Improving diaper design to address incontinence associated dermatitis

<p>Abstract</p> <p>Background</p> <p>Incontinence associated dermatitis (IAD) is an inflammatory skin disease mainly triggered by prolonged skin contact with urine, feces but also liberal detergent use when cleansing the skin. To minimize the epidermal barrier challenge we optimized the design of adult incontinence briefs. In the fluid absorption area we interposed a special type of acidic, curled-type of cellulose between the top sheet in contact with the skin and the absorption core beneath containing the polyacrylate superabsorber. The intention was to minimize disturbance of the already weak acid mantle of aged skin. We also employed air-permeable side panels to minimize skin occlusion and swelling of the stratum corneum.</p> <p>Methods</p> <p>The surface pH of diapers was measured after repeated wetting with a urine substitute fluid at the level of the top sheet. Occlusive effects and hydration of the stratum corneum were measured after a 4 hour application of different side panel materials by corneometry on human volunteers. Finally, we evaluated skin symptoms in 12 patients with preexisting IAD for 21 days following the institutional switch to the optimized diaper design. Local skin care protocols remained in place unchanged.</p> <p>Results</p> <p>The improved design created a surface pH of 4.6 which was stable even after repeated wetting throughout a 5 hour period. The "standard design" briefs had values of 7.1, which is alkaline compared to the acidic surface of normal skin. Side panels made from non-woven material with an air-permeability of more than 1200 l/m²/s avoided excessive hydration of the stratum corneum when compared to the commonly employed air-impermeable plastic films. Resolution of pre-existing IAD skin lesions was noted in 8 out of 12 patients after the switch to the optimized brief design.</p> <p>Conclusions</p> <p>An improved design of adult-type briefs can create an acidic pH on the surface and breathable side panels avoid over-hydration of the stratum corneum and occlusion. This may support the epidermal barrier function and may help to reduce the occurrence of IAD.</p

A competitive integration model of exogenous and endogenous eye movements

We present a model of the eye movement system in which the programming of an eye movement is the result of the competitive integration of information in the superior colliculi (SC). This brain area receives input from occipital cortex, the frontal eye fields, and the dorsolateral prefrontal cortex, on the basis of which it computes the location of the next saccadic target. Two critical assumptions in the model are that cortical inputs are not only excitatory, but can also inhibit saccades to specific locations, and that the SC continue to influence the trajectory of a saccade while it is being executed. With these assumptions, we account for many neurophysiological and behavioral findings from eye movement research. Interactions within the saccade map are shown to account for effects of distractors on saccadic reaction time (SRT) and saccade trajectory, including the global effect and oculomotor capture. In addition, the model accounts for express saccades, the gap effect, saccadic reaction times for antisaccades, and recorded responses from neurons in the SC and frontal eye fields in these tasks. © The Author(s) 2010

Occupational Therapy and Physiotherapy: Similar, but separate

Three articles were published in the 1998 volume of the British Journal of Occupational Therapy which dealt with the issue of professional boundaries and role overlap between occupational therapy and physiotherapy. There has also been some recent debate on the same topic in the USA and Canada. This paper discusses issues related to the perceived professional role overlap between occupational therapy and physiotherapy. The implications for occupational therapy are discussed and recommendations are made

Substantial export of suspended sediment to the global oceans from glacial erosion in Greenland

Limited measurements along Greenland’s remote coastline hamper quantification of the sediment and associated nutrients draining the Greenland ice sheet, despite the potential influence of river-transported suspended sediment on phytoplankton blooms and carbon sequestration. Here we calibrate satellite imagery to estimate suspended sediment concentration for 160 proglacial rivers across Greenland. Combining these suspended sediment reconstructions with numerical calculations of meltwater runoff, we quantify the amount and spatial pattern of sediment export from the ice sheet. We find that, although runoff from Greenland represents only 1.1% of the Earth’s freshwater flux, the Greenland ice sheet produces approximately 8% of the modern fluvial export of suspended sediment to the global ocean. Sediment loads are highly variable between rivers, consistent with observed differences in ice dynamics and thus with control by glacial erosion. Rivers that originate from deeply incised, fast-moving glacial tongues form distinct sediment-export hotspots: just 15% of Greenland’s rivers transport 80% of the total sediment load of the ice sheet. We conclude that future acceleration of melt and ice sheet flow may increase sediment delivery from Greenland to its fjords and the nearby ocean