Exploring innovative solutions for quality of life and care of bed-ridden nursing home residents through Codesign sessions

Bed-ridden nursing home residents are in need of environments which are homelike and facilitate the provision of care. Design guidance for this group of older people is limited. This study concerned the exploration and generation of innovative environmental enrichment scenarios for bed-ridden residents. This exploration was conducted through a combination of participatory action research with user-centred design involving 56 professional stakeholders in interactive work sessions. This study identified numerous design solutions, both concepts and products that are available on the marketplace and that on a higher level relate to improvements in resident autonomy and the supply of technological items and architectural features. The methodology chosen can be used to explore the creative potential of stakeholders from the domain of healthcare in product innovation

The essential elements for a nursing home according to stakeholders from healthcare and technology: perspectives from multiple simultaneous monodisciplinary workshops

Technology and architectural solutions are needed as a means of support in future nursing homes. This study investigated how various monodisciplinary groups of stakeholders from healthcare and technology envision the nursing home of the future and which elements are necessary for its creation. Moreover, differences in needs and interests between the various stakeholders were considered. This qualitative study gathered data via 10 simultaneous sticky note brainstorm sessions with 95 professional stakeholders, which resulted in 1459 quotes in five categories that were clustered into themes and processed into word clouds. The stakeholders prioritized the needs of the resident and placed the most importance on the fact that a nursing home is primarily a place to live in the final stages of one's life. A mix of factors related to the quality of care and the quality of the built environment and technology is needed. Given the fact that there are differences in what monodisciplinary groups of stakeholders see as an ideal nursing home, multidisciplinary approaches should be pursued in practice to incorporate as many new views and stakeholder needs as possible

Reduced prevalence of arterial thrombosis in von Willebrand disease

High von Willebrand factor (VWF) levels are an established risk factor for arterial thrombosis, including coronary heart disease and ischemic stroke. It has been hypothesized that von Willebrand disease (VWD) patients are protected against arterial thrombosis; however, this has never been confirmed in clinical studies.To investigate the prevalence of arterial thrombosis in VWD patients relative to the general population.We included 635 adult patients with VWF levels ?30?U?dL(-1) , aged 16-85 years, from the nationwide cross-sectional 'Willebrand in the Netherlands' (WiN) study and compared the prevalence of arterial thrombosis with two reference populations from the general Dutch population adjusted for age and sex as standardized morbidity ratios (SMRs).Twenty-nine arterial thrombotic events occurred in 21 patients (3.3%). Five patients suffered an acute myocardial infarction and three an ischemic stroke. Unstable angina pectoris was recorded 12 times, transient ischemic attack nine. The prevalence of all arterial thrombotic events combined (acute myocardial infarction, ischemic stroke and coronary heart disease) was 39% and 63% lower than in the two reference populations. The prevalence of cardiovascular disease in VWD was lower than in the general population, SMR 0.60 (95% CI, 0.32-0.98) for coronary heart disease and SMR 0.40 (95% CI, 0.13-0.83) for acute myocardial infarction. For ischemic stroke the prevalence was 35-67% lower compared with two reference populations, SMR 0.65 (95% CI, 0.12-1.59) and 0.33 (95% CI, 0.06-0.80), respectively.This is the first study showing that VWD patients have a reduced prevalence of arterial thrombosis and provides important insights into the role of VWF in the pathogenesis of arterial thrombosis.? 2013 International Society on Thrombosis and Haemostasis

Technological and architectural solutions for Dutch nursing homes: results of a multidisciplinary mind mapping session with professional stakeholders

There is an increasing call in society for the improvement of well-being for nursing home residents and the support of care professionals through a wide array of architectural and technological solutions that are available in modern nursing homes. This study investigated which of these solutions are considered essential by stakeholders from healthcare and technology. Data were gathered via 22 simultaneously held multidisciplinary mind map sessions with 97 stakeholders, resulting in 43 mind maps. These, in turn, were grouped into a single mind map of the nursing home in general, the private rooms for residents with somatic or psychogeriatric health problems, and the group living room. A prioritization of solutions was added. The contents of the mind maps reflect a Dutch consensus on the necessary architectural and technological features for the design of nursing homes

Factor VIII gene (F8) mutation and risk of inhibitor development in nonsevere hemophilia A

<p>Neutralizing antibodies (inhibitors) toward factor VIII form a severe complication in nonsevere hemophilia A, profoundly aggravating the bleeding pattern. Identification of high-risk patients is hampered by lack of data that take exposure days to therapeutic factor VIII concentrates into account. In the INSIGHT study, we analyzed the association between F8 mutation and inhibitor development in patients with nonsevere hemophilia A (factor VIII 2-40 IU/dL). This analysis included 1112 nonsevere hemophilia A patients from 14 centers in Europe and Australia that had genotyped at least 70% of their patients. Inhibitor risk was calculated as Kaplan-Meier incidence with cumulative number of exposure days as the time variable. During 44 800 exposure days (median, 24 exposure days per patient; interquartile range [IQR], 7-90), 59 of the 1112 patients developed an inhibitor; cumulative incidence of 5.3% (95% confidence interval [CI], 4.0-6.6) after a median of 28 exposure days (IQR, 12-71). The inhibitor risk at 50 exposure days was 6.7% (95% CI, 4.5-8.9) and at 100 exposure days the risk further increased to 13.3% (95% CI, 9.6-17.0). Among a total of 214 different F8 missense mutations 19 were associated with inhibitor development. These results emphasize the importance of F8 genotyping in nonsevere hemophilia A.</p>

Le Paysan de Cochinchine... Hebdomadaire de soutien des intérêts agricoles ["puis" Hebdomadaire français]

22 février 19401940/02/22 (N246)-1940/02/22