ABSTRACT
Nonlinear saturation of a beta-induced Alfvén eigenmode, driven by slowing down energetic particles via transit resonance, is investigated by the nonlinear hybrid magnetohyrodynamic gyrokinetic code. Saturation is characterized by frequency chirping and symmetry breaking between co- and counter-passing particles, which can be understood as the evidence of resonance detuning. The scaling of the saturation amplitude with the growth rate is also demonstrated to be consistent with radial resonance detuning due to the radial nonuniformity and mode structure.
ABSTRACT
This paper reports on the development and testing of a tool designed to assess chronic wounds for the clinical signs and symptoms of localized infection. Thirty-one wounds were assessed by two independent nurse observers for the signs and symptoms of infection using the Clinical Signs and Symptoms Checklist. The Clinical Signs and Symptoms Checklist delineates 12 signs and symptoms of infection (i.e., pain, erythema, edema, heat, purulent exudate, serous exudate with concurrent inflammation, delayed healing, discoloration of granulation tissue, friable granulation tissue, pocketing at the base of the wound, foul odor, and wound breakdown) and their definitions. The reliability of each sign or symptom on the checklist was calculated using percent agreement and the Kappa statistic. Percent agreement ranged from 65% to 100%, and Kappa statistics ranged from 0.53 to 1.00, excluding pocketing of the wound base. The reliability estimates obtained for signs and symptoms on the Clinical Signs and Symptoms Checklist compare favorably with other data regarding interclinician agreement on wound assessment. Incorporating a structured approach to assess and monitor for wound infection, such as the Clinical Signs and Symptoms Checklist, may improve clinician skill and accuracy in identifying this condition.
Subject(s)
Nursing Assessment/methods , Wound Infection/diagnosis , Aged , Chronic Disease , Female , Humans , Male , Pressure Ulcer/diagnosis , Pressure Ulcer/nursing , Reproducibility of Results , Wound Infection/nursingABSTRACT
Anaemia is common in renal insufficiency and has various causes: 1) depressed marrow production of red cells, probably due to reduced production of erythropoietin, though the possibility of direct marrow inhibition on the part of uraemic toxins cannot be ruled out, together with iron deficiency, as occurs in prolonged dialysis management; 2) greater red cell destruction attributable to extraglobular factors and other mechanisms (microangiopathy, drugs, etc.); 3) greater blood loss following thrombocytopenia, reduced platelet adhesivity and agglutinability, dialysis. The main premisses on which the treatment of anaemia of uraemic patients is based are discussed.
