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1.
ACS Appl Mater Interfaces ; 14(47): 52715-52728, 2022 Nov 30.
Article in English | MEDLINE | ID: mdl-36394288

ABSTRACT

Silicon-containing Li-ion batteries have been the focus of many energy storage research efforts because of the promise of high energy density. Depending on the system, silicon generally demonstrates stable performance in half-cells, which is often attributed to the unlimited lithium supply from the lithium (Li) metal counter electrode. Here, the electrochemical performance of silicon with a high voltage NMC622 cathode was investigated in superconcentrated phosphonium-based ionic liquid (IL) electrolytes. As a matter of fact, there is very limited work and understanding of the full cell cycling of silicon in such a new class of electrolytes. The electrochemical behavior of silicon in the various IL electrolytes shows a gradual and steeper capacity decay, compared to what we previously reported in half-cells. This behavior is linked to a different evolution of the silicon morphology upon cycling, and the characterization of cycled electrodes points toward mechanical reasons, complete disconnection of part of the electrode, or internal mechanical stress, due to silicon and Li metal volume variation upon cycling, to explain the progressive capacity fading in full cell configuration. An extremely stable solid electrolyte interphase (SEI) in the full Li-ion cells can be seen from a combination of qualitative and quantitative information from transmission electron microscopy, X-ray photoelectron spectroscopy, electrochemical impedance spectroscopy, and magic angle spinning nuclear magnetic resonance. Our findings provide a new perspective to full cell interpretation regarding capacity fading, which is oftentimes linked almost exclusively to the loss of Li inventory but also more broadly, and provide new insights into the impact of the evolution of silicon morphology on the electrochemical behavior.

2.
J Geophys Res Space Phys ; 127(8): e2022JA030429, 2022 Aug.
Article in English | MEDLINE | ID: mdl-36247325

ABSTRACT

This study provides first storm time observations of the westward-propagating medium-scale traveling ionospheric disturbances (MSTIDs), particularly, associated with characteristic subauroral storm time features, storm-enhanced density (SED), subauroral polarization stream (SAPS), and enhanced thermospheric westward winds over the continental US. In the four recent (2017-2019) geomagnetic storm cases examined in this study (i.e., 2018-08-25/26, 2017-09-07/08, 2017-05-27/28, and 2016-02-02/03 with minimum SYM-H index -206, -146, -142, and -58 nT, respectively), MSTIDs were observed from dusk-to-midnight local times predominately during the intervals of interplanetary magnetic field (IMF) Bz stably southward. Multiple wavefronts of the TIDs were elongated NW-SE, 2°-3° longitude apart, and southwestward propagated at a range of zonal phase speeds between 100 and 300 m/s. These TIDs initiated in the northeastern US and intensified or developed in the central US with either the coincident SED structure (especially the SED basis region) or concurrent small electron density patches adjacent to the SED. Observations also indicate coincident intense storm time electric fields associated with the magnetosphere-ionosphere-thermosphere coupling electrodynamics at subauroral latitudes (such as SAPS) as well as enhanced thermospheric westward winds. We speculate that these electric fields trigger plasma instability (with large growth rates) and MSTIDs. These electrified MSTIDs propagated westward along with the background westward ion flow which resulted from the disturbance westward wind dynamo and/or SAPS.

3.
Front Oncol ; 12: 885472, 2022.
Article in English | MEDLINE | ID: mdl-35600355

ABSTRACT

Background: Up to 60% of melanoma patients develop melanoma brain metastases (MBM), which traditionally have a poor diagnosis. Current treatment strategies include immunotherapies (IO), targeted therapies (TT), and stereotactic radiosurgery (SRS), but there is considerable heterogeneity across worldwide consensus guidelines. Objective: To summarize current treatments and compare worldwide guidelines for the treatment of MBM. Methods: Review of global consensus treatment guidelines for MBM patients. Results: Substantial evidence supported that concurrent IO or TT plus SRS improves progression-free survival (PFS) and overall survival (OS). Guidelines are inconsistent with regards to recommendations for surgical resection of MBM, since surgical resection of symptomatic lesions alleviates neurological symptoms but does not improve OS. Whole-brain radiation therapy is not recommended by all guidelines due to negative effects on neurocognition but can be offered in rare palliative scenarios. Conclusion: Worldwide consensus guidelines consistently recommend up-front combination IO or TT with or without SRS for the treatment of MBM.

