the same dive, consume more air than women because of their higher body weight. Key words: scuba diving, air, sex, respirator, minute ventilation

No description available.

No description available.

No description available.

Bakgrund: Mekanisk respiratorbehandling är en den mest använda kortsiktiga livsuppehållande interventionen och den vanligaste behandlingsformen inom intensivvården och syftar till att understödja och stötta andningssvikt. Smärta är en vanlig upplevelse hos patienter som vårdas inom intensivvårdsavdelen och som behandlas med mekanisk ventilation, inte bara för själva respiratorbehandlingen utan även för de undersökningar och behandlingar som pågår samtidigt.  Motiv: Smärta är vanligt förekommande hos patienter som vårdas inom intensivvården relaterat till sjukdom, skada, behandling, procedurer och omvårdnad. När patienter vårdas i respirator försvinner förmågan att kunna uttrycka sig verbalt, det gör att de inte med ord kan förmedla sin smärta.   Metod: Kvalitativ innehållsanalys med individuella semistrukturerade intervjuer med induktiv ansats.   Syfte: Syftet var att belysa intensivvårdssjuksköterskors erfarenheter av att tolka smärta hos sederade patienter i respirator.   Resultat: Analysen av studien resulterade i två huvudkategorier med vardera tre subkategorier. Personliga aspekter med följande subkategorier; Individuella bedömningar, tolkning av patientens uttryck och komplexitet i bedömningar. Nästa huvudkategori var; Organisatoriska aspekter med följande subkategorier; sjuksköterskans framträdande roll i teamet, strukturerad informationsöverföring samt professionellt engagemang med kompetens  Konklusion: Resultatet visade att det finns hinder som påverkar bedömning av smärta hos respiratorvårdade patienter. Intensivvårdssjuksköterskan använder erfarenheter och tidigare kunskap istället för formella smärtskattningsinstrument. De uttryckte svårigheter i att bedöma skillnad på oro och smärta. Intensivvårdssjuksköterskorna upplever att det är deras ansvar att patienten får rätt smärtlindring och lyfta diskussionen kring smärta. De belyser även vikten av tydlig dokumentation och rapportering. / Background: Mechanical ventilator treatment is one of the most widely used short-term-life-sustaining interventions and the most common form of treatment in intensive care and aims to support respiratory failure. Pain is a common experience in patients who are cared for in the intensive care unit and who are treated with mechanical ventilation, not only for the respiratory treatment itself but also for the examinations and treatment that take place at the same time.   Motive: Pain is common symptom for intensive care patients, related to illness, injury, treatment, procedures and nursing. When patients are cared for in a ventilator, the ability to express themselves verbally disappears, which means that they cannot convey their pain with words.    Method: Qualitative content analysis with individual semi-structured interviews with an inductive approach.   Aim: The aim was to examine intensive care nurses' experience of interpreting pain in sedated patients on a ventilator.  Results: The analysis of the study resulted in two main categories with three subcategories each. The first main category was Personal aspects with the following subcategories; Individual assessments, interpretation of the patient's expression and complexity in assessments. The next main category was; Organizational aspects with the following subcategories; the nurse's prominent role in the team, structured information transfer and professional commitment with competence.  Conclusion: The results showed that there are obstacles that affect the assessment of pain in respiratory patients. The intensive care nurse uses experience and previous knowledge instead of formal pain assessment instruments. They expressed difficulty in distinguishing between anxiety and pain. The intensive care nurses feel that it’s their responsibility to get the patient the right pain relief and raise the discussion about pain. They also highlight the importance of clear documentation and reporting.

