The evaluation and optimization of sensorial comfort

The factors which are commonly considered to be of prime importance in determining the comfort of garments are thermo-physiological comfort, garment fit and sensorial comfort. The last of these factors is the topic of this thesis. Although these three factors are separated into distinct groups, they are also dependant on one another. Therefore a knowledge of all of them is necessary for an assessment of overall clothing comfort. Sensorial comfort has. been a neglected area of clothing comfort in comparison to the other comfort factors. Vhen research has been carried out it has been on specific sensations or fibres and no over-view of the range of sensations and their relative severity has been established. This means that different research studies in this area cannot be compared because they are so specific. This research programme has established the foundations for future sensorial comfort studies by providing this information. This was done by an extensive wearer trial when a large selection of commercially available fibres and fabrics were worn next to the skin for a range of activities. Nine major discomfort sensations were identified. These were: tight fitting bands, tickle, prickle, scratchiness, local irriation due to labels, seams and trimmings, fibre shedding, initial cold feel, wet cling and tacky cling. Four of these sensations: tickle, local irritation, fibre shedding, and tacky cling had not been investigated before. A glossary of terms was compiled to describe these sensations and this is proposed as a standard terminology. This wearer trial also enabled a hierarchy of potential discomfort to be identified for these nine major discomfort sensations. These sensations were further investigated by specific wearer trials to determine the main physical, physiological and psychological factors influencing their presence and severity. New test procedures were designed and developed to assess a fabric or garment for the presence of discomfort sensations. When.test procedures were inappropriate, recommendations were made. The attitude of the general public to the factors producing discomfort from their clothing was also determined. A range of 1004 people in the north of England were asked for their views on all aspects of clothing comfort. Some of the .major findings were that people associate discomfort with the fibre type, and not the fabric or garment. Fibre absorbency is thought to be very important for clothing comfort, but wet cling is not thought to be an annoying sensation in comparison to other skin sensations, and the appearance of the fabric has an over-riding influence on the acceptance of a garment. This research has provided the information necessary to describe and, in many cases predict the presence of sensorial discomfort sensations

Testing the salinity tolerance levels of similar invasive species found in the San Francisco Bay

Testing the salinity tolerance levels of similar invasive species found in the San Francisco Bay Julia Smith1,2, Elizabeth Sheets2, and C. Sarah Cohen2 1Department of Teacher Education, California State University, Sacramento 2Department of Biology and Romberg Tiburon Center, San Francisco State University Three non-indigenous colonial ascidian species, Botrylloides violaceus, Botrylloides diegensis, and Botryllus schlosseri, have become well established in San Francisco Bay. Two species, B. violaceous and B. schlosseri, are globally distributed, and understanding the salinity ranges and tolerances of these successful invaders in their introduced habitats is important for predicting their spread. We tested the tolerance of these three morphologically similar species to salinity ranges that they may encounter locally in San Francisco Bay, and globally, in their broad distributions, including a freshwater transit experiment designed to simulate conditions for ships transiting through the Panama Canal. Botrylloides violaceus, B. diegensis, and Botryllus schlosseri were exposed to various salinities (10, 15, 18, and 20 ppt) for a period of 14 hours, and then assessed for two signs of vitality immediately after each treatment, and were monitored for survival after a week. Our preliminary results showed survival of Botrylloides diegensis, and B. violaceus at the lowest (10 ppt) salinity treatment after 1 week, but no colonies of Botryllus schlosseri survived this salinity treatment in a preliminary trial. The three species all showed survival at our higher (15, 18, and 20 ppt) salinity treatments. In a separate trial, the three target species were also exposed to a drastic salinity decrease to 0 ppt for 7 hours, related to conditions in the Panama Canal. There were no signs of immediate survival in colonies that experienced very low salinity conditions. However, small vascular fragments appear to remain in many colonies three weeks later, and are currently being monitored in the event that they may regenerate, as local colonies of each of these speceis have successfully carried out whole body regeneration from vascular fragments as small as 3.9 mm (Benson Chow, unpub. data)