4.
ACS Appl Mater Interfaces ; 14(11): 13196-13205, 2022 Mar 23.
Article in English | MEDLINE | ID: mdl-35274926

ABSTRACT

Employing high-voltage Ni-rich cathodes in Li metal batteries (LMBs) requires stabilization of the electrode/electrolyte interfaces at both electrodes. A stable solid-electrolyte interphase (SEI) and suppression of active material pulverization remain the greatest challenges to achieving efficient long-term cycling. Herein, studies of NMC622 (1 mAh cm-2) cathodes were performed using highly concentrated N-methyl-N-propylpyrrolidinium bis(fluorosulfonyl)imide (C3mpyrFSI) 50 mol % lithium bis(fluorosulfonyl)imide (LiFSI) ionic liquid electrolyte (ILE). The resulting SEI formed at the cathode enabled promising cycling performance (98.13% capacity retention after 100 cycles), and a low degree of ion mixing and lattice expansion was observed, even at an elevated temperature of 50 °C. Fitting of acquired impedance spectra indicated that the SEI resistivity (RSEI) had a low and stable contribution to the internal resistivity of the system, whereas active material pulverization and secondary grain isolation significantly increased the charge transfer resistance (RCT) throughout cycling.

5.
Chem Commun (Camb) ; 58(12): 1946-1949, 2022 Feb 08.
Article in English | MEDLINE | ID: mdl-35043800

ABSTRACT

Three-dimensional lithium (Li) hosts have been shown to suppress the growth of Li dendrites for next generation Li metal batteries. Here, we report a cost-effective and scalable approach to produce highly stable Li composite anodes from industrial hemp textile waste. The hemp@Li composite anodes demonstrate stable cycling both in half and full cells.

6.
J Public Health (Oxf) ; 44(1): 51-59, 2022 03 07.
Article in English | MEDLINE | ID: mdl-34343313

ABSTRACT

BACKGROUND: There is a dearth of literature on how different domains of sitting time relate to other health behaviours. Therefore, this study aimed to explore these associations in a sample of office workers. METHODS: 7170 Northern Irish Civil Servants completed an online survey which included information on workday and non-workday sitting time in five domains (travel, work, TV, computer-use, leisure-time), physical activity, fruit and vegetable intake, alcohol consumption and cigarette smoking. An unhealthy behaviour score was calculated by summing the number of health behaviours which did not meet the current guidelines. Multinomial regressions examined associations between unhealthy behaviour score and each domain of sitting time. RESULTS: ≥7 hours sitting at work and ≥2 hours TV viewing on a workday both more than doubled the odds of partaking in ≥3 unhealthy behaviours [Odds ratio, OR = 2.03, 95% CI, (1.59-2.61); OR = 2.19 (1.71-2.80)] and ≥3 hours of TV viewing on a non-workday nearly tripled the odds [OR = 2.96 (2.32-3.77)]. CONCLUSIONS: High sitting time at work and TV viewing on a workday and non-workday are associated with increased odds of partaking in multiple unhealthy behaviours. Interventions need to focus on these domains and public health policy should consider sitting time as an important health behaviour.


Subject(s)
Leisure Activities , Sedentary Behavior , Cross-Sectional Studies , Health Behavior , Humans , Life Style
7.
ACS Appl Mater Interfaces ; 13(24): 28281-28294, 2021 Jun 23.
Article in English | MEDLINE | ID: mdl-34114808

ABSTRACT

The latest advances in the stabilization of Li/Na metal battery and Li-ion battery cycling have highlighted the importance of electrode/electrolyte interface [solid electrolyte interphase (SEI)] and its direct link to cycling behavior. To understand the structure and properties of the SEI, we used combined experimental and computational studies to unveil how the ionic liquid (IL) cation nature and salt concentration impact the silicon/IL electrolyte interfacial structure and the formed SEI. The nature of the IL cation is found to be important to control the electrolyte reductive decomposition that influences the SEI composition and properties and the reversibility of the Li-Si alloying process. Also, increasing the Li salt concentration changes the interface structure for a favorable and less resistive SEI. The most promising interface for the Si-based battery was found to be in P1222FSI with 3.2 m LiFSI, which leads to an optimal SEI after 100 cycles in which LiF and trapped LiFSI are the only distinguishable lithiated and fluorinated products detected. This study shows a clear link between the nanostructure of the IL electrolyte near the electrode surface, the resulting SEI, and the Si negative electrode cycling performance. More importantly, this work will aid the rational design of Si-based Li-ion batteries using IL electrolytes in an area that has so far been neglected, reinforcing the benefits of superconcentrated electrolyte systems.

