Prevention of Pressure Ulcers Interventions

Pressure injuries continue to be a rising problem in hospitalized patients, specifically non-ambulatory patients. Without frequent turning and pressure relieving surfaces, patients may develop a pressure injury that costs them more and lengthens their hospital stay. By comparing frequent turning schedules and pressure relieving foam mattresses in the prevention of pressure injuries, thousands will be prevented. After a thorough search review on articles, five articles were selected in determining which prevention method happens to be the best. Although no articles researched the clinical prevention in foam mattresses and frequent turning, conducting a proposed project is effective. The proposed project consists of analyzing who is are at high risk for a pressure injury, those who are bed-bound, and those who are bed-bound but with minimal assistance to provide a foam mattress or order frequent turning schedule. After analyzing high risk patients, evaluating the support surface that is available is needed in determining what surface goes to specific patients based on their Braden scale. Evaluation of the proposed project would include documentation of the support surface used and evaluate those without a support surface or orders for frequent turning to evaluate their skin surface. Evaluating others would include a full head-to-toe assessment and a thorough skin inspection for other healthcare workers to note and document. Comparing low risk patients, high risk patients with support surface, and high-risk patients with an order for frequent turns will be evaluated for the effectiveness of this proposed project. This evaluation will last up to 6 months and determine if frequent turning intervals or a foam mattress is effective in preventing pressure injuries

Patient perceptions of multiple sclerosis and its treatment

BACKGROUND: In order to improve the treatment outcome in multiple sclerosis, it is important to document the factors that influence adherence to therapy. The purpose of this study was to determine patient perceptions and awareness of multiple sclerosis and its treatment, treatment adherence, and impact on quality of life and daily living. METHODS: This was a cross-sectional observational study performed in France. Each participating neurologist included the first three patients with relapsing-remitting multiple sclerosis who consulted after the start of the study. Data on clinical features were collected from a physician questionnaire and on disease and treatment perception and on quality of life from a patient autoquestionnaire. RESULTS: A total of 175 neurologists entered 202 patients in the study. The mean duration of disease was 8.0 ± 7.0 years, and immunomodulatory treatment had been administered for a mean duration of 3.0 ± 2.0 years. A total of 166 patients (82.2%) were treated with interferon-β preparations and 36 patients (17.8%) with glatiramer acetate. Eighty-five patients (42.1%) reported missing their injections from time to time and 36 patients (17.8%) reported "drug holidays". The most frequently given reason for nonadherence was forgetfulness (38.7% of cases). Eighty-six patients (42.6%) and 70 patients (34.7%) claimed to be well informed about their disease and treatment, respectively. Adherence was significantly higher in well informed patients (P = 0.035). The majority of patients (176 patients, 87.1%) intended continuing their current treatment and 49.5% considered that their current treatment might reduce relapses. The most frequently reported side effect was muscle pain (124 patients, 61.4%). CONCLUSION: Patient understanding of treatment for disease enhances treatment adherence. Greater patient involvement in disease management requires better communication between physicians and their patients.journal article20122012 04 04importe

Manifestations microscopiques des charges biomécaniques sur le second métacarpe humain

Le remodelage osseux est un processus qui permet le renouvellement du tissu osseux tout au long de la vie des individus (Toppets et al. 2004). Il est bien connu que le remodelage est influencé à la fois par l’environnement mécanique (charges, activités) et par les besoins métaboliques (Pearson et Lieberman 2004; Rosas et Martinez-Maza 2010). Cependant, les effets des charges mécaniques sur le remodelage osseux restent encore peu compris (Lad and al. 2016; Pfeiffer and al 2006). Cette étude a pour but d’évaluer les réponses microscopiques des os aux charges mécaniques. L’échantillon étudié correspond à des paires de seconds métacarpes, issues de deux populations d’origine géographique distinctes (n=103, 55 Euro-Canadiens et 48 Inuits). À partir de section en coupe provenant de la mi-diaphyse, les lames minces ont été analysées selon quatre quadrants anatomiques : antérieur, médial, postérieur et latéral. Afin de contrôler les facteurs non mécaniques qui influencent le remodelage (tels l’âge) l’asymétrie entre les paires des métacarpes est calculée pour toutes les variables étudiées. Les charges sont estimées par les valeurs d’asymétrie de trois variables biomécaniques macroscopiques : Imax, Imin et J. Les asymétries de la densité de population des ostéons (OPD), de l’aire moyenne des ostéons et des canaux de Havers furent calculées pour estimer la réponse osseuse microscopique. De plus, il fut testé l’effet de la densité de population des ostéons sur leur aire moyenne. Les résultats démontrent que la densité d’ostéons diminue pour certains groupes (chez les hommes de St Thomas, r = - 0,412 et les femmes Inuits r = -0,547), et que les aires moyennes des ostéons et des canaux de Havers augmentent dans le quadrant antérieur du métacarpe le plus chargé (chez St-Thomas r = 0,297). De plus, il existe une relation négative entre l’augmentation de la densité d’ostéons et leur aire moyenne, dans le quadrant postérieur des femmes de St Thomas (r = -0,496). En conclusion, les charges mécaniques ont un impact sur la microstructure de l’os, rendant possible l’étude des charges à travers l’analyse histomorphologique du tissu osseux.Bone remodeling is the process by which the skeleton can be renewed throughout the life of individuals (Toppets and al. 2004). It is well known that bone remodeling is a function of both mechanical (loads, activities) and non-mechanical factors such as metabolic needs of the bone (Pierson and Lieberman 2004; Rosas and Martinez-Maza 2010). However, the effects of mechanical environment on bone remodeling still remain poorly understood (Lad and al. 2016; Pfeiffer and al. 2006). This study aims to evaluate the microscopic bone responses to mechanical loading. The sample analyzed represents pairs of second metacarpal from two genetically separated populations (n=103, 55 Euro-Canadiens and 48 Inuits). From mid-shaft sections, thin sections were analyzed using four anatomical quadrants: anterior, medial, posterior and lateral. In order to control the influence of non-mechanical factors on bone remodeling, the asymmetry between pairs of metacarpals is calculated for each variable studied. Mechanical loading is estimated from the asymmetry values of three macroscopic biomechanical variables: Imax, Imin and J. Besides, asymmetries of osteon population density (OPD), mean areas of osteons and Havers canals were measured to estimate the microscopic bone response. Furthermore, it was tested the effect of osteon population density on osteon area. Results show that osteon population density decreases in some groups (in St-Thomas men r = - 0,412 and Inuit women r = -0,547), and the mean area of osteon and Havers canals increase in the more loaded side (in St-Thomas r = 0,297). In addition, there is a negative relationship between increased density of osteons and their mean areas in the posterior quadrant in St-Thomas women (r = -0,496). In conclusion, mechanical loading seems to have an impact on bone microstructure, making possible the inference of mechanical loadings through the study of bone histomorphology

