A systematic review of topical skin care in aged care facilities

This systematic review aimed to evaluate the best available evidence regarding the effectiveness of topical skin care interventions for residents of aged care facilities. Introduction. Natural changes to skin, as well as increased predisposition to pressure sores and incontinence, means residents of aged care facilities readily require topical skin care. A range of interventions exist that aim to maintain or improve the integrity of skin of older adults. Methods. Pubmed, Embase, Current Contents, CINAHL and The Cochrane Library databases were searched, as well as Health Technology Assessment websites up to April 2003. Systematic reviews and randomized or non-randomized controlled trials were evaluated for quality and data were independently extracted by two reviewers. Results. The effectiveness of topical skin interventions was variable and dependent on the skin condition being treated. Studies examined the effectiveness of washing products on incontinence irritated skin. Disposable bodyworns may prevent deterioration of skin condition better than non-disposable underpads or bodyworns. Clinisan, a no-rinse cleanser may reduce the incidence of incontinence associated pressure ulcers when compared with soap and water. Conclusion. In general the quality of evidence for interventions to improve or maintain the skin condition in the older person was poor and more research in this area is needed. Relevance to Clinical Practice. Skin care is a major issue for nurses working with older people. On the basis of this review no clear recommendations can be made. This lack of strong evidence for nurses to base effective practice decisions is problematic. However, the 'best' evidence suggests that disposable bodyworns are a good investment in the fight against skin deterioration. No rinse cleansers are to be preferred over soap and the use of the bag bath appears to be a useful practice to reduce the risk of dry skin ( a risk factor for breaches in skin integrity).

Differences in sharing knowledge interpersonally and via databases: The role of evaluation apprehension and perceived benefits

Knowledge sharing is an essential component of effective knowledge management. However, evaluation apprehension, or the fear that your work may be critiqued, can inhibit knowledge sharing. Using the general framework of social exchange theory, we examined the effects of evaluation apprehension and perceived benefit of knowledge sharing ( such as enhanced reputation) on employees' knowledge sharing intentions in two contexts: interpersonal (i.e., by direct contact between two employees) and database (i.e., via repositories). Evaluation apprehension was negatively associated with knowledge sharing intentions in both contexts while perceived bene. it was only positively associated with knowledge sharing intentions in the database context. Moreover, compared to the interpersonal context, evaluation apprehension was higher and knowledge sharing lower in the database context. Finally, the negative effects of evaluation apprehension upon knowledge sharing intentions were worse when perceived benefits were low compared to when perceived benefits were high.

Multiresolution spatial databases: Making web-based spatial advances faster

Spatial data has now been used extensively in the Web environment, providing online customized maps and supporting map-based applications. The full potential of Web-based spatial applications, however, has yet to be achieved due to performance issues related to the large sizes and high complexity of spatial data. In this paper, we introduce a multiresolution approach to spatial data management and query processing such that the database server can choose spatial data at the right resolution level for different Web applications. One highly desirable property of the proposed approach is that the server-side processing cost and network traffic can be reduced when the level of resolution required by applications are low. Another advantage is that our approach pushes complex multiresolution structures and algorithms into the spatial database engine. That is, the developer of spatial Web applications needs not to be concerned with such complexity. This paper explains the basic idea, technical feasibility and applications of multiresolution spatial databases.

Efficiently computing weighted proximity relationships in spatial databases

Spatial data mining recently emerges from a number of real applications, such as real-estate marketing, urban planning, weather forecasting, medical image analysis, road traffic accident analysis, etc. It demands for efficient solutions for many new, expensive, and complicated problems. In this paper, we investigate the problem of evaluating the top k distinguished “features” for a “cluster” based on weighted proximity relationships between the cluster and features. We measure proximity in an average fashion to address possible nonuniform data distribution in a cluster. Combining a standard multi-step paradigm with new lower and upper proximity bounds, we presented an efficient algorithm to solve the problem. The algorithm is implemented in several different modes. Our experiment results not only give a comparison among them but also illustrate the efficiency of the algorithm.