8.
Nat Mater ; 20(9): 1255-1263, 2021 Sep.
Article in English | MEDLINE | ID: mdl-33941912

ABSTRACT

A critical challenge for next-generation lithium-based batteries lies in development of electrolytes that enable thermal safety along with the use of high-energy-density electrodes. We describe molecular ionic composite electrolytes based on an aligned liquid crystalline polymer combined with ionic liquids and concentrated Li salt. This high strength (200 MPa) and non-flammable solid electrolyte possesses outstanding Li+ conductivity (1 mS cm-1 at 25 °C) and electrochemical stability (5.6 V versus Li|Li+) while suppressing dendrite growth and exhibiting low interfacial resistance (32 Ω cm2) and overpotentials (≤120 mV at 1 mA cm-2) during Li symmetric cell cycling. A heterogeneous salt doping process modifies a locally ordered polymer-ion assembly to incorporate an inter-grain network filled with defective LiFSI and LiBF4 nanocrystals, strongly enhancing Li+ conduction. This modular material fabrication platform shows promise for safe and high-energy-density energy storage and conversion applications, incorporating the fast transport of ceramic-like conductors with the superior flexibility of polymer electrolytes.

9.
Epilepsy Behav ; 121(Pt B): 106556, 2021 08.
Article in English | MEDLINE | ID: mdl-31676240

ABSTRACT

Epilepsy diagnosis can be costly, time-consuming, and not uncommonly inaccurate. The reference standard diagnostic monitoring is continuous video-electroencephalography (EEG) monitoring, ideally capturing all events or concordant interictal discharges. Automating EEG data review would save time and resources, thus enabling more people to receive reference standard monitoring and also potentially heralding a more quantitative approach to therapeutic outcomes. There is substantial research into the automated detection of seizures and epileptic activity from EEG. However, automated detection software is not widely used in the clinic, and despite numerous published algorithms, few methods have regulatory approval for detecting epileptic activity from EEG. This study reports on a deep learning algorithm for computer-assisted EEG review. Deep convolutional neural networks were trained to detect epileptic discharges using a preexisting dataset of over 6000 labelled events in a cohort of 103 patients with idiopathic generalized epilepsy (IGE). Patients underwent 24-hour ambulatory outpatient EEG, and all data were curated and confirmed independently by two epilepsy specialists (Seneviratne et al., 2016). The resulting automated detection algorithm was then used to review diagnostic scalp EEG for seven patients (four with IGE and three with events mimicking seizures) to validate performance in a clinical setting. The automated detection algorithm showed state-of-the-art performance for detecting epileptic activity from clinical EEG, with mean sensitivity of >95% and corresponding mean false positive rate of 1 detection per minute. Importantly, diagnostic case studies showed that the automated detection algorithm reduced human review time by 80%-99%, without compromising event detection or diagnostic accuracy. The presented results demonstrate that computer-assisted review can increase the speed and accuracy of EEG assessment and has the potential to greatly improve therapeutic outcomes. This article is part of the Special Issue "NEWroscience 2018".


Subject(s)
Epilepsy, Generalized , Epilepsy , Algorithms , Computers , Electroencephalography , Epilepsy, Generalized/diagnosis , Humans , Signal Processing, Computer-Assisted
10.
ACS Appl Mater Interfaces ; 12(35): 39195-39204, 2020 Sep 02.
Article in English | MEDLINE | ID: mdl-32805831

