University of Salford

About: University of Salford is a education organization based out in Salford, Manchester, United Kingdom. It is known for research contribution in the topics: Population & Context (language use). The organization has 13049 authors who have published 22957 publications receiving 537330 citations. The organization is also known as: University of Salford Manchester & The University of Salford Manchester.

Emergency intubation for acutely ill and injured patients.

Abstract: Background Emergency intubation has been widely advocated as a life saving procedure in severe acute illness and injury associated with real or potential compromises to the patient's airway and ventilation. However, some initial data have suggested a lack of observed benefit. Objectives To determine in acutely ill and injured patients who have real or anticipated problems in maintaining an adequate airway whether emergency endotracheal intubation, as opposed to other airway management techniques, improves the outcome in terms of survival, degree of disability at discharge or length of stay and complications occurring in hospital. Search methods We searched the Cochrane Injuries Group Specialised Register (December 2006), Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2006, Issue 4), MEDLINE (1950 to November 2006), EMBASE (1980 to week 50, December 2006), National Research Register (Issue 4, 2006), CINAHL (1980 to December 2006), BIDS (to December 2006) and ICNARC (to December 2006). We also examined reference lists of articles for relevant material and contacted experts in the field. Non-English language publications were searched for and examined. Selection criteria All randomised (RCTs) or controlled clinical trials involving the emergency use of endotracheal intubation in the injured or acutely ill patient were examined. Data collection and analysis The full texts of 452 studies were reviewed independently by two authors using a standard form. Where the review authors felt a study may be relevant for inclusion in the final review or disagreed, the authors examined the study and a collective decision was made regarding its inclusion or exclusion from the review. The results were not combined in a meta-analysis due to the heterogeneity of patients, practitioners and alternatives to intubation that were used. Main results We identified three eligible RCTs carried out in urban environments. Two trials involved adults with non-traumatic out-of-hospital cardiac arrest. One of these trials found a non-significant survival disadvantage in patients randomised to receive a physician-operated intubation versus a combi-tube (RR 0.44, 95% CI 0.09 to 1.99). The second trial detected a non-significant survival disadvantage in patients randomised to paramedic intubation versus an oesophageal gastric airway (RR 0.86, 95% CI 0.39 to 1.90). The third included study was a trial of children requiring airway intervention in the prehospital environment. The results indicated no difference in survival (OR 0.82, 95% CI 0.61 to 1.11) or neurologic outcome (OR 0.87, 95% CI 0.62 to 1.22) between paramedic intubation versus bag-valve-mask ventilation and later hospital intubation by emergency physicians; however, only 42% of the children randomised to paramedic endotracheal intubation actually received it. Authors' conclusions The efficacy of emergency intubation as currently practised has not been rigorously studied. The skill level of the operator may be key in determining efficacy. In non-traumatic cardiac arrest, it is unlikely that intubation carries the same life saving benefit as early defibrillation and bystander cardiopulmonary resuscitation (CPR). In trauma and paediatric patients, the current evidence base provides no imperative to extend the practice of prehospital intubation in urban systems. It would be ethical and pertinent to initiate a large, high quality randomised trial comparing the efficacy of competently practised emergency intubation with basic bag-valve-mask manoeuvres (BVM) in urban adult out-of-hospital non-traumatic cardiac arrest.

Enhanced modelling and performance in braided pneumatic muscle actuators

Abstract: Pneumatic technology has been successfully applied for over two millennia. Even today, pneumatic cylinder based technology forms the keystone of many manufacturing processes where there is a need for simple, high-speed, low-cost, reliable motion. But when the system requires accurate control of position, velocity or acceleration profiles, these actuators form a far from satisfactory solution. Braided pneumatic muscle actuators (pMAs) form an interesting development of the pneumatic principle offering even higher power/weight performance, operation in a wide range of environments and accurate control of position, motion and force. This technology provides an interesting and potentially very successful alternative actuation source for robots as well as other applications. However, there are difficulties with this approach due to the following.(i)Modeling errors. Models of the force response are still nonoptimal and for good results these models are highly complex, which makes accurate design difficult.(ii)L...

The effect of nurse-to-patient ratios on nurse-sensitive patient outcomes in acute specialist units: a systematic review and meta-analysis

Abstract: Background:Nurses are pivotal in the provision of high quality care in acute hospitals. However, the optimal dosing of the number of nurses caring for patients remains elusive. In light of this, an...

Psychiatric disorders in preclinical Huntington's disease

Abstract: Background: Psychiatric symptoms are a common feature of Huntington’s disease (HD) and often precede the onset of motor and cognitive impairments However, it remains unclear whether psychiatric changes in the preclinical period result from structural change, are a reaction to being at risk or simply a coincidental occurrence Few studies have investigated the temporal course of psychiatric disorder across the preclinical period Objectives: To compare lifetime and current prevalence of psychiatric disorder in presymptomatic gene carriers and non-carriers and to examine the relationship of psychiatric prevalence in gene carriers to temporal proximity of clinical onset Methods: Lifetime and current psychiatric histories of 204 at risk individuals (89 gene carriers and 115 non-carriers) were obtained using a structured clinical interview, the Composite International Diagnostic Interview Psychiatric disorders were classified using both standardised diagnostic criteria and a more subtle symptom based approach Follow-up of gene carriers (n = 51) enabled analysis of the role of temporal proximity to clinical onset Results: Gene carriers and non-carriers did not differ in terms of the lifetime frequency of clinical psychiatric disorders or subclinical symptoms However, gene carriers reported a significantly higher rate of current depressive symptoms Moreover, the rate of depression increased as a function of proximity to clinical onset Conclusions: Affective disorder is an important feature of the prodromal stages of HD The findings indicate that depression cannot be accounted for by natural concerns of being at risk There is evidence of a window of several years in which preclinical symptoms are apparent