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An outbreak of OXA-23-producing carbapenem-resistant Acinetobacter baumannii amongst ICU-patients with COVID-19 likely occurred by transmission through inanimate surfaces, potentially facilitated by a contaminated positioning pillow shared between patients. Subsequent rapid spread may have been caused by exposure to respiratory secretions contaminating healthcare worker's gloves and gowns during prone positioning. [ABSTRACT FROM AUTHOR]

Pillow plate heat exchangers show promising performance in extending the operating range of thermosiphon reboilers. Here, the evaporation of binary mixtures during natural circulation evaporation in a pillow plate apparatus was investigated. The experimental results show that the thermal performance is dominated by mixture effects and a component system‐dependent minimum is found. The model approach according to Bennett and Chen has proven to reliably estimate the product‐side heat transfer coefficient for pure substances and mixtures with a low boiling point distance. For wide‐boiling mixtures and low pressures the approach must be adjusted. [ABSTRACT FROM AUTHOR]

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Introduction: Pressure injuries are a preventable yet highly prevalent health concern. Wheelchair cushion prescription can have significant implications for wheelchair users' risk of pressure injury development, which can impact functional abilities and quality of life. The efficacy of a wheelchair cushion to redistribute pressure has been well‐researched, but the efficacy to manage the microclimate is less clear, particularly in warm‐hot environments. The aim of this study was to systematically review studies examining the effect of wheelchair cushions on temperature, moisture and thermal perception to determine which cushions are superior to improve these responses. Method: A systematic review with meta‐analyses of randomised cross‐over and randomised control trials of wheelchair cushion interventions on measures of temperature, moisture, and thermal perception was conducted. Results: Eight studies were identified that met the eligibility criteria and six meta‐analyses were conducted. Pooled analyses identified a significantly lower temperature on foam‐gel cushions compared to air cushions (MD = 0.80, 95% CI: 0.31, 1.29; p = 0.002) and a significantly lower temperature on foam‐gel cushions compared to foam cushions (SMD = 0.76, 95%CI; 0.45, 1.06; p < 0.00001). Pooled analyses also demonstrated significantly lower relative humidity (i.e., moisture) on foam cushions compared to foam‐gel cushions (p = 0.02). Differences in thermal perception were inconclusive due to limited data found. Conclusion: It is clear that not one cushion is ideal in managing all aspects of microclimate, as foam‐gel cushions were the superior cushion to manage temperature and foam cushions were the superior cushion to manage moisture. This article provides occupational therapists and other health professionals with evidence‐based information to assist with wheelchair cushion prescription that minimises the temperature and moisture accumulation, and associated risk of pressure injury for wheelchair users. [ABSTRACT FROM AUTHOR]

The increasing number of wheelchair users and their risk of medical complications such as pressure ulcers (PU) make it important to have a better understanding of their seating characteristics. However, while most studies tackling this issue are based on static measurements, wheelchair users are active in their wheelchairs when performing daily life activities. This suggests the need to assess the mechanical loads at the wheelchair user's body–seat interface during dynamic activities. A scoping review was conducted to explore the existing data (shear load and pressure) and highlight significant parameters, relevant conditions and methodological strategies when studying wheelchair users performing a dynamic task. The literature search was performed by applying the PRISMA methodology. A total of 11 articles met the inclusion criteria. Differences between static and dynamic data were found in the literature for peak pressure values, pressure distribution and the location of peak pressure. None measured tangential load at the seat/body interface, although two studies measured the shift of the ischial region. A significant impact of the type of pathology has been quantified, showing the need to perform experimental studies on diverse populations. The protocol and the pressure parameters studied were very diverse. Further studies carefully choosing interface pressure mapping parameters and investigating a broader range of pathologies are required. Additionally, researchers should focus on finding a way to measure seated tangential load. [ABSTRACT FROM AUTHOR]