An analog current servo of an intensive care ventilator is being developed at Getinge in Stockholm. The current servo is used to control the output gas flow of an inspiration valve to a patient’s lungs. The ventilator’s control system is in a cascade design of two closed-loops, of which the current servo is the controller for the inner loop. The inner loop control system consists of three parts; a PI-controller, a Pulse-Width-Modulation (PWM) signal generator, and an actuator of a solenoid. The project aims to investigate if a digital version of the current controller is feasible with comparable performance as the present analog controller. The project involves studying linear mathematical models, nonlinear simulation models, and physic prototypes. The solenoid model is first modelled as an RL-circuit, secondly modified by adding the term Electro-Motive-Force (EMF), and finally verified by physical measurement data. Different control techniques are tested with the simulation model, such as feedforward control. A digital controller is then implemented in a processor of a Nucleo board and connected to the inspiration valve hardware with a resulting sampling rate of 8 kHz. The selected hardware components for the implementation are described in detail, and a step-by-step explanation of the software implementation is included in Appendix B. Finally, the model-tested control techniques have been implemented in a physical prototype and discussed. The developed digital current controller is feasible to achieve similar control performance as the present analog design. However, for configuring the digital current controller into a future digital ventilator’s Central Processing Unit (CPU), the sampling rate will need to be adopted to the limited recourses of the CPU executing both the current controller and all other functions of the inspiration valve. The code of the digital current controller will also need to be optimized in future work to compensate for the shared data capacity. / Ett analogt strömservo tillhörande en intensivvårds respirator har undersökts och digitaliserats på företaget Getinge i Stockholm. Strömservot används för att styra en inspirationsventils gasflöde till patientens lungor. Styrsystemet är av två stängda loopar i en kaskadreglering där strömservot är den inre regulatorn. Den inre loopen har tre huvuddelar; en PI-regulator, en Pulse-Width-Modulation (PWM) generator och ställdon som en dragmagnet. Syftet med projektet är att undersöka huruvida en digital strömregulator är implementerbar och om dess karaktär kan motsvara dagens analoga variant. Projektet använder sig av linjära matematiska modeller, ickelinjära simulerings modeller i Simulink samt fysiska prototyper. Metoden är att först testa enkla modeller, som för dragmagneten en RL-krets. Vid behov utvecklas modellen som för RL-kretsen där dess Electro-Motive Force (EMF) har inkluderats. Sedan verifieras den slutgiltiga modellen genom jämförelse med mätningar. En digital styrning har utvecklats och testats med olika styrtekniker så som framkopplingsteknik. Slutligen är en digital regulator implementerad i ett Nucleo-korts processor med en resulterad samplingstid på 8 kHz. Komponentval för hårdvaruimplementering är beskrivna och en stegförsteg lista av mjukvaruimplementeringen finns i Appendix B. De modelltestade styrteknikerna har blivit implementerade i en fysisk prototyp och diskuterade. Sammanfattningsvis är en digital version av strömregulatorn med dess samplingstid implementerbar och har snarlik prestanda som den analoga versionen. För framtida konfigurering i en digital gasmodul ska samplingstiden adopteras till den akutella datakapaciteten. Den resulterande C-koden för den digitala strömregulatorn går att optimera i många avseenden.

Introduktion: I dagens intensivvård hålls patienter som vårdas i respirator mer ytligt sederade. Patienterna blir berövade sitt verbala tal och behandlas i en miljö som kan upplevas som skrämmande. Detta ställer högre krav på sjuksköterskan, att bemöta patientens psykosociala behov på ett bra sätt och etablera en vårdande relation. Syfte: Att belysa sjuksköterskors erfarenheter av att skapa en vårdande relation med en vaken eller lätt sederad patient som vårdas i respirator på en intensivvårdsavdelning. Metod: En kvalitativ induktiv design användes och data insamlades med hjälp av fyra fokusgruppsintervjuer, med totalt 14 kvinnliga sjuksköterskor med minst två års yrkeserfarenhet av intensivvård. Studien utgick från tre intensivvårdsenheter i västra Sverige. Den insamlade datan analyserades med hjälp av kvalitativ innehållsanalys. Resultat: Sjuksköterskors erfarenheter av att skapa en vårdande relation med en vaken eller lätt sederad patient som vårdas i respirator, tolkades utifrån följande teman för att belysa olika faktorer som är av vikt: kommunikation i mötet, att lyfta fram personen bakom patienten, det vårdande rummet och när relationen försvåras. Slutsats: Att med hjälp av kommunikation skapa en gemensam förståelse, att lära känna patienten och orientera patienten i nuet, att vårda med respekt och trygghet och slutligen att sträva efter att lösa eventuella hinder som uppstår på vägen, var alla centrala faktorer i skapandet av en vårdande relation. Som blivande intensivvårdssjuksköterskor anser författarna att studien ger viktiga infallsvinklar i problemområdet som kan vara användbara i deras kommande yrkesroll. / Introduction: In today's intensive care, patients who are mechanically ventilated are more often lightly sedated. Patients are deprived of their verbal communication and treated in an environment that they can find frightening. This puts greater demands on the nurse, in order to respond to the patient's psychosocial needs in a positive way and establish a caring relationship. Aim: To illuminate nurses’ experience of creating a caring relationship with an awake or lightly sedated patient undergoing mechanical ventilation in an intensive care unit. Method: A qualitative inductive design was used and data was collected with four focus groups, with a total of 14 female registered nurses with at least two years professional experience of intensive care. The study was conducted at three intensive care units in western Sweden. Data was analysed with a qualitative content analysis.   Result: Nurses' experience of creating a caring relationship with an awake or lightly sedated patient undergoing mechanical ventilation, was interpreted on the basis of the following themes to highlight the various factors that are of importance; communication in the meeting, to highlight the person behind the patient, the room of caring and when the relationship is complicated. Conclusion: Using communication to create a common understanding, to get to know the patient and orient the patient in the present, to provide care with respect and impart a sense of comfort, and finally strive to resolve any challenges that may arise along the way, were all key factors in creating a caring relationship. As future intensive care nurses, the authors consider that the study provides important insights into the problem area that may be useful in their future profession.