48 CFR 52.222-21 - Prohibition of segregated facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... rest rooms or necessary dressing or sleeping areas provided to assure privacy between the sexes. (b... Contractor agrees that a breach of this clause is a violation of the Equal Opportunity clause in this...

Dress codes and appearance policies: challenges under federal legislation, part 3: Title VII, the Americans with Disabilities Act, and the National Labor Relations Act.

PubMed

Mitchell, Michael S; Koen, Clifford M; Darden, Stephen M

2014-01-01

As more and more individuals express themselves with tattoos and body piercings and push the envelope on what is deemed appropriate in the workplace, employers have an increased need for creation and enforcement of reasonable dress codes and appearance policies. As with any employment policy or practice, an appearance policy must be implemented and enforced without regard to an individual's race, color, sex, national origin, religion, disability, age, or any other protected status. A policy governing dress and appearance based on the business needs of an employer that is applied fairly and consistently and does not have a disproportionate effect on any protected class will generally be upheld if challenged in court. By examining some of the more common legal challenges to dress codes and how courts have resolved the disputes, health care managers can avoid many potential problems. This article, the third part of a 3-part examination of dress codes and appearance policies, focuses on the issues of race and national origin under the Civil Rights Act, disability under the Americans With Disabilities Act, and employees' rights to engage in concerted activities under the National Labor Relations Act. Pertinent court cases that provide guidance for employers are addressed.

Quantitative Analysis of Standardized Dress Code and Minority Academic Achievement

ERIC Educational Resources Information Center

Proctor, J. R.

2013-01-01

This study was designed to investigate if a statistically significant variance exists in African American and Hispanic students' attendance and Texas Assessment of Knowledge and Skills test scores in mathematics before and after the implementation of a standardized dress code. For almost two decades supporters and opponents of public school…

Dress Codes in Post-Apartheid South African Workplaces

ERIC Educational Resources Information Center

Grant, Terri; Nodoba, Gaontebale

2009-01-01

There are many factors that influence dress code decision making in formal and informal business arenas. In South Africa, with its colonial and apartheid history followed by an exuberant resurgence of Africanism, factors such as diversity of race, ethnicity, religion, and culture play a critical role in lifestyle and worldview. These many and…

Uniform Policy/Dress Codes: School Staff and Parent Perceptions of Need and Impact.

ERIC Educational Resources Information Center

Stevenson, Zollie, Jr.; Chunn, Eva Wells

This study examines the impact of uniform/dress codes and practices on school climate, educational attainment, and student affective and cognitive domains in Washington (District of Columbia) schools. Information was drawn from surveys of 301 principals and teachers and 268 parents. The following findings are presented: (1) reasons cited for…

[Footwear according to the "business dress code", and the health condition of women's feet--computer-assisted holistic evaluation].

PubMed

Lorkowski, Jacek; Mrzygłód, Mirosław; Kotela, Ireneusz; Kiełbasiewicz-Lorkowska, Ewa; Teul, Iwona

2013-01-01

According to the verdict of the Supreme Court in 2005, an employer may dismiss an employee if their conduct (including dress) exposes the employer to losses or threatens his interests. The aim of the study was a holistic assessment of the pleiotropic effects of high-heeled pointed shoes on the health condition of women's feet, wearing them at work, in accordance with the existing rules of the "business dress code". A holistic multidisciplinary analysis was performed. It takes into account: 1) women employees of banks and other large corporations (82 persons); 2) 2D FEM computer model developed by the authors of foot deformed by pointed high-heeled shoes; 3) web site found after entering the code "business dress code". Over 60% of women in the office wore high-heeled shoes. The following has been found among people walking to work in high heels: 1) reduction in the quality of life in about 70% of cases, through periodic occurrence of pain and reduction of functional capacity of the feet; 2) increase in the pressure on the plantar side of the forefoot at least twice; 3) the continued effects the forces deforming the forefoot. 1. An evolutionary change of "dress code" shoes is necessary in order to lead to a reduction in non-physiological overload of feet and the consequence of their disability. 2. These changes are particularly urgent in patients with so-called "sensitive foot".

Professional Characteristics Communicated by Formal versus Casual Workplace Attire

ERIC Educational Resources Information Center

Cardon, Peter W.; Okoro, Ephraim A.

2009-01-01

Employees are frequently advised to dress for success to build their careers. From the corporate perspective, employees who are well dressed are believed to form better impressions with colleagues, clients, and customers. Many companies create dress codes in order to gain the benefits of a professionally appearing workforce. Developing effective…

Teachers' Perceptions of the Effect of Their Attire on Middle-School Students' Behavior and Learning

ERIC Educational Resources Information Center

Sampson, Elizabeth Clemons

2016-01-01

Teachers were once held to a professional dress code. This code has become lax, resulting in teachers dressing in more casual attire. A local middle school in rural Georgia was experiencing complaints about teachers' unprofessional attire from other teachers, administrators, and parents. Teachers play an integral role in modeling cultural and…

Statistical inference of static analysis rules

NASA Technical Reports Server (NTRS)

Engler, Dawson Richards (Inventor)

2009-01-01

Various apparatus and methods are disclosed for identifying errors in program code. Respective numbers of observances of at least one correctness rule by different code instances that relate to the at least one correctness rule are counted in the program code. Each code instance has an associated counted number of observances of the correctness rule by the code instance. Also counted are respective numbers of violations of the correctness rule by different code instances that relate to the correctness rule. Each code instance has an associated counted number of violations of the correctness rule by the code instance. A respective likelihood of the validity is determined for each code instance as a function of the counted number of observances and counted number of violations. The likelihood of validity indicates a relative likelihood that a related code instance is required to observe the correctness rule. The violations may be output in order of the likelihood of validity of a violated correctness rule.

Predicting Regulatory Compliance in Beer Advertising on Facebook.

PubMed

Noel, Jonathan K; Babor, Thomas F

2017-11-01

The prevalence of alcohol advertising has been growing on social media platforms. The purpose of this study was to evaluate alcohol advertising on Facebook for regulatory compliance and thematic content. A total of 50 Budweiser and Bud Light ads posted on Facebook within 1 month of the 2015 NFL Super Bowl were evaluated for compliance with a self-regulated alcohol advertising code and for thematic content. An exploratory sensitivity/specificity analysis was conducted to determine if thematic content could predict code violations. The code violation rate was 82%, with violations prevalent in guidelines prohibiting the association of alcohol with success (Guideline 5) and health benefits (Guideline 3). Overall, 21 thematic content areas were identified. Displaying the product (62%) and adventure/sensation seeking (52%) were the most prevalent. There was perfect specificity (100%) for 10 content areas for detecting any code violation (animals, negative emotions, positive emotions, games/contests/promotions, female characters, minorities, party, sexuality, night-time, sunrise) and high specificity (>80%) for 10 content areas for detecting violations of guidelines intended to protect minors (animals, negative emotions, famous people, friendship, games/contests/promotions, minorities, responsibility messages, sexuality, sunrise, video games). The high prevalence of code violations indicates a failure of self-regulation to prevent potentially harmful content from appearing in alcohol advertising, including explicit code violations (e.g. sexuality). Routine violations indicate an unwillingness to restrict advertising content for public health purposes, and statutory restrictions may be necessary to sufficiently deter alcohol producers from repeatedly violating marketing codes. Violations of a self-regulated alcohol advertising code are prevalent in a sample of beer ads published on Facebook near the US National Football League's Super Bowl. Overall, 16 thematic content areas demonstrated high specificity for code violations. Alcohol advertising codes should be updated to expressly prohibit the use of such content. © The Author 2017. Medical Council on Alcohol and Oxford University Press. All rights reserved.

Use of the Means/Ends Test to Evaluate Public School Dress-Code Policies

ERIC Educational Resources Information Center

Workman, Jane E.; Studak, Cathryn M.

2008-01-01

The purpose of this article is to explain how a means/ends test can be adapted for the school environment. Public school officials can use a means/ends test to document an analysis of whether dress-code policies will be effective in diminishing risks to the health, safety, or morality of the school population. Elements of policy evaluation--ends,…

Associations Between Thematic Content and Industry Self-Regulation Code Violations in Beer Advertising Broadcast During the U.S. NCAA Basketball Tournament.

PubMed

Noel, Jonathan K; Xuan, Ziming; Babor, Thomas F

2017-07-03

Beer marketing in the United States is controlled through self-regulation, whereby the beer industry has created a marketing code and enforces its use. We performed a thematic content analysis on beer ads broadcast during a U.S. college athletic event and determined which themes are associated with violations of a self-regulated alcohol marketing code. 289 beer ads broadcast during the U.S. NCAA Men's and Women's 1999-2008 basketball tournaments were assessed for the presence of 23 thematic content areas. Associations between themes and violations of the U.S. Beer Institute's Marketing and Advertising Code were determined using generalized linear models. Humor (61.3%), taste (61.0%), masculinity (49.2%), and enjoyment (36.5%) were the most prevalent content areas. Nine content areas (i.e., conformity, ethnicity, sensation seeking, sociability, romance, special occasions, text responsibility messages, tradition, and individuality) were positively associated with code violations (p < 0.001-0.042). There were significantly more content areas positively associated with code violations than content areas negatively associated with code violations (p < 0.001). Several thematic content areas were positively associated with code violations. The results can inform existing efforts to revise self-regulated alcohol marketing codes to ensure better protection of vulnerable populations. The use of several themes is concerning in relation to adolescent alcohol use and health disparities.

An Empirical Evaluation of the US Beer Institute’s Self-Regulation Code Governing the Content of Beer Advertising

PubMed Central

Xuan, Ziming; Damon, Donna; Noel, Jonathan

2013-01-01

Objectives. We evaluated advertising code violations using the US Beer Institute guidelines for responsible advertising. Methods. We applied the Delphi rating technique to all beer ads (n = 289) broadcast in national markets between 1999 and 2008 during the National Collegiate Athletic Association basketball tournament games. Fifteen public health professionals completed ratings using quantitative scales measuring the content of alcohol advertisements (e.g., perceived actor age, portrayal of excessive drinking) according to 1997 and 2006 versions of the Beer Institute Code. Results. Depending on the code version, exclusion criteria, and scoring method, expert raters found that between 35% and 74% of the ads had code violations. There were significant differences among producers in the frequency with which ads with violations were broadcast, but not in the proportions of unique ads with violations. Guidelines most likely to be violated included the association of beer drinking with social success and the use of content appealing to persons younger than 21 years. Conclusions. The alcohol industry’s current self-regulatory framework is ineffective at preventing content violations but could be improved by the use of new rating procedures designed to better detect content code violations. PMID:23947318

An empirical evaluation of the US Beer Institute's self-regulation code governing the content of beer advertising.

PubMed

Babor, Thomas F; Xuan, Ziming; Damon, Donna; Noel, Jonathan

2013-10-01

We evaluated advertising code violations using the US Beer Institute guidelines for responsible advertising. We applied the Delphi rating technique to all beer ads (n = 289) broadcast in national markets between 1999 and 2008 during the National Collegiate Athletic Association basketball tournament games. Fifteen public health professionals completed ratings using quantitative scales measuring the content of alcohol advertisements (e.g., perceived actor age, portrayal of excessive drinking) according to 1997 and 2006 versions of the Beer Institute Code. Depending on the code version, exclusion criteria, and scoring method, expert raters found that between 35% and 74% of the ads had code violations. There were significant differences among producers in the frequency with which ads with violations were broadcast, but not in the proportions of unique ads with violations. Guidelines most likely to be violated included the association of beer drinking with social success and the use of content appealing to persons younger than 21 years. The alcohol industry's current self-regulatory framework is ineffective at preventing content violations but could be improved by the use of new rating procedures designed to better detect content code violations.

Assessment of Self-Regulatory Code Violations in Brazilian Television Beer Advertisements*

PubMed Central

Vendrame, Alan; Pinsky, Ilana; Souza E Silva, Rebeca; Babor, Thomas

2010-01-01

Objective: Research suggests that alcoholic beverage advertisements may have an adverse effect on teenagers and young adults, owing to their vulnerability to suggestive message content. This study was designed to evaluate perceived violations of the content guidelines of the Brazilian alcohol marketing self-regulation code, based on ratings of the five most popular beer advertisements broadcast on television in the summer of 2005–2006 and during the 2006 FIFA (Fédération Internationale de Football Association) World Cup games. Method: Five beer advertisements were selected from a previous study showing that they were perceived to be highly appealing to a sample of Brazilian teenagers. These advertisements were evaluated by a sample of Brazilian high school students using a rating procedure designed to measure the content of alcohol advertisements covered in industry self-regulation codes. Results: All five advertisements were found to violate multiple guidelines of the Brazilian code of marketing self-regulation. The advertisement with the greatest number of violations was Antarctica's “Male Repellent,” which was perceived to violate 11 of the 16 guidelines in the code. Two advertisements had nine violations, and one had eight. The guidelines most likely to be violated by these advertisements were Guideline 1, which is aimed at protecting children and teenagers, and Guideline 2, which prohibits content encouraging excessive and irresponsible alcoholic beverage consumption. Conclusions: The five beer advertisements rated as most appealing to Brazilian teenagers were perceived by a sample of the same population to have violated numerous principles of the Brazilian self-regulation code governing the marketing of alcoholic beverages. Because of these numerous perceived code violations, it now seems important for regulatory authorities to submit industry marketing content to more systematic evaluation by young people and public health experts and for researchers to focus more on the ways in which alcohol advertising influences early onset of drinking and excessive alcohol consumption. PMID:20409439

Assessment of self-regulatory code violations in Brazilian television beer advertisements.

PubMed

Vendrame, Alan; Pinsky, Ilana; e Silva, Rebeca Souza; Babor, Thomas

2010-05-01

Research suggests that alcoholic beverage advertisements may have an adverse effect on teenagers and young adults, owing to their vulnerability to suggestive message content. This study was designed to evaluate perceived violations of the content guidelines of the Brazilian alcohol marketing self-regulation code, based on ratings of the five most popular beer advertisements broadcast on television in the summer of 2005-2006 and during the 2006 FIFA (Federation Internationale de Football Association) World Cup games. Five beer advertisements were selected from a previous study showing that they were perceived to be highly appealing to a sample of Brazilian teenagers. These advertisements were evaluated by a sample of Brazilian high school students using a rating procedure designed to measure the content of alcohol advertisements covered in industry self-regulation codes. All five advertisements were found to violate multiple guidelines of the Brazilian code of marketing self-regulation. The advertisement with the greatest number of violations was Antarctica's "Male Repellent," which was perceived to violate 11 of the 16 guidelines in the code. Two advertisements had nine violations, and one had eight. The guidelines most likely to be violated by these advertisements were Guideline 1, which is aimed at protecting children and teenagers, and Guideline 2, which prohibits content encouraging excessive and irresponsible alcoholic beverage consumption. The five beer advertisements rated as most appealing to Brazilian teenagers were perceived by a sample of the same population to have violated numerous principles of the Brazilian self-regulation code governing the marketing of alcoholic beverages. Because of these numerous perceived code violations, it now seems important for regulatory authorities to submit industry marketing content to more systematic evaluation by young people and public health experts and for researchers to focus more on the ways in which alcohol advertising influences early onset of drinking and excessive alcohol consumption.

The brain's dress code: How The Dress allows to decode the neuronal pathway of an optical illusion.

PubMed

Schlaffke, Lara; Golisch, Anne; Haag, Lauren M; Lenz, Melanie; Heba, Stefanie; Lissek, Silke; Schmidt-Wilcke, Tobias; Eysel, Ulf T; Tegenthoff, Martin

2015-12-01

Optical illusions have broadened our understanding of the brain's role in visual perception. A modern day optical illusion emerged from a posted photo of a striped dress, which some perceived as white and gold and others as blue and black. Here we show, using functional magnetic resonance imaging (fMRI), that those who perceive The Dress as white/gold have higher activation in response to the image of The Dress in brain regions critically involved in higher cognition (frontal and parietal brain areas). These results are consistent with theories of top-down modulation and present a neural signature associated with the differences in perceiving The Dress as white/gold or blue/black. Furthermore the results support recent psychophysiological data on this phenomenon and provide a fundamental building block to study interindividual differences in visual processing. Copyright © 2015 Elsevier Ltd. All rights reserved.

Challenged Dress Code Prohibited Clothing with Offensive Illustrations.

ERIC Educational Resources Information Center

Kozlowski, James C.

2001-01-01

Discusses the extent to which public recreation programs can regulate attire which many people might consider offensive, noting that the U.S. Supreme Court states that school boards have the authority to decide what constitutes appropriate behavior and dress in public schools. One case involving a student who wanted to wear a Marilyn Manson…

A new method for evaluating compliance with industry self-regulation codes governing the content of alcohol advertising.

PubMed

Babor, Thomas F; Xuan, Ziming; Damon, Donna

2013-10-01

This study evaluated the use of a modified Delphi technique in combination with a previously developed alcohol advertising rating procedure to detect content violations in the U.S. Beer Institute Code. A related aim was to estimate the minimum number of raters needed to obtain reliable evaluations of code violations in television commercials. Six alcohol ads selected for their likelihood of having code violations were rated by community and expert participants (N = 286). Quantitative rating scales were used to measure the content of alcohol advertisements based on alcohol industry self-regulatory guidelines. The community group participants represented vulnerability characteristics that industry codes were designed to protect (e.g., age <21); experts represented various health-related professions, including public health, human development, alcohol research, and mental health. Alcohol ads were rated on 2 occasions separated by 1 month. After completing Time 1 ratings, participants were randomized to receive feedback from 1 group or the other. Findings indicate that (i) ratings at Time 2 had generally reduced variance, suggesting greater consensus after feedback, (ii) feedback from the expert group was more influential than that of the community group in developing group consensus, (iii) the expert group found significantly fewer violations than the community group, (iv) experts representing different professional backgrounds did not differ among themselves in the number of violations identified, and (v) a rating panel composed of at least 15 raters is sufficient to obtain reliable estimates of code violations. The Delphi technique facilitates consensus development around code violations in alcohol ad content and may enhance the ability of regulatory agencies to monitor the content of alcoholic beverage advertising when combined with psychometric-based rating procedures. Copyright © 2013 by the Research Society on Alcoholism.

A New Method for Evaluating Compliance with Industry Self-regulation Codes Governing the Content of Alcohol Advertising

PubMed Central

Babor, Thomas F.; Xuan, Ziming; Damon, Donna

2013-01-01

Background This study evaluated the use of a modified Delphi technique in combination with a previously developed alcohol advertising rating procedure to detect content violations in the US Beer Institute code. A related aim was to estimate the minimum number of raters needed to obtain reliable evaluations of code violations in television commercials. Methods Six alcohol ads selected for their likelihood of having code violations were rated by community and expert participants (N=286). Quantitative rating scales were used to measure the content of alcohol advertisements based on alcohol industry self-regulatory guidelines. The community group participants represented vulnerability characteristics that industry codes were designed to protect (e.g., age < 21); experts represented various health-related professions, including public health, human development, alcohol research and mental health. Alcohol ads were rated on two occasions separated by one month. After completing Time 1 ratings, participants were randomized to receive feedback from one group or the other. Results Findings indicate that (1) ratings at Time 2 had generally reduced variance, suggesting greater consensus after feedback, (2) feedback from the expert group was more influential than that of the community group in developing group consensus, (3) the expert group found significantly fewer violations than the community group, (4) experts representing different professional backgrounds did not differ among themselves in the number of violations identified; (5) a rating panel composed of at least 15 raters is sufficient to obtain reliable estimates of code violations. Conclusions The Delphi Technique facilitates consensus development around code violations in alcohol ad content and may enhance the ability of regulatory agencies to monitor the content of alcoholic beverage advertising when combined with psychometric-based rating procedures. PMID:23682927

32 CFR 552.145 - Violations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... prohibited by law or lawful regulation * * * shall be fined for not more than $500.00 or imprisoned not more... this subpart. (c) In addition, violation of this subpart by persons subject to the Uniform Code of Military Justice (10 U.S.C. 801-940) is a violation of Article 92 of the Uniform Code of Military Justice. ...

Marketing of breast-milk substitutes in Zambia: evaluation of compliance to the international regulatory code.

PubMed

Funduluka, P; Bosomprah, S; Chilengi, R; Mugode, R H; Bwembya, P A; Mudenda, B

2018-03-01

We sought to assess the level of non-compliance with the International Code of Marketing breast-milk substitutes (BMS) and/or Statutory Instrument (SI) Number 48 of 2006 of the Laws of Zambia in two suburbs, Kalingalinga and Chelstone, in Zambia. This was a cross sectional survey. Shop owners (80), health workers (8) and mothers (214) were interviewed. BMS labels and advertisements (62) were observed. The primary outcome was mean non-compliance defined as the number of article violations divided by the total 'obtainable' violations. The score ranges from 0 to 1 with 0 representing no violations in all the articles and one representing violations in all the articles. A total of 62 BMS were assessed. The mean non-compliance score by manufacturers in terms of violations in labelling of BMS was 0.33 (SD = 0.28; 95% CI: 0.26, 0.40). These violations were mainly due to labels containing pictures or graphics representing an infant. 80 shops were also assessed with mean non-compliance score in respect of violations in tie-in-sales, special display, and contact with mothers at the shop estimated as 0.14 (SD = 0.14; 95% CI: 0.11, 0.18). Non-compliance with the Code and/or the local SI is high after 10 years of domesticating the Code.

A Study of Visible Tattoos in Entry-Level Dental Hygiene Education Programs.

PubMed

Search, Kathryn R; Tolle, Susan L; McCombs, Gayle B; Arndt, Aaron

2018-02-01

Purpose: The purpose of this study was to survey entry-level dental hygiene program directors in the United States (U.S.) to assess their perceptions of dental hygienists with visible tattoos as well as to determine current policies related to dress codes in U.S. dental hygiene programs. Methods: Data was collected with an online survey emailed to 340 dental hygiene program directors yielding a 43% (n=141) response rate. Participants indicated their opinions of visible tattoos on the basis of professionalism and school policy satisfaction. Results: Eighty percent of respondents reported their program as having dress code policies on visible tattoos, with the majority (97%) requiring visible tattoos to be covered. Results revealed both students (M=5.57, p<.0005) and faculty (M=5.76, p<.0005) with visible tattoos were perceived as significantly less professional. Most participants agreed that dental hygiene faculty should discuss the impact of visible tattoos on future employment opportunities, and that the community would view the school as less professional if students had visible tattoos (p<0.0005). Personal tolerance toward tattoos (p< 0.001), but not age, (p = 0.50), was significantly associated with satisfaction concerning program tattoo policies. A lower tolerance towards visible tattoos (p < 0.001) was associated with an increased likelihood that the dental hygiene program dress code included policy on visible tattoos. Conclusion: Study results showed that visible tattoos were not perceived favorably and that personal perceptions of dental hygiene program directors may have influenced school dress code polices regarding visible tattoos. These findings provide evidence based information for dental hygienists, students, faculty, administrators and hiring managers for formulating policies relating to body art. Copyright © 2018 The American Dental Hygienists’ Association.

28 CFR 2.81 - Reparole decisions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Reparole decisions. (a) If the prisoner is not serving a new, parolable D.C. Code sentence, the Commission... parole on a new D.C. Code felony sentence that has been aggregated with the prisoner's parole violation... new D.C. Code felony sentence but the prisoner's parole violation term has not commenced (i.e., the...

28 CFR 2.81 - Reparole decisions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Reparole decisions. (a) If the prisoner is not serving a new, parolable D.C. Code sentence, the Commission... parole on a new D.C. Code felony sentence that has been aggregated with the prisoner's parole violation... new D.C. Code felony sentence but the prisoner's parole violation term has not commenced (i.e., the...

The CAD triad hypothesis: a mapping between three moral emotions (contempt, anger, disgust) and three moral codes (community, autonomy, divinity).

PubMed

Rozin, P; Lowery, L; Imada, S; Haidt, J

1999-04-01

It is proposed that 3 emotions--contempt, anger, and disgust--are typically elicited, across cultures, by violations of 3 moral codes proposed by R. A. Shweder and his colleagues (R. A. Shweder, N. C. Much, M. Mahapatra, & L. Park, 1997). The proposed alignment links anger to autonomy (individual rights violations), contempt to community (violation of communal codes including hierarchy), and disgust to divinity (violations of purity-sanctity). This is the CAD triad hypothesis. Students in the United States and Japan were presented with descriptions of situations that involve 1 of the types of moral violations and asked to assign either an appropriate facial expression (from a set of 6) or an appropriate word (contempt, anger, disgust, or their translations). Results generally supported the CAD triad hypothesis. Results were further confirmed by analysis of facial expressions actually made by Americans to the descriptions of these situations.

75 FR 37498 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing of Proposed Rule Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-29

... of a code of ethics by an investment advisor to include, at a minimum: (i) Standards of business... any violations of the code of ethics promptly to the chief compliance officer (``CCO'') or, provided the CCO also receives reports of all violations, to other persons designated in the code of ethics...

Are neighborhood-level characteristics associated with indoor allergens in the household?

PubMed

Rosenfeld, Lindsay; Rudd, Rima; Chew, Ginger L; Emmons, Karen; Acevedo-García, Dolores

2010-02-01

Individual home characteristics have been associated with indoor allergen exposure; however, the influence of neighborhood-level characteristics has not been well studied. We defined neighborhoods as community districts determined by the New York City Department of City Planning. We examined the relationship between neighborhood-level characteristics and the presence of dust mite (Der f 1), cat (Fel d 1), cockroach (Bla g 2), and mouse (MUP) allergens in the household. Using data from the Puerto Rican Asthma Project, a birth cohort of Puerto Rican children at risk of allergic sensitization (n = 261), we examined associations between neighborhood characteristics (percent tree canopy, asthma hospitalizations per 1,000 children, roadway length within 100 meters of buildings, serious housing code violations per 1000 rental units, poverty rates, and felony crime rates), and the presence of indoor allergens. Allergen cutpoints were used for categorical analyses and defined as follows: dust mite: >0.25 microg/g; cat: >1 microg/g; cockroach: >1 U/g; mouse: >1.6 microg/g. Serious housing code violations were statistically significantly positively associated with dust mite, cat, and mouse allergens (continuous variables), adjusting for mother's income and education, and all neighborhood-level characteristics. In multivariable logistic regression analyses, medium levels of housing code violations were associated with higher dust mite and cat allergens (1.81, 95%CI: 1.08, 3.03 and 3.10, 95%CI: 1.22, 7.92, respectively). A high level of serious housing code violations was associated with higher mouse allergen (2.04, 95%CI: 1.15, 3.62). A medium level of housing code violations was associated with higher cockroach allergen (3.30, 95%CI: 1.11, 9.78). Neighborhood-level characteristics, specifically housing code violations, appear to be related to indoor allergens, which may have implications for future research explorations and policy decisions.

Self-Regulation of Beer Advertising: A Comparative Analysis of Perceived Violations by Adolescents and Experts.

PubMed

Vendrame, Alan; Silva, Rebeca; Xuan, Ziming; Sparks, Robert; Noel, Jonathan; Pinsky, Ilana

2015-09-01

We assessed the impact of the 2010 revisions to Brazil's self-regulatory alcohol marketing code using expert and adolescent raters. Five popular TV beer ads were selected. Ads were rated based on the 2010 Brazilian self-regulatory marketing code. The expert group (N = 31) represented health-related professions; the adolescent group (N = 110) were public high school students. At least 1 ad violated 11 of 17 guidelines included in the study. Ratings by experts and adolescents were similar. Both found violations in all sections of the self-regulatory code, but significant group differences were seen in applying the section that prohibits the promotion of excessive alcohol consumption, with experts identifying more violations than adolescents. Beer ads in the sample systematically violated the self-regulatory standards for alcohol advertising in Brazil according to both experts and youth. Public policies for more effective restrictions and prohibitions in alcohol ads should be considered. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

Monitoring compliance with the International Code of Marketing of Breastmilk Substitutes in west Africa: multisite cross sectional survey in Togo and Burkina Faso

PubMed Central

Aguayo, Victor M; Ross, Jay S; Kanon, Souleyman; Ouedraogo, Andre N

2003-01-01

Objectives To monitor compliance with the International Code of Marketing of Breastmilk Substitutes in health systems, sales outlets, distribution points, and the news media in Togo and Burkina Faso, west Africa. Design Multisite cross sectional survey. Participants Staff at 43 health facilities and 66 sales outlets and distribution points, 186 health providers, and 105 mothers of infants aged ⩽5 months in 16 cities. Results Six (14%) health facilities had received donations of breast milk substitutes. All donations were being given to mothers free of charge. Health providers in five (12%) health facilities had received free samples of breast milk substitutes for purposes other than professional research or evaluation. Health professionals in five (12%) health facilities had received promotional gifts from manufacturers. Promotional materials of commercial breast milk substitutes were found in seven (16%) health facilities. Special displays to market commercial breast milk substitutes were found in 29 (44%) sales and distribution points. Forty commercial breast milk substitutes violated the labelling standards of the code: 21 were manufactured by Danone, 11 by Nestlé, and eight by other national and international manufacturers. Most (148, 90%) health providers had never heard of the code, and 66 mothers (63%) had never received any counselling on breast feeding by their health providers. Conclusion In west Africa manufacturers are violating the code of marketing of breast milk substitutes. Comparable levels of code violations are observed with (Burkina Faso) or without (Togo) regulating legislation. Legislation must be accompanied by effective information, training, and monitoring systems to ensure that healthcare providers and manufacturers comply with evidence based practice and the code. What is already known on this topicAll member states of the World Health Assembly have reaffirmed their support for the International Code of Marketing of Breastmilk SubstitutesViolations by manufacturers of breast milk substitutes have been reported in industrialised and developing countriesWhat this study addsManufacturers of breast milk substitutes are violating the code in Togo and Burkina FasoThe levels of code violations are similar in a country with (Burkina Faso) and one without (Togo) legislation on the marketing of breast milk substitutesLegislation must be accompanied by effective information, training, and monitoring systems to ensure compliance with the code PMID:12531842

Learning to Be Gendered: Gender Socialization in Early Adolescence Among Urban Poor in Delhi, India, and Shanghai, China.

PubMed

Basu, Sharmistha; Zuo, Xiayun; Lou, Chaohua; Acharya, Rajib; Lundgren, Rebecka

2017-10-01

The purpose of the study is to understand the gender socialization process in early adolescence. The study was located in two disadvantaged urban communities in Delhi, India and Shanghai, China and was part of the multicountry (15) Global Early Adolescent Study. Qualitative methodologies were used with boys and girls aged 11-13 years, including 16 group-based timeline exercises and 65 narrative interviews. In addition, 58 parents of participating adolescents were interviewed. Interviews were recorded, transcribed, translated, and uploaded into Atlas.ti for coding and thematic analysis. Boys and girls growing up in the same community were directed onto different pathways during their transition from early to late adolescence. Adolescents and parents in both sites identified mothers as the primary actor, socializing adolescents into how to dress and behave and what gender roles to play, although fathers were also mentioned as influential. Opposite-sex interactions were restricted, and violations enforced by physical violence. In Delhi, gender roles and mobility were more strictly enforced for girls than boys. Restrictions on opposite-sex interactions were rigid for both boys and girls in Delhi and Shanghai. Sanctions, including beating, for violating norms about boy-girl relationships were more punitive than those related to dress and demeanor, especially in Delhi. Education and career expectations were notably more equitable in Shanghai. Parents teach their children to adhere to inequitable gender norms in both Delhi and Shanghai. However, education and career expectations for boys and girls in the two sites differed. Although gender norms varied by site according to the particular cultural and historical context, similar patterns of gender inequity reflect the underlying patriarchal system in both settings. The tendency of parents to pass on the norms they grew up with is evident, yet these results illustrate the social construction of gender through children's interaction with the social ecology, including evolving political and economic systems. Efforts to bend gender norms toward greater equality can build on these results by empowering children and parents to reflect critically on inequitable gender norms and roles and by mobilizing economic and social support at key turning points in adolescents' lives. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Violations of exhibiting and FDA rules at an American Psychiatric Association annual meeting.

PubMed

Lurie, Peter; Tran, Tung; Wolfe, Sidney Manuel; Goodman, Robert

2005-12-01

We conducted a cross-sectional study of all exhibit booths for the 24 pharmaceutical companies at the 2002 American Psychiatric Association (APA) convention. We collected and categorized one of each item distributed by the companies at each booth. A total of 268 items were collected from 24 companies (median=8). The most common categories of items were "reprints or pamphlets" (37%) and "noneducational gifts" (27%), including music CDs and invitations to dinners and museums. There were a total of 16 violations of the APA's own exhibit rules: eight companies had one violation and two companies had four violations. Four companies engaged in FDA-prohibited off-label promotion; one also violated the APA code. Over half of all companies (54%) were in violation of either APA rules or FDA regulations. The APA's voluntary code has failed to adequately reduce inappropriate promotional activity at the annual APA meeting.

Prostitution advertisements suggest association of transvestism and masochism.

PubMed

Chivers, M; Blanchard, R

1996-01-01

Previous research and clinical observation have suggested that the sexual interest of many transvestites include involvement in sadomasochistic sexual acts. Through data gathered via prostitution advertisements in print media, we tested the hypothesis that prostitutes welcoming cross-dressing client would be primarily those describing themselves as dominant. The specialty of the prostitute was recorded by coding the advertisements for the presence or absence of the features of dominance, submissiveness, acceptance of cross-dressing clients, and whether the prostitute was a biological male presenting as a woman or quasi-woman. The findings showed that 20% of prostitutes describing themselves as dominant welcomed cross-dressing clients, whereas none of the other subgroups of prostitutes mentioned cross-dressing clients in their advertisements. These findings reinforce other lines of indirect evidence suggesting that, in heterosexual men, the presence of masochism increases the likelihood of transvestism, and vice versa.

B+ L violation at colliders and new physics

NASA Astrophysics Data System (ADS)

Cerdeño, David G.; Reimitz, Peter; Sakurai, Kazuki; Tamarit, Carlos

2018-04-01

Chiral electroweak anomalies predict baryon ( B) and lepton ( L) violating fermion interactions, which can be dressed with large numbers of Higgs and gauge bosons. The estimation of the total B + L-violating rate from an initial two-particle state — potentially observable at colliders — has been the subject of an intense discussion, mainly centered on the resummation of boson emission, which is believed to contribute to the cross-section with an exponential function of the energy, yet with an exponent (the "holy-grail" function) which is not fully known in the energy range of interest. In this article we focus instead on the effect of fermions beyond the Standard-Model (SM) in the polynomial contributions to the rate. It is shown that B + L processes involving the new fermions have a polynomial contribution that can be several orders of magnitude greater than in the SM, for high centre-of-mass energies and light enough masses. We also present calculations that hint at a simple dependence of the holy grail function on the heavy fermion masses. Thus, if anomalous B + L violating interactions are ever detected at high-energy colliders, they could be associated with new physics.

Clothing norms as markers of status in a hospital setting: A Bourdieusian analysis.

PubMed

Jenkins, Tania M

2014-09-01

This article uses a Bourdieusian framework to understand the importance of clothing norms for symbolizing and reproducing social, as well as professional, hierarchy in hospitals. Using data from participant observation, it examines how a complex yet informal dress code has emerged at a community hospital in the Northeastern United States, in a setting where very few formal guidelines exist on how to dress. By conceptualizing professionals as holders of various types of capital (economic, cultural, and symbolic), this article expands previous research which considered clothing only as a marker of professional identity. The findings demonstrate (1) how clothing norms are used in subtle, but purposeful, ways to reflect varying degrees of cultural and economic capital and (2) how these complex norms also reflect professional boundaries in medical authority (symbolic capital), which is important during critical moments where clothing can quickly signal who can take control. The discussion borrows Bourdieu's concepts of habitus and field to explain why subordinates subscribe to these clothing norms, in the absence of a formal organizational dress code. © The Author(s) 2014.

Are Neighborhood-Level Characteristics Associated with Indoor Allergens in the Household?

PubMed Central

Rosenfeld, Lindsay; Rudd, Rima; Chew, Ginger L.; Emmons, Karen; Acevedo-García, Dolores

2010-01-01

Background Individual home characteristics have been associated with indoor allergen exposure; however, the influence of neighborhood-level characteristics has not been well-studied. We defined neighborhoods as community districts determined by the New York Department of City Planning. Objective We examined the relationship between neighborhood-level characteristics and the presence of dust mite (Der f 1), cat (Fel d 1), cockroach (Bla g 2), and mouse (MUP) allergens in the household. Methods Using data from the Puerto Rican Asthma Project, a birth cohort of Puerto Rican children at risk of allergic sensitization (n=261) we examined associations between neighborhood characteristics (percent tree canopy, asthma hospitalizations per 1000 children, roadway length within 100 meters of buildings, serious housing code violations per 1000 rental units, poverty rates, and felony crime rates) and the presence of indoor allergens. Allergen cutpoints were used for categorical analyses and defined as follows: dust mite: >0.25 μg/g; cat: >1 μg/g; cockroach: >1 U/g; mouse: >1.6 μg/g. Results Serious housing code violations were statistically significantly positively associated with dust mite, cat and mouse allergens (continuous variables), adjusting for mother's income and education, and all neighborhood-level characteristics. In multivariable logistic regression analyses, medium levels of housing code violations were associated with higher dust mite and cat allergens (1.81, 95%CI: 1.08, 3.03 and 3.10, 95%CI: 1.22, 7.92, respectively). A high level of serious housing code violations was associated with higher mouse allergen (2.04, 95%CI: 1.15, 3.62). A medium level of housing code violations was associated with higher cockroach allergen (3.30, 95%CI: 1.11, 9.78). Conclusions Neighborhood-level characteristics, specifically housing code violations, appear to be related to indoor allergens, which may have implications for future research explorations and policy decisions. PMID:20100024

Enforcing the International Code of Marketing of Breast-milk Substitutes for Better Promotion of Exclusive Breastfeeding: Can Lessons Be Learned?

PubMed

Barennes, Hubert; Slesak, Guenther; Goyet, Sophie; Aaron, Percy; Srour, Leila M

2016-02-01

Exclusive breastfeeding, one of the best natural resources, needs protection and promotion. The International Code of Marketing of Breast-milk Substitutes (the Code), which aims to prevent the undermining of breastfeeding by formula advertising, faces implementation challenges. We reviewed frequently overlooked challenges and obstacles that the Code is facing worldwide, but particularly in Southeast Asia. Drawing lessons from various countries where we work, and following the example of successful public health interventions, we discussed legislation, enforcement, and experiences that are needed to successfully implement the Code. Successful holistic approaches that have strengthened the Code need to be scaled up. Community-based actions and peer-to-peer promotions have proved successful. Legislation without stringent enforcement and sufficient penalties is ineffective. The public needs education about the benefits and ways and means to support breastfeeding. It is crucial to combine strong political commitment and leadership with strict national regulations, definitions, and enforcement. National breastfeeding committees, with the authority to improve regulations, investigate violations, and enforce the laws, must be established. Systematic monitoring and reporting are needed to identify companies, individuals, intermediaries, and practices that infringe on the Code. Penalizing violators is crucial. Managers of multinational companies must be held accountable for international violations, and international legislative enforcement needs to be established. Further measures should include improved regulations to protect the breastfeeding mother: large-scale education campaigns; strong penalties for Code violators; exclusion of the formula industry from nutrition, education, and policy roles; supportive legal networks; and independent research of interventions supporting breastfeeding. © The Author(s) 2015.

49 CFR 578.6 - Civil penalties for violations of specified provisions of Title 49 of the United States Code.

Code of Federal Regulations, 2012 CFR

2012-10-01

... violations is $1,175,000. (d) Consumer information—(1) Crashworthiness and damage susceptibility. A person that violates 49 U.S.C. 32308(a), regarding crashworthiness and damage susceptibility, is liable to the...

49 CFR 578.6 - Civil penalties for violations of specified provisions of Title 49 of the United States Code.

Code of Federal Regulations, 2011 CFR

2011-10-01

... violations is $1,175,000. (d) Consumer information—(1) Crashworthiness and damage susceptibility. A person that violates 49 U.S.C. 32308(a), regarding crashworthiness and damage susceptibility, is liable to the...

Minimum Standards for Student Conduct and Discipline, Including Suggested Guidelines and Model Codes. Oregon Administrative Rules 21-050 -- 21-085.

ERIC Educational Resources Information Center

Parnell, Dale

The guidelines and codes in this booklet were written to assist teachers and administrators strengthen their positions in times of legal and social confusion and in the face of challenges to administrative and staff authority. Model codes are provided for student (1) assembly, (2) dress and grooming, (3) motor vehicles, (4) search and seizure, (5)…

10 CFR 820.20 - Purpose and scope.

Code of Federal Regulations, 2013 CFR

2013-01-01

... OF ENERGY PROCEDURAL RULES FOR DOE NUCLEAR ACTIVITIES Enforcement Process § 820.20 Purpose and scope... violations of the DOE Nuclear Safety Requirements, for determining, whether a violation has occurred, for... of a violation of: (1) Any DOE Nuclear Safety Requirement set forth in the Code of Federal...

10 CFR 820.20 - Purpose and scope.

Code of Federal Regulations, 2012 CFR

2012-01-01

... OF ENERGY PROCEDURAL RULES FOR DOE NUCLEAR ACTIVITIES Enforcement Process § 820.20 Purpose and scope... violations of the DOE Nuclear Safety Requirements, for determining, whether a violation has occurred, for... of a violation of: (1) Any DOE Nuclear Safety Requirement set forth in the Code of Federal...

10 CFR 820.20 - Purpose and scope.

Code of Federal Regulations, 2011 CFR

2011-01-01

... OF ENERGY PROCEDURAL RULES FOR DOE NUCLEAR ACTIVITIES Enforcement Process § 820.20 Purpose and scope... violations of the DOE Nuclear Safety Requirements, for determining, whether a violation has occurred, for... of a violation of: (1) Any DOE Nuclear Safety Requirement set forth in the Code of Federal...

10 CFR 820.20 - Purpose and scope.

Code of Federal Regulations, 2014 CFR

2014-01-01

... OF ENERGY PROCEDURAL RULES FOR DOE NUCLEAR ACTIVITIES Enforcement Process § 820.20 Purpose and scope... violations of the DOE Nuclear Safety Requirements, for determining, whether a violation has occurred, for... of a violation of: (1) Any DOE Nuclear Safety Requirement set forth in the Code of Federal...

25 CFR 11.445 - Driving violations.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 1 2013-04-01 2013-04-01 false Driving violations. 11.445 Section 11.445 Indians BUREAU... ORDER CODE Criminal Offenses § 11.445 Driving violations. (a) A person who shall operate any vehicle in a manner dangerous to the public safety is guilty of reckless driving, a petty misdemeanor, unless...

25 CFR 11.445 - Driving violations.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 1 2014-04-01 2014-04-01 false Driving violations. 11.445 Section 11.445 Indians BUREAU... ORDER CODE Criminal Offenses § 11.445 Driving violations. (a) A person who shall operate any vehicle in a manner dangerous to the public safety is guilty of reckless driving, a petty misdemeanor, unless...

25 CFR 11.445 - Driving violations.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 25 Indians 1 2012-04-01 2011-04-01 true Driving violations. 11.445 Section 11.445 Indians BUREAU... ORDER CODE Criminal Offenses § 11.445 Driving violations. (a) A person who shall operate any vehicle in a manner dangerous to the public safety is guilty of reckless driving, a petty misdemeanor, unless...

25 CFR 11.445 - Driving violations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false Driving violations. 11.445 Section 11.445 Indians BUREAU... ORDER CODE Criminal Offenses § 11.445 Driving violations. (a) A person who shall operate any vehicle in a manner dangerous to the public safety is guilty of reckless driving, a petty misdemeanor, unless...

Working in Corporate France: A Cross-Cultural Challenge.

ERIC Educational Resources Information Center

Federico, Salvatore; Moore, Catherine

1997-01-01

Discusses the experience of an American executive working in Paris. Touches on the working environment, working hours and vacation, dress code, professional hierarchy, internal communication, benefits, and cultural attitudes. (Six references) (CK)

32 CFR 935.52 - Violations of Subpart O or P of this part.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 6 2014-07-01 2014-07-01 false Violations of Subpart O or P of this part. 935... TERRITORIAL AND INSULAR REGULATIONS WAKE ISLAND CODE Penalties § 935.52 Violations of Subpart O or P of this part. (a) Whoever is found guilty of a violation of subpart O or P of this part is subject to a fine of...

32 CFR 935.52 - Violations of Subpart O or P of this part.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 6 2013-07-01 2013-07-01 false Violations of Subpart O or P of this part. 935... TERRITORIAL AND INSULAR REGULATIONS WAKE ISLAND CODE Penalties § 935.52 Violations of Subpart O or P of this part. (a) Whoever is found guilty of a violation of subpart O or P of this part is subject to a fine of...

32 CFR 935.52 - Violations of Subpart O or P of this part.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 6 2012-07-01 2012-07-01 false Violations of Subpart O or P of this part. 935... TERRITORIAL AND INSULAR REGULATIONS WAKE ISLAND CODE Penalties § 935.52 Violations of Subpart O or P of this part. (a) Whoever is found guilty of a violation of subpart O or P of this part is subject to a fine of...

32 CFR 935.52 - Violations of Subpart O or P of this part.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 6 2011-07-01 2011-07-01 false Violations of Subpart O or P of this part. 935... TERRITORIAL AND INSULAR REGULATIONS WAKE ISLAND CODE Penalties § 935.52 Violations of Subpart O or P of this part. (a) Whoever is found guilty of a violation of subpart O or P of this part is subject to a fine of...

32 CFR 935.52 - Violations of Subpart O or P of this part.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 6 2010-07-01 2010-07-01 false Violations of Subpart O or P of this part. 935... TERRITORIAL AND INSULAR REGULATIONS WAKE ISLAND CODE Penalties § 935.52 Violations of Subpart O or P of this part. (a) Whoever is found guilty of a violation of subpart O or P of this part is subject to a fine of...

32 CFR 935.51 - Motor vehicle violations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 6 2010-07-01 2010-07-01 false Motor vehicle violations. 935.51 Section 935.51... REGULATIONS WAKE ISLAND CODE Penalties § 935.51 Motor vehicle violations. Whoever is found guilty of a... than 30 days, or suspension or revocation of his motor vehicle operator's permit, or any combination or...

32 CFR 935.51 - Motor vehicle violations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 6 2011-07-01 2011-07-01 false Motor vehicle violations. 935.51 Section 935.51... REGULATIONS WAKE ISLAND CODE Penalties § 935.51 Motor vehicle violations. Whoever is found guilty of a... than 30 days, or suspension or revocation of his motor vehicle operator's permit, or any combination or...

