Doctor-based basic cardiopulmonary resuscitation course: an alternative to the conventional approach

United Christian Hospital initiated a doctor-based cardiopulmonary resuscitation (CPR) Program. It is a two-hour, focused, adult CPR course, suitable for adults of different age groups and of different educational levels. The course was rated highly by the participants. Most trainees acquired CPR knowledge and skills, and had confidence to perform CPR. This type of training could improve the rate of bystander CPR for out-of-hospital cardiac arrest patients in this region. Avoiding the complexity and pass-fail psychology that is used in the traditional CPR training curriculum, it can be an alternative to the traditional four-hour instructor-based Basic Life Support (BLS) course.     

Urgotul: alternative to conventional non-adherence dressings

This article describes a novel dressing product that was developed from existing technology: hydrocolloid. The main benefits of Urgotul relate to the fact that it does not adhere to the wound surface, so both wound trauma on removal and the build up of moisture under the dressing are avoided.     

Bayesian statistics in medical research: an intuitive alternative to conventional data analysis

Statistical analysis of both experimental and observational data is central to medical research. Unfortunately, the process of conventional statistical analysis is poorly understood by many medical scientists. This is due, in part, to the counter-intuitive nature of the basic tools of traditional (frequency-based) statistical inference. For example, the proper definition of a conventional 95% confidence interval is quite confusing. It is based upon the imaginary results of a series of hypothetical repetitions of the data generation process and subsequent analysis. Not surprisingly, this formal definition is often ignored and a 95% confidence interval is widely taken to represent a range of values that is associated with a 95% probability of containing the true value of the parameter being estimated. Working within the traditional framework of frequency-based statistics, this interpretation is fundamentally incorrect. It is perfectly valid, however, if one works within the framework of Bayesian statistics and assumes a 'prior distribution' that is uniform on the scale of the main outcome variable. This reflects a limited equivalence between conventional and Bayesian statistics that can be used to facilitate a simple Bayesian interpretation based on the results of a standard analysis. Such inferences provide direct and understandable answers to many important types of question in medical research. For example, they can be used to assist decision making based upon studies with unavoidably low statistical power, where non-significant results are all too often, and wrongly, interpreted as implying 'no effect'. They can also be used to overcome the confusion that can result when statistically significant effects are too small to be clinically relevant. This paper describes the theoretical basis of the Bayesian-based approach and illustrates its application with a practical example that investigates the prevalence of major cardiac defects in a cohort of children born using the assisted reproduction technique known as ICSI (intracytoplasmic sperm injection).     

Stubby prostheses in the rehabilitation of infants and small children with bilateral lower limb deficiencies

Stubby prostheses have been used in the habilitation of very small children with bilateral lower limb deficiencies, particularly bilateral above knee limb deficiencies. While we reported on "The Use of Stubbies For the Child with Bilateral Lower Limb Deficiencies" in 1973, the literature has very little except in relation to the geriatric amputee. We have continued since 1973 to use stubbies in the bilateral above knee limb deficient child, as well as in the child with an above knee/below knee combination, with great success in establishing early balance, followed within several months by the application of articulated prostheses with equal success in establishing independent walking without the use of crutches or walkers.     

Noninvasive imaging of prosthetic cardiac devices

The major advances in cardiovascular care can be linked to the combined growth of advanced imaging modalities and the variety of treatment options available for patients with complex structural, acquired and congenital, valvular, myocardial and aortic diseases. Paralleling this growth are the number and spectrum of complications - such as device failures and infections - that these patients will inevitably encounter. The keys to successful implementation of advanced cardiac therapy are the real-time images, 3D reconstructions, and the hemodynamic and tissue profiles that can be obtained to evaluate these patients and their devices. We will review the roles of echocardiography, multidetector computed tomography and MRI in the evaluation of normal and abnormal cardiac device function.     

Consider alternative technologies to maintain vascular access devices

Investigate alternatives to heparin, such as valved infusion catheters and luer-activated positive fluid displacement valves.     

Carboxymethyl cellulose-based materials as an alternative source for sustainable electrochemical devices: a review

In electrochemistry, bio-based materials are preferred over the traditional costly and synthetic polymers due to their abundance, versatility, sustainability and low cost. One of the bio-based polymers is carboxymethyl cellulose (CMC) which has become an overarching material in electrochemical devices pertaining to its amphiphilic nature with multi-carbon functional groups. Owing to its flexible framework with fascinating groups on its surface like hydroxide (–OH) and carboxylate (–COO⁻), CMC is able to be modified into conducting materials by blending it with other biopolymers, synthetic polymers, salts, acids and others. This blending has improved the profile of CMC by exploiting the ability of hydrogen bonding, swelling, adhesiveness and dispersion of charges and ions. These properties of CMC have made it possible to utilize this bio-sourced polymer in several applications as a conducting electrolyte, binder in electrodes, detector, sensor and active material in fuel cells, actuators and triboelectric nanogenerators (TENG). Thus, CMC based materials are cheap, environment friendly, hydrophilic, biodegradable, non-toxic and biocompatible which render it a desirable material in energy storage devices.

This review describes the applications of CMC and superiority of other bio-based materials over the traditional costly and synthetic polymers in electrochemistry due to their abundance, versatility, sustainability and low cost.     

A is for airway: alternative airway devices

There are many alternative airway devices available on today's market. The type of device that your department uses will depend on your medical control, as well as local protocols and regulations. These devices all require practice, refresher training and on-going skill maintenance. Endotracheal intubation remains the gold standard for airway control; however, proper usage of an alternative airway device can allow patients to be ventilated and oxygenated, even if they cannot be immediately intubated.     

Reflection: an alternative to nursing models

The value of models is currently being challenged by some health-care practitioners. Alternative theoretical underpinnings are required on which to base nursing care. Informal processes which support learning from experience should be formalized to advance nursing practice.     

Effect on gait using various prosthetic ankle-foot devices

Five different commonly prescribed ankle-foot devices for below-knee prostheses were tested for effects on gait: SACH, SAFE, SEATTLE, SINGLE AXIS, and MULTIPLE AXIS. Subjective ratings by the amputees served to resolve which physical variables determined the preferred ankle-foot device. Ratings were related to age, body weight, length of residual limb, and ratio of stride frequency to stride length. Distinctions in performances were derived from analyses of anterior-posterior angular accelerations occurring in the prosthesis immediately following heel strike. The accelerations were characterized as a damped oscillatory waveform. These objective findings, when related to the subjective ratings, showed that the amputees preferred devices which developed the lesser shock and greater damping.