AbstractThe fundamental function of an optimal cervical pillow is to provide sufficient support to maintain normal spinal alignment and minimize biological stress on the contact surface throughout sleep. The recent advancements in cervical pillows have mainly focused on the subjective and objective evaluations of support comfort, as well as the relationship between pillow height and cervical vertebrae posture. However, only a few studies have addressed shape design guidelines and mechanical performances of the pillows themselves. In this study, a two-sectional contour cervical pillow comprising an arc and a Bezier curve is designed to support the head and neck. The design of the arc-shaped neck section incorporates the Cobb’s angle and Borden value from healthy individuals to reflect the consistency of normal cervical anatomical features. The Bezier curve-based head section takes the head length and neck depth into account as significant individual differences. Static analysis and lattice optimization are performed in ANSYS Workbench to develop a variable-density cellular structure, aimed at improving air permeability and reducing the risk of pressure ulcers associated with the cervical pillow. The rapid prototyping technique fused deposition modeling (FDM) and thermoplastic material polylactic acid (PLA) are employed for fabricating different cellular structures. The results demonstrate that the neck section experiences less stress and greater deformation in comparison to the head section, indicating good comfort and support provided by the designed cervical pillow. Additionally, the compressive, bending, and cushion properties of the 3D-printed cervical pillow with variable-density cellular structure are experimentally validated, further confirming its effectiveness. [ABSTRACT FROM AUTHOR]

Objective: A feasibility study to test the proposed methodology for a larger randomised control trial was conducted, investigating the comparative effectiveness of the two types of pressure management support surfaces with regards to healing pressure injuries (PI). A secondary objective was to provide insights into the user acceptability of the two types of pressure management support surfaces. Method: A randomised control feasibility study was conducted in a community health setting in Canberra, Australia. Patients aged ≥65 years with an existing Stage 2 PI who slept in a bed were eligible. Participants were randomised to either the active mattress group or the reactive mattress group for use on their bed. All participants received standard wound care by community nursing staff and were provided an air-flotation cushion for use when not in bed. Photographs were taken and used for blind assessment of wound healing. Secondary information was gathered through a survey regarding user acceptability of the support surfaces and changes in habits regarding PI prevention strategies. Results: In total, five patients were recruited, with one passing away prior to mattress allocation. Results were inconclusive with regards to comparative effectiveness and user acceptability due to the small sample size; however, secondary data indicated an increasing implementation of PI prevention strategies. Conclusion: This study confirmed the need for further high quality research comparing reactive and active pressure mattresses. Trends indicate the importance of including education on PI prevention strategies to promote changes in behaviour. Changes to the proposed methodology will be made to increase recruitment in the primary study. [ABSTRACT FROM AUTHOR]

To describe the current seating recommendations made by a seating clinic for wheelchair users who presented with a Pressure Injury (PrI) or history of PrI. Retrospective review of electronic medical records of 133 adults who used a wheelchair as their primary means of mobility who had a cushion evaluation during which interface pressure mapping data was documented. Clinicians adjusted 71% of participants' wheelchair cushions, including 49% who received a new cushion, and 37% of participants' wheelchairs. The most common adjustments besides receiving a new cushion were: addition of an underlay, adjusting the inflation of a cushion, and adjustments to the foot or back support of the wheelchair. Forty-five participants only received adjustments (i.e. no new cushion), while 23 participants only received education and feedback rather than equipment modifications. Those 23 participants had significantly lower Peak Pressure Index (PPI) than those who received equipment modifications (mean [95% CI] 76.7 [59.1, 94.3] versus 111.6 [102.1, 121.2] respectively, p = 0.001). The PPI was reduced by an average of 22.5 mmHg from the initial to final seating system amongst those who received modifications ([13.9–31.0], p<.001). The seating clinicians considered interface pressure mapping in their decision-making and effectively reduced interface pressures with their interventions. Cushion replacement is important when someone presents with a PrI. However, adjusting an existing wheelchair cushion and/or seating system provides important additions and alternatives to consider for reducing interface pressure. There is also a role for education about proper use of equipment, weight shifts, and alternate seating surfaces. A cushion evaluation may involve evaluating more than one cushion configuration and using pressure mapping to compare the best options. To address perceived wheelchair cushion issues, posture and positioning should be evaluated and adjusted as necessary, in addition to evaluating the cushion itself. Common positioning modifications include: modifying/adding cushion underlays or inflation and foot and back supports in response to clients' changing postural needs and wheelchair components coming out of optimal position due to wear and tear. Adjustments to the wheelchair and cushion aim to distribute body weight over a larger surface area, reduce pressure at high-risk locations, improve posture, and increase function. These adjustments should consider individual's specific needs and goals, while also being mindful of funding barriers. [ABSTRACT FROM AUTHOR]

