Pressure Ulcer prediction using ADT

Objective : To develop a prediction model for pressure ulcer cases that continue to occur at an acute care hospital with a low occurrence rate of pressure ulcers. Methods : Analyzing data were collected from patients hospitalized at Tokushima University Hospital during 2012 using an alternating decision tree (ADT) data mining method. Results : The ADT-based analysis revealed transfer activity, operation time, and low body mass index (BMI) as important factors for predicting pressure ulcer development. Discussion : Among the factors identified, only “transfer activity” can be modified by nursing intervention. While shear force and friction are known to lead to pressure ulcers, transfer activity has not been identified as such. Our results suggest that transfer activities creating shear force and friction correlate with pressure ulcer development. The ADT algorithm was effective in determining prediction factors, especially for highly imbalanced data. Our three stumps ADT yielded accuracy, sensitivity, and specificity values of 72.1%±3.7%, 79.3%±18.1%, and 72.1%±3.8%, respectively. Conclusion : Transfer activity, identified as an interventional factor, can be modified through nursing interventions to prevent pressure ulcer formation. The ADT method was effective in identifying factors within largely imbalanced data

Biomedical Applications of Wrinkling Polymers

Advancements in surface engineering and material fabrication techniques have enabled the creation and replication of naturally occurring surface topographies or the extrapolation of natural patterns to become achievable targets. Polymers are used extensively in the field of biomedical sciences for containment, handling, and as cell culture substrates. It is well established that several polymers exhibit good biocompatibility for cell culture, with properties that include exhibiting minimal to no cytotoxicity and being sufficiently hydrophilic to facilitate cell adhesion. However, when using biologically representative materials, there is always a challenge of achieving tissue representative surface topography and architecture. Wrinkles in human skin represent a considerably common surface topography, resulting from aging and maturity of the tissue. Inspired by this natural topography, the present review article discusses the various techniques for generating wrinkle-like patterns on the polymer surfaces, along with their potential biomedical applications. Wrinkling as material science and as a physical concept has been explored only during the last century. The transfer of the knowledge related to wrinkling from hard engineering materials to soft elastomers has resulted in the development of an active research field, although it remains in its infancy in terms of application in biomedical science and engineering. It is suggested that wrinkling of polymers, particularly elastomers, would have numerous applications, ranging from tissue modeling in drug and therapy design to in vitro organogenesis for therapeutic explants in the field of regenerative medicine

Biomedical Applications of Wrinkling Polymers

Advancements in surface engineering and material fabrication techniques have enabled the creation and replication of naturally occurring surface topographies or the extrapolation of natural patterns to become achievable targets. Polymers are used extensively in the field of biomedical sciences for containment, handling, and as cell culture substrates. It is well established that several polymers exhibit good biocompatibility for cell culture, with properties that include exhibiting minimal to no cytotoxicity and being sufficiently hydrophilic to facilitate cell adhesion. However, when using biologically representative materials, there is always a challenge of achieving tissue representative surface topography and architecture. Wrinkles in human skin represent a considerably common surface topography, resulting from aging and maturity of the tissue. Inspired by this natural topography, the present review article discusses the various techniques for generating wrinkle-like patterns on the polymer surfaces, along with their potential biomedical applications. Wrinkling as material science and as a physical concept has been explored only during the last century. The transfer of the knowledge related to wrinkling from hard engineering materials to soft elastomers has resulted in the development of an active research field, although it remains in its infancy in terms of application in biomedical science and engineering. It is suggested that wrinkling of polymers, particularly elastomers, would have numerous applications, ranging from tissue modeling in drug and therapy design to in vitro organogenesis for therapeutic explants in the field of regenerative medicine

