Ergonomic evaluation of hospital bed design features during patient handling tasks

Patient handling tasks (e.g., transportation and repositioning) are important causes of musculoskeletal disorders among healthcare workers. The purpose of this study was to evaluate, during two patient handling tasks, the physical demands resulting from alternative hospital bed design features. Twenty-four novice participants were involved in two laboratory-based studies. The effects of a steering lock and adjustable push height were evaluated during a patient transportation task using perceptual responses and measures of performance and physical demands, and the effect of a bed contour feature was determined based on patient sliding distance during repeated bed raising/lowering. Use of the steering lock reduced the number of adjustments during bed maneuvering by 28% and decreased ratings of physical demands. Use of the adjustable push height reduced shoulder moments by 30%. With the contour feature, patient sliding distance was reduced by ∼40% over 12 raise/lower cycles. These results suggest that the steering lock and adjustable push height features can reduce physical demands placed on healthcare workers during patient transportation tasks. Although patient sliding distance was reduced using the contour feature, assessing direct effects of this feature on physical demands (e.g., reduced need for workers to reposition patients) will require further investigation.

Relevance to industry

Hospital bed design features have the potential to reduce physical demands required of healthcare workers, yet there have been only limited empirical studies of these. Findings of the two current studies suggest that proactive ergonomic considerations in hospital bed design can reduce these physical demands.     

Inflammatory central nervous system demyelination: correlation of magnetic resonance imaging findings with lesion pathology

Magnetic resonance imaging (MRI) is widely used to evaluate and monitor disease activity in inflammatory demyelinating central nervous system (CNS) diseases such as multiple sclerosis. The present study aimed at correlating MRI findings with histological parameters in 6 cases of biopsy-proven inflammatory demyelination of the CNS. The earliest stages of demyelinating activity manifested as almost isointense lesions with a massive gadolinium-DTPA (Gd-DTPA) enhancement in T1-weighted scans. In T2-weighted scans, early active lesions formed a border of decreased intensity compared with the lesion center and the perifocal edema. The morphological correlate of this pattern in our patients was activated macrophages in the zone of myelin destruction at the plaque border. Late active lesions were hypointense in T1 and hyperintense in T2 scans. Inactive demyelinated and remyelinating lesions were hyperintense in T2 scans and enhanced inhomogenously after Gd-DTPA application. T1 scans revealed major differences in the degree of hypointensity that correlated with the extent of axonal damage, extracellular edema, and the degree of demyelination or remyelination.     

Coexisting chaotic and periodic dynamics in clock escapements

This paper addresses the nature of noise in machines. As a concrete example, we examine the dynamics of clock escapements from experimental, historical and analytical points of view. Experiments on two escapement mechanisms from the Reuleaux kinematic collection at Cornell University are used to illustrate chaotic-like noise in clocks. These vibrations coexist with the periodic dynamics of the balance wheel or pendulum. A mathematical model is presented that shows how self-generated chaos in clocks can break the dry friction in the gear train. This model is shown to exhibit a strange attractor in the structural vibration of the clock. The internal feedback between the oscillator and the escapement structure is similar to anti-control of chaos models.     

Intestinal foreign body with sigmoid perforation in an area of carcinomatous stenosis: incidental finding or etiology?

Ingestion of a foreign body is a common incident. In most cases it rarely produces symptoms, but sometimes may cause severe complications such as abscess formation, obstruction or perforation. A definite diagnosis can be difficult to obtain for the following reasons: 1. the past history doesn't give any clue; 2. the symptoms are veiled by another intestinal disease; 3. radio opaquity of the foreign body is absent; 4. complications can mimic different symptoms inspite of their unique etiology. The following case reports a patient with an intestinal perforation, where a foreign body and a stenosis, caused by a sigma neoplasm, were simultaneously present. Histological findings showed that the foreign body, not the neoplasm, was causing the perforation, whereas for the underlying disease it only was an incidental finding.     