Non-adiabatic dynamics of molecules in optical cavities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kowalewski, Markus, E-mail: mkowalew@uci.edu; Bennett, Kochise; Mukamel, Shaul, E-mail: smukamel@uci.edu

2016-02-07

Strong coupling of molecules to the vacuum field of micro cavities can modify the potential energy surfaces thereby opening new photophysical and photochemical reaction pathways. While the influence of laser fields is usually described in terms of classical field, coupling to the vacuum state of a cavity has to be described in terms of dressed photon-matter states (polaritons) which require quantized fields. We present a derivation of the non-adiabatic couplings for single molecules in the strong coupling regime suitable for the calculation of the dressed state dynamics. The formalism allows to use quantities readily accessible from quantum chemistry codes likemore » the adiabatic potential energy surfaces and dipole moments to carry out wave packet simulations in the dressed basis. The implications for photochemistry are demonstrated for a set of model systems representing typical situations found in molecules.« less

Preparation and Use of Liposomes in Immunological Studies

DTIC Science & Technology

1993-01-01

SYMBOL MFI RO W 0 E FANIZATION Division of Bioctmnistry El O9V09W399 6c. ADDRESS (City, State, and ZIP Code). DRESS(Ci State, and ZIP Code) "Walter Reed...Anuv Institute of Research 1 A Washington. DC 20307-5100 oC" 8a. NAME OF FUNDING/SPONSORING 8b. OFFICE SYMBOL 9. PROCUREMENT INSTRUMENT IDENTIFICATION...12a NAME OF RESPONSIBLE INDIVIDUAL 22b. TELEPHONE (Include Area Code) 22c. OFFICE SYMBOL OD Form 1473, JUN 86 Previous editions are obsolete

Code Help: Can This Unique State Regulatory Intervention Improve Emergency Department Crowding?

PubMed

Michael, Sean S; Broach, John P; Kotkowski, Kevin A; Brush, D Eric; Volturo, Gregory A; Reznek, Martin A

2018-05-01

Emergency department (ED) crowding adversely affects multiple facets of high-quality care. The Commonwealth of Massachusetts mandates specific, hospital action plans to reduce ED boarding via a mechanism termed "Code Help." Because implementation appears inconsistent even when hospital conditions should have triggered its activation, we hypothesized that compliance with the Code Help policy would be associated with reduction in ED boarding time and total ED length of stay (LOS) for admitted patients, compared to patients seen when the Code Help policy was not followed. This was a retrospective analysis of data collected from electronic, patient-care, timestamp events and from a prospective Code Help registry for consecutive adult patients admitted from the ED at a single academic center during a 15-month period. For each patient, we determined whether the concurrent hospital status complied with the Code Help policy or violated it at the time of admission decision. We then compared ED boarding time and overall ED LOS for patients cared for during periods of Code Help policy compliance and during periods of Code Help policy violation, both with reference to patients cared for during normal operations. Of 89,587 adult patients who presented to the ED during the study period, 24,017 (26.8%) were admitted to an acute care or critical care bed. Boarding time ranged from zero to 67 hours 30 minutes (median 4 hours 31 minutes). Total ED LOS for admitted patients ranged from 11 minutes to 85 hours 25 minutes (median nine hours). Patients admitted during periods of Code Help policy violation experienced significantly longer boarding times (median 20 minutes longer) and total ED LOS (median 46 minutes longer), compared to patients admitted under normal operations. However, patients admitted during Code Help policy compliance did not experience a significant increase in either metric, compared to normal operations. In this single-center experience, implementation of the Massachusetts Code Help regulation was associated with reduced ED boarding time and ED LOS when the policy was consistently followed, but there were adverse effects on both metrics during violations of the policy.

6 CFR 29.9 - Investigation and reporting of violation of PCII procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... PROTECTED CRITICAL INFRASTRUCTURE INFORMATION § 29.9 Investigation and reporting of violation of PCII... or employee thereof, shall be fined under title 18 of the United States Code, imprisoned not more...

CAD or MAD? Anger (not disgust) as the predominant response to pathogen-free violations of the divinity code.

PubMed

Royzman, Edward; Atanasov, Pavel; Landy, Justin F; Parks, Amanda; Gepty, Andrew

2014-10-01

The CAD triad hypothesis (Rozin, Lowery, Imada, & Haidt, 1999) stipulates that, cross-culturally, people feel anger for violations of autonomy, contempt for violations of community, and disgust for violations of divinity. Although the disgust-divinity link has received some measure of empirical support, the results have been difficult to interpret in light of several conceptual and design flaws. Taking a revised methodological approach, including use of newly validated (Study 1), pathogen-free violations of the divinity code, we found (Study 2) little evidence of disgust-related phenomenology (nausea, gagging, loss of appetite) or action tendency (desire to move away), but much evidence of anger-linked desire to retaliate, as a major component of individuals' projected response to "pure" (pathogen-free) violations of the divinity code. Study 3 replicated these results using faces in lieu of words as a dependent measure. Concordant findings emerged from an archival study (Study 4) examining the aftermath of a real-life sacred violation-the burning of Korans by U.S. military personnel. Study 5 further corroborated these results using continuous measures based on everyday emotion terms and new variants of the divinity-pure scenarios featuring sacrilegious acts committed by a theologically irreverent member of one's own group rather than an ideologically opposed member of another group. Finally, a supplemental study found the anger-dominant attribution pattern to remain intact when the impious act being judged was the judge's own. Based on these and related results, we posit anger to be the principal emotional response to moral transgressions irrespective of the normative content involved. PsycINFO Database Record (c) 2014 APA, all rights reserved.

49 CFR 578.6 - Civil penalties for violations of specified provisions of Title 49 of the United States Code.

Code of Federal Regulations, 2014 CFR

2014-10-01

... under this paragraph for a related series of daily violations is $17,350,000. (b) National Automobile... for a civil penalty of not more than $140,000 a day for each violation. (h) Automobile fuel economy...) or (B) for automobiles to which the standard applies manufactured by the manufacturer during the...

49 CFR 578.6 - Civil penalties for violations of specified provisions of Title 49 of the United States Code.

Code of Federal Regulations, 2013 CFR

2013-10-01

... under this paragraph for a related series of daily violations is $17,350,000. (b) National Automobile... for a civil penalty of not more than $140,000 a day for each violation. (h) Automobile fuel economy...) or (B) for automobiles to which the standard applies manufactured by the manufacturer during the...

BHDD: Primordial black hole binaries code

NASA Astrophysics Data System (ADS)

Kavanagh, Bradley J.; Gaggero, Daniele; Bertone, Gianfranco

2018-06-01

BHDD (BlackHolesDarkDress) simulates primordial black hole (PBH) binaries that are clothed in dark matter (DM) halos. The software uses N-body simulations and analytical estimates to follow the evolution of PBH binaries formed in the early Universe.

Malt Beverage Brand Popularity Among Youth and Youth-Appealing Advertising Content.

PubMed

Xuan, Ziming; DeJong, William; Siegel, Michael; Babor, Thomas F

2017-11-01

This study examined whether alcohol brands more popular among youth are more likely to have aired television advertisements that violated the alcohol industry's voluntary code by including youth-appealing content. We obtained a complete list of 288 brand-specific beer advertisements broadcast during the National Collegiate Athletic Association (NCAA) men's and women's basketball tournaments from 1999 to 2008. All ads were rated by a panel of health professionals using a modified Delphi method to assess the presence of youth-appealing content in violation of the alcohol industry's voluntary code. The ads represented 23 alcohol brands. The popularity of these brands was operationalized as the brand-specific popularity of youth alcohol consumption in the past 30 days, as determined by a 2011 to 2012 national survey of underage drinkers. Brand-level popularity was used as the exposure variable to predict the odds of having advertisements with youth-appealing content violations. Accounting for other covariates and the clustering of advertisements within brands, increased brand popularity among underage youth was associated with significantly increased odds of having youth-appeal content violations in ads televised during the NCAA basketball tournament games (adjusted odds ratio = 1.70, 95% CI: 1.38, 2.09). Alcohol brands popular among underage drinkers are more likely to air television advertising that violates the industry's voluntary code which proscribes youth-appealing content. Copyright © 2017 by the Research Society on Alcoholism.

Misleading Advertising for Antidepressants in Sweden: A Failure of Pharmaceutical Industry Self-Regulation

PubMed Central

Zetterqvist, Anna V.; Mulinari, Shai

2013-01-01

Background The alleged efficacy of pharmaceutical industry self-regulation has been used to repudiate increased government oversight over promotional activity. European politicians and industry have cited Sweden as an excellent example of self-regulation based on an ethical code. This paper considers antidepressant advertising in Sweden to uncover the strengths and weaknesses of self-regulation. Methodology We analyzed all antidepressant advertisements in the Swedish Medical Journal, 1994–2003. The regulation of these advertisements was analyzed using case reports from self-regulatory bodies. The authors independently reviewed this material to investigate: (1) extent of violative advertising; (2) pattern of code breaches; (3) rate at which the system reacted to violative advertising; (4) prevalence of and oversight over claims regarding antidepressant efficacy and disease causality, and (5) costs for manufactures associated with violative advertising. Principal Findings Self-regulatory bodies identified numerous code breaches. Nonetheless, they failed to protect doctors from unreliable information on antidepressants, since as many as 247 of 722 (34%) advertisements breached the industry code. Self-regulatory bodies repeatedly failed to challenge inflated claims of antidepressant efficacy, lending evidence of lax oversight. On average, 15 weeks elapsed between printing and censure of a wrongful claim, and in 25% of cases 47 weeks or more elapsed. Industry paid roughly €108000 in fines for violative advertising, adding an estimated additional average cost of 11% to each purchased violative advertisement, or amounting to as little as 0.009% of total antidepressant sales of around €1.2 billion. Conclusions Lax oversight, combined with lags in the system and low fines for violations, may explain the Swedish system’s failure to pressure companies into providing reliable antidepressants information. If these shortcomings prove to be consistent across self-regulatory settings, and if appropriate measures are not taken to amend shortcomings, many countries may want to reconsider the current balance between self-regulation, and legislative control with government oversight. PMID:23650519

Misleading advertising for antidepressants in Sweden: a failure of pharmaceutical industry self-regulation.

PubMed

Zetterqvist, Anna V; Mulinari, Shai

2013-01-01

The alleged efficacy of pharmaceutical industry self-regulation has been used to repudiate increased government oversight over promotional activity. European politicians and industry have cited Sweden as an excellent example of self-regulation based on an ethical code. This paper considers antidepressant advertising in Sweden to uncover the strengths and weaknesses of self-regulation. We analyzed all antidepressant advertisements in the Swedish Medical Journal, 1994-2003. The regulation of these advertisements was analyzed using case reports from self-regulatory bodies. The authors independently reviewed this material to investigate: (1) extent of violative advertising; (2) pattern of code breaches; (3) rate at which the system reacted to violative advertising; (4) prevalence of and oversight over claims regarding antidepressant efficacy and disease causality, and (5) costs for manufactures associated with violative advertising. Self-regulatory bodies identified numerous code breaches. Nonetheless, they failed to protect doctors from unreliable information on antidepressants, since as many as 247 of 722 (34%) advertisements breached the industry code. Self-regulatory bodies repeatedly failed to challenge inflated claims of antidepressant efficacy, lending evidence of lax oversight. On average, 15 weeks elapsed between printing and censure of a wrongful claim, and in 25% of cases 47 weeks or more elapsed. Industry paid roughly €108000 in fines for violative advertising, adding an estimated additional average cost of 11% to each purchased violative advertisement, or amounting to as little as 0.009% of total antidepressant sales of around €1.2 billion. Lax oversight, combined with lags in the system and low fines for violations, may explain the Swedish system's failure to pressure companies into providing reliable antidepressants information. If these shortcomings prove to be consistent across self-regulatory settings, and if appropriate measures are not taken to amend shortcomings, many countries may want to reconsider the current balance between self-regulation, and legislative control with government oversight.

The Economic Impact of Closed-Incision Negative-Pressure Therapy in High-Risk Abdominal Incisions: A Cost-Utility Analysis.

PubMed

Chopra, Karan; Gowda, Arvind U; Morrow, Chris; Holton, Luther; Singh, Devinder P

2016-04-01

Complex abdominal wall reconstruction is beset by postoperative complications. A recent meta-analysis comparing the use of closed-incision negative-pressure therapy to standard dressings found a statistically significant reduction in surgical-site infection. The use of closed-incision negative-pressure therapy is gaining acceptance in this population; however, the economic impact of this innovative dressing remains unknown. In this study, a cost-utility analysis was performed assessing closed-incision negative-pressure therapy and standard dressings following closure of abdominal incisions in high-risk patients. Cost-utility methodology involved reviewing literature related to closed-incision negative-pressure therapy in abdominal wall surgery, obtaining utility estimates to calculate quality-adjusted life-year scores for successful surgery and surgery complicated by surgical-site infection, summing costs using Medicare Current Procedural Terminology codes, and creating a decision tree illuminating the most cost-effective dressing strategy. One-way sensitivity analysis was performed to assess the robustness of the results. The aforementioned meta-analysis comparing closed-incision negative-pressure therapy to standard dressings included a subset of five studies assessing abdominal wall surgery in 829 patients (260 closed-incision negative-pressure therapy and 569 standard dressings). Decision tree analysis revealed an estimated savings of $1546.52 and a gain of 0.0024 quality-adjusted life-year with closed-incision negative-pressure therapy compared with standard dressings; therefore, closed-incision negative-pressure therapy is a dominant treatment strategy. One-way sensitivity analysis revealed that closed-incision negative-pressure therapy is a cost-effective option when the surgical-site infection rate is greater than 16.39 percent. The use of closed-incision negative-pressure therapy is cost-saving following closure of abdominal incisions in high-risk patients.

Symbolic Speech

ERIC Educational Resources Information Center

Podgor, Ellen S.

1976-01-01

The concept of symbolic speech emanates from the 1967 case of United States v. O'Brien. These discussions of flag desecration, grooming and dress codes, nude entertainment, buttons and badges, and musical expression show that the courts place symbolic speech in different strata from verbal communication. (LBH)

Interviewing Guidelines.

ERIC Educational Resources Information Center

Lorenzen, Elizabeth A.; And Others

Directed especially at graduating college seniors, this paper contains information about employment interviews and how to prepare for them. Subjects discussed include the following: preparing for interviews (analyzing strengths and weaknesses, gathering information about the company); points to remember (dress codes, follow up thank-you letters);…

Baby milk companies accused of breaching marketing code.

PubMed

Wise, J

1997-01-18

A consortium of 27 religious and health organizations has released a report entitled "Cracking the Code," which criticizes the bottle-feeding marketing techniques used by Nestle, Gerber, Mead Johnson, Wyeth, and Nutricia. Research for the report was carried out in Thailand, Bangladesh, South Africa, and Poland using a random sample of 800 mothers and 120 health workers in each country. In all 4 sites, women had received information that violated the World Health Organization's 1981 international code of marketing breast milk substitutes. Violations included promoting artificial feeding without recognizing breast feeding as the best source of infant nutrition. The investigation also found that women and health workers in all 4 sites received free samples of artificial milk. The report includes detailed examples of manufacturer representatives making unrequested visits to give product information to mothers, providing incentives to health workers to promote products, and promoting products outside of health care facilities. While the International Association of Infant Food Manufacturers condemned the study as biased, the Nestle company promised to review the allegations contained in the report and to deal with any breaches in the code. The Interagency Group on Breastfeeding Monitoring, which prepared the report, was created in 1994 to provide data to groups supporting a boycott of Nestle for code violations.

Student Conduct and Discipline.

ERIC Educational Resources Information Center

Oregon State Dept. of Education, Salem.

To aid Oregon's school districts in developing policies and procedures for student conduct and discipline, this document suggests guidelines for district preparation and distribution of student conduct codes, including formal and informal student assembly, dress and grooming, use of motor vehicles, search and seizure, attendance, freedom of…

ARES: A System for Real-Time Operational and Tactical Decision Support

DTIC Science & Technology

1986-12-01

In B]LE LCLGf. 9 NAVAL POSTGRADUATE SCHOOL Monterey, California Vi,-. %*.. THESIS - ’ A RE S A SYSTEM -OR REAL- 1I I .-.. --- OPERATIONAL AND...able) aval Postgraduate School 54 Naval Postgraduate School NN DRESS (City,. State,. and ZIP Code) 7b ADDRESS (City,. State,. and ZIP Code...SUBJECT TERMS (Continue on reverse if necessaty and identify by block number) LD GROUP SUB-GROUP Decision Support System, Logistics Model, Operational

Violations of the international code of marketing of breast milk substitutes: prevalence in four countries

PubMed Central

Taylor, Anna

1998-01-01

Objective: To estimate the prevalence of violations of the international code of marketing of substitutes for breast milk in one city in each of Bangladesh, Poland, South Africa, and Thailand. Design: Multistage random sampling was used to select pregnant women and mothers of infants ⩽6 months old to interview at health facilities. Women were asked whether they had received free samples of substitutes for breast milk (including infant formula designed to meet the nutritional needs of infants from birth to 4 to 6 months of age, follow on formula designed to replace infant formula at the age of 4 to 6 months, and complementary foods for infants aged ⩽6 months), bottles, or teats. The source of the free sample and when it had been given to the women was also determined. 3 health workers were interviewed at each facility to assess whether the facility had received free samples, to determine how they had been used, and to determine whether gifts had been given to health workers by companies that manufactured or distributed breast milk substitutes. Compliance with the marketing code for information given to health workers was evaluated using a checklist. Setting: Health facilities in Dhaka, Bangladesh; Warsaw, Poland; Durban, South Africa; and Bangkok, Thailand. Subjects: 1468 pregnant women, 1582 mothers of infants aged ⩽6 months, and 466 health workers at 165 health facilities. Main outcome measures: Number of free samples received by pregnant women, mothers, and health workers; number of gifts given to health workers; and availability of information that violated the code in health facilities. Results: 97 out of 370 (26%) mothers in Bangkok reported receiving free samples of breast milk substitutes, infant formula, bottles, or teats compared with only 1 out of 385 mothers in Dhaka. Across the four cities from 3 out of 40 (8%) to 20 out of 40 (50%) health facilities had received free samples which were not being used for research or professional evaluation; from 2 out of 123 (2%) to 21 out of 119 (18%) health workers had received gifts from companies involved in the manufacturing or distribution of breast milk substitutes. From 6 out of 40 (15%) to 22 out of 39 (56%) health facilities information that violated the code had been provided by companies and was available to staff. Conclusion: Violations of the code were detected with a simple survey instrument in all of the four countries studied. Governmental and non-governmental agencies should monitor the prevalence of code violations using the simple methodology developed for this study. Key messages A simple multistage random sampling procedure can be used to interview women and health professionals to assess whether violations of the international code of marketing of substitutes for breast milk are occurring 3050 women and 466 health professionals were interviewed at 165 health facilities in Bangladesh, Poland, South Africa, and Thailand 97 out of 370 mothers in Bangkok reported receiving free samples of breast milk substitutes, infant formula, bottles, or teats compared with only 1 out of 385 mothers in Dhaka. In Bangkok health workers reported that 20 out of 40 health facilities had also received free samples. Most free samples were distributed by health facilities In Warsaw 56% of facilities surveyed were found to have information available for health workers that had been provided by manufacturers or distributors of breast milk substitutes in contravention of the code; 18% of health workers in Warsaw had received free gifts from manufacturers PMID:9552947

Celebrate Your Freedom! May 1, Law Day 1997.

ERIC Educational Resources Information Center

Michaud, Mike; And Others

1997-01-01

Presents seven brief articles on legal issues concerning young people. Addresses such topics as curfews, teen smoking, dress codes, and child labor. Some articles are student-written while others profile student activity. Student authors include Mike Michaud, Danny Rosen, Carrie Kendrick, and William Hansen. (MJP)

Do School Uniforms Fit?

ERIC Educational Resources Information Center

White, Kerry A.

2000-01-01

In 1994, Long Beach (California) Unified School District began requiring uniforms in all elementary and middle schools. Now, half of all urban school systems and many suburban schools have uniform policies. Research on uniforms' effectiveness is mixed. Tightened dress codes may be just as effective and less litigious. (MLH)

Welcoming Diversity? Symbolic Boundaries and the Politics of Normativity in Kansas City's LGBTQ Communities.

PubMed

Vogler, Stefan

2016-01-01

Using document analysis and ethnographic field work, this article examines the debate within the LGBTQ community of Kansas City over the decision to hold its Pride festival in the Power and Light District (P&L), a renewed downtown area with a controversial dress code. Despite the developers' and city's goals of creating a cosmopolitan urban space that welcomed diverse populations, the P&L acquired a reputation as an anti-Black, anti-queer space due to its dress code and redevelopment history. I argue that the debate surrounding this controversy reveals limits to notions of diversity and diverging approaches to sexual politics within the LGBTQ community that are normally obscured by political actors within the movement but that work to create symbolic boundaries that exclude "non-respectable" members of the LGBTQ population. Recovering queer perspectives allows us to imagine a more capacious definition of diversity and inclusion, both within the LGBTQ movement and in urban space.

How To Keep Your Schools Safe and Secure.

ERIC Educational Resources Information Center

Gilbert, Christopher B.

1996-01-01

Discusses unforeseen costs (including potential litigation expenses), benefits, and consequences of adopting security measures (such as metal detectors, drug dogs, security cameras, campus police, dress codes, crime watch programs, and communication devices) to counter on-campus violence and gang activity. High-tech gadgetry alone is insufficient.…

United States Attorney Prosecutions

DTIC Science & Technology

1993-10-01

property of CocaCola Bottling Company, Fayetteville, North Carolina, of a value in excess of $100.00, in violation of Title 18 United States Code, Section...another, to-wit: a Cocacola soft drink machine, the amount of damage to said personal property being more than $200.00, in violation of North Carolina

25 CFR 11.445 - Driving violations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... violation of this section, or has been involved in a motor vehicle accident or collision resulting in property damage, personal injury, or death. (d) In the absence of an applicable tribal traffic code, the provisions of state traffic laws applicable in the state where a Court of Indian Offenses is located shall...

Simulation of free-electron lasers seeded with broadband radiation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bajlekov, Svetoslav; Fawley, William; Schroeder, Carl

2011-03-10

The longitudinal coherence of free-electron laser (FEL) radiation can be enhanced by seeding the FEL with high harmonics of an optical laser pulse. The radiation produced by high-harmonic generation (HHG), however, has a fast-varying temporal profile that can violate the slowly varying envelope approximation and limited frequency window that is employed in conventional free-electron laser simulation codes. Here we investigate the implications of violating this approximation on the accuracy of simulations. On the basis of both analytical considerations and 1D numerical studies, it is concluded that, for most realistic scenarios, conventional FEL codes are capable of accurately simulating the FELmore » process even when the seed radiation violates the slowly varying envelope approximation. We additionally discuss the significance of filtering the harmonic content of broadband HHG seeds.« less

Using the Student Edition of Update on Law-Related Education.

ERIC Educational Resources Information Center

Banaszak, Ronald A.

1997-01-01

Provides accompanying learning activities for each of the articles in the same issue. The brief articles address a number of legal issues concerning young people including dress codes, teen smoking, curfews, restricted areas (such as the mall), and child labor. Includes a law term crossword puzzle. (MJP)

High School Student Can Be Turned On to P.E.

ERIC Educational Resources Information Center

Donovan, John; Monti, Bill

1978-01-01

The Physical Education program at San Rafael High School seeks to boost students' sense of identity and self worth by abolishing rigid rules and dress codes and allowing students to choose from elective courses. The school administration has made commitments to the program and student enrollment is increasing. (SJL)

N-formylation of amines via the aerobic oxidation of methanol over supported gold nanoparticles.

PubMed

Ishida, Tamao; Haruta, Masatake

2009-01-01

Dress code: formyl. Gold nanoparticles supported on NiO catalyze the one-pot N-formylation of amines with methanol and molecular oxygen to produce formamide at a selectivity of 90 %. This process generates methyl formate in situ, followed by reaction with amines.

The Courts as Educational Policy Makers.

ERIC Educational Resources Information Center

Maready, William F.

This report discusses the expanding role of Federal judges as educational policymakers. The report discusses court decisions related to interpretations by the Federal Courts of the U.S. Constitution. The report notes that court decisions have covered the following topics: dress codes, flying of the flag, freedom of speech, unwed mothers,…

Creating a Sun-Safe Camp.

ERIC Educational Resources Information Center

Landrey, Ann

1996-01-01

Strategies for minimizing sun exposure of campers and staff include educating campers about the sun's effect on their skin, scheduling activities when the sun is less intense, creating shade at the camp site, incorporating sun protection into camp dress code, and training staff regarding sun protection. Addresses OSHA and liability issues. (LP)

Supplementing Public Health Inspection via Social Media

PubMed Central

Schomberg, John P.; Haimson, Oliver L.; Hayes, Gillian R.; Anton-Culver, Hoda

2016-01-01

Foodborne illness is prevented by inspection and surveillance conducted by health departments across America. Appropriate restaurant behavior is enforced and monitored via public health inspections. However, surveillance coverage provided by state and local health departments is insufficient in preventing the rising number of foodborne illness outbreaks. To address this need for improved surveillance coverage we conducted a supplementary form of public health surveillance using social media data: Yelp.com restaurant reviews in the city of San Francisco. Yelp is a social media site where users post reviews and rate restaurants they have personally visited. Presence of keywords related to health code regulations and foodborne illness symptoms, number of restaurant reviews, number of Yelp stars, and restaurant price range were included in a model predicting a restaurant’s likelihood of health code violation measured by the assigned San Francisco public health code rating. For a list of major health code violations see (S1 Table). We built the predictive model using 71,360 Yelp reviews of restaurants in the San Francisco Bay Area. The predictive model was able to predict health code violations in 78% of the restaurants receiving serious citations in our pilot study of 440 restaurants. Training and validation data sets each pulled data from 220 restaurants in San Francisco. Keyword analysis of free text within Yelp not only improved detection of high-risk restaurants, but it also served to identify specific risk factors related to health code violation. To further validate our model we applied the model generated in our pilot study to Yelp data from 1,542 restaurants in San Francisco. The model achieved 91% sensitivity 74% specificity, area under the receiver operator curve of 98%, and positive predictive value of 29% (given a substandard health code rating prevalence of 10%). When our model was applied to restaurant reviews in New York City we achieved 74% sensitivity, 54% specificity, area under the receiver operator curve of 77%, and positive predictive value of 25% (given a prevalence of 12%). Model accuracy improved when reviews ranked highest by Yelp were utilized. Our results indicate that public health surveillance can be improved by using social media data to identify restaurants at high risk for health code violation. Additionally, using highly ranked Yelp reviews improves predictive power and limits the number of reviews needed to generate prediction. Use of this approach as an adjunct to current risk ranking of restaurants prior to inspection may enhance detection of those restaurants participating in high risk practices that may have gone previously undetected. This model represents a step forward in the integration of social media into meaningful public health interventions. PMID:27023681

Supplementing Public Health Inspection via Social Media.

PubMed

Schomberg, John P; Haimson, Oliver L; Hayes, Gillian R; Anton-Culver, Hoda

2016-01-01

Foodborne illness is prevented by inspection and surveillance conducted by health departments across America. Appropriate restaurant behavior is enforced and monitored via public health inspections. However, surveillance coverage provided by state and local health departments is insufficient in preventing the rising number of foodborne illness outbreaks. To address this need for improved surveillance coverage we conducted a supplementary form of public health surveillance using social media data: Yelp.com restaurant reviews in the city of San Francisco. Yelp is a social media site where users post reviews and rate restaurants they have personally visited. Presence of keywords related to health code regulations and foodborne illness symptoms, number of restaurant reviews, number of Yelp stars, and restaurant price range were included in a model predicting a restaurant's likelihood of health code violation measured by the assigned San Francisco public health code rating. For a list of major health code violations see (S1 Table). We built the predictive model using 71,360 Yelp reviews of restaurants in the San Francisco Bay Area. The predictive model was able to predict health code violations in 78% of the restaurants receiving serious citations in our pilot study of 440 restaurants. Training and validation data sets each pulled data from 220 restaurants in San Francisco. Keyword analysis of free text within Yelp not only improved detection of high-risk restaurants, but it also served to identify specific risk factors related to health code violation. To further validate our model we applied the model generated in our pilot study to Yelp data from 1,542 restaurants in San Francisco. The model achieved 91% sensitivity 74% specificity, area under the receiver operator curve of 98%, and positive predictive value of 29% (given a substandard health code rating prevalence of 10%). When our model was applied to restaurant reviews in New York City we achieved 74% sensitivity, 54% specificity, area under the receiver operator curve of 77%, and positive predictive value of 25% (given a prevalence of 12%). Model accuracy improved when reviews ranked highest by Yelp were utilized. Our results indicate that public health surveillance can be improved by using social media data to identify restaurants at high risk for health code violation. Additionally, using highly ranked Yelp reviews improves predictive power and limits the number of reviews needed to generate prediction. Use of this approach as an adjunct to current risk ranking of restaurants prior to inspection may enhance detection of those restaurants participating in high risk practices that may have gone previously undetected. This model represents a step forward in the integration of social media into meaningful public health interventions.

Monitoring compliance with the International Code of Marketing of Breastmilk Substitutes in west Africa: multisite cross sectional survey in Togo and Burkina Faso.

PubMed

Aguayo, Victor M; Ross, Jay S; Kanon, Souleyman; Ouedraogo, Andre N

2003-01-18

To monitor compliance with the International Code of Marketing of Breastmilk Substitutes in health systems, sales outlets, distribution points, and the news media in Togo and Burkina Faso, west Africa. Multisite cross sectional survey. Staff at 43 health facilities and 66 sales outlets and distribution points, 186 health providers, and 105 mothers of infants aged < or =5 months in 16 cities. Six (14%) health facilities had received donations of breast milk substitutes. All donations were being given to mothers free of charge. Health providers in five (12%) health facilities had received free samples of breast milk substitutes for purposes other than professional research or evaluation. Health professionals in five (12%) health facilities had received promotional gifts from manufacturers. Promotional materials of commercial breast milk substitutes were found in seven (16%) health facilities. Special displays to market commercial breast milk substitutes were found in 29 (44%) sales and distribution points. Forty commercial breast milk substitutes violated the labelling standards of the code: 21 were manufactured by Danone, 11 by Nestlé, and eight by other national and international manufacturers. Most (148, 90%) health providers had never heard of the code, and 66 mothers (63%) had never received any counselling on breast feeding by their health providers. In west Africa manufacturers are violating the code of marketing of breast milk substitutes. Comparable levels of code violations are observed with (Burkina Faso) or without (Togo) regulating legislation. Legislation must be accompanied by effective information, training, and monitoring systems to ensure that healthcare providers and manufacturers comply with evidence based practice and the code.

How Effective Is Honor Code Reporting over Instructor- Implemented Measures? A Pilot Study

ERIC Educational Resources Information Center

Barnard-Brak, Lucy; Schmidt, Marcelo; Wei, Tianlan

2013-01-01

Honor codes have become increasingly popular at institutions of higher education as a means of reducing violations of academic integrity such as cheating and other academically dishonest acts. Previous research on honor code effectiveness has been limited to correlational research designs that preclude the examination of cause-and-effect…

26 CFR 1.42-5 - Monitoring compliance with low-income housing credit requirements.

Code of Federal Regulations, 2012 CFR

2012-04-01

... be required to retain the original local health, safety, or building code violation reports or... account local health, safety, and building codes (or other habitability standards), and the State or local government unit responsible for making local health, safety, or building code inspections did not issue a...

26 CFR 1.42-5 - Monitoring compliance with low-income housing credit requirements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... be required to retain the original local health, safety, or building code violation reports or... account local health, safety, and building codes (or other habitability standards), and the State or local government unit responsible for making local health, safety, or building code inspections did not issue a...

Degenerate quantum codes and the quantum Hamming bound

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sarvepalli, Pradeep; Klappenecker, Andreas

2010-03-15

The parameters of a nondegenerate quantum code must obey the Hamming bound. An important open problem in quantum coding theory is whether the parameters of a degenerate quantum code can violate this bound for nondegenerate quantum codes. In this article we show that Calderbank-Shor-Steane (CSS) codes, over a prime power alphabet q{>=}5, cannot beat the quantum Hamming bound. We prove a quantum version of the Griesmer bound for the CSS codes, which allows us to strengthen the Rains' bound that an [[n,k,d

Spatial versus sequential correlations for random access coding

NASA Astrophysics Data System (ADS)

Tavakoli, Armin; Marques, Breno; Pawłowski, Marcin; Bourennane, Mohamed

2016-03-01

Random access codes are important for a wide range of applications in quantum information. However, their implementation with quantum theory can be made in two very different ways: (i) by distributing data with strong spatial correlations violating a Bell inequality or (ii) using quantum communication channels to create stronger-than-classical sequential correlations between state preparation and measurement outcome. Here we study this duality of the quantum realization. We present a family of Bell inequalities tailored to the task at hand and study their quantum violations. Remarkably, we show that the use of spatial and sequential quantum correlations imposes different limitations on the performance of quantum random access codes: Sequential correlations can outperform spatial correlations. We discuss the physics behind the observed discrepancy between spatial and sequential quantum correlations.

Talk is cheap: the tobacco companies' violations of their own cigarette advertising code.

PubMed

Arnett, Jeffrey Jensen

2005-01-01

In two studies, adolescents and adults were shown a series of cigarette advertisements and asked to respond to a variety of questions concerning aspects of the Cigarette Advertising and Promotion Code, specifically, their perceptions of the ages of the models in the ads and of whether the ads depicted smoking as essential to sexual attraction or essential to success. For many of the ads, especially ads for brands most popular among youth, a majority of the participants perceived the models to be less than 25 years old. A majority also perceived many of the ads to depict smoking as essential to sexual attraction or essential to success. Thus, despite their public pledge, the tobacco companies routinely violate a variety of aspects of the Cigarette Advertising and Promotion Code.

Violations of the International Code of Marketing of Breast-milk Substitutes: Indonesia context.

PubMed

Hidayana, Irma; Februhartanty, Judhiastuty; Parady, Vida A

2017-01-01

To measure compliance with the International Code of Marketing of Breast-milk Substitutes ('the Code') in Indonesia. The study was a cross-sectional survey using the Interagency Group on Breastfeeding Monitoring protocol. Public and private health facilities in six provinces on Java island in Indonesia. A total of 874 women (382 pregnant women and 492 breast-feeding mothers of infants below 6 months) and seventy-seven health workers were recruited from eighteen participating health facilities. The study also analysed a total of forty-four labels of breast-milk substitute products, twenty-seven television commercials for growing-up milk (for children >12 months) of nine brands and thirty-four print advertisements of fourteen brands. The study found that 20 % of the women had received advice and information on the use of breast-milk substitutes and 72 % had seen promotional materials for breast-milk substitutes. About 15 % reported receiving free samples and 16 % received gifts. Nearly a quarter of the health workers confirmed receiving visits from representatives of breast-milk substitute companies. Two health workers reported having received gifts from the companies. The most common labelling violations found were statements or visuals that discouraged breast-feeding and the absence of mention about the consideration of local climate in the expiration date. Violations of the Code by health workers, breast-milk substitute companies and their representatives were found in all provinces studied. A regular monitoring system should be in place to ensure improved compliance with and enforcement of the Code.

An Exploration of How Attire Shapes High School Students' Perceptions of Agriculture Teachers

ERIC Educational Resources Information Center

Shoulders, Catherine W.; Sellick, Sable A.; Southward, Leigh; Blythe, Jessica M.

2017-01-01

An individual's attire sends messages to those who view them (Damhorst, 1990), and the clothing choices made by teachers may influence students' perceptions of the school (Workman & Freeburg, 2010). A majority of teacher dress codes require formal clothing (Workman & Freeburg, 2010); however, agricultural education teachers often work in…

Uniforms: Are They a Good Fit?

ERIC Educational Resources Information Center

Boutelle, Marsha

2008-01-01

In an era where some parents seem unwilling or unable to draw the "clothes" line with their children, where pop culture influences kids' clothing choices as never before, and school safety--including gang violence--is at the top of everyone's minds, school uniforms and dress codes can play a significant role. What that role should be,…

Violence Prevention in Georgia's Rural Public School Systems: Perceptions of School Superintendents.

ERIC Educational Resources Information Center

Ballard, Chet

1998-01-01

Survey responses by superintendents in 81 of Georgia's 114 rural school districts covered violence prevention policies; use of searches, videocamera surveillance, metal detectors, security alarm systems, dress codes, and law enforcement officers on campus; incidence of removal of weapons and various forms of violence; student discipline programs;…

5 CFR 1800.1 - Filing complaints of prohibited personnel practices or other prohibited activities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... allegations of the following prohibited activities: (1) Violation of the Federal Hatch Act at title 5 of the U.S. Code, chapter 73, subchapter III; (2) Violation of the state and local Hatch Act at title 5 of... alleging prohibited personnel practices or other prohibited activities (other than the Hatch Act). (1...

5 CFR 1800.1 - Filing complaints of prohibited personnel practices or other prohibited activities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... allegations of the following prohibited activities: (1) Violation of the Federal Hatch Act at title 5 of the U.S. Code, chapter 73, subchapter III; (2) Violation of the state and local Hatch Act at title 5 of... alleging prohibited personnel practices or other prohibited activities (other than the Hatch Act). (1...

5 CFR 1800.1 - Filing complaints of prohibited personnel practices or other prohibited activities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... allegations of the following prohibited activities: (1) Violation of the Federal Hatch Act at title 5 of the U.S. Code, chapter 73, subchapter III; (2) Violation of the state and local Hatch Act at title 5 of... alleging prohibited personnel practices or other prohibited activities (other than the Hatch Act). (1...

5 CFR 1800.1 - Filing complaints of prohibited personnel practices or other prohibited activities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... allegations of the following prohibited activities: (1) Violation of the Federal Hatch Act at title 5 of the U.S. Code, chapter 73, subchapter III; (2) Violation of the state and local Hatch Act at title 5 of... alleging prohibited personnel practices or other prohibited activities (other than the Hatch Act). (1...

5 CFR 1800.1 - Filing complaints of prohibited personnel practices or other prohibited activities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... allegations of the following prohibited activities: (1) Violation of the Federal Hatch Act at title 5 of the U.S. Code, chapter 73, subchapter III; (2) Violation of the state and local Hatch Act at title 5 of... alleging prohibited personnel practices or other prohibited activities (other than the Hatch Act). (1...

The Suspension of the National Association of Broadcasters' Code and Its Effects on the Regulation of Advertising.

ERIC Educational Resources Information Center

Maddox, Lynda M.; Zanot, Eric J.

After a federal judge ruled in 1982 that some stipulations of the National Association of Broadcasters' (NAB) Television Code were violating antitrust laws, the NAB responded by suspending all code operations. Effects of the suspension on network advertising included (1) the disappearance of preclearance for commercials about cholesterol-related…

Some Colleges Extend Their Codes of Conduct to Off-Campus Behavior.

ERIC Educational Resources Information Center

Gose, Ben

1998-01-01

Protesters at the University of California at Berkeley are calling for the expulsion of a sophomore who failed to report a murder. However, the student's behavior does not violate the university's code of conduct, which is restricted to campus behavior. Some institutions are expanding the geographic reach of their codes to discipline students for…

Quantum correlations and violation of the Bell inequality induced by an external field in a two-photon radiative cascade

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yuan Luqi; Das, Sumanta

2011-06-15

We study the polarization-dependent second-order correlation of a pair of photons emitted in a four-level radiative cascade driven by an external field. It is found that the quantum correlations of the emitted photons, degraded by the energy splitting of the intermediate levels in the radiative cascade, can be efficiently revived by a far-detuned external field. The physics of this revival is linked to an induced Stark shift and the formation of dressed states in the system by the nonresonant external field. Furthermore, we investigated the competition between the effect of the coherent external field and incoherent dephasing of the intermediatemore » levels. We find that the degradation of quantum correlations due to the incoherent dephasing can be contained for small dephasing with the external field. We also studied the nonlocality of the correlations by evaluating the Bell inequality in the linear polarization basis for the radiative cascade. We find that the Bell parameter decreases rapidly with increase in the intermediate-level energy splitting or incoherent dephasing rate to the extent that there is no violation. However, the presence of an external field leads to control over the degrading mechanisms and preservation of nonlocal correlation among the photons. This in turn can induce a violation of Bell's inequality in the radiative cascade for arbitrary intermediate-level splitting and small incoherent dephasing.« less

Sequence Polishing Library (SPL) v10.0

DOE Office of Scientific and Technical Information (OSTI.GOV)

Oberortner, Ernst

The Sequence Polishing Library (SPL) is a suite of software tools in order to automate "Design for Synthesis and Assembly" workflows. Specifically: The SPL "Converter" tool converts files among the following sequence data exchange formats: CSV, FASTA, GenBank, and Synthetic Biology Open Language (SBOL); The SPL "Juggler" tool optimizes the codon usages of DNA coding sequences according to an optimization strategy, a user-specific codon usage table and genetic code. In addition, the SPL "Juggler" can translate amino acid sequences into DNA sequences.:The SPL "Polisher" verifies NA sequences against DNA synthesis constraints, such as GC content, repeating k-mers, and restriction sites.more » In case of violations, the "Polisher" reports the violations in a comprehensive manner. The "Polisher" tool can also modify the violating regions according to an optimization strategy, a user-specific codon usage table and genetic code;The SPL "Partitioner" decomposes large DNA sequences into smaller building blocks with partial overlaps that enable an efficient assembly. The "Partitioner" enables the user to configure the characteristics of the overlaps, which are mostly determined by the utilized assembly protocol, such as length, GC content, or melting temperature.« less

Implementation of School Uniform Policy and the Violation of Students' Human Rights in Schools

ERIC Educational Resources Information Center

Mahlangu, Vimbi Petrus

2017-01-01

The paper highlights the violations of students' human rights in schools. The problem is the incident that took place at a school in Pretoria in 2016 where Black girls protested against the School's Code of Conduct relating to hairstyle. Qualitative approach was used to collect information through a literature review and desk-top research methods.…

49 CFR Appendix B to Part 237 - Schedule of Civil Penalties1

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 4 2012-10-01 2012-10-01 false Schedule of Civil Penalties1 B Appendix B to Part...—Schedule of Civil Penalties1 Section 2 Violation Willful violation Subpart B—Railroad Bridge Safety... designated by a “penalty code,” which is used to facilitate assessment of civil penalties, and which may or...

Lessons from "Ugly Betty": Business Attire as a Conformity Strategy

ERIC Educational Resources Information Center

Burgess-Wilkerson, Barbara; Thomas, Jane Boyd

2009-01-01

Business students should understand the relevance of professional attire as an indication of conformity. Of equal importance is the recognition that some companies have loosened their dress codes to a more flexible policy to recruit young talent. "Ugly Betty" could serve as a teaching tool to initiate the dialogue on conformity in a light-hearted,…

Dress Codes Blues: An Exploration of Urban Students' Reactions to a Public High School Uniform Policy

ERIC Educational Resources Information Center

DaCosta, Kneia

2006-01-01

This qualitative investigation explores the responses of 22 U.S. urban public high school students when confronted with their newly imposed school uniform policy. Specifically, the study assessed students' appraisals of the policy along with compliance and academic performance. Guided by ecological human development perspectives and grounded in…

Young Muslim Women's Experiences of Islam and Physical Education in Greece and Britain: A Comparative Study

ERIC Educational Resources Information Center

Dagkas, Symeon; Benn, Tansin

2006-01-01

Previous research suggests that Muslim women can experience particular problems when taking physical education (PE) lessons, for example with dress codes, mixed-teaching and exercise during Ramadan; and they can face restrictions in extra-curricular activities for cultural and religious reasons. The area is under-researched and there is little…

75 FR 47045 - Self-Regulatory Organizations; Notice of Filing of Proposed Rule Change by NYSE Arca, Inc...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-04

.... This Rule specifically requires the adoption of a code of ethics by an investment advisor to include... requiring supervised persons to report any violations of the code of ethics promptly to the chief compliance... designated in the code of ethics; and (v) provisions requiring the investment advisor to provide each of the...

49 CFR 578.6 - Civil penalties for violations of specified provisions of Title 49 of the United States Code.

Code of Federal Regulations, 2010 CFR

2010-10-01

... paragraph for a related series of violations is $16,375,000. (2) School buses. Notwithstanding paragraph (a... commerce, or importation of a school bus or school bus equipment (as those terms are defined in 49 U.S.C... which a certificate is not provided, or for which a false or misleading certificate is provided, under...

In Search of Deregulation: Connections among Deleted Underbrush Policies, State Criminal Law, and FCC Character Qualifications for Broadcast Licensees.

ERIC Educational Resources Information Center

McGregor, Michael A.

A study examined the extent to which the violation of any one of more than 20 deleted Federal Communications Commission "underbrush" rules or policies (minor rules and policy statements) might result in a threat to the violator's broadcast license. All of the deleted policies and regulations, the criminal codes of California, Florida,…

75 FR 54676 - Self-Regulatory Organizations; Notice of Filing of Proposed Rule Change by NYSE Arca, Inc...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-08

... Advisers Act Rule 204A-1. This Rule specifically requires the adoption of a code of ethics by an investment...) provisions requiring supervised persons to report any violations of the code of ethics promptly to the chief... designated in the code of ethics; and (v) provisions requiring the investment advisor to provide each of the...

76 FR 21081 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-14

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-64284; File No. SR-Phlx-2011-48] Self... Change To Update Provisions Regarding the Dress Code and Trade Verification April 8, 2011. Pursuant to.... 78s(b)(1). \\2\\ 17 CFR 240.19b-4. I. Self-Regulatory Organization's Statement of the Terms of Substance...

Dress Codes and the Academic Conference: McCulloch's Iron Laws of Conferences

ERIC Educational Resources Information Center

McCulloch, Alistair

2018-01-01

Despite being a staple of academic life (or perhaps because it is so taken-for-granted), the academic conference has been generally under-utilised as a site for academic research. Using participant observation as its methodology, this article draws on a long career of conference attendance to present two iron laws of conferences which address the…

World Breastfeeding Week 1994: making the Code work.