Biotribology of the ageing skin—why we should care

Ageing of populations has emerged as one of the most pressing societal, economic and healthcare challenges currently facing most nations across the globe. The ageing process itself results in degradation of physiological functions and biophysical properties of organs and tissues, and more particularly those of the skin. Moreover, in both developed and emerging economies, population ageing parallels concerning increases in lifestyle-associated conditions such as Type 2 diabetes, obesity and skin cancers. When considered together, these demographic trends call for even greater urgency to find clinical and engineering solutions for the numerous age-related deficits in skin function. From a tribological perspective, detrimental alterations of skin biophysical properties with age have fundamental consequences on how one interacts with the body's inner and outer environments. This stems from the fact that, besides being the largest organ of the human body, and also nearly covering its entirety, the skin is a multifunctional interface which mediates these interactions. The aim of this paper is to present a focused review to discuss some of the consequences of skin ageing from the viewpoint of biotribology, and their implications on health, well-being and human activities. Current and future research questions/challenges associated with biotribology of the ageing skin are outlined. They provide the background and motivation for identifying future lines of research that could be taken up by the biotribology and biophysics communities

DEVELOPMENT OF A WHEELCHAIR CUSHION COVER WITH MICROCLIMATE MANAGEMENT TO PREVENT PRESSURE INJURIES

Pressure injuries are a common medical problem that negatively influences mortality, causes financial burdens, and reduces quality of life for people with spinal cord injuries or other mobility impairments. Wheelchair seat cushion designs are developed to reduce risk factors for pressure injuries. Pressure, shear and friction are the primary causative factors known to increase pressure injury risk. Other factors include heat and moisture. Current preventive approaches related to seat cushions focus on reducing pressure, shear, and friction. The important heat and moisture factors are seemingly overlooked. Options to manage microclimate at the support surface interface are limited. This study aims to develop a wheelchair cushion cover, which provides currently available wheelchair cushions with an advanced feature to improve microclimate management by reducing heat and moisture at the body-seat interface to help prevent pressure injuries. The development of the wheelchair cushion cover with microclimate management included the following steps: generating a design specification, developing three design concepts, fabricating a prototype, evaluating the cover and conducting focus group interviews. The prototype cover was modeled on mattress low air loss features and its function was applied to wheelchair cushions. The cover was intended for use with the existing cushion and cover. Evaluation of the prototype cover was performed and focused on quantifying the microclimate control features. A thermodynamic rigid cushion loading indenter simulated the environmental conditions of a human body on three cushion types for 3-hour tests. Comparing results for the three cushions with and without the prototype cover demonstrated significantly lower relative humidity after 1 hour (p 0.002) was found for the entire test session. Standardized cushion characterization tests showed that the prototype cover provided additional pressure distribution (p < 0.002) compared to the three test cushions without the new cover. This study included focus group interviews to gather feedback regarding the prototype cover. The cover received an overall positive response from participants. All participants agreed with the utility of a microclimate management feature and necessity of the product. They would recommend the cover to wheelchair users

Clinical Practice Guideline for Differentiating Risk Factors for Avoidable and Unavoidable Pressure Ulcers.

Pressure ulcers (PUs) present intrinsic risk factors that are not consistently identified by clinical assessments. The objective of this project was to develop a clinical practice guideline (CPG) to provide nurses with guidance in identifying and differentiating how intrinsic and extrinsic risk factors are associated with populations at risk for developing avoidable and unavoidable PUs. CPG development followed a systematic method to search the literature, organize findings, and assess the strength of the resulting evidence and its applicability to the CPG. Quality of the CPG was assessed by a panel of 8 health care professionals using the Appraisal of Guidelines for Research & Evaluation II instrument. Findings of the assessment indicated a high overall quality of the CPG; its immediate use was recommended and systematic evaluation was suggested to promote usage in a wider array of health care contexts. The quality domains with the highest scores were scope, purpose, applicability, editorial independence (all 100%), rigor of development (99.7%), and clarity of presentation (99.3%). The stakeholder involvement domain demonstrated the lowest--yet still robust--score (94.4%). The CPG can be used to emphasize appropriate and specific nursing competencies for making informed decisions when identifying and describing patients at risk for developing PUs. Further research and evaluation of the use of this CPG will be useful to demonstrate how CPGs can help to decrease the incidence of avoidable PUs. The potential for positive social change relative to the prevention of PUs is high. Decreased incidence of preventable PUs will eliminate unnecessary health care costs and improve overall health outcomes of patients at all levels of socioeconomic status