RESUMEN

INTRODUCTION: Modern healthcare, including nursing home care, goes together with the use of technologies to support treatment, the provision of care and daily activities. The challenges concerning the implementation of such technologies are numerous. One of these emerging technologies are location technologies (RTLS or Real-Time Location Systems). that can be utilized in the nursing home for monitoring the use and location of assets. METHODOLOGY: This paper describes a participatory design study of RTLS based on context mapping, conducted in two nursing home organizations. Rather than investigating the technological possibilities, this study investigates the needs and wishes from the perspective of the care professional. RESULTS: The study identified semantic themes that relate to the practicalities of lost and misplaced items in the nursing home, as well as latent themes that cover the wishes regarding technology in the nursing homes. The organizational culture and building typology may play a role in losing items. CONCLUSION: The participants in this study indicated that RTLS can provide a solution to some of the challenges that they encounter in the workplace. However, the implementation of new technologies should be done with care and should be integrated into existing ICT systems in order to minimize additional training and posing a burden on the workload.

RESUMEN

BACKGROUND: The sense of home of nursing home residents is a multifactorial phenomenon which is important for the quality of living. This purpose of this study is to investigate the factors influencing the sense of home of older adults residing in the nursing home from the perspective of residents, relatives and care professionals. METHODS: A total of 78 participants (n = 24 residents, n = 18 relatives and n = 26 care professionals) from 4 nursing homes in the Netherlands engaged in a qualitative study, in which photography was as a supportive tool for subsequent interviews and focus groups. The data were analyzed based on open ended coding, axial coding and selective coding. RESULTS: The sense of home of nursing home residents is influenced by a number of jointly identified factors, including the building and interior design; eating and drinking; autonomy and control; involvement of relatives; engagement with others and activities; quality of care are shared themes. Residents and relatives stressed the importance of having a connection with nature and the outdoors, as well as coping strategies. Relatives and care professionals emphasized the role the organization of facilitation of care played, as well as making residents feel like they still matter. CONCLUSIONS: The sense of home of nursing home residents is influenced by a multitude of factors related to the psychology of the residents, and the social and built environmental contexts. A holistic understanding of which factors influence the sense of home of residents can lead to strategies to optimize this sense of home. This study also indicated that the nursing home has a dual nature as a place of residence and a place where people are supported through numerous care strategies.

Asunto(s)

RESUMEN

BACKGROUND: Individuals with Substance Use Disorders (SUDs) have disruptions in the brain's dopaminergic (DA) system and the functioning of its target neural substrates (striatum and prefrontal cortex). These substrates are important for the normal processing of reward, inhibitory control and motivation. Cognitive deficits in attention, impulsivity and working memory have been found in individuals with SUDs and are predictors of poor SUD treatment outcomes and relapse in alcohol and cocaine dependence specifically. Furthermore, the DA system and accompanying neural substrates play a key role in the timing of motor acts (motor timing). Motor timing deficits have been found in DA system related disorders and more recently also in individuals with SUDs. Motor timing is found to correlate with attention, impulsivity and working memory deficits. To our knowledge motor timing, with regards to treatment outcome and relapse, has not been investigated in populations with SUDs. METHODS/DESIGN: This study aims to investigate motor timing and its relation to treatment response (at 8 weeks) and relapse (at 12 months) in cocaine and/or alcohol dependent individuals. The tested sensitivity values of motor timing parameters will be compared to a battery of neurocognitive tests, owing to the novelty of the motor task battery, the confounding effects of attention and working memory on motor timing paradigms, and high impulsivity levels found in individuals with SUDs. DISCUSSION: This research will contribute to current knowledge of neuropsychological deficits associated with treatment response in SUDs and possibly provide an opportunity to individualize and modify currently available treatments through the possible prognostic value of motor task performance in cocaine and/or alcohol dependent individuals.

Asunto(s)

RESUMEN

Purpose. To provide an overview of factors influencing the sense of home of older adults residing in the nursing home. Methods. A systematic review was conducted. Inclusion criteria were (1) original and peer-reviewed research, (2) qualitative, quantitative, or mixed methods research, (3) research about nursing home residents (or similar type of housing), and (4) research on the sense of home, meaning of home, at-homeness, or homelikeness. Results. Seventeen mainly qualitative articles were included. The sense of home of nursing home residents is influenced by 15 factors, divided into three themes: (1) psychological factors (sense of acknowledgement, preservation of one's habits and values, autonomy and control, and coping); (2) social factors (interaction and relationship with staff, residents, family and friends, and pets) and activities; and (3) the built environment (private space and (quasi-)public space, personal belongings, technology, look and feel, and the outdoors and location). Conclusions. The sense of home is influenced by numerous factors related to the psychology of the residents and the social and built environmental contexts. Further research is needed to determine if and how the identified factors are interrelated, if perspectives of various stakeholders involved differ, and how the factors can be improved in practice.

