Prevention of Damage to Cuffed Catheters

Cuffed catheters, although not ideal for long-term use, are now used more frequently due to an increase in the aging population, in whom the vessels are not suitable for either arteriovenous fistulas or polytetrafluoroethylene (PTFE) grafts. Infections and thrombosis remain the major causes for removal or change of catheters. We recently identified eight catheter defects that required replacement of catheters. Of these, two were due to patient negligence: one catheter was accidentally severed while the patient was shaving; the other was snipped during a haircut. One was believed to have a manufacturing defect. One catheter sustained needle-prick damage near the hub while irrigating the catheter. Two catheters were lost due to needle pricks during skin closure, and one catheter sustained similar damage while fixing the suture wing to the skin. The other two were damaged by suture material slicing through the lumen of the catheter as it expanded due to increased blood flow during repeated dialyses. Importantly, several of these injuries to the catheters were not immediately obvious and were detected only after repeated use of the catheters. Delayed bleeding of cuffed catheters necessitating change or removal has not been reported. Such bleeding may be due to manufacturing defects, patient carelessness, or iatrogenic causes. Avoiding the use of sutures can minimize the latter. Skin closure strips and a double transparent dressing may serve the same purposes, such as securing the catheter and aiding wound healing. In addition, these dressings have the added advantage of being waterproof, bacteria-proof, and cost effective.     

The Housing Consequences of Living Arrangement Choices in Young Adulthood

This paper documents the consequences of the first living arrangements of young adults after leaving the parental home (without a partner, cohabiting, or married) for their housing situation, whether they rent independently, share accommodation, or own their own homes, both immediately after leaving home and in the first eight years after leaving. Data are analysed from two retrospective life-course surveys conducted in the Netherlands in the 1990s, using multinomial logistic regression models. The paper finds a strong influence of the timing and pathway of leaving on the housing situation immediately after leaving: those nest-leavers who make stronger commitments in their household careers (by cohabiting, or by marrying) are more likely to own a home and less likely to share. Although through the years after leaving home this influence decreases, it remains discernible and significant even eight years after leaving. This is remarkable, given the fluidity of the housing careers of nest-leavers.     

Informal care can be better than adequate: Development and evaluation of the Exemplary Care Scale.

Purpose: To evaluate a new measure assessing excellent, or exemplary, informal care--an aspect of caregiving that has received little attention. The Exemplary Care Scale (ECS) was developed on the basis of insights from previous research with items generated by the authors in consultation with a multidisciplinary research team. Design: 310 informal caregivers and 283 of their elderly care recipients completed the ECS and other measures pertaining to quality of care and its presumed correlates. Results: Factor analyses indicated that the ECS consists of 2 factors reflecting provision of exceptional care (Provide) and respect for care recipient autonomy, wishes, and the like (Respect). The ECS factor structure was equivalent among caregivers and care recipients. Both factors were empirically distinct from existing measures of poor quality and adequate care. Each ECS factor was associated with other care-related constructs in predictable ways, implying construct validity. Conclusions: The ECS, in conjunction with existing measures, provides a more comprehensive assessment of the quality-of-care continuum and should prove useful to researchers and practitioners interested in quality of informal care provided to chronically ill or disabled people. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The video window: my life with a ludic system

The video window is a video screen hanging next to a window on my bedroom wall, showing the image from a camera mounted to show the skyline from outside that same window. In this paper, I describe the appeal of living with such a system, and the intermingled aesthetic, utilitarian and practical issues involved in its creation and the experience it offers.     

婴幼儿化妆品市场纵览

论述了婴幼儿护理品市场的发展现状，并对其产品配方组分的选择提出建议。探讨了婴幼儿护理品的原料、产品及安全性。指出，婴幼儿护理品配方用于皮肤上应该是质纯、简约、温和以及安全的，天然和有机绿色产品将是未来婴幼儿护理品的发展趋势。     

全球口腔护理品市场保持平稳发展

对全球口腔护理品市场进行了分析，认为全球口腔护理用品的销售呈稳定的发展趋势。由于天然组分的增加，化学组分将逐渐被具有功能声称的植物基成分所替代。有机物的开发及产品的增长将会变得越来越困难。漱口水／含漱水是该市场中最具活力的一部分，牙线预计将成为第2大增长最快的类别。可持续增长的关键是对消费者的教育。自有品牌产品的销售将会有所增加。     

A genetic algorithm approach to a nurse rerostering problem

The nurse rerostering problem occurs when one or more nurses cannot work in shifts that were previously assigned to her or them. If no pool of reserve nurses exists to replace those absent, then the current roster must be rebuilt. This new roster must comply with the labour rules and institutional constraints. Moreover, it must be as similar as possible to the current one. The present paper describes constructive heuristics, besides several versions of genetic algorithms based on specific encoding and operators for sequencing problems applied to the nurse rerostering problem, defined with hard constraints. In the genetic algorithms described, each individual in the population is associated with a pair of chromosomes, representing permutations of tasks and nurses. Those permutations are used as input to a procedure that generates rosters. The fitness of individuals is given by the similarity between the roster generated from the permutations and the current one. The authors developed several versions of the genetic algorithm, whose difference lay in the encoding of permutations and in the genetic operators used for each encoding. These heuristics were tested with real data from a Lisbon hospital and yielded good quality solutions.     

Method to analyze user behavior in home environment

The development of computing technology affects the environmental change of residential area a lot in a many ways. In other words, we believe that Ubiquitous computing technology will change our very vision of our homes. The most distinct phenomenon of Ubiquitous environment is that the number of personal computers will increase mainfold. That means in the near future we will coexist with computers in routine life and people will have more computers to manage. In terms of User Interface, the interaction between systems and users in home-network environment should step up the next level which is different from present method of using computer. Therefore, Ubiquitous environment should be embodied for people and it must be started with understanding users and grasping sophisticated and fundamental needs of them. In this research study, we have attempted to give shape to ‘Method to Analyze User Behavior’ to make embodiment of user interface in Ubiquitous environment by considering and analyzing user’s behavior patterns. With this aim, we have extracted contexts at home from a case study and will suggest analyzing method by classifying data of the study.     

Collaborative tele-rehabilitation and robot-mediated therapy for stroke rehabilitation at home or clinic

Successful home-rehabilitation should reduce cost, facilitate virtual therapeutic visits, and motivate stroke survivors to engage in under-supervised therapeutic activity at levels necessary for motor learning and generalization to occur. We explored long-distance collaborative “play” using two 6DOF robot-mediated environments and examined the influence on the motivation of able-bodied persons to engage in therapy, sustain play, and relate during a shared task, tic-tac-toe. A clear positive trend existed in favor of the collaborative robot-mediated environment, which subjects found more valuable, interesting, and enjoyable, and was therefore willing to spend more time at the task. Kinematic metrics such as mean velocity of movement and movement smoothness were sensitive to the changes in the level of collaboration in the environment in that sub-movements from rest to the piece were slower and less directed than movements to place the piece at the target tic-tac-toe location. We discuss our experiment, results and its application to stroke rehabilitation and to the development of collaborative tele-rehabilitation at home.