ABSTRACT

Silicon has been considered a good candidate for replacing the commonly used carbon anodes for lithium-ion batteries (LIBs) due to its high specific capacity, which can be up to 11 times higher than that of carbon. However, the desirable advantage that silicon brings to battery performance is currently overshadowed by its stress-induced performance loss and high electronic resistivity. The induced stress arises from two sources, namely, the deposition process (i.e., residual stress) during fabrication and the volume expansion (i.e., mechanical stress) associated with the lithiation/delithiation process. Of the two, residual stress has largely been ignored, underestimated, or considered to have a negligible effect without any rigorous evidence being put forward. In this contribution, we produced silicon thin films having a wide range of residual stress and resistivity using a physical vapor deposition technique, magnetron sputtering. Three pairs of silicon thin-film anodes were utilized to study the effect of residual stress on the electrochemical and cyclability performance as anodes for LIBs. Each set consisted of a pair of films having essentially the same resistivity, density, thickness, and oxidation amount but distinctly different residual stresses. The comparison was evaluated by conducting charge/discharge cycling and cyclic voltammetry (CV) experiments. In contrast to the fixed belief within the literature, higher compressive residual-stress films showed better electrochemical and cycle performance compared to lower residual-stress films. The results, herein, present an informed understanding of the role that residual stress plays, which will help researchers improve the development of silicon-based thin-film anodes.

11.
ACS Omega ; 5(6): 2931-2938, 2020 Feb 18.
Article in English | MEDLINE | ID: mdl-32095715

ABSTRACT

A material design approach was taken for the preparation of an organic ionic plastic crystal (OIPC)-polymer electrolyte material that exhibited both good mechanical and transport properties. Previous attempts to form this type of electrolyte material resulted in the solvation of the OIPC by the ionomer and loss of the plastic crystal component. Here, we prepared, in situ, a macrophase-separated OIPC-polymer electrolyte system by adding lithium bis(fluorosulfonyl)imide (LiFSI) to a (PAMPS-N1222) ionomer. It was found that an optimal compositional window of 40-50 mol % LiFSI exists whereby the electrolyte conductivity suddenly increased 4 orders of magnitude while exhibiting elastic and flexible mechanical properties. The phase behavior and transport properties were studied using differential scanning calorimetry and 7Li and 19F solid-state nuclear magnetic resonance spectroscopy. This is the first example of a fabrication principle that lends itself to a wide range of promising OIPC and ionomeric materials. Subsequent studies are required to characterize and understand the morphology and conductive nature of these systems and their application as electrolyte materials.

12.
Adv Mater ; 32(18): e1905219, 2020 May.
Article in English | MEDLINE | ID: mdl-31961989

ABSTRACT

With increasing demands for safe, high capacity energy storage to support personal electronics, newer devices such as unmanned aerial vehicles, as well as the commercialization of electric vehicles, current energy storage technologies are facing increased challenges. Although alternative batteries have been intensively investigated, lithium (Li) batteries are still recognized as the preferred energy storage solution for the consumer electronics markets and next generation automobiles. However, the commercialized Li batteries still have disadvantages, such as low capacities, potential safety issues, and unfavorable cycling life. Therefore, the design and development of electromaterials toward high-energy-density, long-life-span Li batteries with improved safety is a focus for researchers in the field of energy materials. Herein, recent advances in the development of novel organic electrolytes are summarized toward solid-state Li batteries with higher energy density and improved safety. On the basis of new insights into ionic conduction and design principles of organic-based solid-state electrolytes, specific strategies toward developing these electrolytes for Li metal anodes, high-energy-density cathode materials (e.g., high voltage materials), as well as the optimization of cathode formulations are outlined. Finally, prospects for next generation solid-state electrolytes are also proposed.

13.
J Chem Phys ; 148(19): 193813, 2018 May 21.
Article in English | MEDLINE | ID: mdl-30307212

ABSTRACT

Ionic liquid electrolytes with high alkali salt concentrations have displayed some excellent electrochemical properties, thus opening up the field for further improvements to liquid electrolytes for lithium or sodium batteries. Fundamental computational investigations into these high concentration systems are required in order to gain a better understanding of these systems, yet they remain lacking. Small phosphonium-based ionic liquids with high concentrations of alkali metal ions have recently shown many promising results in experimental studies, thereby prompting us to conduct further theoretical exploration of these materials. Here, we conducted a molecular dynamics simulation on four small phosphonium-based ionic liquids with 50 mol. % LiFSI salt, focusing on the effect of cation structure on local structuring and ion diffusional and rotational dynamics-which are closely related to the electrochemical properties of these materials.

