Effects of wearing a pressure redistribution belt while lying in a hospital bed

Bedsores (ulcers) are caused by multiple factors which include, but are not limited to; pressure, shear force, friction, temperature, age and medication. Specialised support services, such as specialised mattresses, sheepskin coverings etc., are thought to decrease or relieve pressure, resulting in a lowering of pressure ulcer incidence [3]. The primary aim of this study was to compare the upper/central body pressure distribution between normal lying in a hospital bed versus the use of a pressure redistribution belt. The study involved 16 healthy voluntary subjects lying on a hospital bed with and without wearing the belt. Results showed that the use of a pressure redistribution belt results in reduced pressure peaks and prevents the pressure from increasing over time.

The effect of hydrogel and silicone hydrogel contact lenses on the measurement of intraocular pressure with rebound tonometry

Purpose: To assess the accuracy of intraocular pressure(IOP) measurements using rebound tonometry over disposable hydrogel (etafilcon A) and silicone hydrogel (senofilcon A) contact lenses (CLs) of different powers. Methods: The experimental group comprised 36 subjects (19 male, 17 female). IOP measurements were undertaken on the subject’s right eyes in random order using a rebound tonometer (ICare). The CLs had powers of +2.00D, −2.00D and−6.00D. Six measurements were taken over each contact lens and also before and after the CLs had been worn. Results: A good correlation was found between IOP measurements with and without CLs (all r≥0.80; p < 0.05). Bland Altman plots did not show any significant trend in the difference in IOP readings with and without CLs as a function of IOP value. A two-way ANOVA revealed a significant effect of material and power (p < 0.01) but no interaction. All the comparisons between the measurements without CLs and with hydrogel CLs were significant (p < 0.01). The comparisons with silicone hydrogel CLs were not significant. Conclusions: Rebound tonometry can be reliably performed over silicone hydrogel CLs. With hydrogel CLs, the measurements were lower than those without CLs. However, despite the fact that these differences were statistically significant, their clinical significance was minimal.

Interacting constraints of defensive pressure and ball displacement trajectories shape locomotor pointing behaviours in association football

Performance of locomotor pointing tasks (goal-directed locomotion) in sport is typically constrained by dynamic factors, such as positioning of opponents and objects for interception. In the team sport of association football, performers have to coordinate their gait with ball displacement when dribbling and when trying to prevent opponent interception when running to kick a ball. This thesis comprises two studies analysing the movement patterns during locomotor pointing of eight experienced youth football players under static and dynamic constraints by manipulating levels of ball displacement (ball stationary or moving) and defensive pressure (defenders absent, or positioned near or far during performance). ANOVA with repeated measures was used to analyse effects of these task constraints on gait parameters during the run-up and cross performance sub-phase. Experiment 1 revealed outcomes consistent with previous research on locomotor pointing. When under defensive pressure, participants performed the run-up more quickly, concurrently modifying footfall placements relative to the ball location over trials. In experiment 2 players coordinated their gait relative to a moving ball significantly differently when under defensive pressure. Despite no specific task instructions being provided beforehand, context dependent constraints interacted to influence footfall placements over trials and running velocity of participants in different conditions. Data suggest that coaches need to manipulate task constraints carefully to facilitate emergent movement behaviours during practice in team games like football.

The intraocular pressure response to dehydration : a pilot study

This study was designed to determine the Intraocular Pressure (IOP) response to differing levels of dehydration. Seven males participated in a 90 minute treadmill walk (5 km/h and 1 % grade) in both a cool (22 °C) and hot (43 °C) climate. At Baseline and at 30 minute intervals measurements of IOP, by tonometery, and indicators of hydration status (nude weight and plasma osmolality (Posm)) were taken. Body temperature and heart rate were also measured at these time points. Statistically significant interactions (time point (4) by trial (2)) were observed for IOP (F = 10.747, p = 0.009) and body weight loss (F = 50.083, p < 0.001) to decrease, and Posm (F = 34.867, p < 0.001) to increase, by a significantly greater amount during the hot trial compared to the cool. A univariate general linear model showed a significant relationship between IOP and body weight loss (F = 37.63, p < 0.001) and Posm (F = 38.53, p < 0.001). A significant interaction was observed for body temperature (F = 20.908, p < 0.001) and heart rate (F = 25.487, p < 0.001) between the trials and time points, but there was negligible association between these variables and IOP (Pearson correlation coefficient < ±0.5). The present study provides evidence to suggest that IOP is influenced by hydration status.

