Development and validation of an instrument to monitor the healing of incontinence-associated dermatitis

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The bumpy road to change : a retrospective qualitative study on formerly detained adolescents' trajectories towards better lives

Background: Currently, the risk-oriented focus in forensic youth care is increasingly complemented by a growing interest in strengths-based approaches. Knowledge on how detention and the subsequent period in the community is experienced by adolescents, and which elements are helpful in achieving better lives can contribute to this emerging field. The current study aimed to retrospectively explore adolescents’ experiences from the moment they were detained until six to 12 months after they left the institution, identifying positive aspects and strengths. Methods: In-depth interviews were conducted with 25 adolescents (both boys and girls, 15-18 years old) on average eight months after discharge from a closed institution in Belgium. A thematic analysis was performed using NVivo 11. Results: Five themes and corresponding subthemes were identified: (1) adolescents’ own strengths and resilience, (2) re-building personally valued lives, (3) making sense of past experiences, (4) moving away from a harmful lifestyle, and (5) (in-)formal supports. Most adolescents are on their way to finding a new balance in life, however, for a subgroup of them, this is still fragile. Adolescents highly emphasize the importance of feeling closely connected to at least one person; to receive practical help with regard to finances, work and housing; and to be able to experience pleasure and joy in their lives. Conclusions: Adolescents’ narratives suggest that starting a journey towards a normative good life often goes along with an initial difficult period because of a sense of loss with regard to their former life. This stresses the importance of targeting rehabilitation towards prosocial goals and enhancing adolescents’ quality of life on those life domains that matter most for them. Furthermore, we stress the importance of helping adolescents in overcoming structural barriers as a first step in supporting them in their trajectories towards better lives

Independent risk factors for the development of incontinence-associated dermatitis (category 2) in critically ill patients with fecal incontinence : a cross-sectional observational study in 48 ICU units

Background: Critically ill patients suffering from fecal incontinence have a major risk of developing incontinence-associated dermatitis (IAD). The presence of moisture and digestive enzymes (lipase, protease) negatively influences skin barrier function. Additional risk factors will make some patients even more vulnerable than others. In order to provide (cost) effective prevention, this specific patient population should be identified timely. Objectives: To identify independent risk factors for the development of IAD category 2 (skin loss) in critically ill patients with fecal incontinence. Design: A cross-sectional observational study. Setting and participants: The study was performed in 48 ICU wards from 27 Belgian hospitals. Patients of 18 years or older, with fecal incontinence at the moment of data collection, were eligible to participate. Patients with persistent skin redness due to incontinence (IAD category 1) were excluded. Methods: Potential risk factors were carefully determined based on literature and expert consultations. Data were collected over a period of eight months by trained researchers using patient records and observation of skin care practices. At the time a patient was included in the study, all relevant data from the past six days, or since admission at the ICU, were recorded. Simultaneously, direct skin observations were performed and high definition photographs were ratified by an expert IAD researcher. A multiple binary logistic regression model was composed to identify independent risk factors. Variables with P < .25 in single binary logistic regression analyses were added to the multiple model using a forward procedure. A cut-off value of P < .1 was established to retain variables in the final model. Nagelkerke's R 2 and Hosmer-Lemeshow statistic were calculated as measures of model fit. Results: The sample comprised of 206 patients, of which 95 presented with IAD category 2, and 111 were free of IAD. Seven independent risk factors were identified: liquid stool [odds ratio (OR) 4.69; 95% confidence interval (CI) 2.28-9.62], diabetes (OR 2.89; 95% CI 1.34-6.27), age (OR 1.05; 95% CI 1.02-1.08), smoking (OR 2.67; 95% CI 1.21-5.91), non-use of diapers (OR 2.97; 95% CI 1.39-6.33), fever (OR 2.60; 95% CI 1.23-5.53), and low oxygen saturation (OR 2.15; 95% CI 1.03-4.48). Nagelkerke's R 2 was 0.377. The Hosmer-Lemeshow statistic indicated no significant difference between the observed and expected values (p = .301). Conclusions: Liquid stool, diabetes, age, smoking, non-use of diapers, fever, and low oxygen saturation were independently associated with IAD category 2 in critically ill patients with fecal incontinence

Biological Activity of CXCL8 Forms Generated by Alternative Cleavage of the Signal Peptide or by Aminopeptidase-Mediated Truncation

Posttranslational modification of chemokines is one of the mechanisms that regulate leukocyte migration during inflammation. Multiple natural NH(2)-terminally truncated forms of the major human neutrophil attractant interleukin-8 or CXCL8 have been identified. Although differential activity was reported for some CXCL8 forms, no biological data are available for others.status: publishe

Silicone adhesive multilayer foam dressings as adjuvant prophylactic therapy to prevent hospital-acquired pressure ulcers : a pragmatic noncommercial multicentre randomized open-label parallel-group medical device trial