Pressure ulcers (PUs) are prevalent among immobile bed or wheelchair-reliant individuals who experience prolonged sedentary positions. Pressure relief and frequent repositioning of body posture help to mitigate complications associated with PUs. Adherence with regular repositioning is difficult to maintain due to nursing labour shortages or constraints of in-home caregivers. Manual repositioning, transferring, and lifting of immobile patients are physically demanding tasks for caregivers. This review aimed to explore and categorize these devices, discuss the significant technical challenges that need addressing, and identify potential design opportunities. In this review, a literature search was conducted using PubMED, Science Direct, Google Scholar and IEEE Xplore databases including studies from 1995 until Feb 2023 with keywords such as pressure ulcer, assistive device, pressure relief, repositioning, transfer, etc. Both commercial and research-level devices were included in the search. 142 devices or technologies were identified and classified into four main categories that were further subcategorized. Within each category, the devices were investigated in terms of their mechanical design, actuation methods, control strategies, sensing technologies, and level of autonomy. Limitations of current technologies are design complexity, lack of patient comfort, and a lack of autonomy requiring caregivers frequent intervention. Several devices have been developed to help with prevention and mitigation of PUs. There remain challenges that hinder the widespread accessibility and use of current technologies. Advancements in assistive technologies for pressure ulcer mitigation could lie at the intersection of robotics, sensors, perception, user-centered design, and autonomous systems. Future advancements in assistive technologies for pressure ulcer mitigation could lie at the intersection of robotics, sensors, perception, user-centered design, and autonomous systems. Most existing technologies for prevention of pressure ulcers are focused on the mechanical advantage rather than user's needs and preferences. Future designers, engineers, and product developers must be educated to conduct user needs studies concurrently with the development of technology to design the devices based on the user's needs to ensure a balanced design outcome. [ABSTRACT FROM AUTHOR]

Building on a constructivist understanding of the interview techniques common to the social sciences, in this paper I discuss and analyse through a feminist sociological lens the interview setting that I built and experienced during two years of fieldwork with a small sample of Canadian women. Relevant conversational gestures exchanged in such a setting usually encompass verbal and bodily cues, but what principally concerns me here is a further aspect of the interview setting: namely, its visuality, and the related act of gazing carried out by the (female) participants. Using the concept of the 'female gaze' (Riley et al., 2016) - i.e., the self-assessing, judgemental gaze that women direct at one another and at themselves in postfeminist contexts - I offer salient examples from my fieldwork in order to show the ways in which the female gaze shaped my understanding of how women look at themselves and at each other (including at me, as interviewer), both in person and in pictures. My goal is to analyse gazing as a competence, and more specifically as a structured and regulated female competence in postfeminist culture, but also to bring a greater reflexivity to bear on the embodied experience of fieldwork (Oakley, 1981; Pillow, 1997). As I came to learn in the course of this project, the act of gazing while conversing, accompanied by the corresponding verbal cues, played a crucial, if unexpected and unplanned, role in data production and in my subsequent choice of research questions. [ABSTRACT FROM AUTHOR]

Proning, or turning a patient face down, is a technique used to manage patients with acute respiratory distress in intensive care units (ICUs). Research suggests that the type of pillow used in proning may have a significant impact on patient outcomes and increase the risk of disfiguring pressure injuries to the face. However, there is little evidence surrounding the usability of these pillows in the ICU. The aim of this study was to identify redesign opportunities by understanding how the tools, tasks, people, environment, and organization all interact during proning in the ICU. Thirty‐six ICU clinicians from two Australian public metropolitan hospitals completed an online questionnaire regarding their opinions and experiences with proned patients and the prevention of pressure injuries. Seven ICU clinicians then completed journey mapping activities to document the key workflows, critical incidents, considerations, and personnel involved in managing proned patients in the ICU. Several barriers and facilitators to pressure injury prevention were identified, including interactions between the various tools (e.g., proning pillows with one opening limits the management of several medical devices), the tasks (e.g., high frequency of repositioning), the people (e.g., clinical inexperience, patient features), the environment (e.g., limited availability of tools), and the organization (e.g., limited number of staff to support tasks). This holistic approach revealed several opportunities for the redesign of proning pillows and associated systems. Key takeaways include the limitations of a one‐size‐fits‐all approach to proning in the ICU context, and the need for flexibility and customization to improve proning pillows, associated medical devices, prophylactic dressings, aids, and processes. [ABSTRACT FROM AUTHOR]