The evaluation and optimization of sensorial comfort

The factors which are commonly considered to be of prime importance in determining the comfort of garments are thermo-physiological comfort, garment fit and sensorial comfort. The last of these factors is the topic of this thesis. Although these three factors are separated into distinct groups, they are also dependant on one another. Therefore a knowledge of all of them is necessary for an assessment of overall clothing comfort.Sensorial comfort has. been a neglected area of clothing comfort in comparison to the other comfort factors. Vhen research has been carried out it has been on specific sensations or fibres and no over-view of the range of sensations and their relative severity has been established. This means that different research studies in this area cannot be compared because they are so specific. This research programme has established the foundations for future sensorial comfort studies by providing this information.This was done by an extensive wearer trial when a large selection of commercially available fibres and fabrics were worn next to the skin for a range of activities. Nine major discomfort sensations were identified. These were: tight fitting bands, tickle, prickle, scratchiness, local irriation due tolabels, seams and trimmings, fibre shedding, initial cold feel, wet cling and tacky cling. Four of these sensations: tickle, local irritation, fibre shedding, and tacky cling had not been investigated before. A glossary of terms was compiled to describe these sensations and this is proposed as a standard terminology. This wearer trial also enabled a hierarchy of potential discomfort to be identified for these nine major discomfort sensations.These sensations were further investigated by specific wearer trials to determine the main physical, physiological and psychological factors influencing their presence and severity. New test procedures were designed and developed to assess a fabric or garment for the presence of discomfort sensations. When.test procedures were inappropriate, recommendations were made.The attitude of the general public to the factors producing discomfort from their clothing was also determined. A range of 1004 people in the north of England were asked for their views on all aspects of clothing comfort. Some of the .major findings were that people associate discomfort with the fibre type, and not the fabric or garment. Fibre absorbency is thought to be very important for clothing comfort, but wet cling is not thought to be an annoying sensation in comparison to other skin sensations, and the appearance of the fabric has an over-riding influence on the acceptance of a garment.This research has provided the information necessary to describe and, in many cases predict the presence of sensorial discomfort sensations

Exploring the role of pain as an early predictor of category 2 pressure ulcers: a prospective cohort study

Objective To explore pressure area related pain as a predictor of category ≥2 pressure ulcer (PU) development. Design Multicentre prospective cohort study. Setting UK hospital and community settings. Participants inclusion Consenting acutely ill patients aged ≥18 years, defined as high risk (Braden bedfast/chairfast AND completely immobile/very limited mobility; pressure area related pain or; category 1 PU). Exclusion Patients too unwell, unable to report pain, 2 or more category ≥2 PUs. Follow-up Twice weekly for 30 days. Primary and secondary outcome measures Development and time to development of one or more category ≥2 PUs. Results Of 3819 screened, 1266 were eligible, 634 patients were recruited, 32 lost to follow-up, providing a 602 analysis population. 152 (25.2%) developed one or more category ≥2 PUs. 464 (77.1%) patients reported pressure area related pain on a healthy, altered or category 1 skin site of whom 130 (28.0%) developed a category ≥2 PU compared with 22 (15.9%) of those without pain. Full stepwise variable selection was used throughout the analyses. (1) Multivariable logistic regression model to assess 9 a priori factors: presence of category 1 PU (OR=3.25, 95% CI (2.17 to 4.86), p<0.0001), alterations to intact skin (OR=1.98, 95% CI (1.30 to 3.00), p=0.0014), pressure area related pain (OR=1.56, 95% CI (0.93 to 2.63), p=0.0931). (2) Multivariable logistic regression model to account for overdispersion: presence of category 1 PU (OR=3.20, 95% CI (2.11 to 4.85), p<0.0001), alterations to intact skin (OR=1.90, 95% CI (1.24 to 2.91), p=0.0032), pressure area related pain (OR=1.85, 95% CI (1.07 to 3.20), p=0.0271), pre-existing category 2 PU (OR=2.09, 95% CI (1.35 to 3.23), p=0.0009), presence of chronic wound (OR=1.66, 95% CI (1.06 to 2.62), p=0.0277), Braden activity (p=0.0476). (3) Accelerated failure time model: presence of category 1 PU (AF=2.32, 95% CI (1.73 to 3.12), p<0.0001), pressure area related pain (AF=2.28, 95% CI (1.59 to 3.27), p<0.0001). (4) 2-level random-intercept logistic regression model: skin status which comprised 2 levels (versus healthy skin); alterations to intact skin (OR=4.65, 95% CI (3.01 to 7.18), p<0.0001), presence of category 1 PU (OR=17.30, 95% CI (11.09 to 27.00), p<0.0001) and pressure area related pain (OR=2.25, 95% CI (1.53 to 3.29), p<0.0001). Conclusions This is the first study to assess pain as a predictor of category ≥2 PU development. In all 4 models, pain emerged as a risk factor associated with an increased probability of category ≥2 PU development