RESUMEN

Introduction: Losing items is a time-consuming occurrence in nursing homes that is ill described. An explorative study was conducted to investigate which items got lost by nursing home residents, and how this affects the residents and family caregivers. Method: Semi-structured interviews and card sorting tasks were conducted with 12 residents with early-stage dementia and 12 family caregivers. Thematic analysis was applied to the outcomes of the sessions. Results: The participants stated that numerous personal items and assistive devices get lost in the nursing home environment, which had various emotional, practical, and financial implications. Significant amounts of time are spent on trying to find items, varying from 1 hr up to a couple of weeks. Numerous potential solutions were identified by the interviewees. Discussion: Losing items often goes together with limitations to the participation of residents. Many family caregivers are reluctant to replace lost items, as these items may get lost again.

RESUMEN

Bed-ridden nursing home residents are in need of environments which are homelike and facilitate the provision of care. Design guidance for this group of older people is limited. This study concerned the exploration and generation of innovative environmental enrichment scenarios for bed-ridden residents. This exploration was conducted through a combination of participatory action research with user-centred design involving 56 professional stakeholders in interactive work sessions. This study identified numerous design solutions, both concepts and products that are available on the marketplace and that on a higher level relate to improvements in resident autonomy and the supply of technological items and architectural features. The methodology chosen can be used to explore the creative potential of stakeholders from the domain of healthcare in product innovation.

RESUMEN

The quality of the built environment can impact the quality of life and the sense of home of nursing home residents. This study investigated (1) which factors in the physical and social environment correlate with the sense of home of the residents and (2) which environmental factors are most meaningful. Twelve participants engaged in a qualitative study, in which photography was as a supportive tool for subsequent interviews. The data were analysed based on the six phases by Braun and Clarke. The four themes identified are (1) the physical view; (2) mobility and accessibility; (3) space, place, and personal belongings; and (4) the social environment and activities. A holistic understanding of which features of the built environment are appreciated by the residents can lead to the design and retrofitting of nursing homes that are more in line with personal wishes.

RESUMEN

Light therapy is increasingly administered and studied as a non-pharmacologic treatment for a variety of health-related problems, including treatment of people with dementia. Light therapy comes in a variety of ways, ranging from being exposed to daylight, to being exposed to light emitted by light boxes and ambient bright light. Light therapy is an area in medicine where medical sciences meet the realms of physics, engineering and technology. Therefore, it is paramount that attention is paid in the methodology of studies to the technical aspects in their full breadth. This paper provides an extensive introduction for non-technical researchers on how to describe and adjust their methodology when involved in lighting therapy research. A specific focus in this manuscript is on ambient bright light, as it is an emerging field within the domain of light therapy. The paper deals with how to (i) describe the lighting equipment, (ii) describe the light measurements, (iii) describe the building and interaction with daylight. Moreover, attention is paid to the uncertainty in standards and guidelines regarding light and lighting for older adults.

Asunto(s)

RESUMEN

INTRODUCTION: Ambient intelligence technologies are a means to support ageing-in-place by monitoring clients in the home. In this study, monitoring is applied for the purpose of raising an alarm in an emergency situation, and thereby, providing an increased sense of safety and security. Apart from these technological solutions, there are numerous environmental interventions in the home environment that can support people to age-in-place. The aim of this study was to investigate the needs and motives, related to ageing-in-place, of the respondents receiving ambient intelligence technologies, and to investigate whether, and how, these technologies contributed to aspects of ageing-in-place. METHODOLOGY: This paper presents the results of a qualitative study comprised of interviews and observations of technology and environmental interventions in the home environment among 18 community-dwelling older adults with a complex demand for care. These respondents had a prototype of the Unattended Autonomous Surveillance system, an example of ambient intelligence technology, installed in their homes as a means to age-in-place. The UAS-system offers a large range of functionalities, including mobility monitoring, voice response, fire detection, as well as wandering detection and prevention, which can be installed in different configurations. RESULTS: The respondents had various motives to use ambient intelligence technologies to support ageing-in-place. The most prominent reason was to improve the sense of safety and security, in particular, in case of fall incidents, when people were afraid not to be able to use their existing emergency response systems. The ambient intelligence technologies were initially seen as a welcome addition to strategies already adopted by the respondents, including a variety of home modifications and assistive devices. The systems tested increased the sense of safety and security and helped to postpone institutionalisation. Respondents came up with a set of specifications in terms of the operation and the design of the technology. False alarms were also regarded as a sign that the ambient intelligence technology is functioning. Moreover, a good integration of the new technologies in the provision of health care is indispensable, and installation should be done in an acceptable and unobtrusive manner. CONCLUSIONS AND IMPLICATIONS: Ambient intelligence technologies can contribute to an increased safety and security at home. The technologies alone offer no all encompassing solution as home care and additional environmental interventions are still needed to support ageing-in-place. Results of the study are used to further improve the ambient intelligence technologies and their implementation.

