Do pressure ulcer risk assessment scales improve clinical practice?

Standardized assessment instruments are deemed important for estimating pressure ulcer risk. Today, more than 40 so-called pressure ulcer risk assessment scales are available but still there is an ongoing debate about their usefulness. From a measurement point of view pressure ulcer (PU) risk assessment scales have serious limitations. Empirical evidence supporting the validity of PU risk assessment scale scores is weak and obtained scores contain varying amounts of measurement error. The concept of pressure ulcer risk is strongly related to the general health status and severity of illness. A clinical impact due do the application of these scales could also not be demonstrated. It is questionable whether completion of standardized pressure ulcer risk scales in clinical practice is really needed

Parallel implementation of the non-smooth contact dynamics method for large particle systems

In numerous industrial applications there is the need to realistically model granular material. For instance, simulating the interaction of vehicles and tools with soil is of great importance for the design of earth moving machinery. The Discrete Element Method (DEM) has been successfully applied to this task [1, 2]. Large scale problems require a lot of computational resources. Hence, for the application in the industrial engineering process, the computational effort is an issue. In DEM parallelization is straight forward, since each contact between adjacent particles is resolved locally without regard of the other contacts. However, modelling a contact as a stiff spring imposes strong limitations on the time step size to maintain a stable simulation. The Non–Smooth Contact Dynamics Method (NSCD), on the other hand, models contacts globally as a set of inequality constraints on a system of perfectly rigid bodies [3]. At the end of every time step, all inequality constraints must be satisfied simultaneously, which can be achieved by solving a complementarity problem. This leads to a numerically stable method that is robust with respect to much larger time steps in comparison to DEM. Since a global problem must be solved, parallelization now strongly depends on the numerical solver that is used for the complementarity problem. We present our first massively parallel implementation of NSCD based on the projected Gauß-Jacobi (PGJ) iterative scheme presented in [4]. Focusing on one-sided asynchronous communication patterns with double buffering for data exchange, global synchronizations can be avoided. Only weak synchronization due to data dependencies of neighboring domains remains. The implementation is based on the Global address space Programming Interface (GPI), supplemented by the Multi Core Threading Package (MCTP) [5] on the processor level. This allows to efficiently overlap calculation and communication between processors

Quantum Breathing Mode of Interacting Particles in a One-dimensional Harmonic Trap

Extending our previous work, we explore the breathing mode---the [uniform] radial expansion and contraction of a spatially confined system. We study the breathing mode across the transition from the ideal quantum to the classical regime and confirm that it is not independent of the pair interaction strength (coupling parameter). We present the results of time-dependent Hartree-Fock simulations for 2 to 20 fermions with Coulomb interaction and show how the quantum breathing mode depends on the particle number. We validate the accuracy of our results, comparing them to exact Configuration Interaction results for up to 8 particles

Enhancing SKIN health and safety in aged CARE (SKINCARE Trial): a study protocol for an exploratory cluster-randomized pragmatic trial

Background: Aged long-term care receivers are affected by various adverse skin conditions like pressure ulcers, incontinence-associated dermatitis, dryness, intertrigo, and many more. Prevention of these skin problems and the provision of general hygiene and skin care activities are key areas of nursing practice. Numerous condition-specific guidelines are available and are implemented separately. On the other hand, there is huge overlap in terms of etiology, pathogenesis, and prevention of the skin conditions mentioned above. This leads to fragmented practice neglecting shared etiologies and prevention and treatment principles. Methods: The overall aims of this trial are to test the feasibility and to estimate possible effects of the implementation of a comprehensive skin care and prevention strategy targeting main nursing-relevant skin problems at the same time. A two-arm cluster-randomized controlled trial will be performed in 20 nursing homes randomly selected from the population of nursing homes of the state of Berlin, comparing skin care according to the skin care and prevention strategy with standard skin care. Discussion: It is expected that the implementation of this evidence-based skin care and prevention strategy will reduce the incidence of pressure ulcers, incontinence dermatitis, and other skin problems frequently related to care dependency. This trial will benefit individual patients and aged nursing home residents in general given the high prevalence and incidence of the addressed skin conditions. Findings of this exploratory trial may lay the foundation for a change in the development and evaluation of clinical standards and practices in general as it moves the perspective from individual conditions to a more comprehensive view on overlapping or coexisting health problems, in this case common skin conditions, in old-age long-term care receivers