14.
J Neural Eng ; 15(5): 055001, 2018 10.
Article in English | MEDLINE | ID: mdl-29889051

ABSTRACT

Responses of retinal ganglion cells to direct electrical stimulation have been shown experimentally to be well described by linear-nonlinear models. These models rely on the simplifying assumption that retinal ganglion cell responses to stimulation with an array of electrodes are driven by a simple linear weighted sum of stimulus current amplitudes from each electrode, known as the 'electrical receptive field'. OBJECTIVE: This paper aims to demonstrate the biophysical basis of the linear-nonlinear model and the electrical receptive field to facilitate the development of improved stimulation strategies for retinal implants. APPROACH: We compare the linear-nonlinear model of subretinal electrical stimulation with a multi-layered, biophysical, volume conductor model of retinal stimulation. MAIN RESULTS: Our results show that the linear electrical receptive field of the linear-nonlinear model matches the transmembrane currents induced by electrodes (the activating function) at the site of the high-density sodium channel band with only minor discrepancies. The discrepancies are mostly eliminated by including axial current flow originating from adjacent cell compartments. Furthermore, for cells where a single linear electrical receptive field is insufficient, we show that cell responses are likely driven by multiple sites of action potential initiation with multiple distinct receptive fields, each of which can be accurately described by the activating function. SIGNIFICANCE: This result establishes that the biophysical basis of the electrical receptive field of the linear-nonlinear model is the superposition of transmembrane currents induced by different electrodes at and near the site of action potential initiation. Together with existing experimental support for linear-nonlinear models of electrical stimulation, this provides a firm basis for using this much simplified model to generate more optimal stimulation patterns for retinal implants.


Subject(s)
Biophysics , Retinal Ganglion Cells/physiology , Action Potentials/physiology , Algorithms , Electric Stimulation , Electrodes , Equipment Design , Humans , Linear Models , Nonlinear Dynamics , Prostheses and Implants , Retinal Ganglion Cells/ultrastructure , Sodium Channels
15.
Chem Commun (Camb) ; 54(42): 5338-5341, 2018 May 22.
Article in English | MEDLINE | ID: mdl-29737981

ABSTRACT

We report a thermally stable high-performance lithium battery using an electrochemically synthesized three-dimensional porous molybdenum disulfide/graphene composite electrode and a phosphonium-based ionic liquid (IL) electrolyte. Benefiting from the structural merits of the chosen electrode and the thermal stability of the electrolyte, the cell coupled with a Li foil exhibits excellent rate performance and cycling capability at room temperature; and that is retained with an even better rate capability at an elevated temperature of 50 °C. This work may provide a new avenue for the development of safe and high performance lithium-ion batteries at high temperature.

16.
PLoS One ; 13(3): e0193598, 2018.
Article in English | MEDLINE | ID: mdl-29494655

ABSTRACT

Currently, a challenge in electrical stimulation of the retina with a visual prosthesis (bionic eye) is to excite only the cells lying directly under the electrode in the ganglion cell layer, while avoiding excitation of axon bundles that pass over the surface of the retina in the nerve fiber layer. Stimulation of overlying axons results in irregular visual percepts, limiting perceptual efficacy. This research explores how differences in fiber orientation between the nerve fiber layer and ganglion cell layer leads to differences in the electrical activation of the axon initial segment and axons of passage. APPROACH: Axons of passage of retinal ganglion cells in the nerve fiber layer are characterized by a narrow distribution of fiber orientations, causing highly anisotropic spread of applied current. In contrast, proximal axons in the ganglion cell layer have a wider distribution of orientations. A four-layer computational model of epiretinal extracellular stimulation that captures the effect of neurite orientation in anisotropic tissue has been developed using a volume conductor model known as the cellular composite model. Simulations are conducted to investigate the interaction of neural tissue orientation, stimulating electrode configuration, and stimulation pulse duration and amplitude. MAIN RESULTS: Our model shows that simultaneous stimulation with multiple electrodes aligned with the nerve fiber layer can be used to achieve selective activation of axon initial segments rather than passing fibers. This result can be achieved while reducing required stimulus charge density and with only modest increases in the spread of activation in the ganglion cell layer, and is shown to extend to the general case of arbitrary electrode array positioning and arbitrary target volume. SIGNIFICANCE: These results elucidate a strategy for more targeted stimulation of retinal ganglion cells with experimentally-relevant multi-electrode geometries and achievable stimulation requirements.