State-of-the-art in studies of glacial isostatic adjustment for the British Isles: a literature review

Understanding the effects of glacial isostatic adjustment (GIA) of the British Isles is essential for the assessment of past and future sea-level trends. GIA has been extensively examined in the literature, employing different research methods and observational data types. Geological evidence from palaeo-shorelines and undisturbed sedimentary deposits has been used to reconstruct long-term relative sea-level change since the Last Glacial Maximum. This information derived from sea-level index points has been employed to inform empirical isobase models of the uplift in Scotland using trend surface and Gaussian trend surface analysis, as well as to calibrate more theory-driven GIA models that rely on Earth mantle rheology and ice sheet history. Furthermore, current short-term rates of GIA-induced crustal motion during the past few decades have been measured using different geodetic techniques, mainly continuous GPS (CGPS) and absolute gravimetry (AG). AG-measurements are generally employed to increase the accuracy of the CGPS estimates. Synthetic aperture radar interferometry (InSAR) looks promising as a relatively new technique to measure crustal uplift in the northern parts of Great Britain, where the GIA-induced vertical land deformation has its highest rate. This literature review provides an in-depth comparison and discussion of the development of these different research approaches

Farmers Markets and the Local Food System: The Case of Gettysburg, Pennsylvania

In order to examine and obtain a better understanding of the local food system within Adams County, Pennsylvania, this study explores the characteristics and perspectives of the customers and vendors at the farmers markets in Gettysburg, Pennsylvania. Survey findings from the Gettysburg Farmers Market and the three Adams County Farmers Markets include customer demographic information, perspectives and shopping behavior as well as vendor product information, farm size and location and preference for market management. Introductory background information on the Farm Bill and the influence of agricultural practices on the environment, human health and nutrition and the relationship between farmers markets and the local economy are offered in order to emphasize the value of a well-managed local food system. Conclusions provide evidence that lower income and lower education levels are not sufficiently represented at all the markets and food stamp programs are being underutilized. This study suggests employing additional marketing to target underrepresented demographic groups, public transportation to potentially inaccessible market locations and increased advertisement and encouragement of food stamp programs at all markets in order to expand the customer base and increase access to healthy, local foods for less advantaged citizens. The results from this study are intended to offer evidence that will promote and facilitate market management, strengthen customer/vendor relationships and encourage better ties between the local community and local food systems at the farmers markets within Gettysburg in Adams County, Pennsylvania

Comparing alternating pressure mattresses and high-specification foam mattresses to prevent pressure ulcers in high-risk patients: the PRESSURE 2 RCT