PubMed

1994-01-01

WHO adopted the International Code of Marketing of Breastmilk Substitutes in 1981, with the US being the only member voting against it. US abandoned its opposition and voted for the International Code at the World Health Assembly in May 1994. The US was also part of a unanimous vote to promote a resolution that clearly proclaims breast milk to be better than breast milk substitutes and the best food for infants. World Breastfeeding Week 1994 began more efforts to promote the International Code. In 1994, through its Making the Code Work campaign, the World Alliance for Breastfeeding Action (WABA) will work on increasing awareness about the mission and promise of the International Code, notify governments of the Innocenti target date, call for governments to introduce rules and regulations based on the International Code, and encourage public interest groups, professional organizations, and the general public to monitor enforcement of the Code. So far, 11 countries have passed legislation including all or almost all provisions of the International Code. Governments of 36 countries have passed legislation including only some provisions of the International Code. The International Baby Food Action Network (IBFAN), a coalition of more than 140 breastfeeding promotion groups, monitors implementation of the Code worldwide. IBFAN substantiates 1000s of violations of the Code in its report, Breaking the Rules 1994. The violations consist of promoting breast milk substitutes to health workers, using labels describing a brand of formula in idealizing terms, or using labels that do not have warnings in the local language. We should familiarize ourselves with the provisions of the International Code and the status of the Code in our country. WABA provides an action folder which contains basic background information on the code and action ideas.

Moral Decision Making and Nontoleration of Honor Code Offenses.

ERIC Educational Resources Information Center

Roffey, Arthur E.; Porter, David B.

1992-01-01

Explored differences in moral development and attitudes toward nontoleration clause of Honor Code of U.S. Air Force Academy between cadets who were convicted honor violators (n=24) and control group of nonviolators (n=162). Found that, as cadet moral development increased from year to year, acceptance and internalization of principle of…

17 CFR 232.106 - Prohibition against electronic submissions containing executable code.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 17 Commodity and Securities Exchanges 2 2011-04-01 2011-04-01 false Prohibition against electronic submissions containing executable code. 232.106 Section 232.106 Commodity and Securities Exchanges SECURITIES... Filer Manual section also may be a violation of the Computer Fraud and Abuse Act of 1986, as amended...

17 CFR 232.106 - Prohibition against electronic submissions containing executable code.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 17 Commodity and Securities Exchanges 2 2013-04-01 2013-04-01 false Prohibition against electronic submissions containing executable code. 232.106 Section 232.106 Commodity and Securities Exchanges SECURITIES... Filer Manual section also may be a violation of the Computer Fraud and Abuse Act of 1986, as amended...

17 CFR 232.106 - Prohibition against electronic submissions containing executable code.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 17 Commodity and Securities Exchanges 2 2012-04-01 2012-04-01 false Prohibition against electronic submissions containing executable code. 232.106 Section 232.106 Commodity and Securities Exchanges SECURITIES... Filer Manual section also may be a violation of the Computer Fraud and Abuse Act of 1986, as amended...

Case study: videogame distraction reduces behavioral distress in a preschool-aged child undergoing repeated burn dressing changes: a single-subject design.

PubMed

Sil, Soumitri; Dahlquist, Lynnda M; Burns, Andrew J

2013-04-01

This single-subject design study evaluated the feasibility and efficacy of passive and interactive videogame distraction on behavioral distress for a preschool-aged child receiving repeated burn dressing changes. A 4-year-old girl underwent 3 baseline and 10 videogame distraction sessions (5 passive and 5 interactive) using a restricted alternating treatments design. Observed behavioral distress was coded, and parents and nurses rated the child's distress and cooperative behavior. Relative to baseline, behavioral distress decreased and cooperative behavior increased immediately after the onset of videogame distraction. Single Case Randomization Tests revealed significantly lower behavioral distress and greater cooperation during interactive videogame distraction relative to passive videogame distraction. Interactive videogame distraction appears to be a feasible and effective pain management strategy for a preschool-aged child undergoing repeated painful medical procedures.

The Work of the Registrar: A Summary of Principles and Practices in American Universities and Colleges

ERIC Educational Resources Information Center

Preinkert, Alma H.

2005-01-01

Take a walk down Memory Lane... In 1940 when AACRAO's new release "The Work of the Registrar" was written: Yale tuition was fifty dollars per quarter; colleges had curfews for women and dress codes; the average salary was $1,299 annually; first class stamps were three cents; and colleges sent progress reports home to parents. Read about what has…

Graduate Dress Code How Undergraduates Are Planning to Use Hair, Clothes and Make-Up to Smooth Their Transition to the Workplace

ERIC Educational Resources Information Center

Cutts, Beth; Hooley, Tristram; Yates, Julia

2015-01-01

This article explores the relationship between students' identities, their ideas about professional appearance and their anticipated transition to the world of work. It is based on a series of semi-structured interviews with 13 students from a vocationally-focused university in England. It was found that participants viewed clothing and appearance…

Chinese High School Students' Perceptions of Freedom of Expression: Implications for Researching Emerging Civil Liberties in Global Educational Contexts

ERIC Educational Resources Information Center

Torres, Mario S.; Qin, Lixia

2017-01-01

This study explored attitudes and perceptions of Chinese high school students regarding freedom of expression in their country. A survey capturing perceptions over various forms of free speech (e.g., student publication, dress code) was administered to a sample of 838, which included students from both urban and rural areas within Shaanxi Province…

Recent Trends in Business Casual Attire and Their Effects on Student Job Seekers

ERIC Educational Resources Information Center

Kiddie, Thomas

2009-01-01

When the author introduces the unit on job hunting in his business communication course, he begins by relating his experiences searching for his first "real" job. He points out that the deciding factor for him in accepting a position at Bell Labs, instead of IBM, was Bell Lab's casual dress code. When he decided to retire from the former Bell…

32 CFR 552.114 - Violations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... subject to disciplinary actions under the Uniform Code of Military Justice, judicial action as authorized by state or federal law, or administrative action as provided by controlling regulation. ...

Ethical Predispositions to Violate or Obey Traffic Rules and the Mediating Role of Driving Styles.

PubMed

Holman, Andrei C; Popusoi, Simona A

2018-07-04

Traffic law violations are the most important determinants of traffic accidents. This study examined the influence of drivers' ethical perspective on their traffic violations and the mediating role of driving styles in these relationships. A sample of 313 drivers participated in the study. Contrary to expectations, high ethical relativism was found to be associated with fewer aggressive traffic violations. This suggests that the informal normative system that parallels the official traffic regulations is the more salient reference against which drivers usually assess the adequacy of their behaviors, highly relativistic drivers being more willing to also take into consideration the official traffic code in these appraisals. We also found significant interactions between idealism and relativism on both ordinary and aggressive violations. Idealism emerged as a predictor of these violations only in drivers low in relativism. In this group, one's concern about the harm that he/she might cause to other traffic participants induces higher traffic law abidingness. These influences of idealism were mediated by certain driving styles. Drivers' general ethical perspective fosters a specific pattern of driving styles and, consequently, the tendency to commit or to refrain from traffic violations.

Sticks and Stones: Why First Amendment Absolutism Fails When Applied to Campus Harassment Codes.

ERIC Educational Resources Information Center

Lumsden, Linda

This paper analyzes how absolutist arguments against campus harassment codes violate the spirit of the first amendment, examining in particular the United States Supreme Court ruling in "RAV v. St. Paul." The paper begins by tracing the current development of first amendment doctrine, analyzing its inadequacy in the campus hate speech…

76 FR 6503 - Self-Regulatory Organizations; NYSE Arca, Inc.; Order Granting Approval of Proposed Rule Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-04

... specifically requires the adoption of a code of ethics by an investment advisor to include, at a minimum: (i... persons to report any violations of the code of ethics promptly to the chief compliance officer (``CCO... of ethics; and (v) provisions requiring the investment advisor to provide each of the supervised...

Systematic Heuristic Evaluation of Computerized Consultation Order Templates: Clinicians' and Human Factors Engineers' Perspectives.

PubMed

Savoy, April; Patel, Himalaya; Flanagan, Mindy E; Weiner, Michael; Russ, Alissa L

2017-08-01

We assessed the usability of consultation order templates and identified problems to prioritize in design efforts for improving referral communication. With a sample of 26 consultation order templates, three evaluators performed a usability heuristic evaluation. The evaluation used 14 domain-independent heuristics and the following three supplemental references: 1 new domain-specific heuristic, 6 usability goals, and coded clinicians' statements regarding ease of use for 10 sampled templates. Evaluators found 201 violations, a mean of 7.7 violations per template. Minor violations outnumbered major violations almost twofold, 115 (57%) to 62 (31%). Approximately 68% of violations were linked to 5 heuristics: aesthetic and minimalist design (17%), error prevention (16%), consistency and standards (14%), recognition rather than recall (11%), and meet referrers' information needs (10%). Severe violations were attributed mostly to meet referrers' information needs and recognition rather than recall. Recorded violations yielded potential negative consequences for efficiency, effectiveness, safety, learnability, and utility. Evaluators and clinicians demonstrated 80% agreement in usability assessment. Based on frequency and severity of usability heuristic violations, the consultation order templates reviewed may impede clinical efficiency and risk patient safety. Results support the following design considerations: communicate consultants' requirements, facilitate information seeking, and support communication. While the most frequent heuristic violations involved interaction design and presentation, the most severe violations lacked information desired by referring clinicians. Violations related to templates' inability to support referring clinicians' information needs had the greatest potential negative impact on efficiency and safety usability goals. Heuristics should be prioritized in future design efforts.

Thermal Face Protection Delays Finger Cooling and Improves Thermal Comfort during Cold Air Exposure

DTIC Science & Technology

2011-01-01

code) 2011 Journal Article-Eur Journal of Applied Physiology Thermal face protection delays Fnger cooling and improves thermal comfort during cold air...remains exposed. Facial cooling can decrease finger blood flow, reducing finger temperature (Tf). This study examined whether thermal face protection...limits Wnger cooling and thereby improves thermal comfort and manual dexterity during prolonged cold exposure. Tf was measured in ten volunteers dressed

Case Study: Videogame Distraction Reduces Behavioral Distress in a Preschool-Aged Child Undergoing Repeated Burn Dressing Changes: A Single-Subject Design

PubMed Central

Sil, Soumitri; Burns, Andrew J.

2013-01-01

Objective This single-subject design study evaluated the feasibility and efficacy of passive and interactive videogame distraction on behavioral distress for a preschool-aged child receiving repeated burn dressing changes. Method A 4-year-old girl underwent 3 baseline and 10 videogame distraction sessions (5 passive and 5 interactive) using a restricted alternating treatments design. Observed behavioral distress was coded, and parents and nurses rated the child’s distress and cooperative behavior. Results Relative to baseline, behavioral distress decreased and cooperative behavior increased immediately after the onset of videogame distraction. Single Case Randomization Tests revealed significantly lower behavioral distress and greater cooperation during interactive videogame distraction relative to passive videogame distraction. Conclusions Interactive videogame distraction appears to be a feasible and effective pain management strategy for a preschool-aged child undergoing repeated painful medical procedures. PMID:23248343

48 CFR 203.1003 - Requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... OF DEFENSE GENERAL IMPROPER BUSINESS PRACTICES AND PERSONAL CONFLICTS OF INTEREST Contractor Code of... notification of a possible contractor violation of the type described in FAR 3.1003(b), coordinate the matter...

Natural Language Interface for Safety Certification of Safety-Critical Software

NASA Technical Reports Server (NTRS)

Denney, Ewen; Fischer, Bernd

2011-01-01

Model-based design and automated code generation are being used increasingly at NASA. The trend is to move beyond simulation and prototyping to actual flight code, particularly in the guidance, navigation, and control domain. However, there are substantial obstacles to more widespread adoption of code generators in such safety-critical domains. Since code generators are typically not qualified, there is no guarantee that their output is correct, and consequently the generated code still needs to be fully tested and certified. The AutoCert generator plug-in supports the certification of automatically generated code by formally verifying that the generated code is free of different safety violations, by constructing an independently verifiable certificate, and by explaining its analysis in a textual form suitable for code reviews.

Examination of adult and child bicyclist safety-relevant events using naturalistic bicycling methodology.

PubMed

Hamann, Cara J; Peek-Asa, Corinne

2017-05-01

Among roadway users, bicyclists are considered vulnerable due to their high risk for injury when involved in a crash. Little is known about the circumstances leading to near crashes, crashes, and related injuries or how these vary by age and gender. The purpose of this study was to examine the rates and characteristics of safety-relevant events (crashes, near crashes, errors, and traffic violations) among adult and child bicyclists. Bicyclist trips were captured using Pedal Portal, a data acquisition and coding system which includes a GPS-enabled video camera and graphical user interface. A total of 179 safety-relevant events were manually coded from trip videos. Overall, child errors and traffic violations occurred at a rate of 1.9 per 100min of riding, compared to 6.3 for adults. However, children rode on the sidewalk 56.4% of the time, compared with 12.7% for adults. For both adults and children, the highest safety-relevant event rates occurred on paved roadways with no bicycle facilities present (Adults=8.6 and Children=7.2, per 100min of riding). Our study, the first naturalistic study to compare safety-relevant events among adults and children, indicates large variation in riding behavior and exposure between child and adult bicyclists. The majority of identified events were traffic violations and we were not able to code all risk-relevant data (e.g., subtle avoidance behaviors, failure to check for traffic, probability of collision). Future naturalistic cycling studies would benefit from enhanced instrumentation (e.g., additional camera views) and coding protocols able to fill these gaps. Copyright © 2017 Elsevier Ltd. All rights reserved.

Human substantia nigra and ventral tegmental area involvement in computing social error signals during the ultimatum game

PubMed Central

Hétu, Sébastien; Luo, Yi; D’Ardenne, Kimberlee; Lohrenz, Terry

2017-01-01

Abstract As models of shared expectations, social norms play an essential role in our societies. Since our social environment is changing constantly, our internal models of it also need to change. In humans, there is mounting evidence that neural structures such as the insula and the ventral striatum are involved in detecting norm violation and updating internal models. However, because of methodological challenges, little is known about the possible involvement of midbrain structures in detecting norm violation and updating internal models of our norms. Here, we used high-resolution cardiac-gated functional magnetic resonance imaging and a norm adaptation paradigm in healthy adults to investigate the role of the substantia nigra/ventral tegmental area (SN/VTA) complex in tracking signals related to norm violation that can be used to update internal norms. We show that the SN/VTA codes for the norm’s variance prediction error (PE) and norm PE with spatially distinct regions coding for negative and positive norm PE. These results point to a common role played by the SN/VTA complex in supporting both simple reward-based and social decision making. PMID:28981876

Open pneumothorax: the spectrum and outcome of management based on Advanced Trauma Life Support recommendations.

PubMed

Kong, V Y; Liu, M; Sartorius, B; Clarke, D L

2015-08-01

The current management of open pneumothorax (OPTX) is based on Advanced Trauma Life Support (ATLS) recommendations and consists of the application of a three-way occlusive dressing, followed by intercostal chest drain insertion. Very little is known regarding the spectrum and outcome of this approach, especially in the civilian setting. We conducted a retrospective review of 58 consecutive patients with OPTX over a four-year period managed in a high volume metropolitan trauma service in South Africa. Of the 58 patients included, 95% (55/58) were male, and the mean age for all patients was 21 years. Ninety-seven percent of all injuries were inflicted by knives and the remaining 3% (2/58) of injuries were inflicted by unknown weapons. 59% of injuries were left sided. In six patients (10%) a protocol violation was present in their management. Five of the six patients (83%) in whom protocol violation occurred developed a life-threatening event (tension PTX) compared to none amongst those where the protocol was followed (p < 0.001). There was no mortality as a direct result of management of OPTX following ATLS recommendations. ATLS recommendations for OPTX are safe and effective. Any deviation from this standard practice is associated with avoidable morbidity and potential mortality.

A prospective comparison of a new, synthetic donor site dressing versus an impregnated gauze dressing.

PubMed

Hickerson, W L; Kealey, G P; Smith, D J; Thomson, P D

1994-01-01

Three institutions enrolled 38 patients who required bilateral skin graft donor sites into a safety and efficacy study of a new synthetic donor site dressing. Bilateral donor sites were randomized to receive either a new, synthetic donor site dressing or an impregnated gauze dressing. Wounds were assessed by time to healing, pain, and patient preference. Synthetic dressing wounds were treated 7.9 days compared with 10.2 days for gauze dressing wounds (p < 0.001), and synthetic dressing wounds were more completely epithelialized. Visual analogue pain analysis revealed significantly less donor site pain with synthetic dressing (2.94) versus gauze dressing (4.64) (p < 0.001). Synthetic dressing had fewer treatment-related adverse experiences than gauze dressing (2 vs 7) and was judged by recipients to be superior to gauze dressing in comfort, pain relief, cosmetic appeal, ease of ambulation, and overall acceptance.

Exploring CP violation in the MSSM.

PubMed

Arbey, Alexandre; Ellis, John; Godbole, Rohini M; Mahmoudi, Farvah

We explore the prospects for observing CP violation in the minimal supersymmetric extension of the Standard Model (MSSM) with six CP-violating parameters, three gaugino mass phases and three phases in trilinear soft supersymmetry-breaking parameters, using the CPsuperH code combined with a geometric approach to maximise CP-violating observables subject to the experimental upper bounds on electric dipole moments. We also implement CP-conserving constraints from Higgs physics, flavour physics and the upper limits on the cosmological dark matter density and spin-independent scattering. We study possible values of observables within the constrained MSSM (CMSSM), the non-universal Higgs model (NUHM), the CPX scenario and a variant of the phenomenological MSSM (pMSSM). We find values of the CP-violating asymmetry [Formula: see text] in [Formula: see text] decay that may be as large as 3 %, so future measurements of [Formula: see text] may provide independent information about CP violation in the MSSM. We find that CP-violating MSSM contributions to the [Formula: see text] meson mass mixing term [Formula: see text] are in general below the present upper limit, which is dominated by theoretical uncertainties. If these could be reduced, [Formula: see text] could also provide an interesting and complementary constraint on the six CP-violating MSSM phases, enabling them all to be determined experimentally, in principle. We also find that CP violation in the [Formula: see text] and [Formula: see text] couplings can be quite large, and so may offer interesting prospects for future [Formula: see text], [Formula: see text], [Formula: see text] and [Formula: see text] colliders.

Reevaluating Recovery: Perceived Violations and Preemptive Interventions on Emergency Psychiatry Rounds

PubMed Central

Cohen, Trevor; Blatter, Brett; Almeida, Carlos; Patel, Vimla L.

2007-01-01

Objective Contemporary error research suggests that the quest to eradicate error is misguided. Error commission, detection, and recovery are an integral part of cognitive work, even at the expert level. In collaborative workspaces, the perception of potential error is directly observable: workers discuss and respond to perceived violations of accepted practice norms. As perceived violations are captured and corrected preemptively, they do not fit Reason’s widely accepted definition of error as “failure to achieve an intended outcome.” However, perceived violations suggest the aversion of potential error, and consequently have implications for error prevention. This research aims to identify and describe perceived violations of the boundaries of accepted procedure in a psychiatric emergency department (PED), and how they are resolved in practice. Design Clinical discourse from fourteen PED patient rounds was audio-recorded. Excerpts from recordings suggesting perceived violations or incidents of miscommunication were extracted and analyzed using qualitative coding methods. The results are interpreted in relation to prior research on vulnerabilities to error in the PED. Results Thirty incidents of perceived violations or miscommunication are identified and analyzed. Of these, only one medication error was formally reported. Other incidents would not have been detected by a retrospective analysis. Conclusions The analysis of perceived violations expands the data available for error analysis beyond occasional reported adverse events. These data are prospective: responses are captured in real time. This analysis supports a set of recommendations to improve the quality of care in the PED and other critical care contexts. PMID:17329728

True Dopers or Negligent Athletes? An Analysis of Anti-Doping Rule Violations Reported to the World Anti-Doping Agency 2010-2012.

PubMed

de Hon, Olivier; van Bottenburg, Maarten

2017-12-06

The sanction that an athlete receives when an anti-doping rule violation has been committed depends on the specific circumstances of the case. Anti-doping tribunals decide on the final sanction, following the rules of the World Anti-Doping Code. To assess the athletes' degree of fault based on the length of sanctions imposed on them to feed policy-related discussions. Analysing data from the results management database of the World Anti-Doping Agency for anonymous information of anti-doping rule violations in eight selected sports covering the years 2010-2012. Four out of ten athletes who committed an anti-doping rule violation received a suspension that was lower than the standard. This is an indication that tribunals in many instances are not convinced that the athletes concerned were completely at fault, that mitigating circumstances were applicable, or that full responsibility of the suspected violation should not be held against them. Anabolic agents, peptide hormones, and hormone modulators lead to higher sanctions, as do combinations of several anti-doping rule violations. This first analysis of information from the World Anti-Doping Agency's results management database indicates that a large proportion of the athletes who commit anti-doping rule violations may have done this unintentionally. Anti-doping professionals should strive to improve this situation in various ways.

21 CFR 878.4022 - Hydrogel wound dressing and burn dressing.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hydrogel wound dressing and burn dressing. 878... Hydrogel wound dressing and burn dressing. (a) Identification. A hydrogel wound dressing is a sterile or non-sterile device intended to cover a wound, to absorb wound exudate, to control bleeding or fluid...

21 CFR 878.4022 - Hydrogel wound dressing and burn dressing.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Hydrogel wound dressing and burn dressing. 878... Hydrogel wound dressing and burn dressing. (a) Identification. A hydrogel wound dressing is a sterile or non-sterile device intended to cover a wound, to absorb wound exudate, to control bleeding or fluid...

Virtue and Vice: Morality Police and Social Control in Islamic Regimes

DTIC Science & Technology

2017-12-01

religious, and militant groups since its emergence in 1994. Because of this, the forces of the MPVPV were employed to exert control over the behavior of...wounds.393 Men were also subject to a strict dress and appearance code. Once the Taliban seized control of Kabul, the group mandated that every man...aggressive campaign to establish control over hostile populations. In the United States’ ongoing conflict with militant groups such as the Taliban

Emerging/changing fashion trends and their impact on conduct of anaesthesia.

PubMed

Zaidi, Nadeem

2017-11-01

One of the innate features of human behaviour is to enhance personal image in order to look different from the rest of the crowd and to satisfy a need for individualism. People use different dress codes, body makeup and artificial gadgets to improve their personal and physical appearance. The main motive behind all these efforts is personal satisfaction, to appear attractive to others and to overcome phobias and complexes. Copyright the Association for Perioperative Practice.

Black-tie dress code: two new species of the genus Toxomerus (Diptera, Syrphidae)

PubMed Central

Mengual, Ximo

2011-01-01

Abstract Toxomerus hauseri Mengual sp. n. and Toxomerus picudus Mengual sp. n. are described from Peru and Ecuador respectively. Toxomerus circumcintus (Enderlein, 1938) is treated as a valid species and not considered synonym of Toxomerus marginatus, and Toxomerus ovatus (Hull, 1942) is considered junior synonym of Toxomerus nitidus (Schiner, 1868). An identification key for the Toxomerus species with dark abdomens is given along with diagnoses for each studied species. PMID:22144857

Overriding Ethical Constraints in Lethal Autonomous Systems

DTIC Science & Technology

2012-01-01

absolve the guilt from the party that issued the order in the first place. During the Nuremberg trials it was not sufficient for a soldier to merely...with coded authorization by two separate individuals, ideally the operator and his immediate superior. The inverse situation, denying the system...potentially violating. Permission to override in case 2 requires a coded two-key release by two separate operators, each going through the override

[Mobbing and working environment: towards an organizational prevention].

PubMed

Bosco, Maria Giuseppina; Salerno, Silvana

2004-01-01

Psychological violence in the workplaces is increasing and the Italian national health service and trade unions are mostly involved in single cases of diagnosis strategy. To analyse published mobbing cases using a mobbing prevention approach that takes account of the main civil rights violation in mobbing actions. 25 cases were analysed in order to identify the type of mobbing, gender, the professional position and the main civil rights that were violated. Seven main civil rights had been violated in the 25 mobbing cases: health, work, professional skills, equal treatment, legality, diversity, dignity. Men working in unhealthy conditions, mostly due to unhealthy working environments, were forced to leave under the pressure of moral violence. In women, equal treatment and diversity were the main rights that were violated. Co-worker support was absent in all cases. A civil rights assessment to prevent mobbing is considered. Italian legislation, particularly the Civil Code, can be the legislation key for prevention, with the employer responsible for providing a violence-free environment as indicated in European Directive 626/94.

Comparison of two silver dressings for wound management in pediatric burns.

PubMed

Jester, Ingo; Bohn, Ingo; Hannmann, Thorsten; Waag, Karl-Ludwig; Loff, Steffan

2008-11-01

Purpose. Silver wound dressings are widely used in the treatment of burns. Dressings differ in material characteristics, various antimicrobial activities, and ease of use. The purpose of this study was to evaluate both dressing performance and amount of pain during the dressing changes of 2 silver dressings Urgotul SSD® (Laboratoires Urgo, Chenove, France), and Contreet Ag® (Coloplast, Minneapolis, MN) in children. A retrospective cohort study was performed with 2 groups of 20 burns treated with Urgotul SSD and Contreet Ag until the wounds were healed or grafted. Seventy dressing changes in the Contreet Ag group and 67 dressing changes in the Urgotul group were evaluated. Every dressing change was assessed regarding the dressing performance (exudate, adherence, bleeding, and dressing application/removal), and pain. Pain was "absent or slight" in 61 (92%) dressing changes with Urgotul SSD, and in 60 (85%) of the dressing changes with Contreet Ag. Dressing application in the Urgotul group was more often "very easy" (n = 33; 49%) or "easy" (n = 32; 48%) than in the Contreet Ag group, "very easy" (n = 25; 35%), and "easy" (n = 42; 60%). Contreet Ag had a greater ability to absorb exudate ("very good" n = 60; 85%, and "good" n = 11; 15%) than Urgotul SSD ("very good" n = 34; 51%, and "good" n = 13; 19%). Urgotul SSD and Contreet Ag are comparable regarding pain during dressing change. The dressings differ in their ability to absorb exudate and ease of application. Both dressings provided nearly painless wound management, and therefore were highly accepted by the nurses and especially the children being treated.

15 CFR 744.14 - Restrictions on exports and reexports to designated Foreign Terrorist Organizations (FTOs).

Code of Federal Regulations, 2014 CFR

2014-01-01

... section 303 of the Antiterrorism and Effective Death Penalty Act 1996, as amended (Anti-Terrorism Act) (18... designated FTO and makes violations punishable by criminal penalties under title 18, United States Code...

15 CFR 744.14 - Restrictions on exports and reexports to designated Foreign Terrorist Organizations (FTOs).

Code of Federal Regulations, 2013 CFR

2013-01-01

... section 303 of the Antiterrorism and Effective Death Penalty Act 1996, as amended (Anti-Terrorism Act) (18... designated FTO and makes violations punishable by criminal penalties under title 18, United States Code...

15 CFR 744.14 - Restrictions on exports and reexports to designated Foreign Terrorist Organizations (FTOs).

Code of Federal Regulations, 2010 CFR

2010-01-01

... section 303 of the Antiterrorism and Effective Death Penalty Act 1996, as amended (Anti-Terrorism Act) (18... designated FTO and makes violations punishable by criminal penalties under title 18, United States Code...

15 CFR 744.14 - Restrictions on exports and reexports to designated Foreign Terrorist Organizations (FTOs).

Code of Federal Regulations, 2011 CFR

2011-01-01

... section 303 of the Antiterrorism and Effective Death Penalty Act 1996, as amended (Anti-Terrorism Act) (18... designated FTO and makes violations punishable by criminal penalties under title 18, United States Code...

15 CFR 744.14 - Restrictions on exports and reexports to designated Foreign Terrorist Organizations (FTOs).

Code of Federal Regulations, 2012 CFR

2012-01-01

... section 303 of the Antiterrorism and Effective Death Penalty Act 1996, as amended (Anti-Terrorism Act) (18... designated FTO and makes violations punishable by criminal penalties under title 18, United States Code...

Choosing a Wound Dressing Based on Common Wound Characteristics

PubMed Central

Dabiri, Ganary; Damstetter, Elizabeth; Phillips, Tania

2016-01-01

Significance: Chronic wounds are a major healthcare burden.The practitioner should have an appropriate understanding of both the etiology of the wound as well as the optimal type of dressings to use. Fundamental wound characteristics may be used to guide the practitioner's choice of dressings. The identification of optimal dressings to use for a particular wound type is an important element in facilitating wound healing. Recent Advances: Researchers have sought to design wound dressings that aim to optimize each stage in the healing process. In addition, dressings have been designed to target and kill infection-causing bacteria, with the incorporation of antimicrobial agents. Critical Issues: Chronic wounds are frequently dynamic in presentation, and the numerous wound dressings available make dressing selection challenging for the practitioner. Choosing the correct dressing decreases time to healing, provides cost-effective care, and improves patient quality of life. Future Directions: Research into the mechanisms of wound healing has enhanced our ability to heal chronic wounds at a faster rate through the use of moisture-retentive dressings. Newer dressings are incorporating the use of nanotechnology by incorporating miniature electrical sensors into the dressing. These dressings are engineered to detect changes in a wound environment and alert the patient or practitioner by altering the color of the dressing or sending a message to a smartphone. Additional investigations are underway that incorporate biologic material such as stem cells into dressings. PMID:26858913

APOLLO 10 ASTRONAUT ENTERS LUNAR MODULE SIMULATOR

NASA Technical Reports Server (NTRS)

1969-01-01

Apollo 10 lunar module pilot Eugene A. Cernan prepares to enter the lunar module simulator at the Flight Crew Training Building at the NASA Spaceport. Cernan, Apollo 10 commander Thomas P. Stafford and John W. Young, command module pilot, are to be launched May 18 on the Apollo 10 mission, a dress rehearsal for a lunar landing later this summer. Cernan and Stafford are to detach the lunar module and drop to within 10 miles of the moon's surface before rejoining Young in the command/service module. Looking on as Cernan puts on his soft helmet is Snoopy, the lovable cartoon mutt whose name will be the lunar module code name during the Apollo 10 flight. The command/service module is to bear the code name Charlie Brown.

An experimental investigation of the effect of a justice violation on pain experience and expression among individuals with high and low just world beliefs.

PubMed

Trost, Z; Scott, W; Lange, J M; Manganelli, L; Bernier, E; Sullivan, M J

2014-03-01

Perceptions of injustice are linked with poorer physical and psychological outcomes in the context of pain and injury. Violations of injustice can arise out of violations of just world belief (JWB). However, no study has yet examined whether JWB moderates the effect of justice violation on pain experience. The current study examined the effect of an experimental justice violation on acute pain outcomes and whether JWB moderated this effect. Participants completed the JWB scale and then engaged in two cold pressor tasks (CPT). Half the participants were told that the second CPT immersion was part of standard protocol; the other half were told that the painful procedure had to be repeated due to experimenter negligence. Participants provided report of pain intensity following each CPT immersion. Video records of participants undergoing the CPT were coded for presence and duration of pain behaviour. Exposure to the justice violation resulted in elevated pain intensity from the first to the second immersion only among participants with high JWB. For participants with low JWB and participants in the control condition, there was no significant difference in pain intensity across immersions. Control participants showed a decrease in pain behaviour from the first to the second immersion. In the negligence/ justice violation condition, reductions in pain behaviour were observed only among participants with low JWB. Our results indicate that individuals with high JWB may show particularly adverse reactions in response to justice violations in the context of acute pain experience. © 2013 European Pain Federation - EFIC®

American Nurses Association. position statement on assisted suicide.

PubMed

1995-01-01

Nurses, individually and collectively, have an obligation to provide comprehensive and compassionate end-of-life care which includes the promotion of comfort and the relief of pain and, at times, forgoing life-sustaining treatments. The American Nurses Association (ANA) believes that the nurse should not participate in assisted suicide. Such an act is in violation of the Code for Nurses with Interpretive Statements (Code for Nurses) and the ethical traditions of the profession.

The Hearts & Minds That Matter Most: Maintaining American National Will

DTIC Science & Technology

2008-05-15

even “spin” it, before introducing it to the American people. This interpretation of information is usually benign , but sometimes journalists or...stray from this code of ethics .97 Large portions of the media attempt to influence the public and pressure officials, and others allow fame...conflict of interest and creates a situation that violates the journalistic code of ethics . Once the United States was drawn into the Second World War

Reliability of a rating procedure to monitor industry self-regulation codes governing alcohol advertising content.

PubMed

Babor, Thomas F; Xuan, Ziming; Proctor, Dwayne

2008-03-01

The purposes of this study were to develop reliable procedures to monitor the content of alcohol advertisements broadcast on television and in other media, and to detect violations of the content guidelines of the alcohol industry's self-regulation codes. A set of rating-scale items was developed to measure the content guidelines of the 1997 version of the U.S. Beer Institute Code. Six focus groups were conducted with 60 college students to evaluate the face validity of the items and the feasibility of the procedure. A test-retest reliability study was then conducted with 74 participants, who rated five alcohol advertisements on two occasions separated by 1 week. Average correlations across all advertisements using three reliability statistics (r, rho, and kappa) were almost all statistically significant and the kappas were good for most items, which indicated high test-retest agreement. We also found high interrater reliabilities (intraclass correlations) among raters for item-level and guideline-level violations, indicating that regardless of the specific item, raters were consistent in their general evaluations of the advertisements. Naïve (untrained) raters can provide consistent (reliable) ratings of the main content guidelines proposed in the U.S. Beer Institute Code. The rating procedure may have future applications for monitoring compliance with industry self-regulation codes and for conducting research on the ways in which alcohol advertisements are perceived by young adults and other vulnerable populations.

Evaluation of a non-adherent, povidone-iodine dressing in a case series of chronic wounds.

PubMed

Campbell, N; Campbell, D

2013-08-01

Here we report a product evaluation for a non-adherent, povidone-iodine (PVP-I) dressing, determining the clinical need for the product, performing a literature review, clinical evaluation and cost-analysis, and developing a recommendation. This evaluation included 20 patients who experienced dressing pain with the previous antimicrobial dressing. Two patients discontinued the evaluation and four ulcers were non-healing; the remaining wounds closed with the PVP-I dressing. Patients indicated a preference for the PVP-I dressing, primarily due to lack of dressing pain. The PVP-I dressing was also the most cost-efficient.

A prospective randomised study comparing the jubilee dressing method to a standard adhesive dressing for total hip and knee replacements.

PubMed

Burke, Neil G; Green, Connor; McHugh, Gavin; McGolderick, Niall; Kilcoyne, Carol; Kenny, Patrick

2012-08-01

It is important to reduce potential wound complications in total hip and total knee arthroplasty procedures. The purpose of this study was to compare the jubilee dressing method to a standard adhesive dressing. 124 patients (62 total hip replacements and 62 total knee replacements) were randomly selected to have either a standard adhesive dressing or jubilee method dressing. The number of dressing changes, incidence of blistering, leakage, appearance of inflammation, infection rate and the average stay in hospital was recorded for each patient. The jubilee dressing significantly reduced the rate of blistering, leakage and number of dressing changes when compare to a traditional adhesive dressing (p < 0.05). The rate of inflammation and average length of stay in hospital was not significantly different between the two groups. The authors recommend the use of this dressing for total hip and total knee arthroplasty procedures due to the associated lower complication rate. Copyright © 2012 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

Adhesive retention dressings are more comfortable than alginate dressings on split-skin-graft donor sites.

PubMed

Hormbrey, E; Pandya, A; Giele, H

2003-07-01

Painful split-skin-graft donor sites remain a common problem for patients. We undertook a prospective randomised trial to examine the comparative comfort and ease of care of two different donor-site dressings. One dressing is the alginate Kaltostat, the standard plastic-surgical dressing in the UK and abroad, and the other is the adhesive retention tape Mefix, a novel use of a readily available dressing. We randomised 50 patients requiring split-skin grafts to receive either alginate (Kaltostat) or retention (Mefix) donor-site dressings. Dressings were assessed by interview and questionnaire at 24, 72 h and 2 weeks, and by wound review at 2 weeks. Retention dressings were found to be more comfortable, required less nursing intervention and allowed patients easier mobility with a greater range of daily activities, especially washing, without compromising wound healing. We recommend adhesive retention dressings as cost-effective comfortable dressings, which readily conform to any donor site.

Real-time monitoring of moisture levels in wound dressings in vitro: an experimental study.

PubMed

McColl, David; Cartlidge, Brian; Connolly, Patricia

2007-10-01

Retaining an appropriate level of moisture at the interface between a healing wound and an applied dressing is considered to be critical for effective wound healing. Failure to control exudate at this interface can result in maceration or drying out of the wound surface. The ability to control moisture balance at the wound interface is therefore a key aspect of wound dressing performance. To date it has not been possible to monitor in any effective manner the distribution of moisture within dressings or how this varies with time. A new measurement system is presented based on sensors placed at the wound/dressing interface which are capable of monitoring moisture levels in real time. The system comprises a model wound bed and sensor array complete with fluid injection path to mimic exudate flow. Eight monitoring points, situated beneath the test dressing, allow the moisture profile across the complete dressing to be measured both during and after fluid injection. The system has been used to evaluate the performance of four foam dressings, a composite hydrofibre dressing and a film dressing. Stark contrasts in the performance of the wound contact layer were found between the different wound dressing types. The composite hydrofibre dressing retained moisture at the wound interface throughout the experiments while areas of the foam dressing quickly became dry, even during constant injection of fluid. The abundance of sensors allowed a moisture map of the surface of the wound dressing to be constructed, illustrating that the moisture profile was not uniform across several of the dressings tested during absorption and evaporation of liquid. These results raise questions as to how the dressings behave on a wound in vivo and indicate the need for a similar clinical monitoring system for tracking wound moisture levels.

Consolidated List of Debarred, Suspended, and Ineligible Contractors as of April 10, 1985.

DTIC Science & Technology

1985-04-01

Administration code 202, but Fdral officials calling lon distance Juan L . Smith should use the FTS (Federal "blecommunications 523-4873 Sterr) or AUTVN (Automatic...Washington, DC 20405 Belle N. Davis (Codes A and B) Attention: Mrs. Juan L . Smith 475-8025 FTS/(202) 523-4873 3 r, % .1 𔄀 ’ % Cause and Treatment Codes...for violation of1961, the I is effctve win 0O; It Imposed the Buy American Act (41 U.S.C. 10b(b)) 4 -k % =",W""-- l m. .°6 ."._. ’ t. ,+... W LML

Australasian survey of split skin graft donor site dressings.

PubMed

Lyall, P W; Sinclair, S W

2000-02-01

There is an ever increasing array of products available for wound dressings. The aim of the present study was to establish which dressings should be used as standard controls for future studies; what factors are regarded as most important in assessing a dressing; what the level of satisfaction is with the available products; what the strengths and weaknesses of the commonly used dressings are; and what dressings would be preferred if cost were no issue. A postal survey was sent to every plastic and reconstructive surgeon registered in Australasia (n = 217). A total of 53% responded. The most commonly used dressing type overall is the calcium alginates, despite the fact that they were not the highest performing dressings. This is also the most commonly used in Australia. In contrast scarlet red is still used most commonly in New Zealand. The level of satisfaction with the most commonly used dressing varied very little. The factor regarded most important was patient comfort level. A profile of the commonly used dressing was constructed. Calcium alginates and or scarlet red should be used as the control for new product comparisons. Most of the respondents were satisfied with their preferred dressing and were not interested in trying alternative dressings.

A pilot trial of bordered polyurethane dressings, tissue adhesive and sutureless devices compared with standard polyurethane dressings for securing short-term arterial catheters.

PubMed

Edwards, Melannie; Rickard, Claire M; Rapchuk, Ivan; Corley, Amanda; Marsh, Nicole; Spooner, Amy J; Mihala, Gabor; Fraser, John F

2014-09-01

To improve arterial catheter (AC) securement and reduce AC failure; to assess feasibility of a large randomised controlled trial. A four-arm, parallel, randomised, controlled, non-blinded pilot trial with 195 intensive care patients taking part, in a tertiary referral hospital in Brisbane, Australia from May to November 2012. Standard polyurethane (SPU) dressing (controls); bordered polyurethane (BPU) + SPU dressing; tissue adhesive (TA) + SPU dressing; and sutureless securement device (SSD) + SPU dressing (no sutures used). AC failure, ie, complete dislodgement, occlusion (monitor failure, inability to infuse or fluid leaking), pain or infection (local or blood). Median AC dwell time was 26.2 hours and was comparable between groups. AC failure occurred in 26/195 patients (13%). AC failure was significantly worse with SPU dressings (10/47 [21%]) than with BPU + SPU dressings (2/ 43 [5%]; P = 0.03), but not significantly different to TA + SPU (6/56 [11%]; P = 0.18) or SSD + SPU (8/49 [16%]; P = 0.61). The dressing applied at AC insertion lasted until AC removal in 68% of controls; 56% of BPU + SPU dressings; 73% of TA + SPU dressings; and 80% of SSD + SPU dressings (all P > 0.05). There were no infections or serious adverse events. Patient and staff satisfaction with all products was high. Median costs (labour and materials) for securement per patient were significantly higher in all groups compared with the control group (SPU, $3.48 [IQR, $3.48-$9.79]; BPU + SPU, $5.07 [IQR, $5.07-$12.99]; SSD + SPU, $10.90 [IQR, $10.90-$10.90]; TA + SPU, $17.70 [IQR, $17.70-$38.36]; all P < 0.01). AC failure occurred significantly less often with BPU + SPU dressings than with SPU dressings. TA + SPU and SSD + SPU dressings should be further investigated and compared with BPU + SPU dressings as controls. The novel approach of TA + SPU dressings appeared safe and feasible.

Dressing remedies: a concept for improving access to and use of dressings in nursing homes.

PubMed

Clarkson, A

2007-01-01

Delays in accessing dressings prescribed by general practitioners can result in the inappropriate use of dressings on more than one resident in nursing homes. The dressing remedies concept was developed to overcomes this problem.

The effect of negative pressure wound therapy with antibacterial dressings or antiseptics on an in vitro wound model.

PubMed

Matiasek, J; Domig, K J; Djedovic, G; Babeluk, R; Assadian, O

2017-05-02

The aim of this study was to investigate the bacterial bioburden in experimental in vitro wounds during the application of conventional negative pressure wound therapy (NPWT), with and without antimicrobial dressings (polyhexanide, silver), against NPWT instillation of octenidine. Experimental wounds produced in an in vitro porcine wound model were homogenously contaminated with bacterial suspension and treated with NPWT and different options. Group A: non-antimicrobial polyurethane foam dressing; group B: antimicrobial polyurethane foam dressing containing silver; group C: antimicrobial gauze dressing containing polyhexanide; group D: non-antimicrobial polyurethane foam dressing intermittently irrigated with octenidine; group E: negative control (non-antimicrobial polyurethane foam dressing without NPWT). Standard biopsies were harvested after 24 and 28 hours. This study demonstrated that the use of NPWT with intermitted instillation of octenidine (group D) or application of silver-based polyurethane foam dressings (group B) is significantly superior against Staphylococcus aureus colonisation in experimental wounds compared with non-antimicrobial polyurethane foam dressing (group A) after 48 hours. Surprisingly, the polyhexanide-based dressing (group C) used in this model showed no statistical significant effect compared with the control group (group E) after 24 or 48 hours of treatment. Both intermitted instillation of octenidine and silver-based dressings in standard NPWT were significantly superior compared with non-antimicrobial polyurethane foam dressings or PHMB coated gauze dressing after 48 hours.

Exit-Site Dressing and Infection in Peritoneal Dialysis: A Randomized Controlled Pilot Trial.

PubMed

Mushahar, Lily; Mei, Lim Wei; Yusuf, Wan Shaariah; Sivathasan, Sudhaharan; Kamaruddin, Norilah; Idzham, Nor Juliana Mohd

2016-01-01

♦ Peritoneal dialysis (PD)-related infection is a common cause of catheter loss and the main reason for PD drop-out. Exit-site infection (ESI) is a pathway to developing tunnel infection and peritonitis, hence rigorous exit-site care has always been emphasized in PD therapy. The aim of this study was to evaluate the effect of exit-site dressing vs non-dressing on the rate of PD-related infection. ♦ A prospective randomized controlled study was conducted in prevalent PD patients at the Hospital Tuanku Jaafar Seremban, Negeri Sembilan, Malaysia, from April 2011 until April 2013. All patients were required to perform daily washing of the exit site with antibacterial soap during a shower. In the dressing group (n = 54), patients were required to clean their exit site using povidone-iodine after drying, followed by topical mupirocin antibiotic application to the exit site. The exit site was then covered with a sterile gauze dressing and the catheter immobilized with tape. In the non-dressing group (n = 54), patients were not required to do any further dressing after drying. They were only required to apply mupirocin cream to the exit site and then left the exit site uncovered. The catheter was immobilized with tape. The primary outcome was ESI. The secondary outcomes were evidence of tunnel infection or peritonitis. ♦ A total of 97 patients completed the study. There were a total of 12 ESI episodes: 4 episodes in 4 patients in the dressing group vs 8 episodes in 4 patients in the non-dressing group. This corresponds to 1 episode per 241.3 patient-months vs 1 episode per 111.1 patient-months in the dressing and non-dressing groups respectively. Median time to first ESI episode was shorter in the non-dressing than in the dressing group, but not significant (p = 0.25). The incidence of gram-positive ESI in both groups was similar. There were no gram-negative ESI in the non-dressing group compared with 2 in the dressing group. The peritonitis rate was 1 per 37.1 patient-month in the dressing group and 1 per 44.4 patient-months in the non-dressing group. Median time to first peritonitis episode was significantly shorter in the dressing group compared to non-dressing (p = 0.03). There was no impact of dressing disruptions in the occurrence of major PD catheter-related infection. ♦ Use of a non-dressing technique with only prophylactic topical mupirocin cream application is effective in preventing PD-related infection. The non-dressing technique is more cost-effective and convenient for PD patients, with fewer disposables. Copyright © 2016 International Society for Peritoneal Dialysis.

Antimicrobial Activity of a Novel Vascular Access Film Dressing Containing Chlorhexidine Gluconate.

PubMed

Wibaux, Anne; Thota, Priyaleela; Mastej, Jozef; Prince, Daniel L; Carty, Neal; Johnson, Peter

2015-01-01

Covering insertion sites with chlorhexidine impregnated dressings has been proven to be clinically effective in reducing catheter related blood stream infections (CR-BSI). Two chlorhexidine gluconate (CHG)-impregnated dressings are commercially available, a polyurethane foam disk and a film dressing containing a chlorhexidine gluconate-impregnated gel pad. While both have demonstrated efficacy in clinical settings, the major drawback of high cost and impaired IV insertion site visibility limits their usage. A new, simple film dressing containing CHG within its adhesive layer is now available. The objective of this study was to test the in vitro antimicrobial efficacy of the new dressing in comparison to the CHG-impregnated gel dressing. Quantitative aliquots of suspensions (concentration of 1.0x106 to 5.0x106 cfu/sample) of clinically relevant challenge organisms (Staphylococcus species, gram-negative bacilli, Candida albicans) were incubated in contact with the new CHG-containing film dressing, a placebo version of the same (negative control) and the commercially available CHG-impregnated gel dressing (positive control). Serial dilutions of the surviving organisms were quantified using the pour plate after 1, 3, 5, and 7 days of incubation in order to calculate an antimicrobial log10 reduction for each organism/dressing combination at each point in time. The new CHG-containing film dressing delivered greater than 5.0 log10 reduction throughout the 7 days on all aerobic gram-negative bacilli and Staphylococcus species tested. As of day 1 the CHG-containing film dressing provided greater than 5.0 log10 reduction on Candida albicans. There were no statistically significant differences in the log10 reduction between the two dressings tested. The new CHG-containing film dressing was found to be as effective as the chlorhexidine gluconate-impregnated gel dressing on clinically relevant microbes.