Asunto(s)

RESUMEN

In Western societies, the vast majority of people with dementia live at home and wish to remain doing so for as long as possible. Aging in place can be facilitated through a variety of environmental interventions, including home modifications. This article provides an overview of existing design principles and design goals, and environmental interventions implemented at home, based on literature study and additional focus group sessions. There is a multitude of design principles, design goals, and environmental interventions available to assist with activities of daily living and functions, although few systematic studies have been conducted on the efficacy of these goals and interventions. The own home seems to be a largely ignored territory in research and government policies, which implies that many problems concerning aging in place and environmental interventions for dementia are not adequately dealt with.

Asunto(s)

RESUMEN

UNLABELLED: The predicted mean vote (PMV) model of thermal comfort, created by Fanger in the late 1960s, is used worldwide to assess thermal comfort. Fanger based his model on college-aged students for use in invariant environmental conditions in air-conditioned buildings in moderate thermal climate zones. Environmental engineering practice calls for a predictive method that is applicable to all types of people in any kind of building in every climate zone. In this publication, existing support and criticism, as well as modifications to the PMV model are discussed in light of the requirements by environmental engineering practice in the 21st century in order to move from a predicted mean vote to comfort for all. Improved prediction of thermal comfort can be achieved through improving the validity of the PMV model, better specification of the model's input parameters, and accounting for outdoor thermal conditions and special groups. The application range of the PMV model can be enlarged, for instance, by using the model to assess the effects of the thermal environment on productivity and behavior, and interactions with other indoor environmental parameters, and the use of information and communication technologies. Even with such modifications to thermal comfort evaluation, thermal comfort for all can only be achieved when occupants have effective control over their own thermal environment. PRACTICAL IMPLICATIONS: The paper treats the assessment of thermal comfort using the PMV model of Fanger, and deals with the strengths and limitations of this model. Readers are made familiar to some opportunities for use in the 21st-century information society.

Asunto(s)

RESUMEN

BACKGROUND: We still do not know how genetic and environmental factors cause schizophrenia. The pathogenesis of this illness is unknown. AIM: To develop a pathogenetic model that has greater explanatory power than the existing hypotheses concerning schizophrenia. METHOD: We searched the literature with the help of Medline (from 1966) using the search terms 'schizophrenia', 'basal ganglia', 'striatum' and 'cerebellum'. We also consulted recent manuals on schizophrenia, evolutionary psychiatry and neuroanatomy. RESULTS: The analysis showed that during the phylogenesis and ontogenesis of the brain two mechanisms, which are primarily motor-control mechanisms, are applied to the intentional level of functioning; one of these initiates and delivers power to intentions (the drive mechanism), whereas the other steers and guides intentions (the guidance mechanism). As a result of the repeated application of these two mechanisms an imbalance to the detriment of the drive mechanism in the end manifests itself as schizophrenia. The model clarifies the clinical and epidemiological findings and the course of the illness. CONCLUSION: The model provides a more comprehensive explanation for existing clinical and epidemiological data than do current alternatives. The model is compliable with the main prevailing views of psychiatrists on schizophrenia and it places the genesis of schizophrenia in an evolutionary perspective.

Asunto(s)

RESUMEN

BACKGROUND: A new line of research into psychomotor retardation in patients with a major depressive disorder began about ten years ago. The purpose of the research was twofold: to obtain a clearer understanding of psychomotor retardation in patients with a major depressive disorder and to assess the importance of psychomotor retardation for the diagnosis and treatment. AIM: To present an overview of the results of these studies in which psychomotor retardation of these patients was investigated. METHOD: The patients had to perform visuomotor tasks involving pen movements. The psychomotor retardation was measured by recording their pen movements objectively and accurately by means of a computer and digitiser. RESULTS: Patients with major depressive disorder showed pronounced psychomotor retardation in the visuomotor tasks. The psychomotor retardation appeared to be of both a cognitive and motor nature. The treatment study which examined the effect of fluoxetine on psychomotor retardation revealed that the cognitive retardation disappeared but the motor retardation remained. It was particularly the more retarded patient who responded well to fluoxetine. The research that compared the psychomotor retardation in various subtypes of depression revealed that patients with major depressive disorder showed pronounced retardation but dysthymic patients did not show any retardation. Psychomotor retardation was more severe in patients with major depressive disorder with melancholic features. CONCLUSION: Psychomotor retardation can play an important role in the diagnosis and treatment of depressive disorders.