Background: Pressure ulcers (PUs) are a burden to patients, carers and health-care providers. Specialist mattresses minimise the intensity and duration of pressure on vulnerable skin sites in at-risk patients. Primary objective: Time to developing a new PU of category ≥ 2 in patients using an alternating pressure mattress (APM) compared with a high-specification foam mattress (HSFM). Design: A multicentre, Phase III, open, prospective, planned as an adaptive double-triangular group sequential, parallel-group, randomised controlled trial with an a priori sample size of 2954 participants. Randomisation used minimisation (incorporating a random element). Setting: The trial was set in 42 secondary and community inpatient facilities in the UK. Participants: Adult inpatients with evidence of acute illness and at a high risk of PU development. Interventions and follow-up: APM or HSFM – the treatment phase lasted a maximum of 60 days; the final 30 days were post-treatment follow-up. Main outcome measures: Time to event. Results: From August 2013 to November 2016, 2029 participants were randomised to receive either APM (n = 1016) or HSFM (n = 1013). Primary end point – 30-day final follow-up: of the 2029 participants in the intention-to-treat population, 160 (7.9%) developed a new PU of category ≥ 2. There was insufficient evidence of a difference between groups for time to new PU of category ≥ 2 [Fine and Gray model HR 0.76, 95% confidence interval (CI) 0.56 to 1.04; exact p-value of 0.0890 and 2% absolute difference]. Treatment phase sensitivity analysis: 132 (6.5%) participants developed a new PU of category ≥ 2 between randomisation and end of treatment phase. There was a statistically significant difference in the treatment phase time-to-event sensitivity analysis (Fine and Gray model HR 0.66, 95% CI 0.46 to 0.93; p = 0.0176 and 2.6% absolute difference). Secondary end points – 30-day final follow-up: new PUs of category ≥ 1 developed in 350 (17.2%) participants, with no evidence of a difference between mattress groups in time to PU development, (Fine and Gray model HR 0.83, 95% CI 0.67 to 1.02; p-value = 0.0733 and absolute difference 3.1%). New PUs of category ≥ 3 developed in 32 (1.6%) participants with insufficient evidence of a difference between mattress groups in time to PU development (Fine and Gray model HR 0.81, 95% CI 0.40 to 1.62; p = 0.5530 and absolute difference 0.4%). Of the 145 pre-existing PUs of category 2, 89 (61.4%) healed – there was insufficient evidence of a difference in time to healing (Fine and Gray model HR 1.12, 95% CI 0.74 to 1.68; p = 0.6122 and absolute difference 2.9%). Health economics – the within-trial and long-term analysis showed APM to be cost-effective compared with HSFM; however, the difference in costs models are small and the quality-adjusted life-year gains are very small. There were no safety concerns. Blinded photography substudy – the reliability of central blinded review compared with clinical assessment for PUs of category ≥ 2 was ‘very good’ (kappa statistic 0.82, prevalence- and bias-adjusted kappa 0.82). Quality-of-life substudy – the Pressure Ulcer Quality of Life – Prevention (PU-QoL-P) instrument meets the established criteria for reliability, construct validity and responsiveness. Limitations: A lower than anticipated event rate. Conclusions: In acutely ill inpatients who are bedfast/chairfast and/or have a category 1 PU and/or localised skin pain, APMs confer a small treatment phase benefit that is diminished over time. Overall, the APM patient compliance, very low PU incidence rate observed and small differences between mattresses indicate the need for improved indicators for targeting of APMs and individualised decision-making. Decisions should take into account skin status, patient preferences (movement ability and rehabilitation needs) and the presence of factors that may be potentially modifiable through APM allocation, including being completely immobile, having nutritional deficits, lacking capacity and/or having altered skin/category 1 PU. Future work: Explore the relationship between mental capacity, levels of independent movement, repositioning and PU development. Explore ‘what works for whom and in what circumstances’. Trial registration: Current Controlled Trials ISRCTN01151335. Funding: This project was funded by the National Institute for Health Research Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 52. See the NIHR Journals Library website for further project information

An Outbreak of Serotype 1 Streptococcus pneumoniae Meningitis in Northern Ghana with Features That Are Characteristic of Neisseria meningitidis Meningitis Epidemics

BackgroundThe Kassena-Nankana District (KND) of northern Ghana lies in the African meningitis belt, where epidemics of bacterial meningitis have been reoccurring every 8-12 years. These epidemics are generally caused by Neisseria meningitidis an organism that is considered to be uniquely capable of causing meningitis epidemics MethodsWe recruited all patients with suspected meningitis in the KND between 1998 and 2003. Cerebrospinal fluid samples were collected and analyzed by standard microbiological techniques. Bacterial isolates were subjected to serotyping, multilocus sequence typing (MLST), and antibiotic-resistance testing ResultsA continual increase in the incidence of pneumococcal meningitis was observed from 2000 to 2003. This outbreak exhibited strong seasonality, a broad host age range, and clonal dominance, all of which are characteristic of meningococcal meningitis epidemics in the African meningitis belt. The case-fatality rate for pneumococcal meningitis was 44.4%; the majority of pneumococcal isolates were antibiotic sensitive and expressed the serotype 1 capsule. MLST revealed that these isolates belonged to a clonal complex dominated by sequence type (ST) 217 and its 2 single-locus variants, ST303 and ST612 ConclusionsThe S. pneumoniae ST217 clonal complex represents a hypervirulent lineage with a high propensity to cause meningitis, and our results suggest that this lineage might have the potential to cause an epidemic. Serotype 1 is not included in the currently licensed pediatric heptavalent pneumococcal vaccine. Mass vaccination with a less complex conjugate vaccine that targets hypervirulent serotypes should, therefore, be considere