Implementation of international code of marketing breast-milk substitutes in China.

PubMed

Liu, Aihua; Dai, Yaohua; Xie, Xiaohua; Chen, Li

2014-11-01

Breastmilk is the best source of nourishment for infants and young children, and breastfeeding is one of the most effective ways to ensure child health and survival. In May 1981, the World Health Assembly adopted the International Code of Marketing Breast-Milk Substitutes. Since then several subsequent resolutions have been adopted by the World Health Assembly, which both update and clarify the articles within the International Code (herein after the term "Code" refers to both the International Code and all subsequent resolutions). The Code is designed to regulate "inappropriate sales promotion" of breastmilk substitutes and instructs signatory governments to ensure the implementation of its aims through legislation. The Chinese Regulations of the Code were adopted by six government sectors in 1995. However, challenges in promotion, protection, and support of breastfeeding remain. This study aimed to monitor the implementation of the Code in China. Six cities were selected with considerable geographic coverage. In each city three hospitals and six stores were surveyed. The International Baby Food Action Network Interview Form was adapted, and direct observations were made. Research assistants administered the questionnaires to a random sample of mothers of infants under 6 months old who were in the outpatient department of the hospitals. In total, 291 mothers of infants, 35 stores, 17 hospitals, and 26 companies were surveyed. From the whole sample of 291 mothers, the proportion who reported exclusively breastfeeding their infant was 30.9%; 69.1% of mothers reported feeding their infant with commercially available formula. Regarding violations of the Code, 40.2% of the mothers reported receiving free formula samples. Of these, 76.1% received the free samples in or near hospitals. Among the stores surveyed, 45.7% were found promoting products in a way that violates the Code. Also, 69.0% of the labeling on the formula products did not comply with the regulations set out in the Code. As the social and economic developments continue, the interactions of more and more factors curb further success in breastfeeding. Support from all sectors of the society is needed in order to create a social environment to enable the promotion of breastfeeding, in addition to the efforts already made by the healthcare system.

Closed dressings after laser skin resurfacing.

PubMed

Newman, J P; Koch, R J; Goode, R L

1998-07-01

To evaluate the safety, efficacy, and patient acceptance of closed dressings after full facial resurfacing with the carbon dioxide laser. Prospective cohort of men and women undergoing full facial carbon dioxide laser resurfacing. Ambulatory surgical center at a university hospital. Forty consecutive patients randomized to 1 of 4 dressing groups. All patients underwent full facial resurfacing with a carbon dioxide laser system. One of 5 closed dressings (single- or 3-layer composite foam, plastic mesh, hydrogel, or polymer film) was placed immediately after the procedure. Closed dressings were changed on postoperative day 2 and removed on postoperative day 4. Objective postoperative criteria of erythema, scarring, reepithelialization, and surface irregularities were recorded and photodocumented. Comparisons were made among the closed dressing groups as well as with a group of historical control subjects treated with open dressings. The ease of application, office time for preparation and application, and cost of the individual dressings were collected. Patient characteristics of overall acceptance, comfort, and ease of maintenance were recorded with a visual analog scale. There were no complications of scarring, surface irregularities, or contact dermatitis from the application or maintenance of the closed dressings. There were no significant differences in the number of days of postoperative erythema or in the rate of facial reepithelialization among the groups. Most patients preferred not to continue with the closed dressings past 2 days. Positive features from the use of closed dressings included reduction in crust formation, decreased pruritus, decreased erythema, and decreased postoperative pain, compared with historical controls. Negative features included time in preparation and application of the dressings. Costs ranged from $9.79 to $50 per dressing change. Closed dressings are safe and offer benefits noted during the first 4 postoperative days. Patients can be expected to maintain a closed dressing for at least 24 hours but no longer than 4 days. The positive features of closed dressings and patient acceptance outweigh the cost and office time involved with their application and maintenance.

Interactive Programming Support for Secure Software Development

ERIC Educational Resources Information Center

Xie, Jing

2012-01-01

Software vulnerabilities originating from insecure code are one of the leading causes of security problems people face today. Unfortunately, many software developers have not been adequately trained in writing secure programs that are resistant from attacks violating program confidentiality, integrity, and availability, a style of programming…

24 CFR 905.200 - Eligible activities.

Code of Federal Regulations, 2014 CFR

2014-04-01

... reduction. Physical improvements to reduce the number of units that are vacant. Not included are costs for... physical improvement costs associated with: (i) Correcting violations of local building code or the Uniform...) Management improvements. Noncapital activities that are project-specific or PHA-wide improvements needed to...

Dress Nicer = Know More? Young Children’s Knowledge Attribution and Selective Learning Based on How Others Dress

PubMed Central

McDonald, Kyla P.; Ma, Lili

2015-01-01

This research explored whether children judge the knowledge state of others and selectively learn novel information from them based on how they dress. The results indicated that 4- and 6-year-olds identified a formally dressed individual as more knowledgeable about new things in general than a casually dressed one (Study 1). Moreover, children displayed an overall preference to seek help from a formally dressed individual rather than a casually dressed one when learning about novel objects and animals (Study 2). These findings are discussed in relation to the halo effect, and may have important implications for child educators regarding how instructor dress might influence young students’ knowledge attribution and learning preferences. PMID:26636980

Are biopolymers potential deodourising agents in wound management?

PubMed

Lee, G; Anand, S C; Rajendran, S

2009-07-01

To investigate the odour-adsorbing properties of biopolymers, with a view to using the findings to develop a novel dressing with odour-adsorbing properties. The odour-adsorbing properties of a selection of biopolymers (aloe vera, tea tree oil, neem oil and manuka honey) and three commercially available dressings containing activated charcoal cloth (ACC) were quantitatively assessed using laboratory test equipment. An aloe vera-containing composite dressing, designed and developed by the authors, was also compared with the ACC dressings. Aloe vera was the most adsorbent of the biopolymers and a 40% dilution had comparable values to those of the ACC dressings. Furthermore, values for the novel composite dressing were similar to those of the ACC dressings. The novel composite dressing may be a potential alternative to ACC dressings, and has the added advantages of having antimicrobial properties as well as the ability to promote a moist wound environment. However, more research is needed.

Dressing disrupted: negotiating care through the materiality of dress in the context of dementia.

PubMed

Buse, Christina; Twigg, Julia

2018-02-01

This paper explores how the materiality of dress mediates and shapes practices of care in the context of dementia. Earlier research called for an approach to conceptualising care that recognised the role played by everyday artefacts. We extend this to a consideration of dress and dressing the body in relation to people with dementia that involves the direct manipulation of material objects, as well as the materiality of bodies. The paper draws on an ESRC funded study Dementia and Dress, which examined experiences of dress for people with dementia, families and care-workers using ethnographic and qualitative methods. Our analysis explores the process of dressing the body, the physicality of guiding and manipulating bodies into clothing, dealing with fabrics and bodies which 'act back' and are resistant to the process of dressing. We consider how the materiality of clothing can constrain or enable practices of care, exploring tensions between garments that support ease of dressing and those that sustain identity. Examining negotiations around dress also reveals tensions between competing 'logics' of care (Mol ). © 2018 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.

Effect of periodontal dressings on human gingiva fibroblasts in vitro

DOE Office of Scientific and Technical Information (OSTI.GOV)

Eber, R.M.; Shuler, C.F.; Buchanan, W.

1989-08-01

In vitro cytotoxicity studies of periodontal dressings have not generally produced a result consistent with in vivo observations. These prior in vitro studies have not used human intraoral cell lines. We tested the effects of two eugenol containing and two non-eugenol periodontal dressings on cultured human gingival fibroblasts (HGF) (ATCC No. 1292). Replicate HGF cultures grown in microtiter plates were exposed to stock, 1:4 and 1:16 dilutions of extracts made from each of the four periodontal dressings. The HGF cultures were pulse labelled with tritiated thymidine (3HTdR) after 24, 48, and 72 hours. Incorporations of the labelled thymidine were measuredmore » using liquid scintillation counting and expressed as counts per minute. The results showed that undiluted extracts from all four periodontal dressings totally inhibited 3HTdR uptake (P less than 0.05). The 1:4 dilution of eugenol dressings inhibited 3HTdR uptake significantly more than non-eugenol dressings (P less than 0.05). Interestingly, at 72 hours the 1:16 dilution of the non-eugenol dressings caused significantly increased 3HTdR uptake which was not observed with the eugenol dressings. The present results suggest that the use of a human fibroblastic cell line for testing the effects of periodontal dressings may provide information about the relative biological effects of these dressings. Using this cell line, we have found that eugenol dressings inhibit fibroblast proliferation to a greater extent than non-eugenol dressings.« less

Prototype Development of a Responsive Emotive Sensing System (DRESS) to aid older persons with dementia to dress independently

PubMed Central

Mahoney, Diane Feeney; Burleson, Winslow; Lozano, Cecil; Ravishankar, Vijay; Mahoney, Edward Leo

2015-01-01

Background Prior research has critiqued the lack of attention to the stressors associated with dementia related dressing issues, stigmatizing patient clothing, and wearable technology challenges. This paper describes the conceptual development and feasibility testing of an innovative ‘smart dresser’ context aware affective system (DRESS) to enable dressing by people with moderate memory loss through individualized audio and visual task prompting in real time. Methods Mixed method feasibility study involving qualitative focus groups with 25 Alzheimer’s family caregivers experiencing dressing difficulties to iteratively inform system design and a quantitative usability trial with 10 healthy subjects in a controlled laboratory setting to assess validity of technical operations. Results Caregivers voiced the need for tangible dressing assistance to reduce their frustration from time spent in repetitive cueing and power struggles over dressing. They contributed 6 changes that influenced the prototype development, most notably adding a dresser top iPad to mimic a familiar ‘TV screen’ for the audio and visual cueing. DRESS demonstrated promising overall functionality, however the validity of identification of dressing status ranged from 0% for the correct pants dressing to 100% for all shirts dressing scenarios. Adjustments were made to the detection components of the system raising the accuracy of detection of all acted dressing scenarios for pants from 50% to 82%. Conclusions Findings demonstrate family caregiver acceptability of the proposed system, the successful interoperability of the built system’s components, and the system’s ability to interpret correct and incorrect dressing actions in controlled laboratory simulations. Future research will advance the system to the alpha stage and subsequent testing with end users in real world settings. PMID:26321895

Alcohol industry self-regulation: who is it really protecting?

PubMed

Noel, Jonathan; Lazzarini, Zita; Robaina, Katherine; Vendrame, Alan

2017-01-01

Self-regulation has been promoted by the alcohol industry as a sufficient means of regulating alcohol marketing activities. However, evidence suggests that the guidelines of self-regulated alcohol marketing codes are violated routinely, resulting in excessive alcohol marketing exposure to youth and the use of content that is potentially harmful to youth and other vulnerable populations. If the alcohol industry does not adhere to its own regulations the purpose and design of these codes should be questioned. Indeed, implementation of alcohol marketing self-regulation in Brazil, the United Kingdom and the United States was likely to delay statutory regulation rather than to promote public health. Moreover, current self-regulation codes suffer from vague language that may allow the industry to circumvent the guidelines, loopholes that may obstruct the implementation of the codes, lax exposure guidelines that can allow excessive youth exposure, even if properly followed, and a standard of review that may be inappropriate for protecting vulnerable populations. Greater public health benefits may be realized if legislative restrictions were applied to alcohol marketing, and strict statutory alcohol marketing regulations have been implemented and defended successfully in the European Union, with European courts declaring that restrictions on alcohol marketing are proportional to the benefits to public health. In contrast, attempts to restrict alcohol marketing activities in the United States have occurred through private litigation and have been unsuccessful. None the less, repeated violations of industry codes may provide legislators with sufficient justification to pass new legislation and for such legislation to withstand constitutional review in the United States and elsewhere. © 2016 Society for the Study of Addiction.

Prediction suppression and surprise enhancement in monkey inferotemporal cortex.

PubMed

Ramachandran, Suchitra; Meyer, Travis; Olson, Carl R

2017-07-01

Exposing monkeys, over the course of days and weeks, to pairs of images presented in fixed sequence, so that each leading image becomes a predictor for the corresponding trailing image, affects neuronal visual responsiveness in area TE. At the end of the training period, neurons respond relatively weakly to a trailing image when it appears in a trained sequence and, thus, confirms prediction, whereas they respond relatively strongly to the same image when it appears in an untrained sequence and, thus, violates prediction. This effect could arise from prediction suppression (reduced firing in response to the occurrence of a probable event) or surprise enhancement (elevated firing in response to the omission of a probable event). To identify its cause, we compared firing under the prediction-confirming and prediction-violating conditions to firing under a prediction-neutral condition. The results provide strong evidence for prediction suppression and limited evidence for surprise enhancement. NEW & NOTEWORTHY In predictive coding models of the visual system, neurons carry signed prediction error signals. We show here that monkey inferotemporal neurons exhibit prediction-modulated firing, as posited by these models, but that the signal is unsigned. The response to a prediction-confirming image is suppressed, and the response to a prediction-violating image may be enhanced. These results are better explained by a model in which the visual system emphasizes unpredicted events than by a predictive coding model. Copyright © 2017 the American Physiological Society.

21 CFR 169.115 - French dressing.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 2 2010-04-01 2010-04-01 false French dressing. 169.115 Section 169.115 Food and... § 169.115 French dressing. (a) Description. French dressing is the separable liquid food or the..., lecithin, or polyglycerol esters of fatty acids. (d) Nomenclature. The name of the food is “French dressing...

Antimicrobial Activity of a Novel Vascular Access Film Dressing Containing Chlorhexidine Gluconate

PubMed Central

Wibaux, Anne; Thota, Priyaleela; Mastej, Jozef; Prince, Daniel L.; Carty, Neal; Johnson, Peter

2015-01-01

Background Covering insertion sites with chlorhexidine impregnated dressings has been proven to be clinically effective in reducing catheter related blood stream infections (CR-BSI). Two chlorhexidine gluconate (CHG)-impregnated dressings are commercially available, a polyurethane foam disk and a film dressing containing a chlorhexidine gluconate-impregnated gel pad. While both have demonstrated efficacy in clinical settings, the major drawback of high cost and impaired IV insertion site visibility limits their usage. A new, simple film dressing containing CHG within its adhesive layer is now available. The objective of this study was to test the in vitro antimicrobial efficacy of the new dressing in comparison to the CHG-impregnated gel dressing. Methods Quantitative aliquots of suspensions (concentration of 1.0x106 to 5.0x106 cfu/sample) of clinically relevant challenge organisms (Staphylococcus species, gram-negative bacilli, Candida albicans) were incubated in contact with the new CHG-containing film dressing, a placebo version of the same (negative control) and the commercially available CHG-impregnated gel dressing (positive control). Serial dilutions of the surviving organisms were quantified using the pour plate after 1, 3, 5, and 7 days of incubation in order to calculate an antimicrobial log10 reduction for each organism/dressing combination at each point in time. Results The new CHG-containing film dressing delivered greater than 5.0 log10 reduction throughout the 7 days on all aerobic gram-negative bacilli and Staphylococcus species tested. As of day 1 the CHG-containing film dressing provided greater than 5.0 log10 reduction on Candida albicans. There were no statistically significant differences in the log10 reduction between the two dressings tested. Conclusion The new CHG-containing film dressing was found to be as effective as the chlorhexidine gluconate-impregnated gel dressing on clinically relevant microbes. PMID:26599087

Optimization of the dressing parameters in cylindrical grinding based on a generalized utility function

NASA Astrophysics Data System (ADS)

Aleksandrova, Irina

2016-01-01

The existing studies, concerning the dressing process, focus on the major influence of the dressing conditions on the grinding response variables. However, the choice of the dressing conditions is often made, based on the experience of the qualified staff or using data from reference books. The optimal dressing parameters, which are only valid for the particular methods and dressing and grinding conditions, are also used. The paper presents a methodology for optimization of the dressing parameters in cylindrical grinding. The generalized utility function has been chosen as an optimization parameter. It is a complex indicator determining the economic, dynamic and manufacturing characteristics of the grinding process. The developed methodology is implemented for the dressing of aluminium oxide grinding wheels by using experimental diamond roller dressers with different grit sizes made of medium- and high-strength synthetic diamonds type ??32 and ??80. To solve the optimization problem, a model of the generalized utility function is created which reflects the complex impact of dressing parameters. The model is built based on the results from the conducted complex study and modeling of the grinding wheel lifetime, cutting ability, production rate and cutting forces during grinding. They are closely related to the dressing conditions (dressing speed ratio, radial in-feed of the diamond roller dresser and dress-out time), the diamond roller dresser grit size/grinding wheel grit size ratio, the type of synthetic diamonds and the direction of dressing. Some dressing parameters are determined for which the generalized utility function has a maximum and which guarantee an optimum combination of the following: the lifetime and cutting ability of the abrasive wheels, the tangential cutting force magnitude and the production rate of the grinding process. The results obtained prove the possibility of control and optimization of grinding by selecting particular dressing parameters.

[Effectiveness of the transparent sterile dressing vs standard to fix the peripheral venous catheter (PVC) on the incidence of phlebitis. A randomized controlled trial].

PubMed

Forni, Cristiana; D'Alessandro, Fabio; Gambino, Orazio; Amodeo, Alfredo; Pignotti, Elettra; Zanotti, Enrichetta; Tremosini, Morena; Trofa, Carmela; Sabattini, Tania; Matino, Federica; Genco, Rossana; Schiavone, Miguel; Bombino, Caterina; Mini, Sandra; Rocchegiani, Laura; Notarnicola, Teresa; Capezzali, Daniela; Boschi, Rita; Loro, Loretta

2012-01-01

Effectiveness of the transparent sterile dressing vs standard to fix the peripheral venous catheter (PVC), on the incidence of phlebitis. A randomized controlled trial. The type of dressing could contribute to the incidence of phlebitis, infiltration and accidental removals but the results of the studies are contrasting and samples are limited. To compare the effectiveness of a transparent polyurethane sterile dressing on the rate of phlebitis associated to peripheral venous catheter (PVC) vs a non sterile sticking plaster in use in current practice (standard dressing). Randomized controlled trial. Participants. 1061 PVCs (703 patients, adults and children) at a research orthopedic hospital in the north of Italy; 540 PVCs allocated to receive the sterile and 521 the standard dressing. 96 PVCs were excluded for phlebitis, 48 (9.6%) in the sterile and 48 (10.1%) in the standard dressing group, RR 0.96 (95%CI 0.697 - 1.335). Accidental removal of the PVCs was more frequent with the sterile dressing (9.6% vs 6.3%) but the number of catheters removed without complications was larger in the standard dressing group (48.9% vs 54.9% P=0.0503). Eighty-five PVCs were replaced for detachment of the dressing (50, 9.2% sterile and 35, 6.7% standard dressing). The cheapest transparent sterile dressing costs 32 cents while the standard 9 cents. A sticking non sterile plasters is not influential on the rate of phlebitis and ensures an good fix of the PVC compared the transparent sterile dressing to of polyurethane film.

Nanofibrillar cellulose wound dressing in skin graft donor site treatment.

PubMed

Hakkarainen, T; Koivuniemi, R; Kosonen, M; Escobedo-Lucea, C; Sanz-Garcia, A; Vuola, J; Valtonen, J; Tammela, P; Mäkitie, A; Luukko, K; Yliperttula, M; Kavola, H

2016-12-28

Although new therapeutic approaches for burn treatment have made progress, there is still need for better methods to enhance wound healing and recovery especially in severely burned patients. Nanofibrillar cellulose (NFC) has gained attention due to its renewable nature, good biocompatibility and excellent physical properties that are of importance for a range of applications in pharmaceutical and biomedical fields. In the present study, we investigated the potential of a wood based NFC wound dressing in a clinical trial on burn patients. Previously, we have investigated NFC as a topical functionalized wound dressing that contributes to improve wound healing in mice. Wood based NFC wound dressing was tested in split-thickness skin graft donor site treatment for nine burn patients in clinical trials at Helsinki Burn Centre. NFC dressing was applied to split thickness skin graft donor sites. The dressing gradually dehydrated and attached to donor site during the first days. During the clinical trials, physical and mechanical properties of NFC wound dressing were optimized by changing its composition. From patient 5 forward, NFC dressing was compared to commercial lactocapromer dressing, Suprathel® (PMI Polymedics, Germany). Epithelialization of the NFC dressing-covered donor site was faster in comparison to Suprathel®. Healthy epithelialized skin was revealed under the detached NFC dressing. NFC dressing self-detached after 11-21days for patients 1-9, while Suprathel® self-detached after 16-28days for patients 5-9. In comparison studies with patients 5-9, NFC dressing self-detached on average 4days earlier compared with Suprathel®. Lower NFC content in the material was evaluated to influence the enhanced pliability of the dressing and attachment to the wound bed. No allergic reaction or inflammatory response to NFC was observed. NFC dressing did not cause more pain for patients than the traditional methods to treat the skin graft donor sites. Based on the preliminary clinical data, NFC dressing seems to be promising for skin graft donor site treatment since it is biocompatible, attaches easily to wound bed, and remains in place until donor site has renewed. It also detaches from the epithelialized skin by itself. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Randomized controlled trial of chlorhexidine dressing and highly adhesive dressing for preventing catheter-related infections in critically ill adults.

PubMed

Timsit, Jean-François; Mimoz, Olivier; Mourvillier, Bruno; Souweine, Bertrand; Garrouste-Orgeas, Maïté; Alfandari, Serge; Plantefeve, Gaétan; Bronchard, Régis; Troche, Gilles; Gauzit, Remy; Antona, Marion; Canet, Emmanuel; Bohe, Julien; Lepape, Alain; Vesin, Aurélien; Arrault, Xavier; Schwebel, Carole; Adrie, Christophe; Zahar, Jean-Ralph; Ruckly, Stéphane; Tournegros, Caroline; Lucet, Jean-Christophe

2012-12-15

Most vascular catheter-related infections (CRIs) occur extraluminally in patients in the intensive care unit (ICU). Chlorhexidine-impregnated and strongly adherent dressings may decrease catheter colonization and CRI rates. To determine if chlorhexidine-impregnated and strongly adherent dressings decrease catheter colonization and CRI rates. In a 2:1:1 assessor-masked randomized trial in patients with vascular catheters inserted for an expected duration of 48 hours or more in 12 French ICUs, we compared chlorhexidine dressings, highly adhesive dressings, and standard dressings from May 2010 to July 2011. Coprimary endpoints were major CRI with or without catheter-related bloodstream infection (CR-BSI) with chlorhexidine versus nonchlorhexidine dressings and catheter colonization rate with highly adhesive nonchlorhexidine versus standard nonchlorhexidine dressings. Catheter-colonization, CR-BSIs, and skin reactions were secondary endpoints. A total of 1,879 patients (4,163 catheters and 34,339 catheter-days) were evaluated. With chlorhexidine dressings, the major-CRI rate was 67% lower (0.7 per 1,000 vs. 2.1 per 1,000 catheter-days; hazard ratio [HR], 0.328; 95% confidence interval [CI], 0.174-0.619; P = 0.0006) and the CR-BSI rate 60% lower (0.5 per 1,000 vs. 1.3 per 1,000 catheter-days; HR, 0.402; 95% CI, 0.186-0.868; P = 0.02) than with nonchlorhexidine dressings; decreases were noted in catheter colonization and skin colonization rates at catheter removal. The contact dermatitis rate was 1.1% with and 0.29% without chlorhexidine. Highly adhesive dressings decreased the detachment rate to 64.3% versus 71.9% (P < 0.0001) and the number of dressings per catheter to two (one to four) versus three (one to five) (P < 0.0001) but increased skin colonization (P < 0.0001) and catheter colonization (HR, 1.650; 95% CI, 1.21-2.26; P = 0.0016) without influencing CRI or CR-BSI rates. A large randomized trial demonstrated that chlorhexidine-gel-impregnated dressings decreased the CRI rate in patients in the ICU with intravascular catheters. Highly adhesive dressings decreased dressing detachment but increased skin and catheter colonization. Clinical trial registered with www.clinicaltrials.gov (NCT 01189682).

The design, characteristics, and application of polyurethane dressings using the electrospinning process

NASA Astrophysics Data System (ADS)

Kampeerapappun, Piyaporn

In general, a dressing is used to protect and help heal wounds. There are several types of dressings on the market such as hydrocolloid, hydrogel, and medicated dressings. One technique for making a dressing is electrospinning, which is a very simple procedure used to produce fibers. Due to much smaller fiber-diameters than produced with the conventional technique, the fibers from electrospinning have unique properties: high porosity and high surface areas, which are advantageous for wound healing. In this research, the fibers were electrospun using polyurethane, TecophilicRTM or TecoflexRTM, with various additives. First, multilayer transdermal electrospun dressings, four and five-layers, were developed that allowed for the controlled release of nitric oxide (NO) from a NO2 -/ascorbic acid system encapsulated in polymer nanofibers. The amount of NO released from each wound dressing was investigated. Both the four and five-layer dressings were tested for morphology of fibers, water absorption, nitrite distribution, NO release profile after sterilization by gamma radiation, and stability. In the case of the four-layer transdermal dressing, the dressing was tested in diabetic, periodontal, and cutaneous leishmaniasis patients. Furthermore, the color change of dressing was investigated. TecophilicRTM was also spun with an antimicrobial agent, which was added to the TecophilicRTM solution to electrospin an antimicrobial dressing. The morphology of fibers was tested using an optical microscope and the water absorption, uniformity, and percent extraction of dressing were also determined. In addition, the efficiency of the antimicrobial agent in the dressing was determined according to SN 195920-1994 and ASTM 2149-01. Another NO-releasing dressing was developed employing the NO donor molecules, sodium salt of linear polyethylenimine NONOates (LPEINO-Na) and calcium salt of linear polyethylenimine NONOates (LPEINO-Ca), which were electrospun with TecophilicRTM. The NO release profiles for the LPEINO fibers were generated using a nitric oxide analyzer (NOA) and distribution of the particles in the dressing was examined. Moreover, the amount of NO released after patch storage for 1 and 2 months was determined.

Wet to dry dressing changes

MedlinePlus

... as much gauze or packing gauze. Removing the Old Dressing Follow these steps to remove your dressing: ... sterile gloves. Carefully remove the tape. Remove the old dressing. If it is sticking to your skin, ...

A prospective randomized clinical trial to evaluate methods of postoperative care of hypospadias.

PubMed

McLorie, G; Joyner, B; Herz, D; McCallum, J; Bagli, D; Merguerian, P; Khoury, A

2001-05-01

Hypospadias repair is a common operation performed by pediatric urologists. Perhaps the greatest variable and source of controversy of postoperative care is the surgical dressing. We hypothesized that using no dressing would achieve surgically comparable results to those traditionally achieved by a postoperative dressing and it would also simplify postoperative parent delivered home care. Accordingly we designed a prospective randomized clinical trial to compare surgical outcome and postoperative care after hypospadias repair in boys with no dressing and those who received 1 of the 2 most common types of dressing. In a 12-month period 120 boys with an average age of 2.2 years underwent primary 1-stage hypospadias repair at a single center with 4 participating surgeons. Repair was performed in 60 boys with proximal and 60 with distal hypospadias on an outpatient basis. Ethics and Internal Review Board approval, and informed consent were obtained. Boys were then prospectively randomized to receive no dressing, an adhesive biomembrane dressing or a compressive wrap dressing. Comprehensive instructions on postoperative care were distributed to all families and a questionnaire was distributed to the parents at the initial followup. Surgical outcome was evaluated and questionnaire responses were analyzed. Fisher's exact test was done to test the significance of differences in surgical outcomes and questionnaire responses. A total of 117 boys completed the prospective randomized trial. Surgical staff withdrew 3 cases from randomized selection to place a dressing for postoperative hemostasis. We obtained 101 questionnaires for response analysis. The type or absence of the dressing did not correlate with the need for repeat procedures, urethrocutaneous fistula, or meatal stenosis or regression. Analysis revealed less narcotic use in the no dressing group and fewer telephone calls to the urology nurse, or on-call resident and/or fellow. These findings were statistically significant. In addition, there were more unscheduled visits to the urology clinic, emergency room or primary physician office by boys with than without a dressing. Furthermore, 29% of the parents were not psychologically prepared to remove the dressing and 12% were so reluctant that the dressing was removed at the urology outpatient clinic. The surgical outcome and rate of adverse events or complications were not compromised without a postoperative dressing. An absent dressing simplified postoperative ambulatory parent delivered home care. We recommend that dressings should be omitted from routine use after hypospadias repair.

Evaluation of a foam dressing for acute and chronic wound exudate management.

PubMed

Bullough, Lindsay; Johnson, Sue; Forder, Rebecca

2015-09-01

This article discusses the use of a foam dressing for exudate management in both chronic and acute wounds, such as surgical wounds, pressure ulcers, diabetic ulcers, trauma wounds, and leg ulcers. The primary objective of the study was to observe patients' wound progression in terms of wound size and the condition of the wound bed, when using this foam dressing as either a primary or secondary dressing. The outcome of the evaluation demonstrated that ActivHeal Foam Contact dressing effectively managed exudate. It was also observed that the dressing can assist in autolysis and support improvements in peri-wound status. Choosing an appropriate dressing to manage a wound is essential. Clinicians working in the NHS are under pressure to deliver good-quality clinical outcomes, and the ActivHeal Foam Contact dressing supports this outcome.

An Assistive Technology System that Provides Personalized Dressing Support for People Living with Dementia: Capability Study.

PubMed

Burleson, Winslow; Lozano, Cecil; Ravishankar, Vijay; Lee, Jisoo; Mahoney, Diane

2018-05-01

Individuals living with advancing stages of dementia (persons with dementia, PWDs) or other cognitive disorders do not have the luxury of remembering how to perform basic day-to-day activities, which in turn makes them increasingly dependent on the assistance of caregivers. Dressing is one of the most common and stressful activities provided by caregivers because of its complexity and privacy challenges posed during the process. In preparation for in-home trials with PWDs, the aim of this study was to develop and evaluate a prototype intelligent system, the DRESS prototype, to assess its ability to provide automated assistance with dressing that can afford independence and privacy to individual PWDs and potentially provide additional freedom to their caregivers (family members and professionals). This laboratory study evaluated the DRESS prototype's capacity to detect dressing events. These events were engaged in by 11 healthy participants simulating common correct and incorrect dressing scenarios. The events ranged from donning a shirt and pants inside out or backwards to partial dressing-typical issues that challenge a PWD and their caregivers. A set of expected detections for correct dressing was prepared via video analysis of all participants' dressing behaviors. In the initial phases of donning either shirts or pants, the DRESS prototype missed only 4 out of 388 expected detections. The prototype's ability to recognize other missing detections varied across conditions. There were also some unexpected detections such as detection of the inside of a shirt as it was being put on. Throughout the study, detection of dressing events was adversely affected by the relatively smaller effective size of the markers at greater distances. Although the DRESS prototype incorrectly identified 10 of 22 cases for shirts, the prototype preformed significantly better for pants, incorrectly identifying only 5 of 22 cases. Further analyses identified opportunities to improve the DRESS prototype's reliability, including increasing the size of markers, minimizing garment folding or occlusions, and optimal positioning of participants with respect to the DRESS prototype. This study demonstrates the ability to detect clothing orientation and position and infer current state of dressing using a combination of sensors, intelligent software, and barcode tracking. With improvements identified by this study, the DRESS prototype has the potential to provide a viable option to provide automated dressing support to assist PWDs in maintaining their independence and privacy, while potentially providing their caregivers with the much-needed respite. ©Winslow Burleson, Cecil Lozano, Vijay Ravishankar, Jisoo Lee, Diane Mahoney. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 01.05.2018.

Evaluation of dressings used with local anaesthetic cream and for peripheral venous cannulation.

PubMed

Needham, Rowan; Strehle, Eugen-Matthias

2008-10-01

To compare four polyurethane dressings manufactured by two different companies for use in children. Seventy-eight dressings were applied to secure either local anaesthetic creams (n = 62) or intravenous cannulae (n = 16). Each dressing was evaluated for ease of application, security and ease of removal, using a simple scoring system. 84 per cent of Opsite flexigrid and 90 per cent of Tegaderm local anaesthetic cream dressings were rated as easy or very easy to apply. Opsite flexigrid was felt to be more secure, whereas Tegaderm was easier to remove. The Tegaderm cannula dressing was easier to apply than the iv3000 dressing. There was little difference between the two brands, including costs.

"Posh Music Should Equal Posh Dress": An Investigation into the Concert Dress and Physical Appearance of Female Soloists

ERIC Educational Resources Information Center

Griffiths, Noola K.

2010-01-01

This study investigates the effects of concert dress and physical appearance on perceptions of female classical soloists' musical abilities over a range of genres. Four female violinists were recorded playing three pieces, in four styles of dress of varying formality. Each combination of performer, piece and dress was recorded twice, once as the…

Use of wound dressings with soft silicone adhesive technology.

PubMed

Morris, Clare; Emsley, Paulene; Marland, Elizabeth; Meuleneire, Frans; White, Richard

2009-04-01

To evaluate how pain, during and in-between dressing changes, is affected by the introduction of Mepilex Border Lite, a wound dressing manufactured by Mölnlycke Health Care using Safetac soft silicone adhesive technology, to the treatment of different types of paediatric wounds/skin injuries. Wounds/skin injuries that met the criteria for inclusion in the study were dressed with Mepilex Border Lite. Patients were followed for six weeks or until their wounds/skin injuries had healed, whichever occurred earlier. At each dressing change, pain severity before and during dressing removal was rated by the patient and the investigator on a scale from zero (no pain at all) to ten (worst pain ever). Other variables measured included: signs of trauma to wound/skin injury and surrounding skin, the proportion of viable/non-viable tissue, the quantity and appearance of exudate, odour, and clinical signs of infection. At the final dressing change, patients and investigators completed questionnaires to rate the dressing performance. Mean pain severity scores were significantly lower (p < or = 0.003) at the first dressing change than at baseline. Over 99.5 per cent of the Mepilex Border Lite dressing changes were reported to be atraumatic and more than half of the wounds healed within the study period. Conformability, ease of use, ease of removal, patient comfort, and overall experience with the dressing were rated as 'good' to 'very good' at the vast majority of final visit evaluations. This study provides further evidence of the ability of dressings with Safetac soft silicone adhesive technology to minimise trauma and pain and demonstrates the ability of Mepilex Border Lite to overcome the clinical challenges associated with the use of dressings on the wounds/skin injuries of paediatric patients.

A comparison of the in vitro moisture vapour transmission rate and in vivo fluid-handling capacity of six adhesive foam dressings to a newly reformulated adhesive foam dressing.

PubMed

Zehrer, Cindy L; Holm, David; Solfest, Staci E; Walters, Shelley-Ann

2014-12-01

This study compared moisture vapour transmission rate (MVTR) and wear time or fluid-handling capacities of six adhesive foam dressings to a reformulated control dressing. Standardised in vitro MVTR methodology and a previously published in vivo artificial wound model (AWM) were used. Mean inverted MVTR for the reformulated dressing was 12 750 g/m(2) /24 hours and was significantly higher than four of the six comparator dressings (P < 0·0001), which ranged from 830 to 11 360 g/m(2) /24 hours. Mean upright MVTR for the reformulated dressing was 980 g/m(2) /24 hours and was significantly different than all of the comparator dressings (P < 0·0001), which ranged from 80 to 1620 g/m(2) /24 hours (three higher/three lower). The reformulated dressing median wear time ranged from 6·1 to >7·0 days, compared with 1·0 to 3·5 days for the comparator dressings (P = 0·0012 to P < 0·0001). The median fluid volume handled ranged from 78·0 to >87 ml compared with 13·0 to 44·5 ml for the comparator dressings (P = 0·0007 to P < 0·001). Interestingly, inverted MVTR did not correspond well to the AWM. These results suggest that marked differences exist between the dressings in terms of both MVTR and wear time or fluid-handling capacity. Furthermore, high inverted MVTR does not necessarily predict longer wear time or fluid-handling capacities of absorbent dressings. © 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Threats to bioethical principles in medical practice in Brazil: new medical ethics code period.

PubMed

Gracindo, G C L; da Silva Gallo, J H; Nunes, R

2018-03-15

We aimed to outline the profile of medical professionals in Brazil who have violated the deontological norms set forth in the ethics code of the profession, and whose cases were judged by the higher tribunal for medical ethics between 2010 and 2016. This survey was conducted using a database formed from professional ethics cases extracted from the plenary of the medical ethics tribunal of the Federal Council of Medicine. These were disciplinary ethics cases that were judged at appeal level between 2010 and 2016. Most of these professionals were male (88.5%) and their mean age was 59.9 years (SD=11.62) on the date of judgment of their appeals, ranging from 28 to 95 years. Most of them were based in the southeastern region of Brazil (50.89%). Articles 1 and 18 of the medical ethics code were the rules most frequently violated. The sentence given most often was the cancellation of their professional license (37.6%) and the acts most often sentenced involved malpractice, imprudence, and negligence (18.49%). It is acknowledged that concern for the principles of bioethics was present in the appeal decisions made by the plenary of the medical ethics tribunal of the Federal Council of Medicine.

Using fault tree analysis to identify causes of non-compliance: enhancing violation outcome data for the purposes of education and prevention.

PubMed

Emery, R J; Charlton, M A; Orders, A B; Hernandez, M

2001-02-01

An enhanced coding system for the characterization of notices of violation (NOV's) issued to radiation permit holders in the State of Texas was developed based on a series of fault tree analyses serving to identify a set of common causes. The coding system enhancement was retroactively applied to a representative sample (n = 185) of NOV's issued to specific licensees of radioactive materials in Texas during calendar year 1999. The results obtained were then compared to the currently available summary NOV information for the same year. In addition to identifying the most common NOV's, the enhanced coding system revealed that approximately 70% of the sampled NOV's were issued for non-compliance with a specific regulation as opposed to a permit condition. Furthermore, an underlying cause of 94% of the NOV's was the failure on the part of the licensee to execute a specific task. The findings suggest that opportunities exist to improve permit holder compliance through various means, including the creation of summaries which detail specific tasks to be completed, and revising training programs with more focus on the identification and scheduling of permit-related requirements. Broad application of these results is cautioned due to the bias associated with the restricted scope of the project.

The safety and efficacy of bacterial nanocellulose wound dressing incorporating sericin and polyhexamethylene biguanide: in vitro, in vivo and clinical studies.

PubMed

Napavichayanun, Supamas; Yamdech, Rungnapha; Aramwit, Pornanong

2016-03-01

In our previous work, we have attempted to develop a novel bacterial nanocellulose wound dressing which composed of both polyhexamethylene biguanide (PHMB) as an antimicrobial agent and sericin as an accelerative wound healing component. The loading sequence and concentration of PHMB and sericin were optimized to provide the wound dressing with the most effective antimicrobial activity and enhanced collagen production. In this study, further in vitro, in vivo, and clinical studies of this novel wound dressing were performed to evaluate its safety, efficacy, and applicability. For the in vitro cytotoxic test with L929 mouse fibroblast cells, our novel dressing was not toxic to the cells and also promoted cell migration as good as the commercially available dressing, possibly due to the component of sericin released. When implanted subcutaneously in rats, the lower inflammation response was observed for the novel dressing implanted, comparing to the commercially available dressing. This might be that the antimicrobial PHMB component of the novel dressing played a role to reduce infection and inflammation reaction. The clinical trial patch test was performed on the normal skin of healthy volunteers to evaluate the irritation effect of the dressing. Our novel dressing did not irritate the skin of any volunteers, as characterized by the normal levels of erythema and melanin and the absence of edema, papule, vesicle, and bullae. Then, the novel dressing was applied for the treatment of full-thickness wounds in rats. The wounds treated with our novel dressing showed significantly lower percentage of wound size and higher extent of collagen formation mainly due to the activity of sericin. We concluded that our novel bacterial nanocellulose incorporating PHMB and sericin was a safe and efficient wound dressing material for further investigation in the wound healing efficacy in clinic.

Case Studies of a Behavior Inclusion Model in an Elementary School District

ERIC Educational Resources Information Center

Santa Cruz, Margaret Escobar

2017-01-01

School discipline practices have traditionally been reactive and punitive in nature. Students violating a school district's code of conduct were often met with exclusionary discipline policies such as out-of-school suspensions, long-term suspensions, and expulsions. Districts attempted to resolve these practices by creating alternative education…

Immigration and the Low-Cost Housing Shortage: The Los Angeles Area's Experience.

ERIC Educational Resources Information Center

Nielsen, John

Rising housing costs, increased homelessness, and the debate over illegal immigrants residing in publically assisted housing have renewed media and public interest in immigration's contribution to the Los Angeles, California area's problems of scarce low-cost housing, homelessness, and housing code violations. Recent data suggest that immigrants…

26 CFR 301.7433-2 - Civil cause of action for violation of section 362 or 524 of the Bankruptcy Code.

Code of Federal Regulations, 2010 CFR

2010-04-01

... federal tax with respect to a taxpayer, an officer or employee of the Internal Revenue Service willfully..., certified public accountant, enrolled actuary, or any other person permitted to represent the taxpayer... 14321, Mar. 25, 2003] The Tax Court procedure ...

Coaches' Perceptions of Conference Code of Ethics

ERIC Educational Resources Information Center

Jordan, Jeremy S.; Greenwell, T. Christopher; Geist, Alan L.; Pastore, Donna L.; Mahony, Daniel F.

2004-01-01

In society today, there is a greater concern about the moral and ethical conduct of those in leadership. In particular, rules violations within intercollegiate athletics have risen, which has lead to increased pressure on administrators to encourage positive ethical behavior within the realm of their influence. One result of this greater concern…

Finding The Right Way: Towards an Army Institutional Ethic

DTIC Science & Technology

2012-03-22

professionally and ethically," "demonstrate organisational values and codes of conduct," and "display high ethical and professional standards in all aspects of...government officials may find it necessary to violate that legal ban (official disobedience) in those instances.薍 Charitably , this is a tortured

School District Superintendents' Response to Ethical Dilemmas: A Grounded Theory

ERIC Educational Resources Information Center

Sprouse, Fay Simpson

2009-01-01

Ethical dilemmas, situations involving a conflict between values or principles, often arise when employees of school districts violate laws or professional codes of behavior. Ethical dilemmas also occur when there are inequities in educational programming, resulting in missed opportunities for students. This qualitative study, conducted with the…

Dressing the post-Newtonian two-body problem and classical effective field theory

NASA Astrophysics Data System (ADS)

Kol, Barak; Smolkin, Michael

2009-12-01

We apply a dressed perturbation theory to better organize and economize the computation of high orders of the 2-body effective action of an inspiralling post-Newtonian (PN) gravitating binary. We use the effective field theory approach with the nonrelativistic field decomposition (NRG fields). For that purpose we develop quite generally the dressing theory of a nonlinear classical field theory coupled to pointlike sources. We introduce dressed charges and propagators, but unlike the quantum theory there are no dressed bulk vertices. The dressed quantities are found to obey recursive integral equations which succinctly encode parts of the diagrammatic expansion, and are the classical version of the Schwinger-Dyson equations. Actually, the classical equations are somewhat stronger since they involve only finitely many quantities, unlike the quantum theory. Classical diagrams are shown to factorize exactly when they contain nonlinear worldline vertices, and we classify all the possible topologies of irreducible diagrams for low loop numbers. We apply the dressing program to our post-Newtonian case of interest. The dressed charges consist of the dressed energy-momentum tensor after a nonrelativistic decomposition, and we compute all dressed charges (in the harmonic gauge) appearing up to 2PN in the 2-body effective action (and more). We determine the irreducible skeleton diagrams up to 3PN and we employ the dressed charges to compute several terms beyond 2PN.

Cost of dressings for prevention of sacral pressure ulcers.

PubMed

Inoue, Kelly Cristina; Matsuda, Laura Misue

2016-01-01

to identify costs of dressings to prevent sacral pressure ulcers in an adult intensive care unit in Paraná, Brazil. secondary analysis study with 25 patients admitted between October 2013 and March 2014, using transparent polyurethane film (n=15) or hydrocolloid dressing (n=10) on the sacral region. The cost of each intervention was based on the unit amount used in each type of dressing, and its purchase price (transparent film = R$15.80, hydrocolloid dressing = R$68.00). the mean cost/patient was R$23.17 for use of transparent film and R$190.40 for use of hydrocolloid dressing. The main reason for changing the dressing was detachment. the transparent film was the most economically advantageous alternative to prevent sacral pressure ulcers in critical care patients. However, additional studies should be carried out including assessment of the effectiveness of both dressings.

Topical petrolatum gel alone versus topical silver sulfadiazine with standard gauze dressings for the treatment of superficial partial thickness burns in adults: a randomized controlled trial.

PubMed

Genuino, Glenn Angelo S; Baluyut-Angeles, Kathrina Victoria; Espiritu, Andre Paolo T; Lapitan, Marie Carmela M; Buckley, Brian S

2014-11-01

Non-extensive superficial partial thickness burns constitute a major proportion of burns. Conventional treatment involves regular changing of absorptive dressings including the application of a topical antimicrobial, commonly silver sulfadiazine. A systematic review has found insufficient evidence to support or refute such antimicrobial prophylaxis. Another review compared silver sulfadiazine dressings with other occlusive and non-antimicrobial dressings and found insufficient evidence to guide practice. Other research has suggested that dressings with petrolatum gel are as effective as silver sulfadiazine. Single-center, randomized, controlled parallel group trial comparing conventional silver sulfadiazine dressings with treatment with petrolatum gel alone. Consenting adults 18-45 years old with superficial partial thickness burns≤10% total body surface area seen within 24h of the injury were randomized to daily dressing either with petrolatum gel without top dressings or conventional silver sulfadiazine treatment with gauze dressings. Primary outcomes were blinded assessment of time to complete re-epithelialization, wound infection or allergic contact dermatitis. Secondary outcomes included assessment of ease, time and pain of dressing changes. 26 patients were randomized to petrolatum and 24 to silver sulfadiazine dressings. Follow up data available for 19 in each group. Mean time to re-epithelialization was 6.2 days (SD 2.8) in the petrolatum group and 7.8 days (SD 2.1) in the silver sulfadiazine group (p=0.050). No wound infection or dermatitis was observed in either group. Scores for adherence to wound, ease of dressing removal and time required to change dressings were significantly better in the petrolatum treatment arm (p<0.01). Petrolatum gel without top dressings may be at least as effective as silver sulfadiazine gauze dressings with regard to time to re-epithelialization, and incidence of infection and allergic contact dermatitis. Petrolatum gel appears to be an effective, affordable and widely available alternative in the treatment of minor superficial partial thickness burns in adults. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Effects of a just-in-time educational intervention placed on wound dressing packages: a multicenter randomized controlled trial.

