Use of night-time positioning equipment in care home residents with postural asymmetry : a pilot study

Twenty four-hour postural care that includes the use of night-time positioning equipment (NTPE) is being increasingly recommended. However, because most of the published studies focus on children, there is a lack of evidence on the use of NTPE in adults. The aim of this pilot study was to assess the effect of NTPE use in UK care home residents with complex health conditions and postural asymmetry. Ten care home residents trialled NTPE over a 12-week period. Qualitative and quantitative data were collected before and after each trial using standardised assessment tools. Semi-structured interviews were conducted with participants and relatives after each trial. Staff's views were elicited via two focus groups at the end of the study. There were notable benefits of NTPE use in terms of participants' pain levels, sleep quality, risk of pressure ulcers, risk of choking, and weight. There was also evidence of improvements in participants' function, ability to undertake activities of daily living and quality of life. However, some equipment was abandoned during the trials because participants found it too hot or restrictive. This pilot study increases the evidence base for a personalised approach to 24-hour postural care that can support older people's health and well-being. Further empirical studies are required to determine how NTPE can be used to improve older people's quality of life. [Abstract copyright: © 2020 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

Women?s health in mid-life: life course social roles and agencyas quality

Data from a prospective British birth cohort study showed that women who were childless, lone mothers or full-timehomemakers between the ages of 26 and 54 were more likely to report poor health at age 54 than women who occupiedmultiple roles between these ages. To explain this finding we developed and tested a theory of role quality based on theconcept of agency by drawing on Giddens? theory of structuration and Doyal and Gough?s theory of human needs.According to our theory, the patriarchal structuration (drawing on Giddens? term) of work and family roles provides bothlimitation and opportunity for the expression of agency. Doyal and Gough?s theory of human needs was then used toidentify the restriction of agency as a possible influence on health. This theory of role quality was operationalised using ameasure of work (paid and unpaid) quality at age 36 and a measure of work and family stress between ages 48 and 54. Therelatively poor subjective health in mid-life of lone mothers was explained by work and family stress and adult social class.In contrast, the poor health in mid-life of long-term homemakers and childless women was less easily explained.Homemaker?s excess risk of reporting poor health at age 54 remained strong and significant even after adjusting for rolequality and socioeconomic indicators, and childless women were at an increased risk of reporting poor health despite thesocial advantage inherent in attaining educational qualifications and occupying professional or managerial occupations.This study highlights the need to develop measures of role quality specifically designed to capture agency aspects of socialroles

CareFlex HydroTilit, SmartSeat, and SmartSeatPro: evaluation of pressure and comfort

The purpose of this study was to explore the use of WaterCell Technology® in the redistribution of pressure of adults with mobility problems who remain seated for extended periods of time and self-reported comfort and discomfort scores using three chairs: HydroTilt, SmartSeat, and SmartSeatPro

Evaluating the impact of WaterCell® Technology on pressure redistribution and comfort/discomfort of adults with limited mobility

Aim of the study The aim of the study was to evaluate the effect of WaterCell® Technology on pressure redistribution and self-reported comfort and discomfort scores of adults with mobility problems who remain seated for extended periods of time. Methods Twelve participants, were recruited and ranged in gender, age, height, weight, and body mass index. Five were male, seven were female, and five were permanent wheelchair users. Each participant was randomly allocated a chair, whose seat comprised of visco-elastic memory foam, high-elastic reflex foam, and watercells, to trial for a week. Data collected at day one and day seven included: interface pressure measurements taken across the gluteal region (peak and average); physiological observations of respiratory rate, pulse rate, and blood pressure; skin inspection and comfort and discomfort scores. Results Watercell® technology was found to offer lower average pressures than those reported to cause potential skin injury. Peak pressure index findings were comparative to other studies. No correlation was found between discomfort intensity rating and pressure redistribution. Discomfort intensity rating was low for all participants and general discomfort ranged from very low to medium. Physiological observations decreased for 50% of participants over the seven days. Conclusion From our study we have found that WaterCell® technology offers comparable pressure redistribution for people with a disability who need to sit for prolonged periods of time and the chairs were found to be comfortable