The Effects of Nursing Overtime Work Hours on Medication Errors and Patient Safety

Abstract Background: The recent global pandemic has uncovered health care inequities among nursing professionals. The nursing shortage has placed pressure on overworked nurses to perform higher level critical care under dire and unsafe conditions. The stress of overworked nurses is a culprit for medical errors that affect the quality and effectiveness of patient care. Methods: Kennesaw State Library, PubMed, 35 articles screened. After thorough screening of various articles addressing this topic, we examined the quantitative and qualitative studies performed in all areas of nursing. Results: Research suggests that nurses working overtime versus full-time hours experience physical, mental, and emotional exhaustion may lead to an increase of medical errors. Events such as falls, pressure ulcers, needle-stick injuries, catheter-associated urinary infections, improper charting are all medical errors that show direct correlation to nurses who work overtime. Conclusion: This systematic review dives deep into the importance of establishing a culture of safety in relation to hours worked by nurses and patients hospitalized. Further study is needed to address policy and procedures to reduce medical errors by overworked nurses. Keywords: nursing overtime, medical errors, patient safet

A multifunctional phosphite-containing electrolyte for 5 V-class LiNi 0.5Mn1.5O4 cathodes with superior electrochemical performance

We report a highly promising organophosphorus compound with an organic substituent, tris(trimethylsilyl)phosphite (TMSP), to improve the electrochemical performance of 5 V-class LiNi0.5Mn 1.5O4 cathode materials. Our investigation reveals that TMSP alleviates the decomposition of LiPF6 by hydrolysis, effectively eliminates HF promoting Mn/Ni dissolution from the cathode, and forms a protective layer on the cathode surface against severe electrolyte decomposition at high voltages. Remarkable improvements in the cycling stability and rate capability of high voltage cathodes were achieved in the TMSP-containing electrolyte. After 100 cycles at 60 ??C, the discharge capacity retention was 73% in the baseline electrolyte, whereas the TMSP-added electrolyte maintained 90% of its initial discharge capacity. In addition, the LiNi 0.5Mn1.5O4 cathode with TMSP delivers a superior discharge capacity of 105 mA h g-1 at a high rate of 3 C and an excellent capacity retention of 81% with a high coulombic efficiency of over 99.6% is exhibited for a graphite/LiNi0.5Mn1.5O 4 full cell after 100 cycles at 30 ??C.close8

Oil palm biotechnology: progress and prospects

Today, a range of biotechnological approaches, from somatic embryogenesis to biomolecular research, play an increasingly important role in breeding strategies for oil palm (Elaeis guineensis Jacq.). Clonal micropropagation. Methods of cloning by in vitro culture led to the development of a micropropagation technique for oil palm based on somatic embryogenesis which was tested at the pilot stage on elite genotypes, thus enabling the production of high oil yielding clones. This phase allowed the identification of limiting factors associated with scaling-up, with respect in particular to the scale of mass production required to meet the needs of planters and to the problem of ensuring genetic fidelity in the regenerated plant material. These two concerns led researchers to look further into the underlying physiological and/or molecular mechanisms involved in somatic embryogenesis and the somaclonal variation events induced by the in vitro cloning procedure. Structural and functional genomics. Marker-assisted breeding in oil palm is a long-term multi-stage project including: molecular analysis of genetic diversity in both E. guineensis and E. oleifera germplasms; large scale development of PCR-based microsatellite markers; and parallel development of three genome mapping and QTL detection projects studying key agronomic characters. Post-genomics. In order to tackle the problem of the mantled flowering abnormality, which is induced during the micropropagation process, studies of gene expression have been carried out in tissue cultures as a means of establishing an early clonal conformity testing procedure. It is important to assess what kind of methodology is the most appropriate for clonal conformity testing by comparing RNA, protein and DNA (PCR) based approaches. Parallel studies on genomic DNA methylation changes induced by tissue culture suggest that the latter may play an important role in the determination of the mantled abnormality. (Résumé d'auteur