1,720,957 research outputs found
The management of night-time incontinence: An investigation into the effects of different pad changing routines on skin and sleep
Full text linkAbsorbent pads are the main method of managing urinary incontinence in residential settings for elderly people. Improvements in technology have resulted in highly absorbent products which may be worn all night, but the effects of prolonged pad wearing on aged skin are unknown. Wet skin is known to be more susceptible to dermatitis, friction and abrasion. Nighttime pad changing (and resident turning) have been found to be associated with sleep fragmentation. However it has not been demonstrated that changes in nighttime continence management result in less sleep fragmentation. The following question was posed: What is the effect of different pad changing regimes on the skin health and sleep of elderly women living in residential settings. In addition, earlier findings were explored, which indicated that a substantial proportion of residents, who were turned by staff, also turned themselves METHODS: A cross-over design was used. Following a two week baseline period subjects from residential settings were randomly allocated to one of two pad changing regimes: a frequent pad changing regime (whereby residents were changed at 22.00, 02.00 and 06.00) or a less frequent pad changing regime (with residents changed at 22.00 and 06.00 only). Each regime lasted four weeks and was followed by the alternative regime. Skin measurements were taken twice during each regime from selected skin sites using the following tools (i) the Diastron erythema meter (ii) visual grading scale (iii) the Servomed evaporimeter (to measure trans-epidermal water loss) (iv) a pH meter. The primary outcome variable was measurement of erythema using the Diastron erythema meter. Sleep measurements were made twice during each regime using the Stowood Scientific Instruments Visi-lab which comprises an infra-red camera and video with movement and audio detection. RESULTS: Eighty one subjects from 18 nursing/residential homes for elderly people completed the skin component of the study and twenty-two subjects from 5 homes completed the sleep component. Statistical analysis for erythema meter, trans-epidermal water loss, pH and sleep fragmentation data (mean number of movements per hour) was carried out by fitting general linear models and visual grading data were analysed using the Mainland-Gart method. Video data (of self- turning) were analysed descriptively using a coding sheet. No significant differences were found in the severity of erythema, or skin pH, between regimes. However, measurements of trans-epidermal water loss were significantly higher in the less frequent pad changing regime indicating that skin was 'wetter' (P = 0.01; difference of means 12.14, 95% confidence interval 2.89 - 21.39). Five subjects developed grade 2 pressure ulcers (abrasions) during the less frequent pad changing regime, but none in the frequent pad changing regime; this result was not significant (P = 0.1; 95% confidence interval 0 - 1.09). No significant differences were found in the sleep measurements (mean number of movements per hour) between regimes. During both pad changing regimes staff seldom turned residents. Subjects who turned themselves were more likely to be turned by staff at the time of pad change, but overall redundant turning was not evident. CONCLUSIONS: No evidence was found that a less frequent pad changing regime has an effect on skin erythema, pH or on sleep fragmentation. However, there is evidence that the skin is wetter, which may make it more vulnerable to friction and abrasion. The non-significant finding of greater incidence of grade 2 pressure ulcers is a cause for concern and merits further investigation. MAIN RECOMMENDATIONS FOR PRACTICE: Residents may use one standard good quality night pad (without changing) throughout the night. Residents who have had (or develop) grade 2 pressure ulcers (including 'wet skin abrasions') should have their pads changed during the night to reduce skin wetness
How well does ISO 11948-1 (the Rothwell method) for measuring the absorption capacity of incontinence pads in the laboratory correlate with clinical pad performance
No full textThe ability of ISO 11948-1 (the Rothwell method) to predict the leakage performance of disposable bodyworn pads for heavy urinary incontinence was investigated by measuring correlations between models based on clinical evaluations of 138 diapers and inserts (the two major design categories), and technical models based on their Rothwell absorption capacities and design features. Correlations were poorer than in the original 1993 study for the standard (r?0.87 compared with r?0.95), but still strong enough to help with purchasing choices.For a given Rothwell capacity, the leakage performance of diapers was far superior to inserts; for example, diapers containing 450 and 300 g of urine performed, as well as inserts containing 300 and 100 g, respectively. No evidence was found for any other design feature having a significant impact on leakage performance. The coefficient of variation for Rothwell capacity (a measure of product consistency) had significant impact on the leakage performance of diapers, but not inserts. The probability of diapers with the poorest consistency leaking exceeded that for the best by about 10 percentage points. Similarly, diapers were about 10 percentage points more likely to leak when used at night than during the day. Differences between day-time and night-time use of inserts were not studied.<br/
Barriers and facilitators to screening for malnutrition by community nurses: a qualitative study
No full textBackgroundA substantial proportion of individuals who live in community settings in the UK experience malnutrition. Routine screening for malnutrition by healthcare practitioners has been recommended in many regions. The present study aimed to understand community nurses' perceptions of barriers and facilitators to undertaking nutritional screening.MethodsA qualitative study was undertaken with a purposive sample of community nurses working in one UK healthcare organisation. Semi-structured interviews were used to elicit perceptions of barriers and facilitators. Interviews were digitally recorded, anonymised and transcribed. Initial codes were assigned for salient constructs identified in the transcripts, refined by grouping, and a thematic list was developed.ResultsTwenty district nurses and community matrons were interviewed at which time saturation of the data was achieved. Six themes emerged: supportive organisational culture, time and resource to screen and intervene, ease and acceptability of the screening tool, professional judgement as good as screening, the need for training and sharing good practice, and enhancing communication between care settings.ConclusionsThe findings of the present study suggest that screening is more likely to be completed where an organisation is perceived to have a clear expectation that it is undertaken and also demonstrates this through training and availability of resources. The need for a process or tool that nurses find easy to use and relevant to their practice area was highlighted. Further research should examine the effect of the use of a nutritional screening tool by community nurses on nutritional care planning and intervention
A computerised real-time measurement system to locate the position of the urine stream in designing urine collection devices for women
No full textClinicians often use intuitive models based on clinical experience or regression models based on population studies to plan treatment of gait-related disorders. Because such models are constructed using data collected from previous patients, the predicted clinical outcome for a particular patient may not be reliable. We propose a new approach that uses computational models based on engineering mechanics to predict post-treatment outcome from pre-treatment movement data. The approach utilizes a four-phase optimization process built around a dynamic, patient-specific gait model. The first three phases calibrate the model's joint, inertial, and control parameters, respectively, where the control parameters are weights in an optimization cost function that tracks the patient's pre-treatment gait motion and loads. The last phase predicts the patient's post-treatment gait pattern by performing a tracking optimization with the calibrated model modified to simulate the selected treatment.We demonstrate the approach by simulating how two treatments for knee osteoarthritis (OA) – gait modification and high tibial osteotomy (HTO) surgery – alter the external knee adduction torque for a specific patient. By performing multiple tracking optimizations, we calibrated the model's parameter values to reproduce the patient's knee adduction torque curve for a toe out gait motion. When we performed a tracking optimization with the calibrated model using a modified footpath to simulate an increased stance width, the predicted reduction in both adduction torque peaks matched experimental results to within 4.8% error. When we performed a tracking optimization with the same model using modified leg geometry to simulate HTO surgery, the predicted reductions were consistent with published data. The approach requires further evaluation with a larger number of patients to determine its effectiveness for planning the treatment of gait-related disorders on a patient-specific basis.<br/
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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