Asunto(s)

RESUMEN

The development of more comfortable seats is an important issue in the automotive industry. However, the development of new car seats is very time consuming and costly since it is typically based on experimental evaluation using prototypes. Computer models of the human-seat interaction could accelerate this process. The objective of this paper is to establish a protocol for the development of seat models using numerically efficient simulation techniques. The methodology is based on multi-body techniques: arbitrary surfaces, providing an accurate surface description, are attached to rigid bodies. The bodies are connected by kinematic joints, representing the seat back recliner and head restraint joint. Properties of the seat foam and frame have been lumped together. Further, experiments have been defined to characterise the mechanical properties required for the seat model for comfort applications. The protocol has been exemplified using a standard car seat. The seat model has been validated based on experiments with rigid loading devices with human-like shapes in terms of force-deflection characteristics. The response of the seat model agrees well with the experimental results. Therefore the presented method can be a useful tool in the seat development process, especially in early stages of the design process.

Asunto(s)

RESUMEN

Seating comfort is becoming increasingly important for the automotive industry. Car manufacturers use seating comfort to distinguish their products from those of competitors. However, the development and design of a new, more comfortable seat is time consuming and costly. The introduction of computer models of human and seat will accelerate this process. The contact interaction between human and seat is an important factor in the comfort sensation of subjects. This paper presents a finite element (FE) model of the human buttocks, able to predict the pressure distribution between human and seating surface by its detailed and realistic geometric description. A validation study based on volunteer experiments shows reasonable correlation in pressure distributions between the buttocks model and the volunteers. Both for simulations on a rigid and a soft cushion, the model predicts realistic seat pressure distributions. A parameter study shows that a pressure distribution at the interface between human and seat strongly depends on variations in human flesh and seat cushion properties.

Asunto(s)

RESUMEN

Herd-level risk factors for salmonellosis in pigs were investigated in a cross-sectional study on 62 Belgian farrow-to-finish pig herds belonging to one slaughterhouse cooperative. Data concerning housing and ventilation, management, hygiene, biosecurity, production parameters, feeding, disease control and transport to the slaughterhouse were collected during a herd visit by means of a questionnaire. The percentage of positive animals in a slaughterhouse delivery, as determined by qualitative Salmonella isolation in the mesenteric lymph nodes taken from 30 slaughter pigs, was the outcome variable. All samples were taken in 4 different slaughterhouses. Variables first were submitted to a univariable analysis using a logistic mixed regression model, with herd as random effect. Variables which were related to the Salmonella prevalence (P < 0.05) were analysed further in a multivariable model. The clustering of Salmonella infection within a pen also was studied in a generalised mixed model with pen as random effect. Salmonella isolates were identified by serotype. In 57 (92%) of the herds, at least one sample was found positive for Salmonella. The median percentage of positive Salmonella samples per delivery was 64% (range: 0-100%). In the multivariable model, only type of floor was related significantly to the prevalence: 100% (95% CI 88-100) for herds with <50% slatted floors to 54% (36-70) for herds with fully slatted floors. The results from the analysis should be interpreted with care because only 62 herds were included in the study. Clustering between pigs from the same pen could not be demonstrated (variance +/- S.D.: 0.11 +/- 0.16). S. typhimurium (30%) and S. derby (20%) were most common among the 23 different serotypes that were found.

Asunto(s)

RESUMEN

Four methods intended for screening muscle tissue for residues belonging to the tetracycline group were compared using artificially contaminated as well as incurred samples. Two agar diffusion methods were studied: one with Bacillus subtilis as a test strain, the second with Bacillus cereus. Two variants of each method were compared: thin plates for analysis of intact or minced meat, and thick plates for analysis of meat fluid. The thin plate variants could not be evaluated with artificially contaminated samples because it was impossible to prepare homogeneously spiked, undiluted meat. The thick plates were suited for doxycycline and chlortetracycline, but they did not detect oxytetracycline or tetracycline in spiked meat fluid. The results of these tests done on incurred meat were very good for doxycycline and satisfying or just failing for oxytetracycline, while the best detection capability was obtained when intact frozen meat was examined on thin plates seeded with B. cereus. Two commercially available screening tests were also evaluated. The Premi(R) test, an inhibitor test with Bacillus stearothermophilus as a test strain and an indicator for growth, was not suited for detection of tetracyclines up to the maximum residue limit. Tetrasensor(R), a receptor test specific for tetracyclines, proved a quick and simple test able to detect meat samples artificially contaminated with tetracycline, oxytetracycline, doxycycline or chlortetracycline, as well as meat incurred with oxytetracycline or doxycycline.