This review provides a concise overview of preventive measures against dust mite allergies in pediatric populations, emphasizing the need for a comprehensive and evolving approach. Dust mites, ubiquitous microscopic arachnids, pose a significant threat to children's health, triggering allergies and asthma. Traditional preventive strategies such as regular cleaning, mattress covers, and humidity control are essential but warrant refinement. Empowering children through personalized hygiene education and exploring innovative bedding solutions showcase a forward-thinking paradigm. Collaboration with healthcare professionals and embracing technology-driven solutions ensures a holistic and adaptable approach to safeguarding pediatric health against dust mite-related ailments. This abstract underscores the importance of continually reassessing and innovating preventive measures to create resilient and health-conscious living environments for children. [ABSTRACT FROM AUTHOR]

IN THIS ISSUE / ART Why Are There No Adult Male Figures on Ancient Chinese Ceramic Pillows? Written by Wanli Zhang and Yi Zhang Archaeologists have found that ancient Chinese [...]

Getting proper rest is an essential issue, but it is neglected as the major component of every person's overall health and well-being. Enough proper rest has a lot of proven health benefits. This paper aims at proposing a systematic framework to find the suitable pillows and mattresses for individuals to have proper rest and sleep. The proposed system includes a set of force-sensing resistors (FSR), thermal sensors, humidity-thermal sensors, and a central unit to process the acquired data. Customized software in LabVIEW is developed to monitor the results and ultimately identify the proper ergonomic mattresses and pillows for users. Initial experiments were performed based on zonal performance and multitasking to design, construct, and test each system as a novel hypothesis. The studies and tests were carried out in two steps. The first step included hardware testing and sensor arrangement, and the second step involved processing the acquired data to identify a good product. In this study, we propose a feasible framework to select convenient mattresses and pillows for each person. [ABSTRACT FROM AUTHOR]

Although coccygodynia was already first described in 1859, it remains a controversially discussed clinical picture to this day. Typical for patients with tailbone pain is a long deal with many preliminary examinations without a real diagnosis. The deep-seated pain directly above the tip of the tailbone, usually only when sitting or changing position, can be seen as a leading symptom. Women are affected more often than men and trauma is only remembered in around 50 % of the cases. From the author's point of view, the dynamic, lateral x-rays of the coccyx are the most informative imaging methods. After diagnosis, conservative measures such as oral NSAID intake and discharge through a donut cushion should be tried. In addition, local infiltrations can be carried out directly on the tailbone with local anaesthetic and a glucocorticoid. Physiotherapy (pelvic floor) and osteopathy can also have a positive influence on the symptoms. Coccygectomy should be considered for treatment-resistant symptoms over 6 months with a good short-term response to conservative treatment. With the correct selection of patients, the removal of the coccyx is a safe method with a success rate of over 80-90 % according to the literature. [ABSTRACT FROM AUTHOR]

Friction blisters are a common injury of the feet sustained by individuals participating in sporting, recreational, and military activities. The high incidence of friction blisters brings into question the effectiveness of common prevention strategies. The purpose of this article was to review current evidence for established blister-prevention strategies and to explore how these interventions address the factors that cause friction blisters. Preventive strategies, focusing on previously overlooked elements of the blister-causing mechanism, are proposed. Areas of future research that are much needed to reduce this common skin injury in active individuals are outlined. [ABSTRACT FROM AUTHOR]