Cost effectiveness of nutrition support in the prevention of pressure ulcer in hospitals

Background/objectives This study estimates the economic outcomes of a nutrition intervention to at-risk patients compared with standard care in the prevention of pressure ulcer. Subjects/methods Statistical models were developed to predict ‘cases of pressure ulcer avoided’, ‘number of bed days gained’ and ‘change to economic costs’ in public hospitals in 2002–2003 in Queensland, Australia. Input parameters were specified and appropriate probability distributions fitted for: number of discharges per annum; incidence rate for pressure ulcer; independent effect of pressure ulcer on length of stay; cost of a bed day; change in risk in developing a pressure ulcer associated with nutrition support; annual cost of the provision of a nutrition support intervention for at-risk patients. A total of 1000 random re-samples were made and the results expressed as output probability distributions. Results The model predicts a mean 2896 (s.d. 632) cases of pressure ulcer avoided; 12 397 (s.d. 4491) bed days released and corresponding mean economic cost saving of euros 2 869 526 (s.d. 2 078 715) with a nutrition support intervention, compared with standard care. Conclusion Nutrition intervention is predicted to be a cost-effective approach in the prevention of pressure ulcer in at-risk patients.

Near-Wall Turbulent Pressure Diffusion Modeling and Influence in Three-Dimensional Secondary Flows

The purpose of this paper is to develop a second-moment closure with a near-wall turbulent pressure diffusion model for three-dimensional complex flows, and to evaluate the influence of the turbulent diffusion term on the prediction of detached and secondary flows. A complete turbulent diffusion model including a near-wall turbulent pressure diffusion closure for the slow part was developed based on the tensorial form of Lumley and included in a re-calibrated wall-normal-free Reynolds-stress model developed by Gerolymos and Vallet. The proposed model was validated against several one-, two, and three-dimensional complex flows.

Open design of high pressure ratio radial-inflow turbine for academic validation

Computational Fluid Dynamics (CFD) simulations are widely used in mechanical engineering. Although achieving a high level of confidence in numerical modelling is of crucial importance in the field of turbomachinery, verification and validation of CFD simulations are very tricky especially for complex flows encountered in radial turbines. Comprehensive studies of radial machines are available in the literature. Unfortunately, none of them include enough detailed geometric data to be properly reproduced and so cannot be considered for academic research and validation purposes. As a consequence, design improvements of such configurations are difficult. Moreover, it seems that well-developed analyses of radial turbines are used in commercial software but are not available in the open literature especially at high pressure ratios. It is the purpose of this paper to provide a fully open set of data to reproduce the exact geometry of the high pressure ratio single stage radial-inflow turbine used in the Sundstrand Power Systems T-100 Multipurpose Small Power Unit. First, preliminary one-dimensional meanline design and analysis are performed using the commercial software RITAL from Concepts-NREC in order to establish a complete reference test case available for turbomachinery code validation. The proposed design of the existing turbine is then carefully and successfully checked against the geometrical and experimental data partially published in the literature. Then, three-dimensional Reynolds-Averaged Navier-Stokes simulations are conducted by means of the Axcent-PushButton CFDR CFD software. The effect of the tip clearance gap is investigated in detail for a wide range of operating conditions. The results confirm that the 3D geometry is correctly reproduced. It also reveals that the turbine is shocked while designed to give a high-subsonic flow and highlight the importance of the diffuser.

A prospective window into medical device-related pressure ulcers in intensive care

Objective: To determine the prevalence, severity, location, etiology, treatment, and healing of medical device-related pressure ulcers in intensive care patients for up to 7 days. Design: Prospective repeated measures study. Setting and participants: Patients in 6 intensive care units of 2 major medical centers, one each in Australia and the United States, were screened 1 day per month for 6 months. Those with device-related ulcers were followed daily up to 7 days. Outcome measures: Device-related ulcer prevalence, pain, infection, treatment, healing. Results: 15/483 patients had device-related ulcers and 9/15 with 11 ulcers were followed beyond screening. Their mean age was 60.5 years, most were men, over-weight, and at increased pressure ulcer risk. Endotracheal and nasogastric tubes were the cause of most device-related ulcers. Repositioning was the most frequent treatment. 4/11 ulcers healed within the 7 day observation period. Conclusion: Device-related ulcer prevalence was 3.1%, similar to that reported in the limited literature available, indicating an ongoing problem. Systematic assessment and repositioning of devices are the mainstays of care. We recommend continued prevalence determination and that nurses remain vigilant to prevent device-related ulcers, especially in patients with nasogastric and endotracheal tubes.