Survey of Moral Distress and Self-Awareness among Health Care Professionals.

Health care professionals experience moral distress due to challenging ethical decision-making during patient care. Self-awareness can be associated with moral distress. This study determined the levels of and relationship between moral distress and self-awareness of health care professionals. A convenience sample of physicians and nurses was recruited. Data were collected using the Moral Distress and Self-Awareness Scales. In total, 168 physicians and 201 nurses participated with a mean age of 30.54 ± 7.87 and clinical experience of 6.40 ± 6.22 years. Moderate levels of moral distress (127.07 ± 71.90) and high levels of self-awareness (70.20 ± 11.37) were found. A weak positive correlation was found between self-awareness and moral distress (r = 0.21, p < 0.001) and weak negative correlation between moral distress (r = - 0.115, p = 0.03) and age. Nurses were more self-aware, but no differences were observed in moral distress based on sex and clinical settings. A weak correlation between self-awareness and moral distress may suggest that self-awareness can increase intrapersonal tensions, contributing to distress. Further research is needed to support any conclusive relationship between moral distress and self-awareness.

Personalized 0D models of normal and stenosed carotid arteries.

BACKGROUND AND OBJECTIVE: Recent advances in medical imaging like MRI, CT-Scan, Doppler ultrasound, etc. have made it possible to study the hemodynamics of cardiovascular system having different levels of vessel abnormalities. METHODS: Within this work, we have developed two different personalized lumped-parameter models of the human carotid arteries having elastic and viscoelastic vessel wall behaviors. The data used in developing the models of the carotid arteries is taken from a healthy subject and a patient having mild carotid stenosis (55%) near a bifurcation using doppler ultrasound. The data consists measurements of blood flow velocities and geometrical parameters at selected locations. Prior to the measurements, the key measurable geometrical parameters are identified by normalized local sensitivity analysis. RESULTS: Finally, both developed and personalized models of carotid arteries are validated against the blood flow measurements obtained near carotid bifurcation. We observe a good agreement between model simulations and blood flow measurements taken near the bifurcation i.e. (r=0.94) for the healthy subject and (r=0.96) for the patient having a stenosis near the bifurcation. CONCLUSIONS: This work provides further evidence, that the hemodynamics near a bifurcation can be modelled well with a 0D approach, even with different levels of stenosis.