Subject(s)
Axons/physiology , Computational Biology/methods , Retinal Ganglion Cells/physiology , Animals , Anisotropy , Electric Stimulation , Humans , Mammals , Models, Neurological , Visual Prosthesis
17.
Neurosurgery ; 80(4): 515-524, 2017 04 01.
Article in English | MEDLINE | ID: mdl-27322807

ABSTRACT

BACKGROUND: Subcortical injury resulting from conventional surgical management of intracranial hemorrhage may counteract the potential benefits of hematoma evacuation. OBJECTIVE: To evaluate the safety and potential benefits of a novel, minimally invasive approach for clot evacuation in a multicenter study. METHODS: The integrated approach incorporates 5 competencies: (1) image interpretation and trajectory planning, (2) dynamic navigation, (3) atraumatic access system (BrainPath, NICO Corp, Indianapolis, Indiana), (4) extracorporeal optics, and (5) automated atraumatic resection. Twelve neurosurgeons from 11 centers were trained to use this approach through a continuing medical education-accredited course. Demographical, clinical, and radiological data of patients treated over 2 years were analyzed retrospectively. RESULTS: Thirty-nine consecutive patients were identified. The median Glasgow Coma Scale (GCS) score at presentation was 10 (range, 5-15). The thalamus/basal ganglion regions were involved in 46% of the cases. The median hematoma volume and depth were 36 mL (interquartile range [IQR], 27-65 mL) and 1.4 cm (IQR, 0.3-2.9 cm), respectively. The median time from ictus to surgery was 24.5 hours (IQR, 16-66 hours). The degree of hematoma evacuation was ≥90%, 75% to 89%, and 50% to 74% in 72%, 23%, and 5.0% of the patients, respectively. The median GCS score at discharge was 14 (range, 8-15). The improvement in GCS score was statistically significant ( P < .001). Modified Rankin Scale data were available for 35 patients. Fifty-two percent of those patients had a modified Rankin Scale score of ≤2. There were no mortalities. CONCLUSION: The approach was safely performed in all patients with a relatively high rate of clot evacuation and functional independence.


Subject(s)
Cerebral Hemorrhage/surgery , Hematoma/surgery , Neurosurgical Procedures/methods , Surgery, Computer-Assisted/methods , Adolescent , Adult , Aged , Aged, 80 and over , Female , Glasgow Coma Scale , Humans , Male , Middle Aged , Neurosurgical Procedures/adverse effects , Retrospective Studies , Surgery, Computer-Assisted/adverse effects , Treatment Outcome , Young Adult
18.
PLoS One ; 11(12): e0167270, 2016.
Article in English | MEDLINE | ID: mdl-28005984

ABSTRACT

BACKGROUND: Healthcare provider training in Emergency Obstetric and Newborn Care (EmOC&NC) is a component of 65% of intervention programs aimed at reducing maternal and newborn mortality and morbidity. It is important to evaluate the effectiveness of this. METHODS: We evaluated knowledge and skills among 5,939 healthcare providers before and after 3-5 days 'skills and drills' training in emergency obstetric and newborn care (EmOC&NC) conducted in 7 sub-Saharan Africa countries (Ghana, Kenya, Malawi, Nigeria, Sierra Leone, Tanzania, Zimbabwe) and 2 Asian countries (Bangladesh, Pakistan). Standardised assessments using multiple choice questions and objective structured clinical examination (OSCE) were used to measure change in knowledge and skills and the Improvement Ratio (IR) by cadre and by country. Linear regression was performed to identify variables associated with pre-training score and IR. RESULTS: 99.7% of healthcare providers improved their overall score with a median (IQR) increase of 10.0% (5.0% - 15.0%) for knowledge and 28.8% (23.1% - 35.1%) for skill. There were significant improvements in knowledge and skills for each cadre of healthcare provider and for each country (p<0.05). The mean IR was 56% for doctors, 50% for mid-level staff and nurse-midwives and 38% for nursing-aides. A teaching job, previous in-service training, and higher percentage of work-time spent providing maternity care were each associated with a higher pre-training score. Those with more than 11 years of experience in obstetrics had the lowest scores prior to training, with mean IRs 1.4% lower than for those with no more than 2 years of experience. The largest IR was for recognition and management of obstetric haemorrhage (49-70%) and the smallest for recognition and management of obstructed labour and use of the partograph (6-15%). CONCLUSIONS: Short in-service EmOC&NC training was associated with improved knowledge and skills for all cadres of healthcare providers working in maternity wards in both sub-Saharan Africa and Asia. Additional support and training is needed for use of the partograph as a tool to monitor progress in labour. Further research is needed to assess if this is translated into improved service delivery.