PubMed

Kent, Dea J

2010-01-01

I compared the effects of a just-in-time educational intervention (educational materials for dressing application attached to the manufacturer's dressing package) to traditional wound care education on reported confidence and dressing application in a simulated model. Nurses from a variety of backgrounds were recruited for this study. The nurses possessed all levels of education ranging from licensed practical nurse to master of science in nursing. Both novice and seasoned nurses were included, with no stipulations regarding years of nursing experience. Exclusion criteria included nurses who spent less than 50% of their time in direct patient care and nurses with advanced wound care training and/or certification (CWOCN, CWON). Study settings included community-based acute care facilities, critical access hospitals, long-term care facilities, long-term acute care facilities, and home care agencies. No level 1 trauma centers were included in the study for geographical reasons. Participants were randomly allocated to control or intervention groups. Each participant completed the Kent Dressing Confidence Assessment tool. Subjects were then asked to apply the dressing to a wound model under the observation of either the principal investigator or a trained observer, who scored the accuracy of dressing application according to established criteria. None of the 139 nurses who received traditional dressing packaging were able to apply the dressing to a wound model correctly. In contrast, 88% of the nurses who received the package with the educational guide attached to it were able to apply the dressing to a wound model correctly (χ2 = 107.22, df = 1, P = .0001). Nurses who received the dressing package with the attached educational guide agreed that this feature gave them confidence to correctly apply the dressing (88%), while no nurse agreed that the traditional package gave him or her the confidence to apply the dressing correctly (χ2 = 147.47, df = 4, P < .0001). A just-in-time education intervention improved nurses' confidence when applying an unfamiliar dressing and accuracy of application when applying the dressing to a simulated model compared to traditional wound care education.

Oxidized Regenerated Cellulose/Collagen Dressings: Review of Evidence and Recommendations.

PubMed

Wu, Stephanie; Applewhite, Andrew J; Niezgoda, Jeffrey; Snyder, Robert; Shah, Jayesh; Cullen, Breda; Schultz, Gregory; Harrison, Janis; Hill, Rosemary; Howell, Melania; Speyrer, Marcus; Utra, Howard; de Leon, Jean; Lee, Wayne; Treadwell, Terry

2017-11-01

Healthcare systems are being challenged to manage increasing numbers of nonhealing wounds. Wound dressings are one of the first lines of defense in wound management, and numerous options exist. The oxidized regenerated cellulose (ORC)/collagen dressing may offer healthcare providers a robust and cost-effective tool for use in a variety of wounds. A multidisciplinary panel meeting was convened to discuss the use of ORC/collagen dressings in wound care and provide practice recommendations. A literature search was conducted to provide a brief review of the peer-reviewed studies published between January 2000 and March 2016 to inform the meeting. A 2-day panel meeting convened in February 2017. Healthcare providers with experience using ORC/collagen dressings. This multidisciplinary panel of 15 experts in wound healing included podiatrists, wound care specialists (doctors, certified wound care nurses, and research scientists), and an orthopedist. The literature search identified 58 articles, a majority of which were low levels of evidence (69.3% were level 3 or lower). Panel members identified wound types, such as abrasions, burns, stalled wounds, diabetic foot ulcers, and pressure injuries, where ORC/collagen dressing use could be beneficial. Panel members then provided recommendations and technical pearls for the use of ORC/collagen dressings in practice. Barriers to ORC/collagen dressing use were discussed, and potential resolutions were offered. An ORC/collagen dressing can be a critical tool for clinicians to help manage a variety of wounds. Clinical and economic studies comparing standard-of-care dressings and plain collagen dressings to ORC/collagen dressings are needed.

Oxidized Regenerated Cellulose/Collagen Dressings: Review of Evidence and Recommendations

PubMed Central

Wu, Stephanie; Applewhite, Andrew J.; Niezgoda, Jeffrey; Snyder, Robert; Shah, Jayesh; Cullen, Breda; Schultz, Gregory; Harrison, Janis; Hill, Rosemary; Howell, Melania; Speyrer, Marcus; Utra, Howard; de Leon, Jean; Lee, Wayne; Treadwell, Terry

2017-01-01

ABSTRACT OBJECTIVE: Healthcare systems are being challenged to manage increasing numbers of nonhealing wounds. Wound dressings are one of the first lines of defense in wound management, and numerous options exist. The oxidized regenerated cellulose (ORC)/collagen dressing may offer healthcare providers a robust and cost-effective tool for use in a variety of wounds. DESIGN: A multidisciplinary panel meeting was convened to discuss the use of ORC/collagen dressings in wound care and provide practice recommendations. A literature search was conducted to provide a brief review of the peer-reviewed studies published between January 2000 and March 2016 to inform the meeting. SETTING: A 2-day panel meeting convened in February 2017. PARTICIPANTS: Healthcare providers with experience using ORC/collagen dressings. This multidisciplinary panel of 15 experts in wound healing included podiatrists, wound care specialists (doctors, certified wound care nurses, and research scientists), and an orthopedist. RESULTS: The literature search identified 58 articles, a majority of which were low levels of evidence (69.3% were level 3 or lower). Panel members identified wound types, such as abrasions, burns, stalled wounds, diabetic foot ulcers, and pressure injuries, where ORC/collagen dressing use could be beneficial. Panel members then provided recommendations and technical pearls for the use of ORC/collagen dressings in practice. Barriers to ORC/collagen dressing use were discussed, and potential resolutions were offered. CONCLUSIONS: An ORC/collagen dressing can be a critical tool for clinicians to help manage a variety of wounds. Clinical and economic studies comparing standard-of-care dressings and plain collagen dressings to ORC/collagen dressings are needed. PMID:29049055

Economics of pressure-ulcer care: review of the literature on modern versus traditional dressings.

PubMed

San Miguel, L; Torra i Bou, J E; Verdú Soriano, J

2007-01-01

Published evidence suggests that some of the benefits of modern dressings--longer wear times and less frequent dressing changes--make them more cost-effective than traditional gauze dressings in pressure ulcer management.

Comprehensive In Situ Killing of Six Common Wound Pathogens With Manuka Honey Dressings Using a Modified AATCC-TM100.

PubMed

Watson, Denis; Bergquist, Stephen; Nicholson, Julie; Norrie, David H

2017-06-28

While Manuka honey in vitro is strongly antimicrobial, there have been, to the best of the authors' knowledge, no studies showing that dressings impregnated with Manuka honey can kill organisms in the dressing itself. The investigators used the American Association of Textile Chemists and Colorists' 100 test methodology to compare honey-impregnated dressings with control dressings (without honey) on the ability to kill common wound pathogens. Organisms were chosen after a review of the causal organisms found in actual wound infections over a 12-month period in a busy outpatient wound clinic. Even when the dressings were challenged daily with further inoculated organisms, > 5-log reductions were routinely noted across a range of pathogens, including multiple drug-resistant species using dressings containing Manuka honey relative to the control. The results presented herein show that when well-characterized medical-grade Manuka honey is used in dressings (ie, a minimum of 400 mg methylglyoxal/kg) these dressings can comprehensively kill common wound pathogens associated with infected wounds.

An Assistive Technology System that Provides Personalized Dressing Support for People Living with Dementia: Capability Study

PubMed Central

Lozano, Cecil; Ravishankar, Vijay; Lee, Jisoo; Mahoney, Diane

2018-01-01

Background Individuals living with advancing stages of dementia (persons with dementia, PWDs) or other cognitive disorders do not have the luxury of remembering how to perform basic day-to-day activities, which in turn makes them increasingly dependent on the assistance of caregivers. Dressing is one of the most common and stressful activities provided by caregivers because of its complexity and privacy challenges posed during the process. Objective In preparation for in-home trials with PWDs, the aim of this study was to develop and evaluate a prototype intelligent system, the DRESS prototype, to assess its ability to provide automated assistance with dressing that can afford independence and privacy to individual PWDs and potentially provide additional freedom to their caregivers (family members and professionals). Methods This laboratory study evaluated the DRESS prototype’s capacity to detect dressing events. These events were engaged in by 11 healthy participants simulating common correct and incorrect dressing scenarios. The events ranged from donning a shirt and pants inside out or backwards to partial dressing—typical issues that challenge a PWD and their caregivers. Results A set of expected detections for correct dressing was prepared via video analysis of all participants’ dressing behaviors. In the initial phases of donning either shirts or pants, the DRESS prototype missed only 4 out of 388 expected detections. The prototype’s ability to recognize other missing detections varied across conditions. There were also some unexpected detections such as detection of the inside of a shirt as it was being put on. Throughout the study, detection of dressing events was adversely affected by the relatively smaller effective size of the markers at greater distances. Although the DRESS prototype incorrectly identified 10 of 22 cases for shirts, the prototype preformed significantly better for pants, incorrectly identifying only 5 of 22 cases. Further analyses identified opportunities to improve the DRESS prototype’s reliability, including increasing the size of markers, minimizing garment folding or occlusions, and optimal positioning of participants with respect to the DRESS prototype. Conclusions This study demonstrates the ability to detect clothing orientation and position and infer current state of dressing using a combination of sensors, intelligent software, and barcode tracking. With improvements identified by this study, the DRESS prototype has the potential to provide a viable option to provide automated dressing support to assist PWDs in maintaining their independence and privacy, while potentially providing their caregivers with the much-needed respite. PMID:29716885

SU-G-TeP1-01: A Simulation Study to Investigate Maximum Allowable Deformations of Implant Geometry Before Plan Objectives Are Violated in Prostate HDR Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Babier, A; Joshi, C; Cancer Center of Southeastern Ontario, Kingston General Hospital, Kingston, Ontario

Purpose: In prostate HDR brachytherapy dose distributions are highly sensitive to changes in prostate volume and catheter displacements. We investigate the maximum deformations in implant geometry before planning objectives are violated. Methods: A typical prostate Ir-192 HDR brachytherapy reference plan was calculated on the Oncentra planning system, which used CT images from a tissue equivalent prostate phantom (CIRS Model 053S) embedded inside a pelvis wax phantom. The prostate was deformed and catheters were displaced in simulations using a code written in MATLAB. For each deformation dose distributions were calculated, based on TG43 methods, using the MATLAB code. The calculations weremore » validated through comparison with Oncentra calculations for the reference plan, and agreed within 0.12%SD and 0.3%SD for dose and volume, respectively. Isotropic prostate volume deformations of up to +34% to −27% relative to its original volume, and longitudinal catheter displacements of 7.5 mm in superior and inferior directions were simulated. Planning objectives were based on American Brachytherapy Society guidelines for prostate and urethra volumes. A plan violated the planning objectives when less than 90% of the prostate volume received the prescribed dose or higher (V{sub 100}), or the urethral volume receiving 125% of prescribed dose or higher was more than 1 cc (U{sub 125}). Lastly, the dose homogeneity index (DHI=1-V{sub 150}/V{sub 100}) was evaluated; a plan was considered sub-optimal when the DHI fell below 0.62. Results and Conclusion: Planning objectives were violated when the prostate expanded by 10.7±0.5% or contracted by 11.0±0.2%; objectives were also violated when catheters were displaced by 4.15±0.15 mm and 3.70±0.15 mm in the superior and inferior directions, respectively. The DHI changes did not affect the plan optimality, except in the case of prostate compression. In general, catheter displacements have a significantly larger impact on plan optimality than prostate volume changes.« less

Effects of adhesive dressings on stratum corneum conductance.

PubMed

Cavallini, Maurizio; Gazzola, Riccardo; Vaienti, Luca

2012-05-01

Stratum corneum is a fundamental layer of epidermis. It acts as a barrier, with antimicrobial features, regulating skin permeability and integrity as well. Adhesive dressings and their removal could alter this layer, affecting cutaneous water balance and lipid composition of stratum corneum. These changes could be monitored by measurement of cutaneous hydration. Ninety-two patients affected by wounds dressed with adhesive tapes or plasters have been studied. Measurement of skin conductance under tape/plaster and in the surrounding healthy skin, immediately after removal of dressing has been performed. Dressing age, wound localization, and characteristics were also considered. Adhesive dressings alter significantly stratum corneum conductance. Although healthy skin hydration has significant variations throughout the body, cutaneous conductance under adhesive dressing in different areas displays no significative changes. Moreover, the increase in hydration due to adhesive tapes/plasters showed no association with wound dehiscence. Adhesive dressings cause a significative increase in stratum corneum conductance, acting as a barrier to apocrine secretions. Although different hydration levels have been observed in healthy skin throughout the body, no difference exists under adhesive dressing among different regions, suggesting no contraindications in their employment throughout the body. Increase in cutaneous hydration showed no correlations with wound dehiscence, thus confirming safety and practicality of these dressings. © 2011 John Wiley & Sons A/S.

Dressed for success? Silver impregnated nanocrystalline dressing for initial treatment of giant omphalocele.

PubMed

Percy, Dean B; Haddock, Candace; Ma, Vivian; Nowak, Amie; Panczuk, Julia; Butterworth, Sonia

2018-05-01

The purpose of this study was to describe outcomes and resource utilization in patients treated with twice-weekly silver impregnated (SI) nanocrystalline dressings for initial non-operative management of giant omphalocele (GO). A retrospective review of patients with GO treated with SI dressings was undertaken. Clinical parameters, cost, and complications were recorded. Five patients with GO were treated with SI dressings between 2014 and 2016. Clinical characteristic (mean ± SD) included gestational age 36 ± 4 weeks, birth weight 2.6 ± 0.63 kg, GO size 10.2 ± 4.7 cm, ventilator days 7.5 ± 8.7 d, days in NICU 41 ± 20 d, days to full feeds, 30 ± 15 d, and LOS 62 ± 41 d. The average in-hospital cost of SI dressings was $110 CAD/week. This is comparable to daily silver sulfadiazine dressings ($109CAD/week) which were used historically. All patients were discharged with once- or twice-weekly dressing changes. No ruptures occurred. There was one mortality secondary to pulmonary sepsis. For initial non-operative management of GO, twice weekly SI nanocrystalline dressings is safe and effective. Use of SI dressings results in decreased handling of infants, reduced physician and nursing resource utilization, and favourable outcomes. IV (Retrospective Case Series). Copyright © 2018. Published by Elsevier Inc.

The Effect of Virtual Reality Distraction on Pain Relief During Dressing Changes in Children with Chronic Wounds on Lower Limbs.

PubMed

Hua, Yun; Qiu, Rong; Yao, Wen-Yan; Zhang, Qin; Chen, Xiao-Li

2015-10-01

It has been demonstrated that patients with chronic wounds experience the most pain during dressing changes. Currently, researchers focus mostly on analgesics and appropriate dressing materials to relieve pain during dressing changes of chronic wounds. However, the effect of nonpharmacologic interventions, such as virtual reality distraction, on pain management during dressing changes of pediatric chronic wounds remains poorly understood. To investigate the effect of virtual reality distraction on alleviating pain during dressing changes in children with chronic wounds on their lower limbs. A prospective randomized study. A pediatric center in a tertiary hospital. Sixty-five children, aged from 4 to 16 years, with chronic wounds on their lower limbs. Pain and anxiety scores during dressing changes were recorded by using the Wong-Baker Faces picture scale, visual analogue scale, and pain behavior scale, as well as physiological measurements including pulse rate and oxygen saturation. Time length of dressing change was recorded. Virtual reality distraction significantly relieved pain and anxiety scores during dressing changes and reduced the time length for dressing changes as compared to standard distraction methods. The use of virtual reality as a distraction tool in a pediatric ward offered superior pain reduction to children as compared to standard distractions. This device can potentially improve clinical efficiency by reducing length time for dressing changes. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Applying of Decision Tree Analysis to Risk Factors Associated with Pressure Ulcers in Long-Term Care Facilities.

PubMed

Moon, Mikyung; Lee, Soo-Kyoung

2017-01-01

The purpose of this study was to use decision tree analysis to explore the factors associated with pressure ulcers (PUs) among elderly people admitted to Korean long-term care facilities. The data were extracted from the 2014 National Inpatient Sample (NIS)-data of Health Insurance Review and Assessment Service (HIRA). A MapReduce-based program was implemented to join and filter 5 tables of the NIS. The outcome predicted by the decision tree model was the prevalence of PUs as defined by the Korean Standard Classification of Disease-7 (KCD-7; code L89 * ). Using R 3.3.1, a decision tree was generated with the finalized 15,856 cases and 830 variables. The decision tree displayed 15 subgroups with 8 variables showing 0.804 accuracy, 0.820 sensitivity, and 0.787 specificity. The most significant primary predictor of PUs was length of stay less than 0.5 day. Other predictors were the presence of an infectious wound dressing, followed by having diagnoses numbering less than 3.5 and the presence of a simple dressing. Among diagnoses, "injuries to the hip and thigh" was the top predictor ranking 5th overall. Total hospital cost exceeding 2,200,000 Korean won (US $2,000) rounded out the top 7. These results support previous studies that showed length of stay, comorbidity, and total hospital cost were associated with PUs. Moreover, wound dressings were commonly used to treat PUs. They also show that machine learning, such as a decision tree, could effectively predict PUs using big data.

Test Particle Simulations of Electron Injection by the Bursty Bulk Flows (BBFs) using High Resolution Lyon-Feddor-Mobarry (LFM) Code

NASA Astrophysics Data System (ADS)

Eshetu, W. W.; Lyon, J.; Wiltberger, M. J.; Hudson, M. K.

2017-12-01

Test particle simulations of electron injection by the bursty bulk flows (BBFs) have been done using a test particle tracer code [1], and the output fields of the Lyon-Feddor-Mobarry global magnetohydro- dynamics (MHD) code[2]. The MHD code was run with high resolu- tion (oct resolution), and with specified solar wind conditions so as to reproduce the observed qualitative picture of the BBFs [3]. Test par- ticles were injected so that they interact with earthward propagating BBFs. The result of the simulation shows that electrons are pushed ahead of the BBFs and accelerated into the inner magnetosphere. Once electrons are in the inner magnetosphere they are further energized by drift resonance with the azimuthal electric field. In addition pitch angle scattering of electrons resulting in the violation conservation of the first adiabatic invariant has been observed. The violation of the first adiabatic invariant occurs as electrons cross a weak magnetic field region with a strong gradient of the field perturbed by the BBFs. References 1. Kress, B. T., Hudson,M. K., Looper, M. D. , Albert, J., Lyon, J. G., and Goodrich, C. C. (2007), Global MHD test particle simulations of ¿ 10 MeV radiation belt electrons during storm sudden commencement, J. Geophys. Res., 112, A09215, doi:10.1029/2006JA012218. Lyon,J. G., Fedder, J. A., and Mobarry, C.M., The Lyon- Fedder-Mobarry (LFM) Global MHD Magnetospheric Simulation Code (2004), J. Atm. And Solar-Terrestrial Phys., 66, Issue 15-16, 1333- 1350,doi:10.1016/j.jastp. Wiltberger, Merkin, M., Lyon, J. G., and Ohtani, S. (2015), High-resolution global magnetohydrodynamic simulation of bursty bulk flows, J. Geophys. Res. Space Physics, 120, 45554566, doi:10.1002/2015JA021080.

Compliance status of product labels to the international code on marketing of breast milk substitutes.

PubMed

Ergin, Ahmet; Hatipoğlu, Celile; Bozkurt, Ali Ihsan; Erdoğan, Aslı; Güler, Serdar; Ince, Gülberat; Kavurgacı, Nuran; Oz, Ahmet; Yeniay, Mustafa K

2013-01-01

The aim of this study was to determine the compliance status of product labels regarding Article 9 of the International Code on Marketing of Breast-milk Substitutes (the Code) in Denizli province, Turkey. A cross-sectional study design was employed to determine the compliance status. The product labels were obtained from a convenience sample of five supermarkets, one store and 5 pharmacies in the City centre and district of Honaz. Using a data collection form prepared by previously published studies, data were collected between July 26, 2010 and August 06, 2010. Data collection form included 13 criteria. In addition, we checked the boxes for the availability of a Turkish written label. Forty product labels of 7 companies were reached and evaluated. These products consisted of 83.0% of the products marketed by these companies in Turkey. Thirty seven (92.5%) of the labels violated Article 9 of the Code in terms of one or more criteria. Thirty four (85.0%) of the labels had photos or pictures idealizing the use of infant formula. Nine (22.5%) had a photo, a picture or any representation of an infant, and five (12.5%) had text which idealize the use of infant formula or discouraging breastfeeding. Eight (20%) did not state that breastfeeding is the best. Four (10%) had a term such as 'similar to breast milk or human milk'. In conclusion, the majority of the product labels of breast milk substitutes marketed in our country violate the Code. It is appropriate that the Turkish Ministry of Health, medical organizations, companies, and NGOs work more actively to increase awareness of this issue.

An Inexpensive Bismuth-Petrolatum Dressing for Treatment of Burns

PubMed Central

Chattopadhyay, Arhana; Chang, Kathleen; Nguyen, Khoa; Galvez, Michael G.; Legrand, Anais; Davis, Christopher; McGoldrick, Rory; Long, Chao; Pham, Hung

2016-01-01

Background: Xeroform remains the current standard for treating superficial partial-thickness burns but can be prohibitively expensive in developing countries with prevalent burn injuries. This study (1) describes the production of an alternative low-cost dressing and (2) compares the alternative dressing and Xeroform using the metrics of cost-effectiveness, antimicrobial activity, and biocompatibility in vitro, and wound healing in vivo. Methods: To produce the alternative dressing, 3% bismuth tribromophenate powder was combined with petroleum jelly by hand and applied to Kerlix gauze. To assess cost-effectiveness, the unit costs of Xeroform and components of the alternative dressing were compared. To assess antimicrobial properties, the dressings were placed on agar plated with Escherichia coli and the Kirby-Bauer assay performed. To assess biocompatibility, the dressings were incubated with human dermal fibroblasts and cells stained with methylene blue. To assess in vivo wound healing, dressings were applied to excisional wounds on rats and the rate of re-epithelialization calculated. Results: The alternative dressing costs 34% of the least expensive brand of Xeroform. Antimicrobial assays showed that both dressings had similar bacteriostatic effects. Biocompatibility assays showed that there was no statistical difference (P < 0.05) in the cytotoxicity of Xeroform, alternative dressing, and Kerlix gauze. Finally, the in vivo healing model showed no statistical difference (P < 0.05) in mean re-epithelialization time between Xeroform (13.0 ± 1.6 days) and alternative dressing (13.5 ± 1.0 days). Conclusions: Xeroform is biocompatible, reduces infection, and enhances healing of burn wounds by preventing desiccation and mechanical trauma. Handmade petrolatum gauze may be a low-cost replacement for Xeroform. Future studies will focus on clinical trials in burn units. PMID:27482485

Cost-effectiveness Analysis of Silver Delivery Approaches in the Management of Partial-thickness Burns.

PubMed

Nherera, Leo; Trueman, Paul; Roberts, Christopher; Berg, Leena

2018-02-23

Burn injury is a common type of traumatic injury that causes considerable morbidity and mortality, resulting in about 30,000 admissions annually in specialist burn centers and costing around $1 billion per year in the United States. One percent silver sulfadiazine has been utilized widely in the management of burns and newer silver dressings are on the market, including nanocrystalline silver dressings, silver-impregnated hydrofiber dressings, and silver-impregnated foam dressings. This study sought to determine the cost effectiveness of the newer silver dressings using clinical data from an indirect treatment comparison using silver sulfadiazine as the baseline. A decision analytic model was developed from a US payer's perspective for burn patients with a total body surface area of < 20%. Outcomes were length of stay, infections and incidence of surgical procedures, quality adjusted life years (QALYs), and cost. The meta-analysis reported a statistically significant reduction in length of hospital stay and clinically important reductions in infections and incidence of surgical procedures in favor of the silver barrier dressing compared with other silver dressings. The estimated QALYs were 0.970 versus 0.969 versus 0.969 and mean cost per patient was $15,892, $23,799, and $24,269 for the nanocrystalline silver dressing, silver-impregnated hydrofiber dressing, and silver-impregnated foam dressing, respectively. The analysis showed the nanocrystalline silver dressing to be a dominant strategy (less costly with better outcomes). These findings were robust to a range of sensitivity analyses. According to data from an indirect treatment comparison, this analysis suggests that nanocrystalline silver dressing is the most cost-effective silver delivery system. Prospective head-to-head research on the costs and outcomes of these silver delivery systems in this patient population is necessary to validate the results of this economic evaluation.

Comparison of three different dressings for partial thickness burns in children: study protocol for a randomised controlled trial.

PubMed

Gee Kee, Emma; Kimble, Roy M; Cuttle, Leila; Stockton, Kellie

2013-11-25

In the paediatric population, pain and distress associated with burn injuries during wound care procedures remain a constant challenge. Although silver dressings are the gold standard for burn care in Australasia, very few high-level trials have been conducted that compare silver dressings to determine which will provide the best level of care clinically. Therefore, for paediatric patients in particular, identifying silver dressings that are associated with lower levels of pain and rapid wound re-epithelialisation is imperative. This study will determine whether there is a difference in time to re-epithelialisation and pain and distress experienced during wound care procedures among Acticoat™, Acticoat™ combined with Mepitel™ and Mepilex Ag™ dressings for acute, paediatric partial thickness burns. Children aged 0 to 15 years with an acute partial thickness (superficial partial to deep partial thickness inclusive) burn injury and a burn total body surface area of ≤ 10% will be eligible for the trial. Patients will be randomised to one of the three dressing groups: (1) Acticoat™ or (2) Acticoat™ combined with Mepitel™ or (3) Mepilex Ag™. A minimum of 28 participants will be recruited for each treatment group. Primary measures of pain, distress and healing will be repeated at each dressing change until complete wound re-epithelialisation occurs or skin grafting is required. Additional data collected will include infection status at each dressing change, physical function, scar outcome and scar management requirements, cost effectiveness of each dressing and staff perspectives of the dressings. The results of this study will determine the effects of three commonly used silver and silicone burn dressing combinations on the rate of wound re-epithelialisation and pain experienced during dressing procedures in acute, paediatric partial thickness burn injuries. Australian New Zealand Clinical Trials Registry ACTRN12613000105741.

Prospective randomized controlled trial: fibrin sealant reduces split skin graft donor-site pain.

PubMed

Healy, Ciaran; Greig, Aina V H; Murphy, Adrian D; Powell, Christopher; Pinder, Richard J; Saour, Samer; Abela, Christopher; Knight, William; Geh, Jenny L C

2013-07-01

Pain at split skin graft donor sites is common. Fibrin sealant has been demonstrated to reduce time to hemostasis at wound sites, and patients receiving this treatment were incidentally noted to report less pain. This study aimed to evaluate pain and incapacity in split skin graft donor sites treated with and without fibrin sealant. Fifty patients requiring thigh donor-site split skin grafts were prospectively randomized to receive either a self-adhesive fabric dressing alone or fibrin sealant plus the self-adhesive fabric dressing as primary donor-site dressings. External secondary dressings were the same. Patients were blinded with regard to treatment group. Using visual analogue scales (scored 0 to 5), patients rated their donor-site pain and incapacity for 14 days postoperatively. Secondary endpoints were length of hospital stay and duration of requirement for dressings. Forty patients were included in the study analysis and completed self-reported pain and incapacity scores. Twenty received the fibrin sealant plus self-adhesive fabric dressing and 20 received the fabric dressing only (controls). Patients using the fibrin sealant plus the dressing reported significantly less pain (mean score, 0.42 versus 1.60, p < 0.001) and significantly less incapacity (mean score, 0.48 versus 1.71, p < 0.001). Patients allocated to the fibrin sealant group recorded shorter lengths of stay and faster time to discontinuation of dressing, though statistical significance was not achieved. Patients whose split skin graft donor sites were dressed with fibrin sealant plus self-adhesive fabric dressing experienced significantly less pain and incapacity than patients with self-adhesive fabric dressings alone, allowing a more rapid return to normal activity. Therapeutic, II.

The C2HDM revisited

NASA Astrophysics Data System (ADS)

Fontes, Duarte; Mühlleitner, Margarete; Romão, Jorge C.; Santos, Rui; Silva, João P.; Wittbrodt, Jonas

2018-02-01

The complex two-Higgs doublet model is one of the simplest ways to extend the scalar sector of the Standard Model to include a new source of CP-violation. The model has been used as a benchmark model to search for CP-violation at the LHC and as a possible explanation for the matter-antimatter asymmetry of the Universe. In this work, we re-analyse in full detail the softly broken ℤ 2 symmetric complex two-Higgs doublet model (C2HDM). We provide the code C2HDM_HDECAY implementing the C2HDM in the well-known HDECAY program which calculates the decay widths including the state-of-the-art higher order QCD corrections and the relevant off-shell decays. Using C2HDM_HDECAY together with the most relevant theoretical and experimental constraints, including electric dipole moments (EDMs), we review the parameter space of the model and discuss its phenomenology. In particular, we find cases where large CP-odd couplings to fermions are still allowed and provide benchmark points for these scenarios. We examine the prospects of discovering CP-violation at the LHC and show how theoretically motivated measures of CP-violation correlate with observables.

TWANG-PIC, a novel gyro-averaged one-dimensional particle-in-cell code for interpretation of gyrotron experiments

NASA Astrophysics Data System (ADS)

Braunmueller, F.; Tran, T. M.; Vuillemin, Q.; Alberti, S.; Genoud, J.; Hogge, J.-Ph.; Tran, M. Q.

2015-06-01

A new gyrotron simulation code for simulating the beam-wave interaction using a monomode time-dependent self-consistent model is presented. The new code TWANG-PIC is derived from the trajectory-based code TWANG by describing the electron motion in a gyro-averaged one-dimensional Particle-In-Cell (PIC) approach. In comparison to common PIC-codes, it is distinguished by its computation speed, which makes its use in parameter scans and in experiment interpretation possible. A benchmark of the new code is presented as well as a comparative study between the two codes. This study shows that the inclusion of a time-dependence in the electron equations, as it is the case in the PIC-approach, is mandatory for simulating any kind of non-stationary oscillations in gyrotrons. Finally, the new code is compared with experimental results and some implications of the violated model assumptions in the TWANG code are disclosed for a gyrotron experiment in which non-stationary regimes have been observed and for a critical case that is of interest in high power gyrotron development.

TWANG-PIC, a novel gyro-averaged one-dimensional particle-in-cell code for interpretation of gyrotron experiments

DOE Office of Scientific and Technical Information (OSTI.GOV)

Braunmueller, F., E-mail: falk.braunmueller@epfl.ch; Tran, T. M.; Alberti, S.

A new gyrotron simulation code for simulating the beam-wave interaction using a monomode time-dependent self-consistent model is presented. The new code TWANG-PIC is derived from the trajectory-based code TWANG by describing the electron motion in a gyro-averaged one-dimensional Particle-In-Cell (PIC) approach. In comparison to common PIC-codes, it is distinguished by its computation speed, which makes its use in parameter scans and in experiment interpretation possible. A benchmark of the new code is presented as well as a comparative study between the two codes. This study shows that the inclusion of a time-dependence in the electron equations, as it is themore » case in the PIC-approach, is mandatory for simulating any kind of non-stationary oscillations in gyrotrons. Finally, the new code is compared with experimental results and some implications of the violated model assumptions in the TWANG code are disclosed for a gyrotron experiment in which non-stationary regimes have been observed and for a critical case that is of interest in high power gyrotron development.« less

Investigation of adhesion of modern wound dressings: a comparative analysis of 56 different wound dressings.

PubMed

Klode, J; Schöttler, L; Stoffels, I; Körber, A; Schadendorf, D; Dissemond, J

2011-08-01

In the process of chronic wound care, adhesive wound dressings may cause pain and injury in the wound environment during dressing changes. At present, no standardized test procedures are available for the investigation of adhesion of wound dressings. Therefore, our study aimed to test the adhesion of different wound dressings on steel as well as on healthy skin. Within an open, comparative study, the adhesive areas of 56 wound dressings were investigated. The adhesives were categorized into acrylate (n = 23), silicone (n = 9), hydrocolloid (n = 17) and polyurethane groups (n = 7). Using an especially modified testing machine, the adhesion of the wound dressings was measured on steel as well as on the skin of healthy study participants, in compliance with the European EN 1939:2003 standard. The energy required to remove the wound dressings from human skin, was measured in Newton (N) and the following median values were obtained: hydrocolloid (2.25 N) > acrylate (1.14 N) > polyurethane (0.9 N) > silicone (0.7 N). The subjective pain intensity during the removal of the wound dressings was recorded using the visual analogue scale (VAS) with values ranging from 0 to 10. For hydrocolloid, it was 6.8, for acrylate 4.9, for polyurethane 3.1 and for silicone 2.5 points VAS. In comparison with human skin, the adhesion of wound dressings was significantly higher on steel (P < 0.0001), but was different for the different groups of wound dressings. Moreover, there was a statistically significant correlation between the adhesion and pain intensity (correlation coefficient 0.806; P = 0.01). The knowledge about the widely differing adhesion properties of different wound dressings on the skin of patients should nowadays be considered during the individual selection of the applied products. Based on these data, different types of wound dressings could be developed, guaranteeing a good adhesion and a low traumatic risk when removed. © 2010 The Authors. Journal of the European Academy of Dermatology and Venereology © 2010 European Academy of Dermatology and Venereology.

Cerebral responses to local and global auditory novelty under general anesthesia

PubMed Central

Uhrig, Lynn; Janssen, David; Dehaene, Stanislas; Jarraya, Béchir

2017-01-01

Primate brains can detect a variety of unexpected deviations in auditory sequences. The local-global paradigm dissociates two hierarchical levels of auditory predictive coding by examining the brain responses to first-order (local) and second-order (global) sequence violations. Using the macaque model, we previously demonstrated that, in the awake state, local violations cause focal auditory responses while global violations activate a brain circuit comprising prefrontal, parietal and cingulate cortices. Here we used the same local-global auditory paradigm to clarify the encoding of the hierarchical auditory regularities in anesthetized monkeys and compared their brain responses to those obtained in the awake state as measured with fMRI. Both, propofol, a GABAA-agonist, and ketamine, an NMDA-antagonist, left intact or even enhanced the cortical response to auditory inputs. The local effect vanished during propofol anesthesia and shifted spatially during ketamine anesthesia compared with wakefulness. Under increasing levels of propofol, we observed a progressive disorganization of the global effect in prefrontal, parietal and cingulate cortices and its complete suppression under ketamine anesthesia. Anesthesia also suppressed thalamic activations to the global effect. These results suggest that anesthesia preserves initial auditory processing, but disturbs both short-term and long-term auditory predictive coding mechanisms. The disorganization of auditory novelty processing under anesthesia relates to a loss of thalamic responses to novelty and to a disruption of higher-order functional cortical networks in parietal, prefrontal and cingular cortices. PMID:27502046

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): A National Analysis of Data from 10-Year Post-marketing Surveillance.

PubMed

Renda, Francesca; Landoni, Giovanni; Bertini Malgarini, Renato; Assisi, Alessandro; Azzolini, Maria Luisa; Mucchetti, Marta; Pimpinella, Giuseppe; Pani, Luca

2015-12-01

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare, severe and potentially fatal cutaneous adverse drug reaction (the mortality rate is up to 10 %) associated with numerous and apparently heterogeneous drugs. The aetiology is unknown. To report Italian cases of DRESS over a 10-year period. We searched the National Pharmacovigilance Network (NPN) for the term 'drug reaction with eosinophilia and systemic symptoms' from 1 January 2004 to 1 January 2014, to identify all reports of DRESS. Each case was checked to avoid duplication. In the NPN, we identified 91 serious cases of DRESS: 68 were spontaneous, still-unpublished reports, while 23 additional cases were derived from screening of the scientific literature, performed by marketing authorization holders. Notably, the single common element linking all cases of DRESS was intake of a drug containing an aromatic ring. Thanks to the largest national DRESS case series ever reported, we were able to hypothesize, for the first time, that there is an association between use of drugs containing an aromatic ring in their chemical structure and DRESS. This might aid understanding of the aetiology of DRESS and facilitate diagnosis.

The multifunctional wound dressing with core-shell structured fibers prepared by coaxial electrospinning

NASA Astrophysics Data System (ADS)

Wei, Qilin; Xu, Feiyang; Xu, Xingjian; Geng, Xue; Ye, Lin; Zhang, Aiying; Feng, Zengguo

2016-06-01

The non-woven wound dressing with core-shell structured fibers was prepared by coaxial electrospinning. The polycaprolactone (PCL) was electrospun as the fiber's core to provide mechanical strength whereas collagen was fabricated into the shell in order to utilize its good biocompatibility. Simultaneously, the silver nanoparticles (Ag-NPs) as anti-bacterial agent were loaded in the shell whereas the vitamin A palmitate (VA) as healing-promoting drug was encapsulated in the core. Resulting from the fiber's core-shell structure, the VA released from the core and Ag-NPs present in the shell can endow the dressing both heal-promoting and anti-bacteria ability simultaneously, which can greatly enhance the dressing's clinical therapeutic effect. The dressing can maintain high swelling ratio of 190% for 3 d indicating its potential application as wet dressing. Furthermore, the dressing's anti-bacteria ability against Staphylococcus aureus was proved by in vitro anti-bacteria test. The in vitro drug release test showed the sustainable release of VA within 72 h, while the cell attachment showed L929 cells can well attach on the dressing indicating its good biocompatibility. In conclusion, the fabricated nanofibrous dressing possesses multiple functions to benefit wound healing and shows promising potential for clinical application.

A Randomized, Controlled Clinical Trial of Honey-Impregnated Dressing for Treating Diabetic Foot Ulcer.

PubMed

Imran, Muhammad; Hussain, Muhammad Barkaat; Baig, Mukhtiar

2015-10-01

To investigate the effect of Beri-honey-impregnated dressing on diabetic foot ulcer and compare it with normal saline dressing. A randomized, controlled trial. Sughra Shafi Medical Complex, Narowal, Pakistan and Bhatti International Trust (BIT) Hospital, Affiliated with Central Park Medical College, Lahore, from February 2006 to February 2010. Patients with Wagner's grade 1 and 2 ulcers were enrolled. Those patients were divided in two groups; group A (n=179) treated with honey dressing and group B (n=169) treated with normal saline dressing. Outcome measures were calculated in terms of proportion of wounds completely healed (primary outcome), wound healing time, and deterioration of wounds. Patients were followed-up for a maximum of 120 days. One hundred and thirty six wounds (75.97%) out of 179 were completely healed with honey dressing and 97 (57.39%) out of 169 wtih saline dressing (p=0.001). The median wound healing time was 18.00 (6 - 120) days (Median with IQR) in group A and 29.00 (7 - 120) days (Median with IQR) in group B (p < 0.001). The present results showed that honey is an effective dressing agent instead of conventional dressings, in treating patients of diabetic foot ulcer.

Complaints, complainants, and rulings regarding drug promotion in the United Kingdom and Sweden 2004-2012: a quantitative and qualitative study of pharmaceutical industry self-regulation.

PubMed

Zetterqvist, Anna V; Merlo, Juan; Mulinari, Shai

2015-02-01

In many European countries, medicines promotion is governed by voluntary codes of practice administered by the pharmaceutical industry under its own system of self-regulation. Involvement of industry organizations in policing promotion has been proposed to deter illicit conduct, but few detailed studies on self-regulation have been carried out to date. The objective of this study was to examine the evidence for promotion and self-regulation in the UK and Sweden, two countries frequently cited as examples of effective self-regulation. We performed a qualitative content analysis of documents outlining the constitutions and procedures of these two systems. We also gathered data from self-regulatory bodies on complaints, complainants, and rulings for the period 2004-2012. The qualitative analysis revealed similarities and differences between the countries. For example, self-regulatory bodies in both countries are required to actively monitor promotional items and impose sanctions on violating companies, but the range of sanctions is greater in the UK where companies may, for instance, be audited or publicly reprimanded. In total, Swedish and UK bodies ruled that 536 and 597 cases, respectively, were in breach, equating to an average of more than one case/week for each country. In Sweden, 430 (47%) complaints resulted from active monitoring, compared with only two complaints (0.2%) in the UK. In both countries, a majority of violations concerned misleading promotion. Charges incurred on companies averaged €447,000 and €765,000 per year in Sweden and the UK, respectively, equivalent to about 0.014% and 0.0051% of annual sales revenues, respectively. One hundred cases in the UK (17% of total cases in breach) and 101 (19%) in Sweden were highlighted as particularly serious. A total of 46 companies were ruled in breach of code for a serious offence at least once in the two countries combined (n = 36 in the UK; n = 27 in Sweden); seven companies were in serious violation more than ten times each. A qualitative content analysis of serious violations pertaining to diabetes drugs (UK, n = 15; Sweden, n = 6; 10% of serious violations) and urologics (UK, n = 6; Sweden, n = 13; 9%) revealed various types of violations: misleading claims (n = 23; 58%); failure to comply with undertakings (n = 9; 23%); pre-licensing (n = 7; 18%) or off-label promotion (n = 2; 5%); and promotion of prescription drugs to the public (n = 6; 15%). Violations that go undetected or unpunished by self-regulatory bodies are the main limitation of this study, since they are likely to lead to an underestimate of industry misconduct. The prevalence and severity of breaches testifies to a discrepancy between the ethical standard codified in industry Codes of Conduct and the actual conduct of the industry. We discuss regulatory reforms that may improve the quality of medicines information, such as pre-vetting and intensified active monitoring of promotion, along with larger fines, and giving greater publicity to rulings. But despite the importance of improving regulatory arrangements in an attempt to ensure unbiased medicines information, such efforts alone are insufficient because simply improving oversight and increasing penalties fail to address additional layers of industry bias.

Complaints, Complainants, and Rulings Regarding Drug Promotion in the United Kingdom and Sweden 2004–2012: A Quantitative and Qualitative Study of Pharmaceutical Industry Self-Regulation

PubMed Central

Zetterqvist, Anna V.; Merlo, Juan; Mulinari, Shai

2015-01-01

Background In many European countries, medicines promotion is governed by voluntary codes of practice administered by the pharmaceutical industry under its own system of self-regulation. Involvement of industry organizations in policing promotion has been proposed to deter illicit conduct, but few detailed studies on self-regulation have been carried out to date. The objective of this study was to examine the evidence for promotion and self-regulation in the UK and Sweden, two countries frequently cited as examples of effective self-regulation. Methods and Findings We performed a qualitative content analysis of documents outlining the constitutions and procedures of these two systems. We also gathered data from self-regulatory bodies on complaints, complainants, and rulings for the period 2004–2012. The qualitative analysis revealed similarities and differences between the countries. For example, self-regulatory bodies in both countries are required to actively monitor promotional items and impose sanctions on violating companies, but the range of sanctions is greater in the UK where companies may, for instance, be audited or publicly reprimanded. In total, Swedish and UK bodies ruled that 536 and 597 cases, respectively, were in breach, equating to an average of more than one case/week for each country. In Sweden, 430 (47%) complaints resulted from active monitoring, compared with only two complaints (0.2%) in the UK. In both countries, a majority of violations concerned misleading promotion. Charges incurred on companies averaged €447,000 and €765,000 per year in Sweden and the UK, respectively, equivalent to about 0.014% and 0.0051% of annual sales revenues, respectively. One hundred cases in the UK (17% of total cases in breach) and 101 (19%) in Sweden were highlighted as particularly serious. A total of 46 companies were ruled in breach of code for a serious offence at least once in the two countries combined (n = 36 in the UK; n = 27 in Sweden); seven companies were in serious violation more than ten times each. A qualitative content analysis of serious violations pertaining to diabetes drugs (UK, n = 15; Sweden, n = 6; 10% of serious violations) and urologics (UK, n = 6; Sweden, n = 13; 9%) revealed various types of violations: misleading claims (n = 23; 58%); failure to comply with undertakings (n = 9; 23%); pre-licensing (n = 7; 18%) or off-label promotion (n = 2; 5%); and promotion of prescription drugs to the public (n = 6; 15%). Violations that go undetected or unpunished by self-regulatory bodies are the main limitation of this study, since they are likely to lead to an underestimate of industry misconduct. Conclusions The prevalence and severity of breaches testifies to a discrepancy between the ethical standard codified in industry Codes of Conduct and the actual conduct of the industry. We discuss regulatory reforms that may improve the quality of medicines information, such as pre-vetting and intensified active monitoring of promotion, along with larger fines, and giving greater publicity to rulings. But despite the importance of improving regulatory arrangements in an attempt to ensure unbiased medicines information, such efforts alone are insufficient because simply improving oversight and increasing penalties fail to address additional layers of industry bias. PMID:25689460

21 CFR 169.150 - Salad dressing.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Salad dressing. 169.150 Section 169.150 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION FOOD DRESSINGS AND FLAVORINGS Requirements for Specific Standardized Food Dressings and Flavorings...

21 CFR 878.4020 - Occlusive wound dressing.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Occlusive wound dressing. 878.4020 Section 878...) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4020 Occlusive wound dressing. (a) Identification. An occlusive wound dressing is a nonresorbable, sterile or non-sterile device...

21 CFR 878.4020 - Occlusive wound dressing.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Occlusive wound dressing. 878.4020 Section 878...) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4020 Occlusive wound dressing. (a) Identification. An occlusive wound dressing is a nonresorbable, sterile or non-sterile device...

21 CFR 169.115 - French dressing.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 2 2011-04-01 2011-04-01 false French dressing. 169.115 Section 169.115 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION FOOD DRESSINGS AND FLAVORINGS Requirements for Specific Standardized Food Dressings and Flavorings...

21 CFR 169.150 - Salad dressing.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 2 2011-04-01 2011-04-01 false Salad dressing. 169.150 Section 169.150 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION FOOD DRESSINGS AND FLAVORINGS Requirements for Specific Standardized Food Dressings and Flavorings...

Houston man with AIDS loses job after co-workers vote to expel him.