Understanding the association between pressure ulcers and sitting in adults what does it mean for me and my carers? Seating guidelines for people, carers and health & social care professionals

The aim of the publication was to develop a practical guide for people, carers and health and social care professionals on how the research and evidence base on pressure ulcer prevention and management can be applied to those who remain seated for extended periods of time. This publication was developed at the request of the Tissue Viability Society in order to revise the original seating guidelines from 2008 as evidence and subsequent care has moved forward in relation to this area. Since 2008, the costs for the prevention and management of pressure ulcers have increased significantly and there is limited published advice from health and social care organisations on seating and preventing pressure ulcers. These guidelines have been written for: • People • Carers • Health and Social Care professionals • Education and training staff • Independent sector Who live or work in primary, secondary, and tertiary settings

Social isolation in childhood and adult inflammation: evidence from the National Child Development Study

Background Social isolation is known to be associated with poorer health amongst adults, including coronary heart disease. It is hypothesized that this association may be mediated by inflammation. There has been little prospective research on the long-term impact of social isolation in childhood on adult health or the pathways which might be involved. The aim of this study was to investigate whether social isolation in childhood is associated with increased adult inflammation and the mechanisms involved across the life course. Methods This study used multiply-imputed data on 7,462 participants of the National Child Development Study in Great Britain. The association between child social isolation (7-11 yrs) and levels of C-reactive protein (CRP) in middle age (44 yrs) was examined. We additionally investigated the role of adult social isolation, psychological distress, health behaviors and socioeconomic factors as potential mediators using path analysis and concurrent measurements made across the life course. Results Socially isolated children had higher levels of C-reactive protein in mid-life (standardized coefficient= 0.05, p≤0.001). In addition children who were socially isolated tended to have lower subsequent educational attainment, be in a less advantaged social class in adulthood, were more likely to be psychologically distressed across adulthood and were more likely to be obese and to smoke. All of these factors partially explained the association between childhood social isolation and CRP. However this association remained statistically significant after considering all mediators simultaneously. Conclusions Social isolation in childhood is associated with higher levels of C-reactive protein in mid-life. This is explained in part through complex mechanisms acting across the life course. Identification and interventions targeted towards socially isolated children may help reduce long-term adult health risk

Design, fabrication, testing and delivery of a solar collector

A two phase program encompassing the redesign and fabrication of a solar collector which is low in cost and aesthetically appealing is described. Phase one work reviewed the current collector design and developed a low-cost design based on specific design/performance/cost requirements. Throughout this phase selected collector component materials were evaluated by testing and by considering cost, installation, maintainability and durability. The resultant collector design was composed of an absorber plate, insulation, frame, cover, desiccant and sealant. In Phase two, three collector prototypes were fabricated and evaluated for both nonthermal and thermal characteristics. Tests included static load tests of covers, burst pressure tests of absorber plates, and tests for optical characteristics of selective absorber plate coatings. The three prototype collectors were shipped to Marshall Space Flight Center for use in their solar heating and cooling test facility

Evaluation of night time therapeutic positioning system for adults with complex postural problems

The purpose of this study is to evaluate the effect of night-time positioning sleep systems for adults using the Simple Stuff Works Limited® system. A combination of quantitative and qualitative methods were used to assess the impact on a variety of factors; pain, physiological observations, oxygen saturation, nutrition and fluid intake, weight, Waterlow risk score, sleep score, choke risk score, skin integrity, comfort and quality of life. The project objectives were to: Evaluate the knowledge and skills of care staff in the delivery of night-time positioning (with and without equipment). Evaluate the equipment used in night-time positioning. Assess the impact of night-time positioning on activities of daily living. Measure the difference between pain, sleep scores, physiological observations, oxygen saturation, nutrition and fluid intake, weight, Waterlow risk score, choke risk score, skin integrity, comfort and quality of life before and after the intervention. The role of the company in the study was to provide the equipment. An independent clinician assessed the participants sleep system equipment requirements, demonstrated the first fitting and drew up the plan of care when using the equipment. Ethical approval to conduct the study was sought and granted by the University of Salford Ethics committee (see appendices, for the letter of approval)