Subject(s)
Delivery, Obstetric/education , Emergency Treatment/nursing , Health Knowledge, Attitudes, Practice , Health Personnel/education , Infant Care , Africa South of the Sahara , Asia , Humans , Infant, Newborn , Linear Models , Program Evaluation
19.
Am J Crit Care ; 25(3): 213-9, 2016 05.
Article in English | MEDLINE | ID: mdl-27134226

ABSTRACT

BACKGROUND: Early detection of pupillary changes in patients with head injuries can alert the care team to increasing intracranial pressure. Previous research has shown inconsistencies in pupil measurement that are most likely due to the subjective nature of measuring pupils without the assistance of technology. OBJECTIVES: To evaluate nurses' abilities to assess pupil diameter accurately and detect unequal pupils. METHODS: In a 3-part study, the accuracy of critical care and neurosurgical nurses' assessments of pupils was determined. The study included assessment of drawings of eyes with an iris and pupil, examination of photographs of human eyes, and bedside examination of patients with a head injury. RESULTS: Subjective assessments of pupil diameter and symmetry were not accurate. Across all phases of the study, pupil diameters were underestimated and the rate of error increased as pupil size increased. Nurses also failed to detect anisocoria and misidentified pupil reactivity. In addition, nearly all nurses relied on subjective estimation, even when tools were available. CONCLUSIONS: Critical care and neurosurgical nurses underestimated pupil size, were unable to detect anisocoria, and incorrectly assessed pupil reactivity. Standardized use of pupil assessment tools such as a pupillometer is necessary to increase accuracy and consistency in pupil measurement and to potentially contribute to earlier detection of subtle changes in pupils. If pupillary changes are identified early, diagnostic and treatment intervention can be delivered in a more timely and effective manner.


Subject(s)
Clinical Competence/statistics & numerical data , Craniocerebral Trauma/nursing , Critical Care Nursing/methods , Nursing Staff, Hospital/statistics & numerical data , Pupil/physiology , Vital Signs/physiology , Female , Humans , Male , Middle Aged , Reproducibility of Results
20.
J Public Health (Oxf) ; 38(1): 53-60, 2016 Mar.
Article in English | MEDLINE | ID: mdl-25573532

ABSTRACT

BACKGROUND: Given links between sedentary behaviour and unfavourable health outcomes, there is a need to understand the influence of socio-demographic factors on sedentary behaviour to inform effective interventions. This study examined domain-specific sitting times reported across socio-demographic groups of office workers. METHODS: The analyses are cross-sectional and based on a survey conducted within the Stormont Study, which is tracking employees in the Northern Ireland Civil Service. Participants self-reported their daily sitting times across multiple domains (work, TV, travel, PC use and leisure) on workdays and non-workdays, along with their physical activity and socio-demographic variables (sex, age, marital status, BMI, educational attainment and work pattern). Total and domain-specific sitting on workdays and non-workdays were compared across socio-demographic groups using multivariate analyses of covariance. RESULTS: Completed responses were obtained from 4436 participants. For the whole sample, total daily sitting times were higher on workdays in comparison to non-workdays (625 ± 168 versus 469 ± 210 min/day, P < 0.001). On workdays and non-workdays, higher sitting times were reported by individuals aged 18-29 years, obese individuals, full-time workers and single/divorced/widowed individuals (P < 0.001). CONCLUSIONS: Interventions are needed to combat the high levels of sedentary behaviour observed in office workers, particularly among the highlighted demographic groups. Interventions should target workplace and leisure-time sitting.


Subject(s)
Sedentary Behavior , Adolescent , Adult , Aged , Cross-Sectional Studies , Exercise , Female , Humans , Leisure Activities , Male , Middle Aged , Northern Ireland , Surveys and Questionnaires , Workplace/statistics & numerical data , Young Adult
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