Objective: The consequences of falls in the elderly are severe, ranging from skin abrasion to hip fracture, which is very easy to cause death. Using advanced technology to develop anti-fall clothing that meets the needs of the elderly can play a significant role in protecting the elderly. By reviewing and analyzing the existing literature on the importance of fall protection clothing in reducing falls and protecting the body of the elderly, it is hoped to explore further research that needs improvement. Methods: Guided by the preferred reporting items for systematic reviews and meta-analyses, eight related studies were identified through Web of Science, Scopus and Chinese National Knowledge Infrastructure. The research objects, approaches, material and equipment, protection principle, and survey results are extracted. Results: Two articles verified the fall detection algorithm adopted in the research through experiments, which significantly improved fall detection accuracy. Six papers found that selecting appropriate cushioning materials can effectively reduce the consequences of falls of the elderly through experimental comparative analysis. Finally, three attributes for significant design value are drawn: (1) size and fit; (2) cushioning materials; (3) wearable sensing elements. Conclusions: Anti-fall clothing can effectively protect the elderly when they fall. Further design experiments are needed to select appropriate cushioning materials and wearable sensing elements based on anthropometry and aesthetics to design the style and structure of the garment to achieve the purpose of protecting the elderly. [ABSTRACT FROM AUTHOR]

Seat pressure maps are often used to evaluate comfort of the users. In this study, we explored the relationships between pressure maps and comfort/discomfort of users in aircraft seats with a focus on a new 6-division method on the pressure maps collected at the bottom of the cushions. An experiment was designed where three cushions with identical shapes but different stiffnesses were prepared. 33 subjects joined the experiment and after sitting on each cushion in 4 postures, they completed comfort questionnaires. Pressure maps on the top as well as the bottom of cushions were collected and analysed. Results indicated that measures on the proposed 6 divisions, especially on the distal posterior thigh regions and regions close to ischial tuberosity of the bottom pressure maps, had larger correlation values to comfort scores compared to other division methods. Practitioner summary: The relations between comfort/discomfort and seat pressure maps collected from the top/bottom of three cushions were studied with 33 subjects in four postures. The distal posterior thigh and ischial tuberosity regions in the proposed 6-division of the bottom pressure maps had larger correlation values to comfort/discomfort compared to other methods. [ABSTRACT FROM AUTHOR]

Many dance educators recognize the value of creativity and the benefits of self-expression through movement. However, approaches to creative-based work in the independent sector are often focused on the product for performance, rather than teaching the tools of composition as an explicit part of the curriculum. Students express interest in exploring and performing their own work without the requisite skills to generate material and despite having backgrounds steeped in "technical" training. This article provides three separate models for guiding student creativity: composition, capstone, and pillow concerts. We discuss what has informed our personal pedagogy, detail steps and relevant applications, and assert that finding ways for students to safely explore ideas and bravely express themselves in the world remains a critical role for dance education. Readers are invited to consider ways to adapt these models in support of their own teaching practices, students, and class offerings. [ABSTRACT FROM AUTHOR]

Background: Long-term care (LTC) residents have been disproportionately affected by COVID-19 with higher morbidity and mortality. The use of canines for the detection of COVID-19 has been successful in controlled laboratory settings. They have the potential to provide rapid, non-invasive screening in congregate living settings. The ability to assess whether laboratory-trained canines can transfer their scent detection skills to the clinical settings has had limited evaluation. Methods: At Vancouver Coastal Health, two canines were previously trained and validated to differentiate COVID-19 positive and negative PCR samples from breath, sweat and gargle clinical samples from scent stands. Subsequently, they were taught to alert from pillowcases. Following successful validation and in collaboration with a local LTC, the canines performed weekly blind screening of residents' pillowcases during the Omicron wave. Results: A third-party, double-blind validation on pillowcases demonstrated an overall sensitivity of 100%. The specificity was 100% for the first canine and 82.6% for the second canine. Although no clinical cases occurred during the six-week pilot project, the agreement between the two canine teams was 98.4% on room alerts. In addition, the two teams were able to seamlessly transfer their laboratory skill sets to the LTC setting. Conclusion: Third-party evaluation determined that canines could successfully be trained to detect COVID-19 from pillowcases. The canine teams were then able to efficiently shift their skill set from the laboratory into an operational setting. This pilot project supports that the deployment of canine detection in a clinical setting is possible and could be considered in congregate living settings. [ABSTRACT FROM AUTHOR]