PubMed

1995-03-10

An employee sued a [name removed] machine shop that held a companywide vote culminating in the firing of the employee because he had AIDS. The lawsuit contended that the employee was able to perform his duties at the shop and that the shop had violated the Texas Health and Safety Code by disclosing his AIDS illness to his co-workers without his consent. The Equal Employment Opportunity Commission (EEOC) found that all the evidence indicated that the sole reason for the employee's firing was due to his disability. It was also judged that the company had violated the employee's right to privacy by publicizing his HIV status.

Aquacel(®) Ag dressing versus Acticoat™ dressing in partial thickness burns: a prospective, randomized, controlled study in 100 patients. Part 1: burn wound healing.

PubMed

Verbelen, Jozef; Hoeksema, Henk; Heyneman, Alexander; Pirayesh, Ali; Monstrey, Stan

2014-05-01

Studies comparing contemporary silver dressings in burns are scarce. In a prospective, randomized, controlled study, counting 50 patients/research group, we compared two frequently used silver dressings, Acticoat™ and Aquacel(®) Ag, in the management of partial thickness burns with a predicted healing time between 7 and 21 days as assessed by laser Doppler imaging between 48 and 72h after burn. Variables investigated were related to baseline research group characteristics, wound healing, bacteriology, economics, nurse, and patient experience. Both research groups were comparably composed taking into account gender, age and burn characteristics. Similar results were obtained as to healing time and bacterial control with both silver dressings. A statistically significant difference in favor of the Aquacel(®) Ag dressing was found for average ease of use (p<0.001), average ease of application (p=0.001), patient pain (p<0.001), patient comfort with the dressing (p=0.017), silver staining (p<0.001), and cost effectiveness (p<0.001). Both silver dressings resulted in comparable healing times and bacterial control but the Aquacel(®) Ag dressing significantly increased comfort for patients as well as nurses and was significantly more cost-effective than the Acticoat™ dressing for the given indication. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

The wound-healing effects of a next-generation anti-biofilm silver Hydrofiber wound dressing on deep partial-thickness wounds using a porcine model.

PubMed

Davis, Stephen C; Li, Jie; Gil, Joel; Valdes, Jose; Solis, Michael; Higa, Alex; Bowler, Philip

2018-06-11

Topical antimicrobials are widely used to control wound bioburden and facilitate wound healing; however, the fine balance between antimicrobial efficacy and non-toxicity must be achieved. This study evaluated whether an anti-biofilm silver-containing wound dressing interfered with the normal healing process in non-contaminated deep partial thickness wounds. In an in-vivo porcine wound model using 2 pigs, 96 wounds were randomly assigned to 1 of 3 dressing groups: anti-biofilm silver Hydrofiber dressing (test), silver Hydrofiber dressing (control), or polyurethane film dressing (control). Wounds were investigated for 8 days, and wound biopsies (n = 4) were taken from each dressing group, per animal, on days 2, 4, 6, and 8 after wounding and evaluated using light microscopy. No statistically significant differences were observed in the rate of reepithelialisation, white blood cell infiltration, angiogenesis, or granulation tissue formation following application of the anti-biofilm silver Hydrofiber dressing versus the 2 control dressings. Overall, epithelial thickness was similar between groups. Some differences in infiltration of specific cell types were observed between groups. There were no signs of tissue necrosis, fibrosis, or fatty infiltration in any group. An anti-biofilm silver Hydrofiber wound dressing did not cause any notable interference with normal healing processes. © 2018 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

An Examination of Differences in Consequences of Punishment among PK-12 School Administrators

ERIC Educational Resources Information Center

Randle, Dawn DuBose

2010-01-01

The purpose of this study was to examine the differences in the administering of punishment procedures for violations of a school district's Code of Student Conduct among school-based administrators. Specifically, this study was concerned with the impact of the socio-demographic variables of: gender, years of administrative experience,…

48 CFR 3.703 - Authority.

Code of Federal Regulations, 2014 CFR

2014-10-01

...(e) of Pub. L. 87-849, 18 U.S.C. 218 (the Act), empowers the President or the heads of executive... bribery, conflict of interest, or any other violation of Chapter 11 of Title 18 of the United States Code (18 U.S.C. 201-224). Executive Order 12448, November 4, 1983, delegates the President's authority...

48 CFR 3.703 - Authority.

Code of Federal Regulations, 2013 CFR

2013-10-01

...(e) of Pub. L. 87-849, 18 U.S.C. 218 (the Act), empowers the President or the heads of executive... bribery, conflict of interest, or any other violation of Chapter 11 of Title 18 of the United States Code (18 U.S.C. 201-224). Executive Order 12448, November 4, 1983, delegates the President's authority...

48 CFR 3.703 - Authority.

Code of Federal Regulations, 2011 CFR

2011-10-01

...(e) of Pub. L. 87-849, 18 U.S.C. 218 (the Act), empowers the President or the heads of executive... bribery, conflict of interest, or any other violation of Chapter 11 of Title 18 of the United States Code (18 U.S.C. 201-224). Executive Order 12448, November 4, 1983, delegates the President's authority...

48 CFR 3.703 - Authority.

Code of Federal Regulations, 2012 CFR

2012-10-01

...(e) of Pub. L. 87-849, 18 U.S.C. 218 (the Act), empowers the President or the heads of executive... bribery, conflict of interest, or any other violation of Chapter 11 of Title 18 of the United States Code (18 U.S.C. 201-224). Executive Order 12448, November 4, 1983, delegates the President's authority...

The Rhetoric of Industrial Espionage: The Case of "Starwood v. Hilton"

ERIC Educational Resources Information Center

Jameson, Daphne A.

2011-01-01

When Starwood Hotels charged Hilton Hotels with industrial espionage, the case hinged on an employment agreement that two executives had violated. The rhetoric of the employment agreement contrasted greatly with that of the corporation's own code of business conduct. Whereas the private agreement stressed narrow self-interest, the public code…

28 CFR 31.303 - Substantive requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) of this section or pursuant to section 922(x) of title 18, United States Code (which prohibits the..., and Federal wards, but excluding Title 18 922(x) violators) and nonoffenders securely detained in any... court order provision or pursuant to title 18 U.S.C. section 922(x); (F) The total number of status...

40 CFR 144.28 - Requirements for Class I, II, and III wells authorized by rule.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (Bankruptcy) of the United States Code which names the owner or operator as debtor, within 10 business days... AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) UNDERGROUND INJECTION CONTROL PROGRAM Authorization of... requirements constitutes a violation of the Safe Drinking Water Act and is grounds for enforcement action...

40 CFR 144.28 - Requirements for Class I, II, and III wells authorized by rule.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (Bankruptcy) of the United States Code which names the owner or operator as debtor, within 10 business days... AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) UNDERGROUND INJECTION CONTROL PROGRAM Authorization of... requirements constitutes a violation of the Safe Drinking Water Act and is grounds for enforcement action...

40 CFR 144.28 - Requirements for Class I, II, and III wells authorized by rule.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (Bankruptcy) of the United States Code which names the owner or operator as debtor, within 10 business days... AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) UNDERGROUND INJECTION CONTROL PROGRAM Authorization of... requirements constitutes a violation of the Safe Drinking Water Act and is grounds for enforcement action...

Make Students Part of the Solution, Not the Problem

ERIC Educational Resources Information Center

Gardner, Trevor

2014-01-01

A California high school develops a Student Justice Panel to hear student concerns about violations of the student code, providing students with a way to not just have a voice but to effect change in how students are disciplined. Restorative justice gives students a feeling of fairness and responsibility for appropriate behavior. Restorative…

A prospective, randomized clinical trial to assess the cost-effectiveness of a modern foam dressing versus a traditional saline gauze dressing in the treatment of stage II pressure ulcers.

PubMed

Payne, Wyatt G; Posnett, John; Alvarez, Oscar; Brown-Etris, Marie; Jameson, Gayle; Wolcott, Randall; Dharma, Hussein; Hartwell, Samantha; Ochs, Diane

2009-02-01

Modern dressings such as hydrocolloids, gels, and foams are typically more expensive than traditional dressings such as gauze. However, if modern dressings require fewer changes, the overall cost of treatment may be lower despite the higher initial purchase price. If healing rates are comparable or better, modern dressings also may be cost-effective. A 4-week, prospective, randomized clinical trial to assess differences in treatment costs and cost-effectiveness between a modern foam dressing and saline-soaked gauze was conducted among 36 patients (22 men, 14 women, mean age 72.8 years) with a Stage II pressure ulcer (mean duration 35 weeks) at five centers in the United States. Participants were randomized to treatment with a self-adhesive polyurethane foam (n = 20) or saline-soaked gauze dressing (n = 16). No difference in time to wound closure was observed (P = 0.817). Patients in the foam group had less frequent dressing changes (P <0.001). Total cost over the study period was lower by $466 per patient (P = 0.055) and spending on dressings was lower by $92 per patient in the foam group (P = 0.025). Cost per ulcer healed was lower by $1,517 and cost per ulcer-free day was lower by $80 for patients in the foam group. On the evidence of this study, the foam dressing is a more cost-effective treatment than saline-soaked gauze for the treatment of Stage II pressure ulcers.

21 CFR 878.4018 - Hydrophilic wound dressing.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Hydrophilic wound dressing. 878.4018 Section 878...) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4018 Hydrophilic wound dressing. (a) Identification. A hydrophilic wound dressing is a sterile or non-sterile device intended to cover...

21 CFR 878.4018 - Hydrophilic wound dressing.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hydrophilic wound dressing. 878.4018 Section 878...) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4018 Hydrophilic wound dressing. (a) Identification. A hydrophilic wound dressing is a sterile or non-sterile device intended to cover...

21 CFR 878.4022 - Hydrogel wound dressing and burn dressing.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Hydrogel wound dressing and burn dressing. 878.4022 Section 878.4022 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4022...

21 CFR 878.4022 - Hydrogel wound dressing and burn dressing.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Hydrogel wound dressing and burn dressing. 878.4022 Section 878.4022 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4022...

21 CFR 878.4022 - Hydrogel wound dressing and burn dressing.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Hydrogel wound dressing and burn dressing. 878.4022 Section 878.4022 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4022...

Colloidal silver-based nanogel as nonocclusive dressing for multiple superficial pellet wounds.

PubMed

Dharmshaktu, Ganesh Singh; Singhal, Aanshu; Pangtey, Tanuja

2016-01-01

A good dressing is mandatory to an uncomplicated wound healing, especially when foreign particles contaminate the wound. Various forms of dressing preparations are available for use and differ in chemical composition and efficacy. Silver has been a known agent with good antimicrobial and healing properties and recent times has seen an upsurge in various silver-based dressing supplements. We describe our report of use and efficacy of a silver nanoparticle- based gel dressing in the healing of multiple superficial firearm pellet wounds.

Quantum Steering Inequality with Tolerance for Measurement-Setting Errors: Experimentally Feasible Signature of Unbounded Violation

NASA Astrophysics Data System (ADS)

Rutkowski, Adam; Buraczewski, Adam; Horodecki, Paweł; Stobińska, Magdalena

2017-01-01

Quantum steering is a relatively simple test for proving that the values of quantum-mechanical measurement outcomes come into being only in the act of measurement. By exploiting quantum correlations, Alice can influence—steer—Bob's physical system in a way that is impossible in classical mechanics, as shown by the violation of steering inequalities. Demonstrating this and similar quantum effects for systems of increasing size, approaching even the classical limit, is a long-standing challenging problem. Here, we prove an experimentally feasible unbounded violation of a steering inequality. We derive its universal form where tolerance for measurement-setting errors is explicitly built in by means of the Deutsch-Maassen-Uffink entropic uncertainty relation. Then, generalizing the mutual unbiasedness, we apply the inequality to the multisinglet and multiparticle bipartite Bell state. However, the method is general and opens the possibility of employing multiparticle bipartite steering for randomness certification and development of quantum technologies, e.g., random access codes.

Self adhesive dressing pouch for the protection of catheters.

PubMed

de la Cruz Martínez, Maria Teresa; Hernández, María José

2002-01-01

This paper is about a new model of dressing, used for the protection of all types of temporary and permanent catheters. Those who developed this dressing realised the practical difficulties during the placement and removal of traditional dressings, used in haemodialysis units. They also realised that it this was unpleasant for the patients, and there was a risk to the catheters when removing the dressings because of the use of scissors and other cutting instruments. This new dressing solves these previously mentioned problems and at the same time contributes to the comfort of the patients. The model has been registered as a standard using model, and therefore it is protected by law and its copyright (Intellectual Property).

Democratisation of AAC Symbol Choices Using Technology.

PubMed

Draffan, E A; Wald, Mike; Zeinoun, Nadine; Banes, David

2017-01-01

The use of an online voting system has been developed to enable democratic choices of newly designed symbols to support speech, language and literacy skills in a localisation situation. The system works for those using and supporting Augmentative and Alternative Communication (AAC) symbols on electronic systems by the provision of simplified scales of acceptance and adapted grids. The methodology and results highlighted the importance of user participation at the outset and concrete examples of symbol adaptations that were found necessary to ensure higher levels of user satisfaction. Design changes included appropriate local dress codes, linguistic nuances, social settings, the built environment and religious sensitivities.

Tunable electromagnetically induced transparency and absorption with dressed superconducting qubits

NASA Astrophysics Data System (ADS)

Ian, Hou; Liu, Yu-Xi; Nori, Franco

2010-06-01

Electromagnetically induced transparency and absorption (EIT and EIA) are usually demonstrated using three-level atomic systems. In contrast to the usual case, we theoretically study the EIT and EIA in an equivalent three-level system: a superconducting two-level system (qubit) dressed by a single-mode cavity field. In this equivalent system, we find that both the EIT and the EIA can be tuned by controlling the level-spacing of the superconducting qubit and hence controlling the dressed system. This tunability is due to the dressed relaxation and dephasing rates which vary parametrically with the level-spacing of the original qubit and thus affect the transition properties of the dressed qubit and the susceptibility. These dressed relaxation and dephasing rates characterize the reaction of the dressed qubit to an incident probe field. Using recent experimental data on superconducting qubits (charge, phase, and flux qubits) to demonstrate our approach, we show the possibility of experimentally realizing this proposal.

Impact of an absorbent silver-eluting dressing system on lower extremity revascularization wound complications.

PubMed

Childress, Beverly B; Berceli, Scott A; Nelson, Peter R; Lee, W Anthony; Ozaki, C Keith

2007-09-01

Surgical wounds for lower extremity revascularization are prone to infection and dehiscence. Acticoat Absorbent, an antimicrobial dressing, offers sustained release of ionic silver. We hypothesized that immediate application of Acticoat as a postoperative dressing would reduce wound complications in patients undergoing leg revascularization. All infrainguinal revascularization cases involving leg incisions at a single Veterans Administration Medical Center were identified from July 1, 2002, to September 30, 2005. The control group received conventional dressings, while the treatment group received an Acticoat dressing. Wound complication rates were captured via National Surgical Quality Improvement Program data. Patient characteristics and procedure distributions were similar between groups. The wound complication rate fell 64% with utilization of the Acticoat-based dressing (control 14% [17/118], treatment 5% [7/130]; P = 0.016). An Acticoat-based dressing system offers a potentially useful, cost-effective adjunct to reduce open surgical leg revascularization wound complications.

Dressing of Cognitively Impaired Nursing Home Residents: Description and Analysis

ERIC Educational Resources Information Center

Cohen-Mansfield, Jiska; Creedon, Michael A.; Malone, Thomas; Parpura-Gill, Aleksandra; Dakheel-Ali, Maha; Heasly, Christopher

2006-01-01

Purpose: Getting dressed is an activity that is of particular difficulty for many persons with dementia, given the need for hand-eye coordination, fine motor skills, and overall planning skills. Despite several studies concerning interventions to improve dressing behavior, very little is known about the dressing process as it is currently…

Women in relationships with cross-dressing men: a descriptive study from a nonclinical setting.

PubMed

Brown, G R

1994-10-01

Over a 6-year period, 106 women involved with men who cross-dress (mostly heterosexual transvestites) completed a questionnaire regarding themselves, their male partners, and their relationships. Interview data supplemented these questionnaires for 75% of the respondents. All respondents were recruited from nonclinical settings. The "modal" female partner was a 40-year-old Protestant, Caucasian woman, who was a firstborn child, in her first marriage. She was more likely than other women her age to be childless, and to have earned at least a 2-year college degree. She was no more likely to have had lesbian experiences or substance use problems than comparably aged American women. She had been married to her cross-dressing mate for 13 years and had known of his activities for 9 years. A quarter of women reported at least occasional sexual arousal to their mate's cross-dressing. The two variables associated with low acceptance of cross-dressing were discovery of their partner's cross-dressing after marriage and lack of sexual arousal to cross-dressing stimuli. Low acceptance was unrelated to firstborn status, amount of exposure to cross-dressing activities, or having had children. This group may be more representative of women in relationships with cross-dressing men than previous reports limited to cross-dressers and spouses who are in treatment.

Umbilical Negative Pressure Dressing for Transumbilical Appendectomy in Childern.

PubMed

Seifarth, Federico G; Kundu, Neilendu; Guerron, Alfredo D; Garland, Mary M; Gaffley, Michaela W G; Worley, Sarah; Knight, Colin G

2016-01-01

Transumbilical laparoscopic-assisted appendectomy (TULAA) carries a high risk for surgical site infection. We investigated the effect of a bio-occlusive umbilical vacuum dressing on wound infection rates after TULAA for patients with acute appendicitis and compared to it with a conventional 3-port appendectomy with a nonvacuum dressing. This study was a retrospective chart review of 1377 patients (2-20 years) undergoing laparoscopic appendectomy for acute appendicitis in 2 tertiary care referral centers from January 2007 through December 2012. Twenty-two different operative technique/dressing variations were documented. The 6 technique/dressing groups with >50 patients were assessed, including a total of 1283 patients. The surgical site infection rate of the 220 patients treated with TULAA and application of an umbilical vacuum dressing with dry gauze is 1.8% (95% CI, 0.0-10.3%). This compares to an infection rate of 4.1% (95% CI, 1.3-10.5%) in 97 patients with dry dressing without vacuum. In the 395 patients who received an umbilical vacuum dressing with gauze and bacitracin, the surgical site infection rate was found to be 4.3% (95% CI, 2.7-6.8%). Application of an umbilical negative-pressure dressing with dry gauze lowers the rate of umbilical site infections in patients undergoing transumbilical laparoscopic-assisted appendectomy for acute appendicitis.

Human neutrophil elastase and collagenase sequestration with phosphorylated cotton wound dressings.

PubMed

Edwards, J Vincent; Howley, Phyllis S

2007-11-01

The design and preparation of wound dressings that redress the protease imbalance in chronic wounds is an important goal of wound healing and medical materials science. Chronic wounds contain high levels of tissue and cytokine-destroying proteases including matrix metalloprotease and neutrophil elastase. Thus, the lowering of excessive protease levels in the wound environment by wound dressing sequestration prevents the breakdown of extracellular matrix proteins and growth factors necessary for wound healing. Phosphorylated cotton wound dressings were prepared to target sequestration of proteases from chronic wound exudate through a cationic uptake binding mechanism involving salt bridge formation of the positively charged amino acid side chains of proteases with the phosphate counterions of the wound dressing fiber. Dressings were prepared by applying sodium hexametaphosphate and diammonium phosphate in separate formulations to cotton gauze by pad/dry/cure methods. Phosphorylated cotton dressings were assessed for their ability to lower elastase and collagenase activity. The phosphorylated cotton dressings lowered elastase and collagenase activity 40-80% more effectively than the untreated cotton wound dressings under conditions that mimic chronic wound exudate. Efficacy of the phosphorylated cotton was found to be related to the level of phosphorylation and a lower pH due to protonated phosphate at the surface of the dressing. The capacity of the modified gauze to sequester continued elastase secretions similar to that found in a chronic wound over a 24-h period was retained within a 80% retention of elastase sequestration and was dose-dependent. Copyright (c) 2007 Wiley Periodicals, Inc.

Analysis of the Pressure Distribution Qualities of a Silicone Border Foam Dressing.

PubMed

Miller, Stephannie K; Sharma, Neal; Aberegg, Lauren C; Blasiole, Kimberly N; Fulton, Judith A

2015-01-01

To determine whether application of a silicone foam dressing is associated with decreased interface pressures when applied to the heel. Prospective, within-subjects design. The study was conducted in a community-based hospital using a convenience sample of 50 healthy volunteers with a mean age of 39.6 years and mean body mass index of 26.6; 70% were female. Application of the silicone border foam dressing was randomized between the left and right heels. Participants were asked to lie down in the supine position on a viscoelastic foam mattress. Interface pressure measurements were captured using a pressure mapping system; measurements were taken once with the dressing applied to the heel (intervention map) and once without (control map). Data were captured after a 4-minute time period allowing stabilization. Analysis was based on mean interface pressure; data points were collected for both heels in each of the 2 frames, yielding 4 observations per subject. Application of the dressing was associated with a significant decrease in average pressure measurements as compared to the heel with no dressing applied (P < .001). Application of the dressing did not impact pressure readings for the heel to which no dressing was applied (P = .53), and application of the dressing to either the left or right heel did not impact pressure readings (ie, the random effect was insignificant; P = .9). Application of a silicone border foam dressing is associated with significant reduction in interface pressure and may be considered as part of a pressure ulcer prevention program.

Enhanced wound contraction in fresh wounds dressed with honey in Wistar rats (Rattus Novergicus).

PubMed

Osuagwu, F C; Oladejo, O W; Imosemi, I O; Aiku, A; Ekpos, O E; Salami, A A; Oyedele, O O; Akang, E U

2004-01-01

Due to reports that honey accelerates wound healing, an investigation on its role in wound contraction in fresh wounds inflicted on wistar rats was carried out. Twenty adult male wistar rats had 2cm by 2cm square wound inflicted on their right dorsolateral trunk. They were divided into two groups. The experimental group had their wounds dressed with honey while the control group had normal saline dressing. Wound dressing was done every five days and measurements taken at each dressing. Wound morphology was also assessed. Dressing with honey significantly enhanced percentage wound contraction on day 10 with value of 79.20+/-2.94 compared to control value of 53.50+/-4.32. p=0.0. The mean wound measurement on day 10 reduced significantly in honey group, 1.15+/-0.18 compared to control group 2.38+/-0.28. p=0.002. However, there was no significant difference in fibroblast count per high power field in honey group 68.0+/-2.59 compared to control 90.2+/-17.40, p=0.242. Honey dressing increased mean blood vessel count per high power field, 18.8+/-3.77 albeit non significantly when compared to control value of 13.4+/-2.44, p=0.264. Also honey dressing caused increased granulation tissue formation in wounds dressed with honey compared to control group. Our study suggests that honey dressing enhances wound contraction in fresh wounds which is one of the key features of wound healing.

Processing parameter optimization for the laser dressing of bronze-bonded diamond wheels

NASA Astrophysics Data System (ADS)

Deng, H.; Chen, G. Y.; Zhou, C.; Li, S. C.; Zhang, M. J.

2014-01-01

In this paper, a pulsed fiber-laser dressing method for bronze-bonded diamond wheels was studied systematically and comprehensively. The mechanisms for the laser dressing of bronze-bonded diamond wheels were theoretically analyzed, and the key processing parameters that determine the results of laser dressing, including the laser power density, pulse overlap ratio, ablation track line overlap ratio, and number of scanning cycles, were proposed for the first time. Further, the effects of these four key parameters on the oxidation-damaged layer of the material surface, the material removal efficiency, the material surface roughness, and the average protrusion height of the diamond grains were explored and summarized through pulsed laser ablation experiments. Under the current experimental conditions, the ideal values of the laser power density, pulse overlap ratio, ablation track line overlap ratio, and number of scanning cycles were determined to be 4.2 × 107 W/cm2, 30%, 30%, and 16, respectively. Pulsed laser dressing experiments were conducted on bronze-bonded diamond wheels using the optimized processing parameters; next, both the normal and tangential grinding forces produced by the dressed grinding wheel were measured while grinding alumina ceramic materials. The results revealed that the normal and tangential grinding forces produced by the laser-dressed grinding wheel during grinding were smaller than those of grinding wheels dressed using the conventional mechanical method, indicating that the pulsed laser dressing technology provides irreplaceable advantages relative to the conventional mechanical dressing method.

Clinical potential of a silk sericin-releasing bioactive wound dressing for the treatment of split-thickness skin graft donor sites.

PubMed

Siritientong, Tippawan; Angspatt, Apichai; Ratanavaraporn, Juthamas; Aramwit, Pornanong

2014-01-01

An ethyl alcohol-precipitated silk sericin/PVA scaffold that controlled the release of silk sericin was previously developed and applied for the treatment of full-thickness wounds in rats and demonstrated efficient healing. In this study, we aimed to further evaluate the clinical potential of this scaffold, hereafter called "silk sericin-releasing wound dressing", for the treatment of split-thickness skin graft donor sites by comparison with the clinically available wound dressing known as "Bactigras®". In vitro characterization and in vivo evaluation for safety of the wound dressings were performed. A clinical trial of the wound dressings was conducted according to standard protocols. The sericin released from the wound dressing was not toxic to HaCat human keratinocytes. A peel test indicated that the silk sericin-releasing wound dressing was less adhesive than Bactigras®, potentially reducing trauma and the risk of repeated injury upon removal. There was no evidence of skin irritation upon treatment with either wound dressing. When tested in patients with split-thickness skin graft donor sites, the wounds treated with the silk sericin-releasing wound dressing exhibited complete healing at 12 ± 5.0 days, whereas those treated with Bactigras® were completely healed at 14 ± 5.2 days (p = 1.99 × 10(-4)). In addition, treatment with the silk sericin-releasing wound dressing significantly reduced pain compared with Bactigras® particularly during the first 4 postoperative days (p = 2.70 × 10(-5) on day 1). We introduce this novel silk sericin-releasing wound dressing as an alternative treatment for split-thickness skin graft donor sites.

A model for quantitative evaluation of skin damage at adhesive wound dressing removal.

PubMed

Matsumura, Hajime; Ahmatjan, Niyaz; Ida, Yukiko; Imai, Ryutaro; Wanatabe, Katsueki

2013-06-01

The removal of adhesive wound dressings from the wound surface involves a risk of damaging the intact stratum corneum and regenerating epithelium. Pain associated with the removal of wound dressings is a major issue for patients and medical personnel. Recently, wound dressings coated with a silicone adhesive have been developed to reduce such skin damage and pain on removal and they have received good evaluation in various clinical settings. However, there is neither a standard method to quantify whether or not the integrity of the stratum corneum and regenerating epithelium is retained or if both structures are damaged by the removal of wound dressings, nor are there standardised values with which to assess skin damage. We applied six different types of adhesive wound dressing on plain copy paper printed with black ink by a laser printer, removed the dressings, examined the adhesive-coated surface of the wound dressings using a high-power videoscope, and examined the stripped areas. Wound dressings coated with a silicone adhesive showed significantly less detachment of the stratum corneum and regenerating epithelium, followed by those coated with polyurethane, hydrocolloid, and acrylic adhesives. The assessment method utilised in this study revealed distinct differences between wound dressing types, but less variation in the evaluation outcome of each type. This assessment method may be useful for the evaluation of adhesive wound dressings, particularly during product development. However, further studies will be needed to examine the effectiveness of this assessment method in the clinical setting because the adherent properties of polyurethane and hydrocolloid adhesives may be altered by the absorption of water from the skin. © 2012 The Authors. International Wound Journal © 2012 John Wiley & Sons Ltd and Medicalhelplines.com Inc.

Effect of different wound dressings on cell viability and proliferation.

PubMed

Paddle-Ledinek, Joanne E; Nasa, Zeyad; Cleland, Heather J

2006-06-01

Many new dressings have been developed since the early 1980s. Wound healing comprises cleansing, granulation/vascularization, and epithelialization phases. An optimum microenvironment and the absence of cytotoxic factors are essential for epithelialization. This study examines the effect of extracts of different wound dressings on keratinocyte survival and proliferation. Keratinocyte cultures were exposed for 40 hours to at least three extracts of each of the following wound dressings, which were tested in octuplicate: Acticoat, Aquacel-Ag, Aquacel, Algisite M, Avance, Comfeel Plus transparent, Contreet-H, Hydrasorb, and SeaSorb. Silicone extract provided the reference material. Controls were included of cells cultured in medium that had been incubated under conditions identical to those used with the extracts. Cell survival (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide reduction) and proliferation (5-bromo-2':-deoxyuridine incorporation) were measured. Extracts of silver-containing dressings (Acticoat, Aquacel-Ag, Contreet-H, and Avance) were most cytotoxic. Extracts of Hydrasorb were less cytotoxic but markedly affected keratinocyte proliferation and morphology. Extracts of alginate-containing dressings (Algisite M, SeaSorb, and Contreet-H) demonstrated high calcium concentrations, markedly reduced keratinocyte proliferation, and affected keratinocyte morphology. Extracts of Aquacel and Comfeel Plus transparent induced small but significant inhibition of keratinocyte proliferation. The principle of minimizing harm should be applied to the choice of wound dressing. Silver-based dressings are cytotoxic and should not be used in the absence of infection. Alginate dressings with high calcium content affect keratinocyte proliferation probably by triggering terminal differentiation of keratinocytes. Such dressings should be used with caution in cases in which keratinocyte proliferation is essential. All dressings should be tested in vitro before clinical application.

Role of natural polysaccharides in radiation formation of PVA hydrogel wound dressing

NASA Astrophysics Data System (ADS)

Varshney, Lalit

2007-02-01

Radiation processed PVA-polysaccharides hydrogels have been observed to be suitable for producing transparent, flexible, mechanically strong, biocompatible, effective and economical hydrogel dressings. The dressings were formed in single stage irradiation process achieving gel formation and sterilization at 25-30 kGy gamma radiation dose. No synthetic plasticizers and additives were used. Different formulations containing poly-vinylalcohol (PVA) and polysaccharides selected from combinations of agar and carrageenan were used to make the dressings. The selected polysaccharides themselves form thermo-reversible gels and degrade on irradiation. Using concentration of polysaccharides as low as 0.5-2% resulted in increase of tensile strength from 45 g/cm 2 to 411 g/cm 2, elongation from 30% to 410% and water uptake from 25% to 157% with respect to PVA gel without polysaccharides. Besides improving mechanical strength, agar contributes more to elongation and carrageenan to mechanical strength of the gel dressing. PVA formulations containing the polysaccharides show significantly different pre-gel viscosities behaviour. Increasing the concentration of agar in the formulation to about 2% converts the sheet gel to paste gel useful for filling wound cavities. The results indicate that pre irradiation network structure of the formulation plays an important role in determining mechanical properties of the irradiated gel dressing. Formulations containing 7-9% PVA, 0.5-1.5% carrageenan and 0.5-1% agar gave highly effective usable hydrogel dressings. Scanning electron micrographs show highly porous structure of the gel. Clinical trials of wound dressing on human patients established safety and efficacy of the dressing. The dressing has been observed to be useful in treating burns, non-healing ulcers of diabetes, leprosy and other external wounds. The dressings are now being marketed in India under different brand names.

A Pilot Randomized Controlled Trial of Novel Dressing and Securement Techniques in 101 Pediatric Patients.

PubMed

Kleidon, Tricia M; Ullman, Amanda J; Gibson, Victoria; Chaseling, Brett; Schoutrop, Jason; Mihala, Gabor; Rickard, Claire M

2017-11-01

To evaluate feasibility of an efficacy trial comparing peripherally inserted central catheter (PICC) dressing and securement techniques to prevent complications and failure. This pilot, 3-armed, randomized controlled trial was undertaken at Royal Children's Hospital and Lady Cilento Children's Hospital, Brisbane, Australia, between April 2014 and September 2015. Pediatric participants (N = 101; age range, 0-18 y) were assigned to standard care (bordered polyurethane [BPU] dressing, sutureless securement device), tissue adhesive (TA) (plus BPU dressing), or integrated securement dressings (ISDs). Average PICC dwell time was 8.1 days (range, 0.2-27.7 d). Primary outcome was trial feasibility including PICC failure. Secondary outcomes were PICC complications, dressing performance, and parent and staff satisfaction. Protocol feasibility was established. PICC failure was 6% (2/32) with standard care, 6% (2/31) with ISD, and 3% (1/32) with TA. PICC complications were 16% across all groups. TA provided immediate postoperative hemostasis, prolonging the first dressing change until 5.5 days compared with 3.5 days and 2.5 days with standard care and ISD respectively. Bleeding was the most common reason for first dressing change: standard care (n = 18; 75%), ISD (n = 11; 69%), TA (n = 4; 27%). Parental satisfaction (median 9.7/10; P = .006) and staff feedback (9.2/10; P = .002) were most positive for ISD. This research suggests safety and acceptability of different securement dressings compared with standard care; securement dressings may also reduce dressing changes after insertion. Further research is required to confirm clinically cost-effective methods to prevent PICC failure. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

Comparison of three different dressings for partial thickness burns in children: study protocol for a randomised controlled trial

PubMed Central

2013-01-01

Background In the paediatric population, pain and distress associated with burn injuries during wound care procedures remain a constant challenge. Although silver dressings are the gold standard for burn care in Australasia, very few high-level trials have been conducted that compare silver dressings to determine which will provide the best level of care clinically. Therefore, for paediatric patients in particular, identifying silver dressings that are associated with lower levels of pain and rapid wound re-epithelialisation is imperative. This study will determine whether there is a difference in time to re-epithelialisation and pain and distress experienced during wound care procedures among Acticoat™, Acticoat™ combined with Mepitel™ and Mepilex Ag™ dressings for acute, paediatric partial thickness burns. Methods/Design Children aged 0 to 15 years with an acute partial thickness (superficial partial to deep partial thickness inclusive) burn injury and a burn total body surface area of ≤10% will be eligible for the trial. Patients will be randomised to one of the three dressing groups: (1) Acticoat™ or (2) Acticoat™ combined with Mepitel™ or (3) Mepilex Ag™. A minimum of 28 participants will be recruited for each treatment group. Primary measures of pain, distress and healing will be repeated at each dressing change until complete wound re-epithelialisation occurs or skin grafting is required. Additional data collected will include infection status at each dressing change, physical function, scar outcome and scar management requirements, cost effectiveness of each dressing and staff perspectives of the dressings. Discussion The results of this study will determine the effects of three commonly used silver and silicone burn dressing combinations on the rate of wound re-epithelialisation and pain experienced during dressing procedures in acute, paediatric partial thickness burn injuries. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12613000105741 PMID:24274190

Comparison of DNA Damage and Apoptosis Induced By Silver Nanoparticle-containing Dressing Materials During Wound Healing.

PubMed

Choi, Young Suk; Gwak, Heui-Chul; Park, Jae Keun; Lim, Ji Yun; Yeo, Eui Dong; Park, Eunseok; Kim, Junyong; Lee, Young Koo

2018-04-13

Silver nanoparticle (AgNP)-containing dressings are used worldwide for the treatment of wounds; however, many studies have indicated that AgNPs are toxic to humans and cause cell death, primarily via apoptosis. In this study, the investigators compare the apoptotic effects of various AgNP dressing materials, with the hypothesis that nanosilver would be less toxic than ionic silver. For the in vivo experiments, Sprague-Dawley (SD) and streptozotocin (STZ)-induced diabetic rats were treated with 5 dressing materials: Aquacel Ag (product A, silver ion; ConvaTec, Berkshire, UK), Acticoat (product B, AgNP; Smith & Nephew, Fort Worth, TX), Medifoam Silver (product C, silver ion; Genewel Science Co Ltd, Seongnam, South Korea), PolyMem Silver (product D, AgNP; Ferris Mfg Corp, Fort Worth, TX), and Vaseline-impregnated dressing gauze (control; Unilever, London, UK). All treatments were applied 3 times per week. After 14 days of treatment, the SD and STZ rats were euthanized, and wound samples were examined for apoptosis. The analysis included immunohistochemistry, terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining, Western blotting, and reverse transcription polymerase chain reaction for a semiquantitative evaluation of apoptosis. The AgNP-containing dressing materials were more cytotoxic than the silver dressings. Compared with the AgNP dressing materials, no significant levels of apoptotic factors were observed in the silver dressing-treated wounds. The TUNEL staining showed that product C-dressed wounds contained the most apoptotic cells, while some apoptotic cells were observed in product B-dressed wounds. Moreover, apoptotic gene expression was altered, including a decline in B-cell lymphoma-2 and activation of caspase-3. This was most evident in wounds treated with product C. Interestingly, apoptotic gene expression was not induced in product A-treated wounds. Finally, product D had a relatively lower silver concentration and was less toxic than products A-C. Dressing materials containing AgNP have an antimicrobial effect. However, the authors observed that some AgNP dressings induced DNA damage and apoptosis. Although AgNP dressings did not cause significant acute apoptotic effects, they should be examined for cytotoxic effects in chronic wounds and should be used with caution when treating chronic wounds and those with low bacteria counts.

Enhancing in situ hydrogen peroxide generation of greige cotton nonwoven wound dressings via ascorbate stabilized copper micro- and nano-particles

USDA-ARS?s Scientific Manuscript database

Understanding how wound dressings may be designed to address critical unsolved issues in wound repair and treatment influences the development of dressings and new concepts of promoting healing. The vast majority of commercial dressing materials focus on the physical aspects of wounds, e.g., acting ...

Multi-dressing suppression and enhancement and all-optical switching in parametrically amplified four-wave mixing

NASA Astrophysics Data System (ADS)

Li, Xinghua; Zhang, Dan; Sun, Ming; Li, Kangkang; Wang, Zhiguo; Zhang, Yanpeng

2018-04-01

We study different dressing effects in parametrically amplified four-wave mixing (PA-FWM) processes. By seeding a weak probe laser into the Stokes or anti-Stokes channel of the FWM, the gain process is generated in the so-called bright twin beams which are the probe and conjugate beams. The dressing types dramatically affect the gain factors in both the probe and conjugate channels. The gain factor of the FWM signal decreases under the cascade-type dressing and the signal's shape splits into two dips under this dressing type. However, the intensity of the FWM signal changes from suppression to enhancement under the parallel-type dressing. We will apply this switching process to all-optical switching.

Overview of Silk Fibroin Use in Wound Dressings.

PubMed

Farokhi, Mehdi; Mottaghitalab, Fatemeh; Fatahi, Yousef; Khademhosseini, Ali; Kaplan, David L

2018-05-12

Recently, biomimetic wound dressings were introduced as potential replacements for treating skin injuries. Although there are some clinically available skin replacements, the range of wound types and locations necessitates a broader range of options for the clinic. Natural polymeric-based dressings are of central interest in this area due to their outstanding biocompatibility, biodegradability, low toxicity, and non-allergenic nature. Among them, silk fibroin (SF) has exceptional characteristics as a wound dressing. SF-based dressings can also be used as carriers for delivering drugs, growth factors, and bioactive agents to the wound area, while providing appropriate support for complete healing. In this review, we describe recent advances in the development of SF-based wound dressings for skin regeneration. Copyright © 2018 Elsevier Ltd. All rights reserved.

School Safety: Safer Schools with Different Kinds of Safety Personnel

ERIC Educational Resources Information Center

Herreras, Henry

2013-01-01

The purpose of this study was to investigate the difference between the total number of education code violations and the security personnel assigned by the school district. This study also proposed to examine factors such as socio-economic level of the district, the size of the district, and its location. Due to the increase in violence in…

Scholarly Ethics and Courtroom Antics: Where Researchers Stand in the Eyes of the Law.

ERIC Educational Resources Information Center

Scarce, Rik

1995-01-01

Presents R. Scarce's account of his jailing for refusal to divulge to the authorities information gathered for his doctoral research. Revealing the information would have been a violation of the American Sociological Association's Code of Ethics. Concludes with 13 concerns and suggestions for protecting scholarly research from legal intrusion.…

20 CFR 667.200 - What general fiscal and administrative rules apply to the use of WIA title I funds?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 29 CFR 97.36(b)(3) (as appropriate), which address codes of conduct and conflict of interest issues... training and related services, by itself, violates these conflict of interest provisions. (5) The addition... workplace requirements. All WIA title I grant recipients and subrecipients must comply with the government...

19 CFR 12.45 - Transportation and marketing of prison-labor products.

Code of Federal Regulations, 2010 CFR

2010-04-01

... violation of section 1761 or 1762, title 18, United States Code, with respect to any imported article comes to the attention of a port director, he shall detain the article and report the facts to the... be taken against the article, it shall be seized and held pending the receipt of further instructions...

34 CFR 300.534 - Protections for children not determined eligible for special education and related services.

Code of Federal Regulations, 2013 CFR

2013-07-01

... has engaged in behavior that violated a code of student conduct, may assert any of the protections...) of this section) that the child was a child with a disability before the behavior that precipitated... knowledge that a child is a child with a disability if before the behavior that precipitated the...

34 CFR 300.534 - Protections for children not determined eligible for special education and related services.

Code of Federal Regulations, 2014 CFR

2014-07-01

... has engaged in behavior that violated a code of student conduct, may assert any of the protections...) of this section) that the child was a child with a disability before the behavior that precipitated... knowledge that a child is a child with a disability if before the behavior that precipitated the...

34 CFR 300.534 - Protections for children not determined eligible for special education and related services.

Code of Federal Regulations, 2012 CFR

2012-07-01

... has engaged in behavior that violated a code of student conduct, may assert any of the protections...) of this section) that the child was a child with a disability before the behavior that precipitated... knowledge that a child is a child with a disability if before the behavior that precipitated the...

Students Behaving Badly: Policies on Weapons Violations in Florida Schools

ERIC Educational Resources Information Center

Dickinson, Wendy B.; Hall, Bruce W.

2003-01-01

This study looks at existing aspects of written school violence policies (Codes of Student Conduct) across large, mid-size, and small school districts in Florida. The aim was to provide a clearer picture of how weapons are defined, and the consequences of their possession, use, or display. Two research areas were addressed: (1) What constitutes a…

Federal Tax Exemption Status of the Private Nonprofit Art Association.

ERIC Educational Resources Information Center

Rodriguez, Edward J.

1978-01-01

The question of whether the selling of art by a private nonprofit art association violates the provisions of section 501(c)(3) of the Internal Revenue Code of 1954 is considered. Revenue rulings of 1971 and 1976 suggest that any sale of art may render the organization ineligible for tax exemption when private interests are benefited. (JMD)

Civility and Academic Freedom: Who Defines the Former (and How) May Imperil Rights to the Latter

ERIC Educational Resources Information Center

McDonald, Theodore W.; Stockton, James D.; Landrum, R. Eric

2018-01-01

An alarming occurrence in academia involves the discipline of faculty, under the guise of violating civility or collegiality codes, for engaging in what should be protected academic free speech. This often occurs when unprincipled and/or corporate-minded administrators seek to punish or dissuade faculty from challenging or questioning their…

76 FR 68788 - Notice of Lodging of Consent Decree Under the Clean Water Act

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-07

... (``Dupont'') violations of (1) Sections 301(a), 309(b) and (d), and 402 of the Federal Water Pollution... Regulations Governing the Control of Water Pollution, 7 Del. Admin. Code Sec. 7201. The United States and... DEPARTMENT OF JUSTICE Notice of Lodging of Consent Decree Under the Clean Water Act Notice is...

Adaptive neural coding: from biological to behavioral decision-making

PubMed Central

Louie, Kenway; Glimcher, Paul W.; Webb, Ryan

2015-01-01

Empirical decision-making in diverse species deviates from the predictions of normative choice theory, but why such suboptimal behavior occurs is unknown. Here, we propose that deviations from optimality arise from biological decision mechanisms that have evolved to maximize choice performance within intrinsic biophysical constraints. Sensory processing utilizes specific computations such as divisive normalization to maximize information coding in constrained neural circuits, and recent evidence suggests that analogous computations operate in decision-related brain areas. These adaptive computations implement a relative value code that may explain the characteristic context-dependent nature of behavioral violations of classical normative theory. Examining decision-making at the computational level thus provides a crucial link between the architecture of biological decision circuits and the form of empirical choice behavior. PMID:26722666

The 2002 PhRMA Code and Pharmaceutical Marketing: did anybody bother to ask the reps?

PubMed

Sillup, George P; Trombetta, Bill; Klimberg, Ronald

2010-10-01

After marketing tactics resulted in $1.2 billion fines, the 2002 PhRMA Code attempted to standardize marketing and sales practices. Self-regulation had varied success by other industries and by pharmaceutical industries in other countries. Similarly, the Code addressed negative responses about pharmaceutical's practices but had no provisions for monitoring violations. Representative's (reps) perspectives were assessed using an 18-item instrument with 72 reps from 25 companies. Analyses indicated that reps from bigger companies, PhRMA and non-PhRMA, adhered better. The way reps adhered was split between adhering reluctantly and following faithfully. Two thirds felt it was more difficult to do their jobs, resulting from prior entertainment-based relationships with physicians.

Implementation of Rule 8 of the International Code of Nomenclature of Prokaryotes for the renaming of classes. Request for an Opinion.

PubMed

Oren, Aharon; Parte, Aidan; Garrity, George M

2016-10-01

The new version of Rule 8 of the International Code of Nomenclature of Prokaryotes as approved in Istanbul in 2008 has the clear advantage of establishing a uniform way to name classes of prokaryotes, similar to the way other higher taxa are named. However, retroactive implementation of the modified Rule is problematic as it destabilizes the nomenclature and requires the replacement of a large number of names of classes that have been validly published, which would be in violation of Principle 1 of the Code. Therefore, we call upon the International Committee on Systematics of Prokaryotes and its Judicial Commission to reconsider the retroactivity of Rule 8.

A retrospective review of burn dressings on a porcine burn model.

PubMed

Wang, Xue-Qing; Kravchuk, Olena; Kimble, Roy M

2010-08-01

This is a study to compare wound healing among three types of dressings on a porcine model with deep-dermal-partial-thickness burns. The burns in this study were from eight animal trials conducted in the past for other purposes and only burns with a uniform pale appearance that had served as controls in original experiments were selected. In total, there were 57 burns in 33 pigs, using one of following three dressings: Acticoat (Silver) (3 trials), Jelonet (Gauze) (3 trials), and Solosite Gel/Jelonet (Gel/Gauze) (2 trials). The wound healing assessments included wound re-epithelialisation during a 6-week period, clinical and histological scar assessments at week 6 after burn. Of all wound healing/scar assessments, only re-epithelialisation showed statistical difference between dressings. Earlier re-epithelialisation was observed in Gel/Gauze dressings compared to Silver and/or Gauze dressings. However, this study revealed huge variation in wound healing outcome between 3 trials within both Silver and/or Gauze dressings, supported by significant differences on re-epithelialisation, clinical and histological scar measurements. In addition, it was found that larger animals healed better than smaller ones, based on weights from 21 pigs. Of all dressings, Silver delivers the best protection for wound colonization/infection. Wound colonization/infection was found to confine wound healing and lead to thinner RND in scars. From this study, we cannot find enough evidence to suggest the beneficial effect of one dressing(s) over others on burn wound healing outcome on a porcine model with small deep-dermal-partial-thickness burns with a relative small sample size.