Asunto(s)

RESUMEN

OBJECTIVE: This paper describes the prediction of spinal forces in car occupants during vertical vibrations using a numerical multi-body occupant model. BACKGROUND: An increasing part of the population is exposed to whole body vibrations in vehicles. In literature, vertical vibrations and low back pain are often related to each other. The cause of these low back pains is not well understood. A numerical human model, predicting intervertebral forces, can help to understand the mechanics of the human spine during vertical vibrations. METHODS: Numerical human and seat models have been used. Human model responses have been validated for vertical vibrations (rigid and standard car seat condition): simulated and experimental seat-to-human frequency response functions have been compared. The spinal shear and compressive forces have been investigated with the model. RESULTS: The human model seat-to-pelvis and seat-to-T1 frequency response functions in the rigid seat condition and all seat-to-human frequency response functions in the standard car seat condition approach the experimental results reasonably. The lumbar and the lower thoracic spine are subjected to the largest shear and compressive forces. CONCLUSIONS: The human model responses correlate reasonable with the volunteer responses. The predicted spinal forces could be used as a basis for derivation of hypothetical mechanisms and better understanding of low back pain disorders. RELEVANCE: In order to solve the problem of whole body vibration related injuries, knowledge about the interaction between human spinal vertebrae in vertical vibrations is required. This interaction cannot be measured in volunteer experiments. This paper describes the application of a numerical human model for prediction of spinal forces, that could be used as a basis for derivation of hypotheses regarding low back pain disorders.

Asunto(s)

RESUMEN

At present, no standard protocol has been described to detect the presence of Escherichia coli O157 in cattle faeces. Therefore, the sensitivity of 26 different isolation methods was determined in order to recommend a method of choice. Faeces samples from 17 different beef cattle at a farm previously found positive for E. coli O157 were subdivided into a total of 40 samples. It was not known whether the 17 cattle shed E. coli O157 at the time of sampling. At another farm where cattle have been found negative for E. coli O157 on different occasions, five faeces samples were collected. Two methods yielded the highest sensitivity (74%): 6h enrichment in modified tryptone soya broth supplemented with novobiocin (mTSBn) followed by an immunomagnetic separation (IMS) with (i) Dynal beads or (ii) Captivate beads and selective plating on Rainbow agar (RA) plates. Enrichment for 6h was significantly better than 24h enrichment. Only after 24h, buffered peptone water (BPw) was significantly better than mTSBn. A sensitivity of 82% was obtained only when the two most sensitive tests were done simultaneously. Because none of the tests gave 100% sensitivity, it can be concluded that isolation rates of E. coli O157 from bovine faeces using only one of the tested procedures results in an underestimation of the incidence of E. coli O157 in cattle. Performing more than one test on the samples must be considered.

Asunto(s)

RESUMEN

From 1999 until 2001, 3625 food samples were examined for the presence of Escherichia coli O157. Samples were from bovine origin (ground beef, n=549; carcasses, n=2452), calves (carcasses, n=147), chicken (breast, n=203; carcasses, n=71) and pigs (carcasses, n=85; trimmings, n=118). Vidas ECO detected 451 (12%) samples positive, but from only 27 (0.74%) samples was E. coli O157 isolated. One strain was isolated from bovine ground beef (0.18%), one from a pig carcass (1.17%) and all others were isolated from bovine carcasses (1.02%). All strains possessed the attaching-and-effacing gene, the enterohemorrhagic plasmid and verotoxin (VT) genes, except the strain isolated from the pig carcass that was therefore eliminated. Six of the strains were urease-positive. Strains were typed by two DNA fingerprinting methods: random amplification of polymorphic DNA (RAPD) and pulsed field gel electrophoresis (PFGE). PFGE revealed a similarity of 71.05%, while RAPD was 77.36% similar. None of the typing methods were able to classify all urease-positive strains to one pattern. Strains in the same PFGE cluster did not belong to one RAPD cluster. This paper highlights that Belgian fresh meat at retail level can be contaminated with E. coli O157 and that two different typing methods divide strains into different types.

Asunto(s)