Chronic diseases, coping with illness and complementary medicine

The increasing demands for complementary medical practises by patients with chronic diseases is seen in the context of a global model of contending with disease. The author assumes that only few variables of this model may influence "supply and demand" in the "marketplace of complementary medical methods" and that the importance of these methods may fade. Finally the encounter with patients asking for complementary medical methods is considered.     

Physiological Dynamics in Demyelinating Diseases: Unraveling Complex Relationships through Computer Modeling

Despite intense research, few treatments are available for most neurological disorders. Demyelinating diseases are no exception. This is perhaps not surprising considering the multifactorial nature of these diseases, which involve complex interactions between immune system cells, glia and neurons. In the case of multiple sclerosis, for example, there is no unanimity among researchers about the cause or even which system or cell type could be ground zero. This situation precludes the development and strategic application of mechanism-based therapies. We will discuss how computational modeling applied to questions at different biological levels can help link together disparate observations and decipher complex mechanisms whose solutions are not amenable to simple reductionism. By making testable predictions and revealing critical gaps in existing knowledge, such models can help direct research and will provide a rigorous framework in which to integrate new data as they are collected. Nowadays, there is no shortage of data; the challenge is to make sense of it all. In that respect, computational modeling is an invaluable tool that could, ultimately, transform how we understand, diagnose, and treat demyelinating diseases.     

Revisiting technological pedagogical content knowledge: Exploring the TPACK framework

This study examines the nature of technological pedagogical content knowledge (TPACK) through the use of a factor analysis. Using a survey with 24 items designed to measure each of the areas described by the TPACK framework, and measuring the responses of 596 online teachers from across the United States, data suggest that while the framework is helpful from an organizational standpoint, it is difficult to separate out each of the domains, calling into question their existence in practice. Three major factors become evident, but rather than being comprised of pedagogy, content, and technology, the only clear domain that distinguishes itself is that of technology. This research examines the validity of the TPACK model and suggests that measuring each of these domains is complicated and convoluted, potentially due to the notion that they are not separate.     

Synthesis and surface characterization of copoly(imide alkyl ether)s containing pendant fluoroalkyl groups

A series of copoly(imide alkyl ether)s were synthesized to explore surface migration of fluorinated alkyl ether blocks (AEFO)s. Mechanical and surface properties of solution cast, thermally imidized films were determined. Incorporation of the AEFO oligomers at loading levels up to 5 wt % resulted in a slight decrease (usually less than 10%) in tensile modulus. Surface migration of the AEFOs raised the advancing water contact angle from approximately 80° to above 95° for the copolymer systems. The composition at which addition of more AEFO further increased water contact angle values was related to the number of fluorine atoms in the perfluorinated side chains. Surface excess concentration of the AEFO at different loading levels was calculated from X‐ray photoelectron spectroscopy results. At higher AEFO loading levels, the surface excess concentration was relatively constant suggesting formation of stable structures within the bulk similar to micelle formation in surfactant solutions. Based on these results, it was determined that surface saturation occurred with the fluorinated AEFO species at loading levels as low as 1 wt % engendering changes in surface properties while retaining the bulk imide properties. © 2014 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2015 , 132, 41538.     

Cooperative Vaccinia Infection Demonstrated at the Single-Cell Level Using FluidFM

The mechanisms used by viruses to enter and replicate within host cells are subjects of intense investigation. These studies are ultimately aimed at development of new drugs that interfere with these processes. Virus entry and infection are generally monitored by dispensing bulk virus suspensions on layers of cells without accounting for the fate of each virion. Here, we take advantage of the recently developed FluidFM to deposit single vaccinia virions onto individual cells in a controlled manner. While the majority of virions were blocked prior to early gene expression, infection of individual cells increased in a nondeterministic fashion with respect to the number of viruses placed. Microscopic analyses of several stages of the virus lifecycle indicated that this was the result of cooperativity between virions during early stages of infection. These findings highlight the importance of performing controlled virus infection experiments at the single cell level.