Effect of virtual reality distraction on pain among patients with hand injury undergoing dressing change.

PubMed

Guo, Chunlan; Deng, Hongyan; Yang, Jian

2015-01-01

To assess the effect of virtual reality distraction on pain among patients with a hand injury undergoing a dressing change. Virtual reality distraction can effectively alleviate pain among patients undergoing a dressing change. Clinical research has not addressed pain control during a dressing change. A randomised controlled trial was performed. In the first dressing change sequence, 98 patients were randomly divided into an experimental group and a control group, with 49 cases in each group. Pain levels were compared between the two groups before and after the dressing change using a visual analog scale. The sense of involvement in virtual environments was measured using the Pearson correlation coefficient analysis, which determined the relationship between the sense of involvement and pain level. The difference in visual analog scale scores between the two groups before the dressing change was not statistically significant (t = 0·196, p > 0·05), but the scores became statistically significant after the dressing change (t = -30·792, p < 0·01). The correlation between the sense of involvement in a virtual environment and pain level during the dressing was statistically significant (R(2) = 0·5538, p < 0·05). Virtual reality distraction can effectively alleviate pain among patients with a hand injury undergoing a dressing change. Better results can be obtained by increasing the sense of involvement in a virtual environment. Virtual reality distraction can effectively relieve pain without side effects and is not reliant on a doctor's prescription. This tool is convenient for nurses to use, especially when analgesics are unavailable. © 2014 John Wiley & Sons Ltd.

A preliminary study of silver sodium zirconium phosphate polyurethane foam wound dressing on wounds of the distal aspect of the forelimb in horses.

PubMed

Kelleher, Maureen E; Kilcoyne, Isabelle; Dechant, Julie E; Hummer, Emma; Kass, Philip H; Snyder, Jack R

2015-04-01

To determine if application of silver sodium zirconium phosphate polyurethane semi-occlusive foam (SPF) dressing would improve measures of wound healing and decrease bacterial contamination compared with a non-adherent, absorbent dressing applied to wounds created on the distal aspect of the equine limb. Controlled randomized experimental study. Adult Quarter Horse and Thoroughbred horses (n = 5). One 6.25 cm(2) wound was created on the dorsomedial aspect of the proximal metacarpus on each forelimb. A SPF dressing was applied to 1 randomly assigned limb as a treatment and a non-adherent, absorbent dressing was applied to the opposite limb as control. Bandages were changed every 3 days for 60 days. Granulation tissue was scored every 3 days, wound area measured every 6 days, and wound bed was cultured every 12 days. SPF-treatment wounds had significantly decreased wound area and decreased granulation tissue scores when evaluated <30 days and over the 60 day study, although complete wound healing times were not significantly different. Bacteria were cultured from all wounds at varying times throughout the study. The SPF wound dressing improved some measures of wound healing compared with the control dressing, most significantly during the first 30 days. This suggests that the SPF wound dressing may be useful in the early management of wounds on the equine lower limb. Further studies using the SPF dressing are needed to characterize the temporal and cellular effects on wound healing and evaluate this dressing in a clinical environment. © Copyright 2014 by The American College of Veterinary Surgeons.

In vitro microbial inhibition and cellular response to novel biodegradable composite wound dressings with controlled release of antibiotics.

PubMed

Elsner, J J; Berdicevsky, I; Zilberman, M

2011-01-01

About 70% of all people with severe burns die from related infections, despite advances in treatment regimens and the best efforts of nurses and doctors. Although silver-eluting wound dressings are available for addressing this problem, there is growing evidence of the deleterious effects of such dressings in delaying the healing process owing to cellular toxicity. A new concept of antibiotic-eluting composite wound dressings is described here. These dressings are based on a polyglyconate mesh coated with a porous poly-(dl-lactic-co-glycolic acid) matrix loaded with antibiotic drugs. The effect of antibiotic release on bacterial inhibition was studied, and cell cytotoxicity was examined. The dressings resulted in a 99.99% decrease in the viable counts of Pseudomonas aeruginosa and Staphylococcus albus at very high initial inoculations of 10⁷-10⁸ CFU ml⁻¹ after only 1 day, while such a decrease in Staphylococcus aureus was obtained within 3 days. Bacterial inhibition zones around the dressing material were found to persist for 2 weeks, indicating a long-lasting antimicrobial effect. Despite severe toxicity to bacteria, the dressing material was found to have no toxic effect on cultured fibroblasts, indicating that the new antibiotic-eluting wound dressings represent an effective option for selective treatment of bacterial infections. Copyright © 2010 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Removal of adhesive wound dressing and its effects on the stratum corneum of the skin: comparison of eight different adhesive wound dressings.

PubMed

Matsumura, Hajime; Imai, Ryutaro; Ahmatjan, Niyaz; Ida, Yukiko; Gondo, Masahide; Shibata, Dai; Wanatabe, Katsueki

2014-02-01

In recent years, adhesive wound dressings have been increasingly applied postoperatively because of their ease of use as they can be kept in place without having to cut and apply surgical tapes and they can cover a wound securely. However, if a wound dressing strongly adheres to the wound, a large amount of stratum corneum is removed from the newly formed epithelium or healthy periwound skin. Various types of adhesives are used on adhesive wound dressings and the extent of skin damage depends on how much an adhesive sticks to the wound or skin surface. We quantitatively determined and compared the amount of stratum corneum removed by eight different wound dressings including polyurethane foam using acrylic adhesive, silicone-based adhesive dressing, composite hydrocolloid and self-adhesive polyurethane foam in healthy volunteers. The results showed that wound dressings with silicone adhesive and self-adhesive polyurethane foam removed less stratum corneum, whereas composite hydrocolloid and polyurethane foam using acrylic adhesive removed more stratum corneum. © 2012 The Authors. International Wound Journal © 2012 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

The Effect of Offloading Heels on Sacral Pressure.

PubMed

Al-Majid, Sadeeka; Vuncanon, Barbara; Carlson, Nika; Rakovski, Cyril

2017-09-01

Offloading a patient's heels during supine surgical procedures is a common practice to prevent heel pressure injuries. This practice may increase sacral pressure and jeopardize sacral skin integrity, but prophylactic dressings may help protect sacral skin. The purpose of this study was to examine the effects of offloading the heels and of multilayered silicone foam dressings on sacral pressure. We measured the sacral pressure of 50 healthy volunteers using a pressure-mapping system under four conditions: heels not offloaded and sacral dressing applied, heels offloaded and dressing applied, heels not offloaded and no dressing, and heels offloaded and no dressing. We used linear mixed-effects modeling to compare the effects of these conditions on sacral pressure. Offloading the heels significantly increased sacral pressure (P < .001), whereas the dressing had no effect on sacral pressure (P = .49). Offloading a patient's heels may increase the risk of sacral pressure injuries. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Computing observables in curved multifield models of inflation—A guide (with code) to the transport method

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dias, Mafalda; Seery, David; Frazer, Jonathan, E-mail: m.dias@sussex.ac.uk, E-mail: j.frazer@sussex.ac.uk, E-mail: a.liddle@sussex.ac.uk

We describe how to apply the transport method to compute inflationary observables in a broad range of multiple-field models. The method is efficient and encompasses scenarios with curved field-space metrics, violations of slow-roll conditions and turns of the trajectory in field space. It can be used for an arbitrary mass spectrum, including massive modes and models with quasi-single-field dynamics. In this note we focus on practical issues. It is accompanied by a Mathematica code which can be used to explore suitable models, or as a basis for further development.

A new postoperative otoplasty dressing technique using cyanoacrylate tissue adhesives.

PubMed

Vetter, Miriam; Foehn, Matthias; Wedler, Volker

2010-04-01

There are many techniques for cosmetic surgery of the ears and also many different procedures for postoperative treatment. The postoperative dressing is described as important for a successful outcome. We present our method of postoperative dressing in the form of liquid bonding. Cyanoacrylate tissue adhesives as liquid bonding agents are used for fixation of the pinna at the mastoid area. After 10-14 days the bonding can be easily removed. No huge dressings, tapes, or plasters are necessary. The patients are satisfied with the light dressing; they do not feel ashamed to appear in public. We have found this dressing technique to be simple and economical, especially because of the use of the bonding for skin closure before. It can be used after otoplasty with an anterior or a posterior approach.

Dressed Wilson loops as dual condensates in response to magnetic and electric fields

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bruckmann, Falk; Endroedi, Gergely

2011-10-01

We introduce dressed Wilson loops as a novel confinement observable. It consists of closed planar loops of arbitrary geometry but fixed area, and its expectation values decay with the latter. The construction of dressed Wilson loops is based on chiral condensates in response to magnetic and electric fields, thus linking different physical concepts. We present results for generalized condensates and dressed Wilson loops on dynamical lattice configurations and confirm the agreement with conventional Wilson loops in the limit of large probe mass. We comment on the renormalization of dressed Wilson loops.

The role of dressings in the prevention of pressure ulcers.

PubMed

Brown, Julie

2016-08-11

Pressure ulceration is a significant global healthcare problem and represents a considerable burden on healthcare resources. Within the literature an increasing number of studies have examined the role prophylactic dressings play in redistributing pressure and helping to protect the skin from the effects of friction and shear. The use of dressings to prevent pressure ulcers may be considered a controversial issue, as previous opinion has been that dressings do not reduce the effects of pressure. This article will critically evaluate the literature to examine the role dressings play in the prevention of pressure ulceration.

Violations identified from routine swimming pool inspections--selected states and counties, United States, 2008.

PubMed

2010-05-21

Swimming is the third most popular U.S. sport or exercise activity, with approximately 314 million visits to recreational water venues, including treated venues (e.g., pools), each year. The most frequently reported type of recreational water illness (RWI) outbreak is gastroenteritis, the incidence of which is increasing. During 1997--2006, chlorine- and bromine-susceptible pathogens (e.g., Shigella and norovirus) caused 24 (23%) of 104 treated venue--associated RWI outbreaks of gastroenteritis, indicating lapses in proper operation of pools. Pool inspectors help minimize the risk for RWIs and injuries by enforcing regulations that govern public treated recreational water venues. To assess pool code compliance, CDC analyzed 2008 data from 121,020 routine pool inspections conducted by a convenience sample of 15 state and local agencies. Because pool codes and, therefore, inspection items differed across jurisdictions, reported denominators varied. Of 111,487 inspections, 13,532 (12.1%) resulted in immediate closure because of serious violations (e.g., lack of disinfectant in the water). Of 120,975 inspections, 12,917 (10.7%) identified disinfectant level violations. Although these results likely are not representative of all pools in the United States, they suggest the need for increased public health scrutiny and improved pool operation. The results also demonstrate that pool inspection data can be used as a potential source for surveillance to guide resource allocation and regulatory decision-making. Collecting pool inspection data in a standardized, electronic format can facilitate routine analysis to support efforts to reduce health and safety risks for swimmers.

Foam dressings for treating pressure ulcers.

PubMed

Walker, Rachel M; Gillespie, Brigid M; Thalib, Lukman; Higgins, Niall S; Whitty, Jennifer A

2017-10-12

Pressure ulcers, also known as pressure injuries and bed sores, are localised areas of injury to the skin or underlying tissues, or both. Dressings made from a variety of materials, including foam, are used to treat pressure ulcers. An evidence-based overview of dressings for pressure ulcers is needed to enable informed decision-making on dressing use. This review is part of a suite of Cochrane Reviews investigating the use of dressings in the treatment of pressure ulcers. Each review will focus on a particular dressing type. To assess the clinical and cost effectiveness of foam wound dressings for healing pressure ulcers in people with an existing pressure ulcer in any care setting. In February 2017 we searched: the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE (including In-Process & Other Non-Indexed Citations); Ovid Embase; EBSCO CINAHL Plus and the NHS Economic Evaluation Database (NHS EED). We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies as well as reviews, meta-analyses and health technology reports to identify additional studies. There were no restrictions with respect to language, date of publication or study setting. Published or unpublished randomised controlled trials (RCTs) and cluster-RCTs, that compared the clinical and cost effectiveness of foam wound dressings for healing pressure ulcers (Category/Stage II or above). Two review authors independently performed study selection, risk of bias and data extraction. A third reviewer resolved discrepancies between the review authors. We included nine trials with a total of 483 participants, all of whom were adults (59 years or older) with an existing pressure ulcer Category/Stage II or above. All trials had two arms, which compared foam dressings with other dressings for treating pressure ulcers.The certainty of evidence ranged from low to very low due to various combinations of selection, performance, attrition, detection and reporting bias, and imprecision due to small sample sizes and wide confidence intervals. We had very little confidence in the estimate of effect of included studies. Where a foam dressing was compared with another foam dressing, we established that the true effect was likely to be substantially less than the study's estimated effect.We present data for four comparisons.One trial compared a silicone foam dressing with another (hydropolymer) foam dressing (38 participants), with an eight-week (short-term) follow-up. It was uncertain whether alternate types of foam dressing affected the incidence of healed pressure ulcers (RR 0.89, 95% CI 0.45 to 1.75) or adverse events (RR 0.37, 95% CI 0.04 to 3.25), as the certainty of evidence was very low, downgraded for serious limitations in study design and very serious imprecision.Four trials with a median sample size of 20 participants (230 participants), compared foam dressings with hydrocolloid dressings for eight weeks or less (short-term). It was uncertain whether foam dressings affected the probability of healing in comparison to hydrocolloid dressings over a short follow-up period in three trials (RR 0.85, 95% CI 0.54 to 1.34), very low-certainty evidence, downgraded for very serious study limitations and serious imprecision. It was uncertain if there was a difference in risk of adverse events between groups (RR 0.88, 95% CI 0.37 to 2.11), very low-certainty evidence, downgraded for serious study limitations and very serious imprecision. Reduction in ulcer size, patient satisfaction/acceptability, pain and cost effectiveness data were also reported but we assessed the evidence as being of very low certainty.One trial (34 participants), compared foam and hydrogel dressings over an eight-week (short-term) follow-up. It was uncertain if the foam dressing affected the probability of healing (RR 1.00, 95% CI 0.78 to 1.28), time to complete healing (MD 5.67 days 95% CI -4.03 to 15.37), adverse events (RR 0.33, 95% CI 0.01 to 7.65) or reduction in ulcer size (MD 0.30 cm 2 per day, 95% CI -0.15 to 0.75), as the certainty of the evidence was very low, downgraded for serious study limitations and very serious imprecision.The remaining three trials (181 participants) compared foam with basic wound contact dressings. Follow-up times ranged from short-term (8 weeks or less) to medium-term (8 to 24 weeks). It was uncertain whether foam dressings affected the probability of healing compared with basic wound contact dressings, in the short term (RR 1.33, 95% CI 0.62 to 2.88) or medium term (RR 1.17, 95% CI 0.79 to 1.72), or affected time to complete healing in the medium term (MD -35.80 days, 95% CI -56.77 to -14.83), or adverse events in the medium term (RR 0.58, 95% CI 0.33 to 1.05). This was due to the very low-certainty evidence, downgraded for serious to very serious study limitations and imprecision. Reduction in ulcer size, patient satisfaction/acceptability, pain and cost effectiveness data were also reported but again, we assessed the evidence as being of very low certainty.None of the included trials reported quality of life or pressure ulcer recurrence. It is uncertain whether foam dressings are more clinically effective, more acceptable to users, or more cost effective compared to alternative dressings in treating pressure ulcers. It was difficult to make accurate comparisons between foam dressings and other dressings due to the lack of data on reduction of wound size, complete wound healing, treatment costs, or insufficient time-frames. Quality of life and patient (or carer) acceptability/satisfaction associated with foam dressings were not systematically measured in any of the included studies. We assessed the certainty of the evidence in the included trials as low to very low. Clinicians need to carefully consider the lack of robust evidence in relation to the clinical and cost-effectiveness of foam dressings for treating pressure ulcers when making treatment decisions, particularly when considering the wound management properties that may be offered by each dressing type and the care context.

Innovative dressing and securement of tunneled central venous access devices in pediatrics: a pilot randomized controlled trial.

PubMed

Ullman, Amanda J; Kleidon, Tricia; Gibson, Victoria; McBride, Craig A; Mihala, Gabor; Cooke, Marie; Rickard, Claire M

2017-08-30

Central venous access device (CVAD) associated complications are a preventable source of patient harm, frequently resulting in morbidity and delays to vital treatment. Dressing and securement products are used to prevent infectious and mechanical complications, however current complication rates suggest customary practices are inadequate. The aim of this study was to evaluate the feasibility of launching a full-scale randomized controlled efficacy trial of innovative dressing and securement products for pediatric tunneled CVAD to prevent complication and failure. An external, pilot, four-group randomized controlled trial of standard care (bordered polyurethane dressing and suture), in comparison to integrated securement-dressing, suture-less securement device, and tissue adhesive was undertaken across two large, tertiary referral pediatric hospitals in Australia. Forty-eight pediatric participants with newly inserted tunneled CVADs were consecutively recruited. The primary outcome of study feasibility was established by elements of eligibility, recruitment, attrition, protocol adherence, missing data, parent and healthcare staff satisfaction and acceptability, and effect size estimates for CVAD failure (cessation of function prior to completion of treatment) and complication (associated bloodstream infection, thrombosis, breakage, dislodgement or occlusion). Dressing integrity, product costs and site complications were also examined. Protocol feasibility was established. CVAD failure was: 17% (2/12) integrated securement-dressing; 8% (1/13) suture-less securement device; 0% tissue adhesive (0/12); and, 0% standard care (0/11). CVAD complications were: 15% (2/13) suture-less securement device (CVAD associated bloodstream infection, and occlusion and partial dislodgement); 8% (1/12) integrated securement-dressing (partial dislodgement); 0% tissue adhesive (0/12); and, 0% standard care (0/11). One CVAD-associated bloodstream infection occurred, within the suture-less securement device group. Overall satisfaction was highest in the integrated securement-dressing (mean 8.5/10; standard deviation 1.2). Improved dressing integrity was evident in the intervention arms, with the integrated securement-dressing associated with prolonged time to first dressing change (mean days 3.5). Improving the security and dressing integrity of tunneled CVADs is likely to improve outcomes for pediatric patients. Further research is necessary to identify novel, effective CVAD securement to reduce complications, and provide reliable vascular access for children. ACTRN12614000280606 ; prospectively registered on 17/03/2014.

Percutaneous urinary procedures - discharge

MedlinePlus

... a shower if you wrap the dressing with plastic wrap and replace the dressing if it gets ... include: Telfa (the dressing material), Tegaderm (the clear plastic tape that holds the plastic ring in place), ...

Ethical violations in the clinical setting: the hidden curriculum learning experience of Pakistani nurses.

PubMed

Jafree, Sara Rizvi; Zakar, Rubeena; Fischer, Florian; Zakar, Muhammad Zakria

2015-03-19

The importance of the hidden curriculum is recognised as a practical training ground for the absorption of medical ethics by healthcare professionals. Pakistan's healthcare sector is hampered by the exclusion of ethics from medical and nursing education curricula and the absence of monitoring of ethical violations in the clinical setting. Nurses have significant knowledge of the hidden curriculum taught during clinical practice, due to long working hours in the clinic and front-line interaction with patients and other practitioners. The means of inquiry for this study was qualitative, with 20 interviews and four focus group discussions used to identify nurses' clinical experiences of ethical violations. Content analysis was used to discover sub-categories of ethical violations, as perceived by nurses, within four pre-defined categories of nursing codes of ethics: 1) professional guidelines and integrity, 2) patient informed consent, 3) patient rights, and 4) co-worker coordination for competency, learning and patient safety. Ten sub-categories of ethical violations were found: nursing students being used as adjunct staff, nurses having to face frequent violence in the hospital setting, patient reluctance to receive treatment from nurses, the near-absence of consent taken from patients for most non-surgical medical procedures, the absence of patient consent taking for receiving treatment from student nurses, the practice of patient discrimination on the basis of a patient's socio-demographic status, nurses withdrawing treatment out of fear for their safety, a non-learning culture and, finally, blame-shifting and non-reportage of errors. Immediate and urgent attention is required to reduce ethical violations in the healthcare sector in Pakistan through collaborative efforts by the government, the healthcare sector, and ethics regulatory bodies. Also, changes in socio-cultural values in hospital organisation, public awareness of how to conveniently report ethical violations by practitioners and public perceptions of nurse identity are needed.

Prospective randomised controlled trial of nanocrystalline silver dressing versus plain gauze as the initial post-debridement management of military wounds on wound microbiology and healing.

PubMed

Fries, C A; Ayalew, Y; Penn-Barwell, J G; Porter, K; Jeffery, S L A; Midwinter, M J

2014-07-01

Recent conflicts have been characterised by the use of improvised explosive devices causing devastating injuries, including heavily contaminated wounds requiring meticulous surgical debridement. After being rendered surgical clean, these wounds are dressed and the patient transferred back to the UK for on-going treatment. A dressing that would prevent wounds from becoming colonised during transit would be desirable. The aim of this study was to establish whether using nanocrystalline silver dressings, as an adjunct to the initial debridement, would positively affect wound microbiology and wound healing compared to standard plain gauze dressings. Patients were prospectively randomised to receive either silver dressings, in a nanocrystalline preparation (Acticoat™), or standard of care dressings (plain gauze) following their initial debridement in the field hospital. On repatriation to the UK microbiological swabs were taken from the dressing and the wound, and an odour score recorded. Wounds were followed prospectively and time to wound healing was recorded. Additionally, patient demographic data were recorded, as well as the mechanism of injury and Injury Severity Score. 76 patients were recruited to the trial between February 2010 and February 2012. 39 received current dressings and 37 received the trial dressings. Eleven patients were not swabbed. There was no difference (p=0.1384, Fishers) in the primary outcome measure of wound colonisation between the treatment arm (14/33) and the control arm (20/32). Similarly time to wound healing was not statistically different (p=0.5009, Mann-Whitney). Wounds in the control group were scored as being significantly more malodorous (p=0.002, Mann-Whitney) than those in the treatment arm. This is the first randomised controlled trial to report results from an active theatre of war. Performing research under these conditions poses additional challenges to military clinicians. Meticulous debridement of wounds remains the critical determinant in wound healing and infection and this study did not demonstrate a benefit of nanocrystaline silver dressing in respect to preventing wound colonisation or promoting healing, these dressings do however seem to significantly reduce the unpleasant odour commonly associated with battlefield wounds. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Cost-Effectiveness Analysis of a Transparent Antimicrobial Dressing for Managing Central Venous and Arterial Catheters in Intensive Care Units

PubMed Central

Bernatchez, Stéphanie F.; Ruckly, Stéphane; Timsit, Jean-François

2015-01-01

Objective To model the cost-effectiveness impact of routine use of an antimicrobial chlorhexidine gluconate-containing securement dressing compared to non-antimicrobial transparent dressings for the protection of central vascular lines in intensive care unit patients. Design This study uses a novel health economic model to estimate the cost-effectiveness of using the chlorhexidine gluconate dressing versus transparent dressings in a French intensive care unit scenario. The 30-day time non-homogeneous markovian model comprises eight health states. The probabilities of events derive from a multicentre (12 French intensive care units) randomized controlled trial. 1,000 Monte Carlo simulations of 1,000 patients per dressing strategy are used for probabilistic sensitivity analysis and 95% confidence intervals calculations. The outcome is the number of catheter-related bloodstream infections avoided. Costs of intensive care unit stay are based on a recent French multicentre study and the cost-effectiveness criterion is the cost per catheter-related bloodstream infections avoided. The incremental net monetary benefit per patient is also estimated. Patients 1000 patients per group simulated based on the source randomized controlled trial involving 1,879 adults expected to require intravascular catheterization for 48 hours. Intervention Chlorhexidine Gluconate-containing securement dressing compared to non-antimicrobial transparent dressings. Results The chlorhexidine gluconate dressing prevents 11.8 infections /1,000 patients (95% confidence interval: [3.85; 19.64]) with a number needed to treat of 85 patients. The mean cost difference per patient of €141 is not statistically significant (95% confidence interval: [€-975; €1,258]). The incremental cost-effectiveness ratio is of €12,046 per catheter-related bloodstream infection prevented, and the incremental net monetary benefit per patient is of €344.88. Conclusions According to the base case scenario, the chlorhexidine gluconate dressing is more cost-effective than the reference dressing. Trial Registration This model is based on the data from the RCT registered with www.clinicaltrials.gov (NCT01189682). PMID:26086783

Antibacterial properties and reduction of MRSA biofilm with a dressing combining polyabsorbent fibres and a silver matrix.

PubMed

Desroche, N; Dropet, C; Janod, P; Guzzo, J

2016-10-02

This study was designed to evaluate the antibacterial activity of a wound dressing which combines polyacrylate fibres and a silver lipido-colloid matrix (UrgoClean Ag, silver polyabsorbent dressing), against biofilm of methicillin-resistant Staphylococcus aureus (MRSA). Samples of silver polyabsorbent dressing and the neutral form of this dressing (UrgoClean) were applied to biofilms of MRSA formed on a collagen I-coated surface, cultured for 24 hours. Different exposure times were tested (1, 2, 4 and 7 days) without dressing change. The biofilm reduction was quantified by using culture methods and by confocal laser scanning microscopy experiments. The application of the silver polyabsorbent dressing resulted in a significant decrease of the biofilm population by a log reduction of 4.6, after 24 hours of exposure. Moreover, the antibiofilm activity was maintained for 7 days with reduction values up to 4 log (reduction of biofilm superior to 99.99%). The application of the neutral dressing also induced a significant reduction of the concentration of sessile cells after 1 day (about 0.90 log). The results obtained with this neutral form of the dressing showed that the polyacrylate fibres were able to exert a mechanical disruption of the biofilm architecture. These in vitro experiments demonstrated that silver polyabsorbent dressing was able to strongly reduce the biofilm of MRSA. The antibiofilm mechanism of this dressing can be explained by a dual action of the polyabsorbent fibres (based on ammonium polyacrylate polymer around an acrylic core) which induced a mechanical disruption of the biofilm matrix and/or a sequestration of sessile cells, and the diffusion of silver ions which produced bactericidal activity. This study was supported by Laboratoires Urgo (Dijon). P. Janod is an employee of Laboratoires Urgo. The company had no influence on the experimental design and the interpretation of the results.

Antibacterial properties of tualang honey and its effect in burn wound management: a comparative study

PubMed Central

2010-01-01

Background The use of honey as a natural product of Apis spp. for burn treatment has been widely applied for centuries. Tualang honey has been reported to have antibacterial properties against various microorganisms, including those from burn-related diagnoses, and is cheaper and easier to be absorbed by Aquacel dressing. The aim of this study is to evaluate the potential antibacterial properties of tualang honey dressing and to determine its effectiveness as a partial thickness burn wound dressing. Methods In order to quantitate the bioburden of the swabs, pour plates were performed to obtain the colony count (CFU/ml). Swabs obtained from burn wounds were streaked on blood agar and MacConkey agar for bacterial isolation and identification. Later, antibacterial activity of Aquacel-tualang honey, Aquacel-Manuka honey, Aquacel-Ag and Aquacel- plain dressings against bacteria isolated from patients were tested (in-vitro) to see the effectiveness of those dressings by zone of inhibition assays. Results Seven organisms were isolated. Four types of Gram-negative bacteria, namely Enterobacter cloacae, Klebsiella pneumoniae, Pseudomonas spp. and Acinetobacter spp., and three Gram-positive bacteria, namely Staphylococcus aureus, coagulase-negative Staphylococcus aureus (CONS) and Streptococcus spp., were isolated. Total bacterial count decreased on day 6 and onwards. In the in-vitro antibacterial study, Aquacel-Ag and Aquacel-Manuka honey dressings gave better zone of inhibition for Gram positive bacteria compared to Aquacel-Tualang honey dressing. However, comparable results were obtained against Gram negative bacteria tested with Aquacel-Manuka honey and Aquacel-Tualang honey dressing. Conclusions Tualang honey has a bactericidal as well as bacteriostatic effect. It is useful as a dressing, as it is easier to apply and is less sticky compared to Manuka honey. However, for Gram positive bacteria, tualang honey is not as effective as usual care products such as silver-based dressing or medical grade honey dressing. PMID:20576085

Antibacterial properties of tualang honey and its effect in burn wound management: a comparative study.

PubMed

Nasir, Nur-Azida Mohd; Halim, Ahmad Sukari; Singh, Kirnpal-Kaur Banga; Dorai, Ananda Aravazhi; Haneef, Mehru-Nisha Muhammad

2010-06-24

The use of honey as a natural product of Apis spp. for burn treatment has been widely applied for centuries. Tualang honey has been reported to have antibacterial properties against various microorganisms, including those from burn-related diagnoses, and is cheaper and easier to be absorbed by Aquacel dressing. The aim of this study is to evaluate the potential antibacterial properties of tualang honey dressing and to determine its effectiveness as a partial thickness burn wound dressing. In order to quantitate the bioburden of the swabs, pour plates were performed to obtain the colony count (CFU/ml). Swabs obtained from burn wounds were streaked on blood agar and MacConkey agar for bacterial isolation and identification. Later, antibacterial activity of Aquacel-tualang honey, Aquacel-Manuka honey, Aquacel-Ag and Aquacel- plain dressings against bacteria isolated from patients were tested (in-vitro) to see the effectiveness of those dressings by zone of inhibition assays. Seven organisms were isolated. Four types of Gram-negative bacteria, namely Enterobacter cloacae, Klebsiella pneumoniae, Pseudomonas spp. and Acinetobacter spp., and three Gram-positive bacteria, namely Staphylococcus aureus, coagulase-negative Staphylococcus aureus (CONS) and Streptococcus spp., were isolated. Total bacterial count decreased on day 6 and onwards. In the in-vitro antibacterial study, Aquacel-Ag and Aquacel-Manuka honey dressings gave better zone of inhibition for Gram positive bacteria compared to Aquacel-Tualang honey dressing. However, comparable results were obtained against Gram negative bacteria tested with Aquacel-Manuka honey and Aquacel-Tualang honey dressing. Tualang honey has a bactericidal as well as bacteriostatic effect. It is useful as a dressing, as it is easier to apply and is less sticky compared to Manuka honey. However, for Gram positive bacteria, tualang honey is not as effective as usual care products such as silver-based dressing or medical grade honey dressing.

Predicting the effectiveness of virtual reality relaxation on pain and anxiety when added to PCA morphine in patients having burns dressings changes.

PubMed

Konstantatos, A H; Angliss, M; Costello, V; Cleland, H; Stafrace, S

2009-06-01

Pain arising in burns sufferers is often severe and protracted. The prospect of a dressing change can heighten existing pain by impacting both physically and psychologically. In this trial we examined whether pre-procedural virtual reality guided relaxation added to patient controlled analgesia with morphine reduced pain severity during awake dressings changes in burns patients. We conducted a prospective randomized clinical trial in all patients with burns necessitating admission to a tertiary burns referral centre. Eligible patients requiring awake dressings changes were randomly allocated to single use virtual reality relaxation plus intravenous morphine patient controlled analgesia (PCA) infusion or to intravenous morphine patient controlled analgesia infusion alone. Patients rated their worst pain intensity during the dressing change using a visual analogue scale. The primary outcome measure was presence of 30% or greater difference in pain intensity ratings between the groups in estimation of worst pain during the dressing change. Of 88 eligible and consenting patients having awake dressings changes, 43 were assigned to virtual reality relaxation plus intravenous morphine PCA infusion and 43 to morphine PCA infusion alone. The group receiving virtual reality relaxation plus morphine PCA infusion reported significantly higher pain intensities during the dressing change (mean=7.3) compared with patients receiving morphine PCA alone (mean=5.3) (p=0.003) (95% CI 0.6-2.8). The addition of virtual reality guided relaxation to morphine PCA infusion in burns patients resulted in a significant increase in pain experienced during awake dressings changes. In the absence of a validated predictor for responsiveness to virtual reality relaxation such a therapy cannot be recommended for general use in burns patients having awake dressings changes.

A comparison of skin graft success in the head & neck with and without the use of a pressure dressing.

PubMed

Dhillon, M; Carter, C P; Morrison, J; Hislop, W S; Currie, W J R

2015-06-01

The success of skin grafting is dependent on the interplay between many factors including nutrient uptake and vascular in-growth. To allow this, it is important that the graft is immobile and traditionally a 'pressure dressing' has been placed over the graft to improve outcome and graft 'take'. We present the findings of our comparative study of full-thickness skin grafts performed in the head, neck and face region over a period of 24 months. We felt that there was an unacceptably high infection rate and graft failure using pressure dressings. Data was collected retrospectively from the case notes on 70 patients who had undergone full-thickness skin grafting to the head, neck and face over a 2 year period. Thirty-five patients underwent grafting with pressure dressing and 35 without. The group with the pressure dressing had the same 'bolster' specification-type dressing and those without had their graft 'quilted' in and chloramphenicol ointment applied topically. Success was determined by the percentage 'take' of the grafts and absence of infection i.e. purulence. Infection in those with a pressure dressing stood at 26 % in contrast to those without, at 9 %. Without a pressure dressing we observed no total graft failures, compared to 6 % in those with a pressure dressing. The results confirmed the perception that there was a higher infection and graft failure rate where a pressure dressing was applied; however, this was not a statistically significant difference and a randomised control trial with a larger sample size would be required to validate the results.

Economic and clinical contributions of an antimicrobial barrier dressing: a strategy for the reduction of surgical site infections.

PubMed

Leaper, David; Nazir, Jameel; Roberts, Chris; Searle, Richard

2010-01-01

In patients at risk of surgical site infection (SSI), there is evidence that an antimicrobial barrier dressing (Acticoat* ) applied immediately post-procedure is effective in reducing the incidence of infection. The objective of this study was to assess when it is appropriate to use an antimicrobial barrier dressing rather than a post-operative film dressing, by evaluating the net cost and budget impact of the two strategies. An economic model was developed, which estimates expected expenditure on dressings and the expected costs of surgical site infection during the initial inpatient episode, based on published literature on the pre-discharge costs of surgical infection and the efficacy of an antimicrobial barrier dressing in preventing SSI. At an SSI risk of 10%, an antimicrobial barrier dressing strategy is cost neutral if the incidence of infection is reduced by at least 9% compared with a post-operative film dressing. At 35% efficacy, expenditure on dressings would be higher by £30,760 per 1000 patients, and the cost of treating infection would be lower by £111,650, resulting in a net cost saving of £80,890. The break-even infection risk for cost neutrality is 2.6%. Although this cost analysis is based on published data, there are limitations in methodology: the model is dependent on and subject to the limitations of the data used to populate it. Further studies would be useful to increase the robustness of the conclusions, particularly in a broader range of surgical specialties. A strategy involving the use of an antimicrobial barrier dressing in patients at moderate (5-10%) or high (>10%) risk of infection appears reasonable and cost saving in light of the available clinical evidence.

Pesticide seed dressings can affect the activity of various soil organisms and reduce decomposition of plant material.

PubMed

Zaller, Johann G; König, Nina; Tiefenbacher, Alexandra; Muraoka, Yoko; Querner, Pascal; Ratzenböck, Andreas; Bonkowski, Michael; Koller, Robert

2016-08-17

Seed dressing with pesticides is widely used to protect crop seeds from pest insects and fungal diseases. While there is mounting evidence that especially neonicotinoid seed dressings detrimentally affect insect pollinators, surprisingly little is known on potential side effects on soil biota. We hypothesized that soil organisms would be particularly susceptible to pesticide seed dressings as they get in direct contact with these chemicals. Using microcosms with field soil we investigated, whether seeds treated either with neonicotinoid insecticides or fungicides influence the activity and interaction of earthworms, collembola, protozoa and microorganisms. The full-factorial design consisted of the factor Seed dressing (control vs. insecticide vs. fungicide), Earthworm (no earthworms vs. addition Lumbricus terrestris L.) and collembola (no collembola vs. addition Sinella curviseta Brook). We used commercially available wheat seed material (Triticum aesticum L. cf. Lukullus) at a recommended seeding density of 367 m(-2). Seed dressings (particularly fungicides) increased collembola surface activity, increased the number of protozoa and reduced plant decomposition rate but did not affect earthworm activity. Seed dressings had no influence on wheat growth. Earthworms interactively affected the influence of seed dressings on collembola activity, whereas collembola increased earthworm surface activity but reduced soil basal respiration. Earthworms also decreased wheat growth, reduced soil basal respiration and microbial biomass but increased soil water content and electrical conductivity. The reported non-target effects of seed dressings and their interactions with soil organisms are remarkable because they were observed after a one-time application of only 18 pesticide treated seeds per experimental pot. Because of the increasing use of seed dressing in agriculture and the fundamental role of soil organisms in agroecosystems these ecological interactions should receive more attention.

Early versus delayed dressing removal after primary closure of clean and clean-contaminated surgical wounds.

PubMed

Toon, Clare D; Lusuku, Charnelle; Ramamoorthy, Rajarajan; Davidson, Brian R; Gurusamy, Kurinchi Selvan

2015-09-03

Most surgical procedures involve a cut in the skin that allows the surgeon to gain access to the deeper tissues or organs. Most surgical wounds are closed fully at the end of the procedure (primary closure). The surgeon covers the closed surgical wound with either a dressing or adhesive tape. The dressing can act as a physical barrier to protect the wound until the continuity of the skin is restored (within about 48 hours) and to absorb exudate from the wound, keeping it dry and clean, and preventing bacterial contamination from the external environment. Some studies have found that the moist environment created by some dressings accelerates wound healing, although others believe that the moist environment can be a disadvantage, as excessive exudate can cause maceration (softening and deterioration) of the wound and the surrounding healthy tissue. The utility of dressing surgical wounds beyond 48 hours of surgery is, therefore, controversial. To evaluate the benefits and risks of removing a dressing covering a closed surgical incision site within 48 hours permanently (early dressing removal) or beyond 48 hours of surgery permanently with interim dressing changes allowed (delayed dressing removal), on surgical site infection. In March 2015 we searched the following electronic databases: The Cochrane Wounds Group Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Database of Abstracts of Reviews of Effects (DARE) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL. We also searched the references of included trials to identify further potentially-relevant trials. Two review authors independently identified studies for inclusion. We included all randomised clinical trials (RCTs) conducted with people of any age and sex, undergoing a surgical procedure, who had their wound closed and a dressing applied. We included only trials that compared early versus delayed dressing removal. We excluded trials that included people with contaminated or dirty wounds. We also excluded quasi-randomised studies, and other study designs. Two review authors independently extracted data on the characteristics of the trial participants, risk of bias in the trials and outcomes for each trial. We calculated risk ratios (RR) with 95% confidence intervals (CI) for binary outcomes and mean difference (MD) with 95% CI for continuous outcomes. We used RevMan 5 software to perform these calculations. Four trials were identified for inclusion in this review. All the trials were at high risk of bias. Three trials provided information for this review. Overall, this review included 280 people undergoing planned surgery. Participants were randomised to early dressing removal (removal of the wound dressing within the 48 hours following surgery) (n = 140) or delayed dressing removal (continued dressing of the wound beyond 48 hours) (n = 140) in the three trials. There were no statistically significant differences between the early dressing removal group and delayed dressing removal group in the proportion of people who developed superficial surgical site infection within 30 days (RR 0.64; 95% CI 0.32 to 1.28), superficial wound dehiscence within 30 days (RR 2.00; 95% CI 0.19 to 21.16) or serious adverse events within 30 days (RR 0.83; 95% CI 0.28 to 2.51). No deep wound infection or deep wound dehiscence occurred in any of the participants in the trials that reported this outcome. None of the trials reported quality of life. The hospital stay was significantly shorter (MD -2.00 days; 95% CI -2.82 to -1.18) and the total cost of treatment significantly less (MD EUR -36.00; 95% CI -59.81 to -12.19) in the early dressing removal group than in the delayed dressing removal group in the only trial that reported these outcomes. The early removal of dressings from clean or clean contaminated surgical wounds appears to have no detrimental effect on outcomes. However, it should be noted that the point estimate supporting this statement is based on very low quality evidence from three small randomised controlled trials, and the confidence intervals around this estimate were wide. Early dressing removal may result in a significantly shorter hospital stay, and significantly reduced costs, than covering the surgical wound with wound dressings beyond the first 48 hours after surgery, according to very low quality evidence from one small randomised controlled trial. Further randomised controlled trials of low risk of bias are necessary to investigate whether dressings are necessary after 48 hours in different types of surgery and levels of contamination and investigate whether antibiotic therapy influences the outcome.

Early versus delayed dressing removal after primary closure of clean and clean-contaminated surgical wounds.

PubMed

Toon, Clare D; Ramamoorthy, Rajarajan; Davidson, Brian R; Gurusamy, Kurinchi Selvan

2013-09-05

Most surgical procedures involve a cut in the skin that allows the surgeon to gain access to the deeper tissues or organs. Most surgical wounds are closed fully at the end of the procedure (primary closure). The surgeon covers the closed surgical wound with either a dressing or adhesive tape. The dressing can act as a physical barrier to protect the wound until the continuity of the skin is restored (within about 48 hours) and to absorb exudate from the wound, keeping it dry and clean, and preventing bacterial contamination from the external environment. Some studies have found that the moist environment created by some dressings accelerates wound healing, although others believe that the moist environment can be a disadvantage, as excessive exudate can cause maceration (softening and deterioration) of the wound and the surrounding healthy tissue. The utility of dressing surgical wounds beyond 48 hours of surgery is, therefore, controversial. To evaluate the benefits and risks of removing a dressing covering a closed surgical incision site within 48 hours permanently (early dressing removal) or beyond 48 hours of surgery permanently with interim dressing changes allowed (delayed dressing removal), on surgical site infection. In July 2013 we searched the following electronic databases: The Cochrane Wounds Group Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Database of Abstracts of Reviews of Effects (DARE) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL. We also searched the references of included trials to identify further potentially-relevant trials. Two review authors independently identified studies for inclusion. We included all randomised clinical trials (RCTs) conducted with people of any age and sex, undergoing a surgical procedure, who had their wound closed and a dressing applied. We included only trials that compared early versus delayed dressing removal. We excluded trials that included people with contaminated or dirty wounds. We also excluded quasi-randomised studies, and other study designs. Two review authors independently extracted data on the characteristics of the trial participants, risk of bias in the trials and outcomes for each trial. We calculated risk ratios (RR) with 95% confidence intervals (CI) for binary outcomes and mean difference (MD) with 95% CI for continuous outcomes. We used RevMan 5 software to perform these calculations. Four trials were identified for inclusion in this review. All the trials were at high risk of bias. Three trials provided information for this review. Overall, this review included 280 people undergoing planned surgery. Participants were randomised to early dressing removal (removal of the wound dressing within the 48 hours following surgery) (n = 140) or delayed dressing removal (continued dressing of the wound beyond 48 hours) (n = 140) in the three trials. There were no statistically significant differences between the early dressing removal group and delayed dressing removal group in the proportion of people who developed superficial surgical site infection within 30 days (RR 0.64; 95% CI 0.32 to 1.28), superficial wound dehiscence within 30 days (RR 2.00; 95% CI 0.19 to 21.16) or serious adverse events within 30 days (RR 0.83; 95% CI 0.28 to 2.51). No deep wound infection or deep wound dehiscence occurred in any of the participants in the trials that reported this outcome. None of the trials reported quality of life. The hospital stay was significantly shorter (MD -2.00 days; 95% CI -2.82 to -1.18) and the total cost of treatment significantly less (MD EUR -36.00; 95% CI -59.81 to -12.19) in the early dressing removal group than in the delayed dressing removal group in the only trial that reported these outcomes. The early removal of dressings from clean or clean contaminated surgical wounds appears to have no detrimental effect on outcomes. However, it should be noted that the point estimate supporting this statement is based on very low quality evidence from three small randomised controlled trials, and the confidence intervals around this estimate were wide. Early dressing removal may result in a significantly shorter hospital stay, and significantly reduced costs, than covering the surgical wound with wound dressings beyond the first 48 hours after surgery, according to very low quality evidence from one small randomised controlled trial. Further randomised controlled trials of low risk of bias are necessary to investigate whether dressings are necessary after 48 hours in different types of surgery and levels of contamination and investigate whether antibiotic therapy influences the outcome.

Pediatric Digital Necrosis Secondary to Dressing Application: A Case Series.

PubMed

Bjorklund, Kim A; Rice, Dahlia M; Amalfi, Ashley N

2018-04-01

Pediatric digital necrosis resulting in revision amputation is a devastating outcome following digital dressing application. We report a series of 4 pediatric patients (age: 21 months-11 years) who presented for surgical consultation related to digital ischemia and irreversible necrosis following the application of Coban digital dressings. A review of the literature demonstrated that such injuries had not previously been described. In our case series, Coban dressing was utilized as a deterrent for thumb sucking, fingertip tuft fractures with nail bed lacerations, and a phalanx fracture secondary to crush injury. All 4 children suffered digital necrosis secondary to Coban dressings and ultimately required revision amputation. We discuss risks factors, application practices, and strategies to minimize complications with digital dressings in the pediatric population with the intent of creating awareness among hand surgeons to help promote safe practices and improve patient outcomes.

Enhancing pressure ulcer prevention using wound dressings: what are the modes of action?

PubMed

Call, Evan; Pedersen, Justin; Bill, Brian; Black, Joyce; Alves, Paulo; Brindle, C Tod; Dealey, Carol; Santamaria, Nick; Clark, Michael

2015-08-01

Recent clinical research has generated interest in the use of sacral wound dressings as preventive devices for patients at risk of ulceration. This study was conducted to identify the modes of action through which dressings can add to pressure ulcer prevention, for example, shear and friction force redistribution and pressure distribution. Bench testing was performed using nine commercially available dressings. The use of dressings can reduce the amplitude of shear stress and friction reaching the skin of patients at risk. They can also effectively redirect these forces to wider areas which minimises the mechanical loads upon skeletal prominences. Dressings can redistribute pressure based upon their effective Poisson ratio and larger deflection areas, providing greater load redistribution. © 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

A comparison of a modified form of Granuflex (Granuflex Extra Thin) and a conventional dressing in the management of lacerations, abrasions and minor operation wounds in an accident and emergency department.

PubMed Central

Heffernan, A; Martin, A J

1994-01-01

A clinical study of 96 patients compared a new hydrocolloid dressing (Granuflex Extra Thin) with a non-adherent dressing (perforated film absorbent dressing) in the management of lacerations, abrasions and minor operation incisions at the Accident and Emergency (A&E) Department of the University College Hospital, Galway. While time to heal was similar for both groups, the patients using Granuflex Extra Thin experienced less pain (P < 0.001), required less analgesia (P = 0.0154) and were able to carry out their normal daily activities including bathing or showering without affecting the dressing or the wound. Patient satisfaction with the new dressing appeared to be very high especially in those patients who pursued an active lifestyle. PMID:7894807

Novel biodegradable composite wound dressings with controlled release of antibiotics: results in a guinea pig burn model.

