An economic appraisal of the Australian Medical Sheepskin for the prevention of sacral pressure ulcers from a nursing home perspective

<p>Abstract</p> <p>Background</p> <p>Many devices are in use to prevent pressure ulcers, but from most little is known about their effects and costs. One such preventive device is the Australian Medical Sheepskin that has been proven effective in three randomized trials. In this study the costs and savings from the use of the Australian Medical Sheepskin were investigated from the perspective of a nursing home.</p> <p>Methods</p> <p>An economic model was developed in which monetary costs and monetary savings in respect of the sheepskin were balanced against each other. The model was applied to a fictional (Dutch) nursing home with 100 beds for rehabilitation patients and a time horizon of one year. Input variables for the model consisted of investment costs for using the sheepskin (purchase and laundry), and savings through the prevented cases of pressure ulcers. The input values for the investment costs and for the effectiveness were empirically based on a trial with newly admitted rehabilitation patients from eight nursing homes. The input values for the costs of pressure ulcer treatment were estimated by means of four different approaches.</p> <p>Results</p> <p>Investment costs for using the Australian Medical Sheepskin were larger than the monetary savings obtained by preventing pressure ulcers. Use of the Australian Medical Sheepskin involves an additional cost of approximately €2 per patient per day. Preventing one case of a sacral pressure ulcer by means of the Australian Medical Sheepskin involves an investment of €2,974 when the sheepskin is given to all patients. When the sheepskin is selectively used for more critical patients only, the investment to prevent one case of sacral pressure ulcers decreases to €2,479 (pressure ulcer risk patients) or €1,847 (ADL-severely impaired patients). The factors with the strongest influence on the balance are the frequency of changing the sheepskin and the costs of washing related to this. The economic model was hampered by considerable uncertainty in the estimations of the costs of pressure ulcer treatment.</p> <p>Conclusions</p> <p>From a nursing home perspective, the investment costs for use of the Australian Medical Sheepskin in newly admitted rehabilitation patients are larger than the monetary savings obtained by preventing pressure ulcers.</p

Identification of platinum nanoparticles in road dust leachate by single particle inductively coupled plasma-mass spectrometry

Elevated platinum (Pt) concentrations are found in road dust as a result of emissions from catalytic converters in vehicles. This study investigates the occurrence of Pt in road dust collected in Ghent (Belgium) and Gothenburg (Sweden). Total Pt contents, determined by tandem ICP-mass spectrometry (ICP-MS/MS), were in the range of 5 to 79 ng g − 1 , comparable to the Pt content in road dust of other medium-sized cities. Further sample characterization was performed by single particle (sp) ICP-MS following an ultrasonic extraction procedure using stormwater runoff for leaching. The method was found to be suitable for the characterization of Pt nanoparticles in road dust leachates. The extraction was optimized using road dust reference material BCR-723, for which an extraction efficiency of 2.7% was obtained by applying 144 kJ of ultrasonic energy. Using this method, between 0.2% and 18% of the Pt present was extracted from road dust samples. spICP-MS analysis revealed that Pt in the leachate is entirely present as nanoparticles of sizes between 9 and 21 nm. Although representing only a minor fraction of the total content in road dust, the nanoparticulate Pt leachate is most susceptible to biological uptake and hence most relevant in terms of bioavailability

BeST - Belgian screening tools : mise à disposition d'outils d'aide à la décision en soins infirmiers

Objectif : Les infirmières n'ont souvent aucune idée de la validité et fiabilité des échelles qu'elles utilisent dans leur pratique. Néanmoins, ces échelles sont rarement accessibles. L'objectif du projet BeST - Belgian Screening Tools - était de construire une base de données avec des échelles valides et fiables utiles dans les soins infirmiers, pour lesquelles un aperçu des critères psychométriques est détaillé. Méthodes : Une revue de la littérature a été réalisée afin d'identifier les échelles valides et fiables. Dès lors, un filtre de recherche a été utilisé dans plusieurs bases de données (Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Cinahl, Invert). Les critères d'inclusion étaient : articles rédigés en anglais, français, néerlandais, allemand entre 1993 et 2009. Les thèmes investigués étaient : désorientation, risque d'escarres, état buccal, nausées-vomissements, coma, douleur, fatigue, sédation, fonction cognitive, état fonctionnel et psychosocial, nutrition, continence, soins de plaies, soins autogérés, qualité de vie et soins aux cathéters. Résultats : Parmi les 141 échelles sélectionnées, 20 sont spécifiques aux enfants, 24 aux adultes, 48 aux personnes âgées et 49 destinées à tout patient ; 42 échelles sont destinées aux infirmières, 21 aux médecins, 39 à tous les prestataires et 20 utilisables par le patient lui-même. Toutes les échelles sélectionnées sont disponibles dans la base de données BeST gratuitement accessible et régulièrement actualisée. Par thème et par échelle, une description de l'échelle, de l'objectif, du groupe-cible, des tables d'évidence et des références est mentionnée. Conclusion : Nombre d'échelles validées sont gratuitement téléchargeables sur le site www.best.ugent.be et donc, facilement accessibles et applicables en pratique clinique

Oxygen-rich poly-bisvanillonitrile embedded amorphous zirconium oxide nanoparticles as reusable and porous adsorbent for removal of arsenic species from water

A new oxygen-rich porous polymer based on bisvanillonitrile was synthesized and characterized. This polymer was employed as support for the anchoring of 14.5 w% amorphous zirconium oxide nanoparticles. The formation of homogeneously dispersed nanoparticles in the poly-bisvanillonitrile (PBVN) host material was confirmed using N2-sorption, XRPD, XPS and electron microscopy. The combination of zirconium oxide nanoparticles having active adsorption sites with the porous supporting material showed excellent adsorption of arsenic species. The resulting adsorption capacities of the hybrid material extend to 245 mg g−1 for arsenite (AsIII) and 115 mg g−1 for arsenate (AsV). Moreover, adsorption kinetics showed a fast removal of both arsenic species with initial adsorption rate h of 0.0646 mg g−1 min−1 for arsenite and 0.0746 mg g−1 min−1 for arsenate. The immobilization was not interfered by the presence of other compounds in solution, indicating the applicability in real working environments. The material could be regenerated in a continuous mode using a 0.1 mol L−1 sodium hydroxide solution at 70 °C to desorb arsenic