Background: Silicone adhesive multilayer foam dressings are used as adjuvant therapy to prevent hospital‐acquired pressure ulcers (PUs). Objectives: Determine if silicone foam dressings in addition to standard prevention reduce PU incidence category 2 or worse compared to standard prevention alone. Methods: Multicentre, randomised controlled, medical device trial conducted in eight Belgian hospitals. At risk adult patients were centrally randomised (n=1633) to study groups based on a 1:1:1 allocation: experimental group 1 (n=542) and 2 (n=545) ‐ pooled as the treatment group ‐ and the control group (n=546). Experimental groups received PU prevention according to hospital protocol, and a silicone foam dressing on these body sites. The control group received standard of care. The primary endpoint was the incidence of a new PU category 2 or worse at these body sites. Results: In the intention‐to‐treat population (n=1605); 4.0% of patients developed PUs category 2 or worse in the treatment group and 6.3% in the control group (RR=0.64, 95% CI 0.41 to 0.99, P=0.04). Sacral PUs were observed in 2.8% and 4.8% of the patients in the treatment group and the control group, respectively (RR=0.59, 95% CI 0.35 to 0.98, P=0.04). Heel PUs occurred in 1.4% and 1.9% of patients in the treatment and control group respectively (RR=0.76, 95% CI 0.34 to 1.68, P=0.49). Conclusions: Silicone foam dressings reduce the incidence of PUs category 2 or worse in hospitalised at‐risk patients when used in addition to standard of care. Results show a decrease for sacrum, but no statistical difference for heel/trochanter areas

Mining social mixing patterns for infectious disease models based on a two-day population survey in Belgium

<p>Abstract</p> <p>Background</p> <p>Until recently, mathematical models of person to person infectious diseases transmission had to make assumptions on transmissions enabled by personal contacts by estimating the so-called WAIFW-matrix. In order to better inform such estimates, a population based contact survey has been carried out in Belgium over the period March-May 2006. In contrast to other European surveys conducted simultaneously, each respondent recorded contacts over two days. Special attention was given to holiday periods, and respondents with large numbers of professional contacts.</p> <p>Methods</p> <p>Participants kept a paper diary with information on their contacts over two different days. A contact was defined as a two-way conversation of at least three words in each others proximity. The contact information included the age of the contact, gender, location, duration, frequency, and whether or not touching was involved.</p> <p>For data analysis, we used association rules and classification trees. Weighted generalized estimating equations were used to analyze contact frequency while accounting for the correlation between contacts reported on the two different days.</p> <p>A contact surface, expressing the average number of contacts between persons of different ages was obtained by a bivariate smoothing approach and the relation to the so-called next-generation matrix was established.</p> <p>Results</p> <p>People mostly mixed with people of similar age, or with their offspring, their parents and their grandparents. By imputing professional contacts, the average number of daily contacts increased from 11.84 to 15.70. The number of reported contacts depended heavily on the household size, class size for children and number of professional contacts for adults. Adults living with children had on average 2 daily contacts more than adults living without children. In the holiday period, the daily contact frequency for children and adolescents decreased with about 19% while a similar observation is made for adults in the weekend. These findings can be used to estimate the impact of school closure.</p> <p>Conclusion</p> <p>We conducted a diary based contact survey in Belgium to gain insights in social interactions relevant to the spread of infectious diseases. The resulting contact patterns are useful to improve estimating crucial parameters for infectious disease transmission models.</p

Breaking ECC2K-130

Elliptic-curve cryptography is becoming the standard public-key primitive not only for mobile devices but also for high-security applications. Advantages are the higher cryptographic strength per bit in comparison with RSA and the higher speed in implementations. To improve understanding of the exact strength of the elliptic-curve discrete-logarithm problem, Certicom has published a series of challenges. This paper describes breaking the ECC2K-130 challenge using a parallelized version of Pollard\u27s rho method. This is a major computation bringing together the contributions of several clusters of conventional computers, PlayStation~3 clusters, computers with powerful graphics cards and FPGAs. We also give /preseestimates for an ASIC design. In particular we present * our choice and analysis of the iteration function for the rho method; * our choice of finite field arithmetic and representation; * detailed descriptions of the implementations on a multitude of platforms: CPUs, Cells, GPUs, FPGAs, and ASICs; * details about running the attack

Case Report: Convalescent Plasma, a Targeted Therapy for Patients with CVID and Severe COVID-19

The disease course of COVID-19 in patients with immunodeficiencies is unclear, as well as the optimal therapeutic strategy. We report a case of a 37-year old male with common variable immunodeficiency disorder and a severe SARS-CoV-2 infection. After administration of convalescent plasma, the patient’s condition improved rapidly. Despite clinical recovery, viral RNA remained detectable up to 60 days after onset of symptoms. We propose that convalescent plasma might be considered as a treatment option in patients with CVID and severe COVID-19. In addition, in patients with immunodeficiencies, a different clinical course is possible, with prolonged viral shedding