PubMed

Elsner, Jonathan J; Egozi, Dana; Ullmann, Yehuda; Berdicevsky, Israela; Shefy-Peleg, Adaya; Zilberman, Meital

2011-08-01

Approximately 70% of all people with severe burns die from related infections despite advances in treatment regimens and the best efforts of nurses and doctors. Silver ion-eluting wound dressings are available for overcoming this problem. However, there are reports of deleterious effects of such dressings due to cellular toxicity that delays the healing process, and the dressing changes needed 1-2 times a day are uncomfortable for the patient and time consuming for the stuff. An alternative concept in wound dressing design that combines the advantages of occlusive dressings with biodegradability and intrinsic topical antibiotic treatment is described herewith. The new composite structure presented in this article is based on a polyglyconate mesh and a porous poly-(dl-lactic-co-glycolic acid) matrix loaded with gentamicin developed to provide controlled release of antibiotics for three weeks. In vivo evaluation of the dressing material in contaminated deep second degree burn wounds in guinea pigs (n=20) demonstrated its ability to accelerate epithelialization by 40% compared to an unloaded format of the material and a conventional dressing material. Wound contraction was reduced significantly, and a better quality scar tissue was formed. The current dressing material exhibits promising results, does not require frequent bandage changes, and offers a potentially valuable and economic approach to treating the life-threatening complication of burn-related infections. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

Release of antibiotics from collagen dressing.

PubMed

Grzybowski, J; Antos-Bielska, M; Ołdak, E; Trafny, E A

1997-01-01

Our new collagen dressing has been developed recently. Three types (A, B, and C) of the dressing were prepared in this study. Each type contained bacitracin, neomycin or colistin. The antibiotic was input into: i. collagen sponge (CS)--type A, ii. layer of limited hydrophobicity (LLH)--type B, and iii. into both CS and LLH layers--type C. The final concentration of the antibiotic that resulted from the loading level was 2 mg/cm2 for the dressings of type A and B and 4 mg/cm2 for the dressing of type C. The antibiotics were then extracted from the pieces of dressings for two days through dialysis membrane. Susceptibility of 54 bacterial strains (S. aureus, P. aeruginosa, and Acinetobacter) isolated from burn wounds were tested to the three antibiotics used for preparation of the dressings. The results of the study evidenced that efficiency of released of antibiotics into the extracts depended on the kind of antibiotic and on the type of dressing. The concentration of the antibiotics proved to be much higher than MIC90 values of the bacterial isolates tested in respect to their susceptibility. The dressing containing mixture of the three antibiotics in two layers--CS and LLH is now considered as potentially effective for care of infected wounds. It may be useful for the treatment of infected wounds or for profilaxis of contaminated wounds, ensuring: i. sufficient antimicrobial activity in wound, and ii. optimal wound environment for the presence of collagenic biomaterial on the damaged tissue.

Bi-Layer Wound Dressing System for Combat Casualty Care

DTIC Science & Technology

2004-09-01

C. Bonacorsi, M.S.G. Raddi, and I.Z. Carlos. 2004. Cytotoxicity of chlorhexidine digluconate to murine macrophages and its effect on hydrogen...chlorexhidine digluconate or 1 % chloramphenicol, as described previously. Each experimental dressing was then covered with a piece of sterile parafilm...chloramphenicol-loaded dressings were 2-log lower for the first 24 h than when applying the chlorhexidine -loaded dressings (Figure 2). However, there was no

Influence of dressing application time after breast augmentation on cutaneous colonization: A randomized clinical trial.

PubMed

Mendes, D A; Veiga, D F; Veiga-Filho, J; Loyola, A B A T; Paiva, L F; Novo, N F; Sabino-Neto, M; Ferreira, L M

2018-06-01

Concepts regarding the best way to treat a surgical wound vary, in literature, ranging from no dressing use to dressing maintenance for 24 to 48 hours or until suture removal. This study aimed to evaluate the influence of the length of dressing maintenance after breast augmentation with implants on cutaneous colonization and surgical site infection. This is a two-arm, parallel group, randomized clinical trial. Eighty patients who were candidates for augmentation mammoplasty with silicone implants were randomly allocated to two groups, in which the dressing was removed on postoperative day 1 (group A, n = 40) or postoperative day 6 (group B, n = 40). Cutaneous colonization was examined by culturing samples collected before and after dressing removal. The criteria defined by the Centers for Disease Control and Prevention were used to assess surgical site infection. No significant difference regarding cutaneous colonization was observed between groups before dressing application. On postoperative day 6, significantly more bacterial growth was observed in group A (p = 0.01). No surgical site infection occurred. We concluded that maintaining the dressing for 6 days led to a lower cutaneous colonization but did not influence surgical site infection rates. Copyright © 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

The clinical and cost effectiveness of bee honey dressing in the treatment of diabetic foot ulcers.

PubMed

Moghazy, A M; Shams, M E; Adly, O A; Abbas, A H; El-Badawy, M A; Elsakka, D M; Hassan, S A; Abdelmohsen, W S; Ali, O S; Mohamed, B A

2010-09-01

Honey is known, since antiquity, as an effective wound dressing. Emergence of resistant strains and the financial burden of modern dressings, have revived honey as cost-effective dressing particularly in developing countries. Its suitability for all stages of wound healing suggests its clinical effectiveness in diabetic foot wound infections. Thirty infected diabetic foot wounds were randomly selected from patients presenting to Surgery Department, Suez Canal University Hospital, Ismailia, Egypt. Honey dressing was applied to wounds for 3 months till healing, grafting or failure of treatment. Changes in grade and stage of wounds, using University of Texas Diabetic Wound Classification, as well as surface area were recorded weekly. Bacterial load was determined before and after honey dressing. Complete healing was significantly achieved in 43.3% of ulcers. Decrease in size and healthy granulation was significantly observed in another 43.3% of patients. Bacterial load of all ulcers was significantly reduced after the first week of honey dressing. Failure of treatment was observed in 6.7% of ulcers. This study proves that commercial clover honey is a clinical and cost-effective dressing for diabetic wound in developing countries. It is omnipresence and concordance with cultural beliefs makes it a typical environmentally based method for treating these conditions. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

A wearable wound moisture sensor as an indicator for wound dressing change: an observational study of wound moisture and status.

PubMed

Milne, Stephen D; Seoudi, Ihab; Al Hamad, Hanadi; Talal, Talal K; Anoop, Anzila A; Allahverdi, Niloofar; Zakaria, Zain; Menzies, Robert; Connolly, Patricia

2016-12-01

Wound moisture is known to be a key parameter to ensure optimum healing conditions in wound care. This study tests the moisture content of wounds in normal practice in order to observe the moisture condition of the wound at the point of dressing change. This study is also the first large-scale observational study that investigates wound moisture status at dressing change. The WoundSense sensor is a commercially available moisture sensor which sits directly on the wound in order to find the moisture status of the wound without disturbing or removing the dressing. The results show that of the 588 dressing changes recorded, 44·9% were made when the moisture reading was in the optimum moisture zone. Of the 30 patients recruited for this study, 11 patients had an optimum moisture reading for at least 50% of the measurements before dressing change. These results suggest that a large number of unnecessary dressing changes are being made. This is a significant finding of the study as it suggests that the protocols currently followed can be modified to allow fewer dressing changes and less disturbance of the healing wound bed. © 2015 The Authors. International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Seeing "the Dress" in the Right Light: Perceived Colors and Inferred Light Sources.

PubMed

Chetverikov, Andrey; Ivanchei, Ivan

2016-08-01

In the well-known "dress" photograph, people either see the dress as blue with black stripes or as white with golden stripes. We suggest that the perception of colors is guided by the scene interpretation and the inferred positions of light sources. We tested this hypothesis in two online studies using color matching to estimate the colors observers see, while controlling for individual differences in gray point bias and color discrimination. Study 1 demonstrates that the interpretation of the dress corresponds to differences in perceived colors. Moreover, people who perceive the dress as blue-and-black are two times more likely to consider the light source as frontal, than those who see the white-and-gold dress. The inferred light sources, in turn, depend on the circadian changes in ambient light. The interpretation of the scene background as a wall or a mirror is consistent with the perceived colors as well. Study 2 shows that matching provides reliable results on differing devices and replicates the findings on scene interpretation and light sources. Additionally, we show that participants' environmental lighting conditions are an important cue for perceiving the dress colors. The exact mechanisms of how environmental lighting and circadian changes influence the perceived colors of the dress deserve further investigation.

Technics study on high accuracy crush dressing and sharpening of diamond grinding wheel

NASA Astrophysics Data System (ADS)

Jia, Yunhai; Lu, Xuejun; Li, Jiangang; Zhu, Lixin; Song, Yingjie

2011-05-01

Mechanical grinding of artificial diamond grinding wheel was traditional wheel dressing process. The rotate speed and infeed depth of tool wheel were main technics parameters. The suitable technics parameters of metals-bonded diamond grinding wheel and resin-bonded diamond grinding wheel high accuracy crush dressing were obtained by a mount of experiment in super-hard material wheel dressing grind machine and by analysis of grinding force. In the same time, the effect of machine sharpening and sprinkle granule sharpening was contrasted. These analyses and lots of experiments had extent instruction significance to artificial diamond grinding wheel accuracy crush dressing.

Tiny patients, tiny dressings: a guide to the neonatal PICC dressing change.

PubMed

Sharpe, Elizabeth L

2008-06-01

Advances in neonatology now support the survival of the tiniest of infants. The peripherally inserted central catheter (PICC) has now become an integral part of routine practice in neonatal intensive care units around the world. Keen attention to safe maintenance of these devices is essential. A properly applied and maintained PICC dressing is the first line of defense to minimize the risk of complications such as dislodgement, migration, and infection. This article describes a neonatal PICC dressing change and discusses the frequently encountered quandaries surrounding this important procedure, including dressing materials, frequency, site preparation, barrier precautions, and other relevant concerns.

Constructing medical social authority on dress in Victorian Canada.

PubMed

O'Connor, Eileen

2008-01-01

During the late-Victorian period, campaigns to "reform" middle-class women's dress were grounded in discourses on health, eugenics, declining birth rates, comfort, and aesthetics. In Britain, the United States and Germany, organized "dress reform" movements emerged in the latter half of the 19th century, while in Canada the campaign was led primarily by physicians through public health education. This article explores the discussion on women's dress in public health literature in Canadian circulation between 1860-1900 and interprets findings within a feminist poststructuralist framework that posits the understanding of women's bodies and gender regulation to be central to knowledge construction on women's dress.

Association of Alpha Tocopherol and Ag Sulfadiazine Chitosan Oleate Nanocarriers in Bioactive Dressings Supporting Platelet Lysate Application to Skin Wounds.

PubMed

Bonferoni, Maria Cristina; Sandri, Giuseppina; Rossi, Silvia; Dellera, Eleonora; Invernizzi, Alessandro; Boselli, Cinzia; Cornaglia, Antonia Icaro; Del Fante, Claudia; Perotti, Cesare; Vigani, Barbara; Riva, Federica; Caramella, Carla; Ferrari, Franca

2018-02-09

Chitosan oleate was previously proposed to encapsulate in nanocarriers some poorly soluble molecules aimed to wound therapy, such as the anti-infective silver sulfadiazine, and the antioxidant α tocopherol. Because nanocarriers need a suitable formulation to be administered to wounds, in the present paper, these previously developed nanocarriers were loaded into freeze dried dressings based on chitosan glutamate. These were proposed as bioactive dressings aimed to support the application to wounds of platelet lysate, a hemoderivative rich in growth factors. The dressings were characterized for hydration capacity, morphological aspect, and rheological and mechanical behavior. Although chitosan oleate nanocarriers clearly decreased the mechanical properties of dressings, these remained compatible with handling and application to wounds. Preliminary studies in vitro on fibroblast cell cultures demonstrated good compatibility of platelet lysate with nanocarriers and bioactive dressings. An in vivo study on a murine wound model showed an accelerating wound healing effect for the bioactive dressing and its suitability as support of the platelet lysate application to wounds.

Association of Alpha Tocopherol and Ag Sulfadiazine Chitosan Oleate Nanocarriers in Bioactive Dressings Supporting Platelet Lysate Application to Skin Wounds

PubMed Central

Bonferoni, Maria Cristina; Dellera, Eleonora; Invernizzi, Alessandro; Cornaglia, Antonia Icaro; Perotti, Cesare; Vigani, Barbara; Caramella, Carla; Ferrari, Franca

2018-01-01

Chitosan oleate was previously proposed to encapsulate in nanocarriers some poorly soluble molecules aimed to wound therapy, such as the anti-infective silver sulfadiazine, and the antioxidant α tocopherol. Because nanocarriers need a suitable formulation to be administered to wounds, in the present paper, these previously developed nanocarriers were loaded into freeze dried dressings based on chitosan glutamate. These were proposed as bioactive dressings aimed to support the application to wounds of platelet lysate, a hemoderivative rich in growth factors. The dressings were characterized for hydration capacity, morphological aspect, and rheological and mechanical behavior. Although chitosan oleate nanocarriers clearly decreased the mechanical properties of dressings, these remained compatible with handling and application to wounds. Preliminary studies in vitro on fibroblast cell cultures demonstrated good compatibility of platelet lysate with nanocarriers and bioactive dressings. An in vivo study on a murine wound model showed an accelerating wound healing effect for the bioactive dressing and its suitability as support of the platelet lysate application to wounds. PMID:29425164

Groin dressing after cardiac catheterization. Comparison between light dressing with thin transparent tape (Tegaderm) and conventional tight/pressure dressing with an elastic adhesive bandage (Tensoplast).

PubMed

Boonbaichaiyapruck, S; Hutayanon, P; Chanthanamatta, P; Dumrongwatana, T; Intarayotha, N; Krisdee, V; Yamvong, S

2001-12-01

Post cardiac catheterization puncture site care is usually done with a tight pressure dressing by an elastic adhesive bandage (Tensoplast) due to the belief that it should prevent bleeding. The practice is uncomfortable to the patients. The authors compared a new way of dressing using light transparent tape (Tegaderm) to the conventional tight pressure one. 126 post coronary angiography patients were randomized to have their groins dressed either with Tensoplast or with Tegaderm. Patients ambulated 8 hours after the procedures. The groin was evaluated for pain, discomfort and bleeding complications. 49 per cent in the Tensoplast vs 26.9 per cent in the Tegaderm group experienced pain (p value of 0.01). 55.5 per cent in the Tensoplast group vs 11.1 per cent in the Tegaderm group reported discomfort. 4.7 per cent in the Tensoplast vs 1.6 per cent in the Tegaderm group developed bleeding or hematoma. Dressing of the puncture site after cardiac catheterization with Tegaderm was more comfortable than the conventional Tensoplast without any difference in bleeding complications.

Effects of honey and sugar dressings on wound healing.

PubMed

Mphande, A N G; Killowe, C; Phalira, S; Jones, H Wynn; Harrison, W J

2007-07-01

To investigate whether there is a difference between the efficacy of honey and sugar as wound dressings. Patients with open or infected wounds were randomised to receive either honey or sugar dressings. Bacterial colonisation, wound size, wound ASEPSIS score and pain were assessed at the start of treatment and at weekly intervals until full healing occurred. Forty patients were enrolled; 18 received sugar dressings and 22 honey dressings. In the honey group, 55% of patients had positive wound cultures at the start of treatment and 23% at one week, compared with 52% and 39% respectively in the sugar group.The median rate of healing in the first two weeks of treatment was 3.8cm2/week for the honey group and 2.2cm2/week for the sugar group. After three weeks of treatment 86% of patients treated with honey had no pain during dressing changes, compared with 72% treated with sugar. Honey appears to be more effective than sugar in reducing bacterial contamination and promoting wound healing, and slightly less painful than sugar during dressing changes and motion.

[Consent and confidentiality in occupational health practice: balance between legal requirements and ethical values].

PubMed

Mora, Erika; Franco, G

2010-01-01

The recently introduced Italian law on the protection of workers' health states that the occupational health physician (competent physician) is required to act according to the Code of Ethics of the International Commission on Occupational Health (ICOH). This paper aims at examining the articles of legislative decree 81/2008 dealing with informed consent and confidentiality compared with the corresponding points of the ICOH Ethics Code. Analysis of the relationship between articles 25 and 39 (informed consent) and 18, 20 and 39 (confidentiality) of the decree shows that there are some points of disagreement between the legal requirements and the Code of Ethics, in particular concerning prescribed health surveillance, consent based on appropriate information (points 8, 10 and 12 of the Code) and some aspects of confidentiality (points 10, 20, 21, 22 and 23 of the Code). Although the competent physician is required to act according to the law, the decisional process could lead to a violation of workers' autonomy.

How Do Teachers Make Judgments about Ethical and Unethical Behaviors? Toward the Development of a Code of Conduct for Teachers

ERIC Educational Resources Information Center

Barrett, David E.; Casey, J. Elizabeth; Visser, Ryan D.; Headley, Kathy N.

2012-01-01

The authors examined the dimensions that underlie teachers' judgments about ethical versus unethical behaviors. 593 educators and teachers in training were administered a 41 item survey. For each item, respondents rated the extent to which they believed the behavior (a) occurred frequently and (b) represented a serious violation of professional…

IDEA 2004: Section 615 (k) (Placement in Alternative Educational Setting). PHP-c111

ERIC Educational Resources Information Center

PACER Center, 2005

2005-01-01

School personnel may consider any unique circumstances on a case-by-case basis when determining whether to order a change in placement for a child with a disability who violates a code of student conduct. This article describes IDEA 2004: Section 615 (k), which discusses the placement of special needs children in alternative educational settings.…

38 CFR 2.6 - Secretary's delegations of authority to certain officials (38 U.S.C. 512).

Code of Federal Regulations, 2010 CFR

2010-07-01

... equipment provided under chapter 39 of title 38, United States Code, or to appoint a designee to perform... based in whole or in part on conduct in violation of the antitrust laws. Such cases will be considered... where the Department of Justice determines that action based upon the alleged fraud, false claim, or...

Putting reward in art: A tentative prediction error account of visual art

PubMed Central

Van de Cruys, Sander; Wagemans, Johan

2011-01-01

The predictive coding model is increasingly and fruitfully used to explain a wide range of findings in perception. Here we discuss the potential of this model in explaining the mechanisms underlying aesthetic experiences. Traditionally art appreciation has been associated with concepts such as harmony, perceptual fluency, and the so-called good Gestalt. We observe that more often than not great artworks blatantly violate these characteristics. Using the concept of prediction error from the predictive coding approach, we attempt to resolve this contradiction. We argue that artists often destroy predictions that they have first carefully built up in their viewers, and thus highlight the importance of negative affect in aesthetic experience. However, the viewer often succeeds in recovering the predictable pattern, sometimes on a different level. The ensuing rewarding effect is derived from this transition from a state of uncertainty to a state of increased predictability. We illustrate our account with several example paintings and with a discussion of art movements and individual differences in preference. On a more fundamental level, our theorizing leads us to consider the affective implications of prediction confirmation and violation. We compare our proposal to other influential theories on aesthetics and explore its advantages and limitations. PMID:23145260

Electrospun polymeric dressings functionalized with antimicrobial peptides and collagen type I for enhanced wound healing

NASA Astrophysics Data System (ADS)

Felgueiras, H. P.; Amorim, M. T. P.

2017-10-01

Modern wound dressings combine medical textiles with active compounds that stimulate wound healing while protecting against infection. Electrospun wound dressings have been extensively studied and the electrospinning technique recognized as an efficient approach for the production of nanoscale fibrous mats. The unique diverse function and architecture of antimicrobial peptides (AMPs) has attracted considerable attention as a tool for the design of new anti-infective drugs. Functionalizing electrospun wound dressings with these AMPs is nowadays being researched. In the present work, we explore these new systems by highlighting the most important characteristics of electropsun wound dressings, revealing the importance of AMPs to wound healing, and the methods available to functionalize the electrospun mats with these molecules. The combined therapeutic potential of collagen type I and these AMP functionalized dressings will be highlighted as well; the significance of these new strategies for the future of wound healing will be clarified.

The Feedback-Related Negativity and the P300 Brain Potential Are Sensitive to Price Expectation Violations in a Virtual Shopping Task.

PubMed

Schaefer, Alexandre; Buratto, Luciano G; Goto, Nobuhiko; Brotherhood, Emilie V

A large body of evidence shows that buying behaviour is strongly determined by consumers' price expectations and the extent to which real prices violate these expectations. Despite the importance of this phenomenon, little is known regarding its neural mechanisms. Here we show that two patterns of electrical brain activity known to index prediction errors-the Feedback-Related Negativity (FRN) and the feedback-related P300 -were sensitive to price offers that were cheaper than participants' expectations. In addition, we also found that FRN amplitude time-locked to price offers predicted whether a product would be subsequently purchased or not, and further analyses suggest that this result was driven by the sensitivity of the FRN to positive price expectation violations. This finding strongly suggests that ensembles of neurons coding positive prediction errors play a critical role in real-life consumer behaviour. Further, these findings indicate that theoretical models based on the notion of prediction error, such as the Reinforcement Learning Theory, can provide a neurobiologically grounded account of consumer behavior.

Enforcing the Courant-Friedrichs-Lewy condition in explicitly conservative local time stepping schemes

NASA Astrophysics Data System (ADS)

Gnedin, Nickolay Y.; Semenov, Vadim A.; Kravtsov, Andrey V.

2018-04-01

An optimally efficient explicit numerical scheme for solving fluid dynamics equations, or any other parabolic or hyperbolic system of partial differential equations, should allow local regions to advance in time with their own, locally constrained time steps. However, such a scheme can result in violation of the Courant-Friedrichs-Lewy (CFL) condition, which is manifestly non-local. Although the violations can be considered to be "weak" in a certain sense and the corresponding numerical solution may be stable, such calculation does not guarantee the correct propagation speed for arbitrary waves. We use an experimental fluid dynamics code that allows cubic "patches" of grid cells to step with independent, locally constrained time steps to demonstrate how the CFL condition can be enforced by imposing a constraint on the time steps of neighboring patches. We perform several numerical tests that illustrate errors introduced in the numerical solutions by weak CFL condition violations and show how strict enforcement of the CFL condition eliminates these errors. In all our tests the strict enforcement of the CFL condition does not impose a significant performance penalty.

The Feedback-Related Negativity and the P300 Brain Potential Are Sensitive to Price Expectation Violations in a Virtual Shopping Task

PubMed Central

Schaefer, Alexandre; Buratto, Luciano G.; Goto, Nobuhiko; Brotherhood, Emilie V.

2016-01-01

A large body of evidence shows that buying behaviour is strongly determined by consumers’ price expectations and the extent to which real prices violate these expectations. Despite the importance of this phenomenon, little is known regarding its neural mechanisms. Here we show that two patterns of electrical brain activity known to index prediction errors–the Feedback-Related Negativity (FRN) and the feedback-related P300 –were sensitive to price offers that were cheaper than participants’ expectations. In addition, we also found that FRN amplitude time-locked to price offers predicted whether a product would be subsequently purchased or not, and further analyses suggest that this result was driven by the sensitivity of the FRN to positive price expectation violations. This finding strongly suggests that ensembles of neurons coding positive prediction errors play a critical role in real-life consumer behaviour. Further, these findings indicate that theoretical models based on the notion of prediction error, such as the Reinforcement Learning Theory, can provide a neurobiologically grounded account of consumer behavior. PMID:27658301

Human errors and violations in computer and information security: the viewpoint of network administrators and security specialists.

PubMed

Kraemer, Sara; Carayon, Pascale

2007-03-01

This paper describes human errors and violations of end users and network administration in computer and information security. This information is summarized in a conceptual framework for examining the human and organizational factors contributing to computer and information security. This framework includes human error taxonomies to describe the work conditions that contribute adversely to computer and information security, i.e. to security vulnerabilities and breaches. The issue of human error and violation in computer and information security was explored through a series of 16 interviews with network administrators and security specialists. The interviews were audio taped, transcribed, and analyzed by coding specific themes in a node structure. The result is an expanded framework that classifies types of human error and identifies specific human and organizational factors that contribute to computer and information security. Network administrators tended to view errors created by end users as more intentional than unintentional, while errors created by network administrators as more unintentional than intentional. Organizational factors, such as communication, security culture, policy, and organizational structure, were the most frequently cited factors associated with computer and information security.

[Split-thickness skin graft donor site: which dressing use?].

PubMed

Caliot, J; Bodin, F; Chiriac, S; Correia, N; Poli-Mérol, M-L; François-Fiquet, C

2015-04-01

The management of split-thickness skin graft donor sites is targeted towards promoting the healing process, reducing pain. This has been an inconclusive topic. The aim of this study was to list and to discuss the French practices in term of split-thickness skin graft (STSG) donor site dressing. Multicentric national study by questionnaire (Google Drive(®)) for the attention of the plastic and/or pediatric surgeons. The type of dressing used on skin and sclap and the rhythm of dressing changes were analyzed. The study included 26 surgical centers on 40 contacted. The alginate is mainly used (Algostéril(®)) (17/26). It is left in position until healing (13/17). Five other types of dressings have been reported: paraffin gauze (3/26), lipidocolloides (1/26), Mepitel(®) (1/26), Mepilex(®) (1/26), indifferent use of gauze or alginate dressings (4/26). Twenty-two out of 26 centers make no difference in dressing choice between skin and scalp. Medical practices did not differ between adult or pediatric departments. Cost-effectiveness has become an important issue in wound management, requiring judicious use. The lack of consensus regarding split-thickness skin graft donor site dressing and our clinical practices force us to reconsider the best therapeutic option. This study coupled with the analysis of the literature highlights the difficulties of the practitioner in choosing the best dressing. The alginate seems to get the preference of our practices by its ease of use, its absence of change (reduces pain by limiting manipulations) and its moderate cost. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

A comparison of an antibacterial sandwich dressing vs dressing containing silver.

PubMed

Krasowski, Grzegorz; Jawień, Arkadiusz; Tukiendorf, Andrzej; Rybak, Zbigniew; Junka, Adam; Olejniczak-Nowakowska, Małgorzata; Bartoszewicz, Marzenna; Smutnicka, Danuta

2015-01-01

The purpose of this study was to compare the efficacy of dressings containing octenidine vs. dressings containing silver in the wound healing in the course of a chronic venous disease. There were two groups of 40 patients who met the inclusion criteria and who did not meet the exclusion criteria. The patients were randomly assigned into the groups (envelope method). The first, "O group" was treated with octenidine-based dressings. The second, "S group" was treated with silver dressings. The study lasted for 56 days. All patients in the research were treated with medical compression stockings with cotton understockings. Microbiological eradication was observed on the 28th day of the study among 33% of patients in the treatment group vs. 6% in control group. On the 56th day of the treatment, these percentages equalled 72% and 35%. The rate of healing was faster in the 0 group than in the S group. In the wounds <10 cm(2) it was faster by 1.35 cm(2)/week and in wounds >10 cm(2) it equalled 3.44 cm(2). The reduction of pain level was 37.5% higher in the O group, in contrast with the S group. One change of a dressing in the O group led to a 0.06 cm(2) greater wound size reduction and in the case of wounds >10 cm(2) to 0.29 cm(2) reduction compared with the S group. The presented results indicate that the efficacy of dressings containing octenidine is higher compared to silver dressings. © 2015 by the Wound Healing Society.

Evaluation of the Efficacy of Highly Hydrophilic Polyurethane Foam Dressing in Treating a Diabetic Foot Ulcer.

PubMed

Jung, Jae-A; Yoo, Ki-Hyun; Han, Seung-Kyu; Dhong, Eun-Sang; Kim, Woo-Kyung

2016-12-01

To demonstrate the efficacy of a highly hydrophilic polyurethane foam dressing in the treatment of diabetic ulcers. Diabetic foot ulcers often pose a difficult treatment problem. Polyurethane foam dressings have been used worldwide to accelerate wound healing, but only a few clinical studies demonstrate the effect of foam dressing on the healing of diabetic ulcers. Medical records of 1342 patients with diabetic ulcers who were admitted and treated at the authors' institution were reviewed. A total of 208 patients met the study's inclusion criteria. Of these 208 patients, 137 were treated with a highly hydrophilic polyurethane foam dressing, and 71 were treated with saline gauze (control group). Except for the application of polyurethane foam dressing, the treatment method was identical for patients in both groups. The wound healing outcomes of the 2 groups were compared. Complete wound healing occurred in 87 patients (63.5%) in the polyurethane foam dressing group and in 28 patients (39.4%) in the control group within 12 weeks (P < .05, X test). The mean percentage of wound area reduction in both groups was statistically significant (P < .05, Mann-Whitney U test). The mean time required for complete closure in patients who achieved complete healing within 12 weeks was 6.2 (SD, 3.4) weeks and 7.3 (SD, 2.6) weeks in the polyurethane foam dressing and control groups, respectively (P < .05, Mann-Whitney U test). These results indicate that the highly hydrophilic polyurethane foam dressing may provide an effective treatment strategy for diabetic foot ulcers.

Modified wound dressing with phyto-nanostructured coating to prevent staphylococcal and pseudomonal biofilm development

NASA Astrophysics Data System (ADS)

Anghel, Ion; Holban, Alina Maria; Grumezescu, Alexandru Mihai; Andronescu, Ecaterina; Ficai, Anton; Anghel, Alina Georgiana; Maganu, Maria; Lazǎr, Veronica; Chifiriuc, Mariana Carmen

2012-12-01

This paper reports a newly fabricated nanophyto-modified wound dressing with microbicidal and anti-adherence properties. Nanofluid-based magnetite doped with eugenol or limonene was used to fabricate modified wound dressings. Nanostructure coated materials were characterized by TEM, XRD, and FT-IR. For the quantitative measurement of biofilm-embedded microbial cells, a culture-based method for viable cell count was used. The optimized textile dressing samples proved to be more resistant to staphylococcal and pseudomonal colonization and biofilm formation compared to the uncoated controls. The functionalized surfaces for wound dressing seems to be a very useful tool for the prevention of wound microbial contamination on viable tissues.

Modified wound dressing with phyto-nanostructured coating to prevent staphylococcal and pseudomonal biofilm development

PubMed Central

2012-01-01

This paper reports a newly fabricated nanophyto-modified wound dressing with microbicidal and anti-adherence properties. Nanofluid-based magnetite doped with eugenol or limonene was used to fabricate modified wound dressings. Nanostructure coated materials were characterized by TEM, XRD, and FT-IR. For the quantitative measurement of biofilm-embedded microbial cells, a culture-based method for viable cell count was used. The optimized textile dressing samples proved to be more resistant to staphylococcal and pseudomonal colonization and biofilm formation compared to the uncoated controls. The functionalized surfaces for wound dressing seems to be a very useful tool for the prevention of wound microbial contamination on viable tissues. PMID:23272823

Modified wound dressing with phyto-nanostructured coating to prevent staphylococcal and pseudomonal biofilm development.

PubMed

Anghel, Ion; Holban, Alina Maria; Grumezescu, Alexandru Mihai; Andronescu, Ecaterina; Ficai, Anton; Anghel, Alina Georgiana; Maganu, Maria; Laz R, Veronica; Chifiriuc, Mariana Carmen

2012-12-31

This paper reports a newly fabricated nanophyto-modified wound dressing with microbicidal and anti-adherence properties. Nanofluid-based magnetite doped with eugenol or limonene was used to fabricate modified wound dressings. Nanostructure coated materials were characterized by TEM, XRD, and FT-IR. For the quantitative measurement of biofilm-embedded microbial cells, a culture-based method for viable cell count was used. The optimized textile dressing samples proved to be more resistant to staphylococcal and pseudomonal colonization and biofilm formation compared to the uncoated controls. The functionalized surfaces for wound dressing seems to be a very useful tool for the prevention of wound microbial contamination on viable tissues.

Exploratory Development of an Ultrafast-Curing Wound Dressing

DTIC Science & Technology

1991-05-31

mils thick: Formulation 2 and 5 .. 36 17. Elution Rates for the 30% Chlorhexidine Gluconate ADD’s at t=0 and Stored at the Temperature Extremes (400C...determined from the in vivo trials conducted earlier (9). The 6 mil thick dressing (Formulation 2) demonstrated effectiveness when tested on guinea pigs...This dressing released approximately 3000 micrograms/sq. cm. in 72 hours or about 64% of the 12 mil dressing tested for shelf stability (Figure 16

Unravelling nocebo effect: the mediating effect of anxiety between anticipation and pain at wound dressing change.

PubMed

Woo, Kevin Y

2015-07-01

The purpose of this study was to examine the mediating effect of anxiety in the relationship between anticipation and pain in people with chronic wounds. Pain is common in people with chronic wounds. Anticipation or negative expectation of discomfort has been shown to have an augmenting effect on pain; also known as nocebo hyperalgesia. This was a cross-sectional study with repeated measures. Prior to dressing change, anticipatory pain level was evaluated by a 11-point numerical rating scale and anxiety by the Six-items State-Trait Anxiety Inventory (STAI-6). During wound dressing changes, pain was measured before dressing removal, at dressing removal, at cleansing and dressing application using the numerical scale. Analysis was completed based on the data from a convenience sample of 96 patients. Participants reported more pain at cleansing and dressing removal than baseline. High levels of anticipation, anxiety and pain at dressing change for wounds were related to heavy exudate and wound that were covered with necrotic tissue. Finally, the relationship between anticipation and pain perception was mediated by anxiety. Anticipation of pain triggers anxiety that can lead to increased pain. There is a need to incorporate evaluation of anxiety and personal expectations as part of comprehensive pain assessment. Clinicians should be aware of the impact of emotions and anticipation on overall pain experience. © 2015 John Wiley & Sons Ltd.

Hydrogel-gauze dressing for moderate-to-severe atopic dermatitis: development and efficacy study on atopic dermatitis-like skin lesions in NC/Nga mice.

PubMed

Ng, Shiow-Fern; Lew, Pit-Chin; Sin, Yong-Boey

2014-11-01

Topical emollients are known to provide symptomatic relief for atopic dermatitis. In hospitals, wet-wrap therapy has been shown to benefit children with moderate-to-severe atopic dermatitis (AD), but the application of wet-wraps is tedious and time-consuming. Topical emollients have low residence time and often dry out easily. The aim of this work was to develop a hydrogel-gauze dressing that is not only easy to apply but also rehydrates and traps moisture to provide longer relief for AD patients. In this study, a prototype hydrogel-gauze dressing was developed with varying ratios of sodium carboxymethylcellulose (NaCMC) and propylene glycol. The hydrogel-gauze dressings were assessed based on the moisture vapor transmission rate, moisture absorption, mechanical properties and storage stability over three months. Then, the efficacy of the hydrogel-gauze dressing was compared to topical emollients using transgenic NC/Nga mice with AD-like lesions. The NaCMC hydrogel-gauze dressings significantly lowered transepidermal water loss, and the animals displayed a faster recovery, which indicates that hydrogel-gauze dressings can trap moisture more effectively and accelerate AD healing. Hence, we propose that hydrogel-gauze dressings can potentially become an alternative to wet-wrap therapy due to the ease of application and the higher efficacy compared to topical products.

Single and Combined Effects of Pesticide Seed Dressings and Herbicides on Earthworms, Soil Microorganisms, and Litter Decomposition.

PubMed

Van Hoesel, Willem; Tiefenbacher, Alexandra; König, Nina; Dorn, Verena M; Hagenguth, Julia F; Prah, Urša; Widhalm, Theresia; Wiklicky, Viktoria; Koller, Robert; Bonkowski, Michael; Lagerlöf, Jan; Ratzenböck, Andreas; Zaller, Johann G

2017-01-01

Seed dressing, i.e., the treatment of crop seeds with insecticides and/or fungicides, aiming to protect seeds from pests and diseases, is widely used in conventional agriculture. During the growing season, those crop fields often receive additional broadband herbicide applications. However, despite this broad utilization, very little is known on potential side effects or interactions between these different pesticide classes on soil organisms. In a greenhouse pot experiment, we studied single and interactive effects of seed dressing of winter wheat ( Triticum aestivum L. var. Capo ) with neonicotinoid insecticides and/or strobilurin and triazolinthione fungicides and an additional one-time application of a glyphosate-based herbicide on the activity of earthworms, soil microorganisms, litter decomposition, and crop growth. To further address food-web interactions, earthworms were introduced to half of the experimental units as an additional experimental factor. Seed dressings significantly reduced the surface activity of earthworms with no difference whether insecticides or fungicides were used. Moreover, seed dressing effects on earthworm activity were intensified by herbicides (significant herbicide × seed dressing interaction). Neither seed dressings nor herbicide application affected litter decomposition, soil basal respiration, microbial biomass, or specific respiration. Seed dressing did also not affect wheat growth. We conclude that interactive effects on soil biota and processes of different pesticide classes should receive more attention in ecotoxicological research.

Randomized controlled trial of care bundles with chlorhexidine dressing and advanced dressings to prevent catheter-related bloodstream infections in pediatric hematology-oncology patients.

PubMed

Gerçeker, Gülçin Özalp; Yardımcı, Figen; Aydınok, Yeşim

2017-06-01

To compare the effects of the care bundles including chlorhexidine dressing and advanced dressings on the catheter-related bloodstream infection (CRBSI) rates in pediatric hematology-oncology patients with central venous catheters (CVCs). Twenty-seven PHO patients were recruited to participate in a prospective, randomized study in Turkey. The researcher used care bundles with chlorhexidine dressing in the experimental group (n = 14), and care bundles with advanced dressings in the control group (n = 13). According to the study results, 28.6% of the patients in the experimental group had CRBSI, while this rate was 38.5% in the control group patients. The CRBSI rate in the experimental group was 3.9, and the control group had 4.4 per 1000 inpatient catheter days. There was no exit-site infection in the experimental group. However, the control group had 1.7 per 1000 inpatient catheter days. Even though there was no difference between the two groups in which the researcher implemented care bundles with chlorhexidine dressing and advanced dressings in terms of CRBSI development, there was reduction in the CRBSI rates thanks to the care bundle approach. It is possible to control the CRBSI rates using care bundles in pediatric hematology-oncology patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

Experimental Comparison of Efficiency of First Aid Dressings in Burning White Phosphorus on Bacon Model.

PubMed

Witkowski, Wojciech; Surowiecka-Pastewka, Agnieszka; Biesaga, Magdalena; Gierczak, Tomasz

2015-08-12

The aim of this study was to determine effectiveness of first aid dressings in extinguishing burning white phosphorous (WP), eliminating WP pieces from the surface, inhibiting re-ignition on the model (fresh bacon covered with military uniform), and preventing from late re-ignition caused by persistent WP pieces. Burning WP was extinguished with several dressings: tactical Military Dressing (WJ10), wet gauze, 2 hydrocolloids, and 3 prototypes of hydrocolloids developed by the authors. All examined dressings were effective in extinguishing WP provided that the entire area of the burning substance was completely covered. Moist gauze was especially effective in extinguishing WP, and also removed and absorbed the majority of the WP mass, preventing deeper penetration of WP particles. The immediate re-ignition was observed when all the remaining examined dressings were removed from the bacon. A stream of water was dangerous, as it splashed and transferred pieces of WP around. Moist gauze placed on burning WP for approximately 3 min was most effective in extinguishing WP and removing most of the WP pieces. We recommend moist gauze, used once or twice, as the best primary means for WP elimination and preventing tissue penetration. As a dressing used for medical evacuation (MEDEVAC), or as a second step after complete removal of visible WP, innovative hydrocolloid or hydrogel dressings should be used.

Experimental Comparison of Efficiency of First Aid Dressings in Burning White Phosphorus on Bacon Model

PubMed Central

Witkowski, Wojciech; Surowiecka-Pastewka, Agnieszka; Biesaga, Magdalena; Gierczak, Tomasz

2015-01-01

Background The aim of this study was to determine effectiveness of first aid dressings in extinguishing burning white phosphorous (WP), eliminating WP pieces from the surface, inhibiting re-ignition on the model (fresh bacon covered with military uniform), and preventing from late re-ignition caused by persistent WP pieces. Material/Methods Burning WP was extinguished with several dressings: tactical Military Dressing (WJ10), wet gauze, 2 hydrocolloids, and 3 prototypes of hydrocolloids developed by the authors. Results All examined dressings were effective in extinguishing WP provided that the entire area of the burning substance was completely covered. Moist gauze was especially effective in extinguishing WP, and also removed and absorbed the majority of the WP mass, preventing deeper penetration of WP particles. The immediate re-ignition was observed when all the remaining examined dressings were removed from the bacon. A stream of water was dangerous, as it splashed and transferred pieces of WP around. Conclusions Moist gauze placed on burning WP for approximately 3 min was most effective in extinguishing WP and removing most of the WP pieces. We recommend moist gauze, used once or twice, as the best primary means for WP elimination and preventing tissue penetration. As a dressing used for medical evacuation (MEDEVAC), or as a second step after complete removal of visible WP, innovative hydrocolloid or hydrogel dressings should be used. PMID:26264209

Development of the upper-body dressing scale for a buttoned shirt: a preliminary correlational study.

PubMed

Suzuki, Makoto; Yamada, Sumio; Omori, Mikayo; Hatakeyama, Mayumi; Sugimura, Yuko; Matsushita, Kazuhiko; Tagawa, Yoshikatsu

2008-09-01

A patient with poststroke hemiparesis learns to use the nonparetic arm to compensate for the weakness of the paretic arm to achieve independence in dressing. This is the learning process of new component actions on dressing. The purpose of this study was to develop the Upper-Body Dressing Scale (UBDS) for buttoned shirt dressing, which evaluates the component actions of upper-body dressing, and to provide preliminary data on internal consistency of the UBDS, as well as its reproducibility, validity, and sensitivity to clinical change. Correlational study of concurrent validity and reliability in which 63 consecutive stroke patients were enrolled in the study and were assessed repeatedly by the UBDS and the dressing item of Functional Independent Measure (FIM). Fifty-one patients completed the 3-wk study. The Cronbach's coefficient alpha of UBDS was 0.88. The principal component analysis extracted two components, which explained 62.3% of total variance. All items of the scale had high loading on the first component (0.65-0.83). Actions on the paralytic side were the positive loadings and actions on the healthy side were the negative loadings on the second component. Intraclass correlation coefficient was 0.87. The level of correlation between UBDS score and FIM dressing item scores was -0.72. Logistic regression analysis showed that only the score of UBDS on the first day of evaluation was a significant independent predictor of dressing ability (odds ratio, 0.82; 95% confidence interval, 0.71-0.95). The UBDS scores for paralytic hand passed into the sleeve, sleeve pulled up beyond the elbow joint, and sleeve pulled up beyond the shoulder joint were worse than the score for the other components of the task. These component actions had positive loading on the second component, which was identified by the principal component analysis. The UBDS has good internal consistency, reproducibility, validity, and sensitivity to clinical changes of patients with poststroke hemiparesis. This detailed UBDS assessment enables us to document the most difficult stages in dressing and to assess motor and process skills for independence of dressing.

8. SIDE VIEW OF NORTHEASTERN ROCKFACED DRESSED AND MORTARED STONE ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

8. SIDE VIEW OF NORTHEASTERN ROCKFACED DRESSED AND MORTARED STONE BRIDGE ABUTMENT (LEFT) AND DRESSED, DRY-LAID RETAINING WALL (RIGHT). FACING WEST. - Coverts Crossing Bridge, Spanning Mahoning River along Township Route 372 (Covert Road), New Castle, Lawrence County, PA

10. SIDE VIEW OF SOUTHEASTERN ROCKFACED DRESSED AND MORTARED STONE ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

10. SIDE VIEW OF SOUTHEASTERN ROCKFACED DRESSED AND MORTARED STONE BRIDGE ABUTMENT (RIGHT) AND DRESSED, DRY-LAID RETAINING WALL (LEFT). FACING NORTHWEST. - Coverts Crossing Bridge, Spanning Mahoning River along Township Route 372 (Covert Road), New Castle, Lawrence County, PA

A.D.A.M. test (Antibiofilm Dressing's Activity Measurement) - Simple method for evaluating anti-biofilm activity of drug-saturated dressings against wound pathogens.

PubMed

Junka, Adam F; Żywicka, Anna; Szymczyk, Patrycja; Dziadas, Mariusz; Bartoszewicz, Marzena; Fijałkowski, Karol

2017-12-01

In the present article, we propose a simple Antibiofilm Dressing's Activity Measurement (A.D.A.M.) test that allows to check in vitro a dressing's suitability against biofilm-related wound infections. To perform the test, three agar discs are covered with biofilm formed by the tested pathogen after which they are assembled one over another in the form of an agar plug and placed in the well of a 24-well plate. The top disc is covered with the analyzed dressing and the entire set is incubated for 24h. During this time, the investigated antimicrobial substance is released from the dressing and penetrates to subsequent biofilm-covered agar discs. Biofilm reduction is measured using 2,3,5-triphenyl-2H-tetrazolium chloride (TTC) spectrometric assay and the results are compared to untreated control samples (agar plug covered with biofilm and without the dressing/or with a passive dressing placed on the top disc). Furthermore, in order to standardize the differences in penetrability of the drugs released from active dressings the results can be expressed as a dimensionless value referred to as the Penetrability Index. In summary, A.D.A.M. test is simple, cheap, can be performed practically in every clinical laboratory and takes no more time than routine microbiological diagnostics. Apart from measuring the released drug's activity, the A.D.A.M. test allows to assess drug penetrability (across three agar discs), reflecting real wound conditions, where microbes are frequently hidden under the necrotic tissue or cloth. In conclusion, the A.D.A.M. test produces a high volume of data that, when analyzed, can provide a researcher with a valuable hint concerning the applicability of active dressings against specific biofilm pathogens in a particular setting. Copyright © 2017 Elsevier B.V. All rights reserved.

The effectiveness of silver-releasing dressings in the management of non-healing chronic wounds: a meta-analysis.

PubMed

Lo, Shu-Fen; Chang, Chee-Jen; Hu, Wen-Yu; Hayter, Mark; Chang, Yu-Ting

2009-03-01

The purpose of this study was to examine the efficacy of silver-releasing dressings in the management of non-healing chronic wounds. Non-healing chronic wounds often have a negative physical impact on patients and place a financial burden on healthcare systems. Silver dressings are wound products designed to control infection and provide a wound environment conducive to healing. However, validation of the clinical efficacy of these dressings is lacking. Systematic review and meta-analysis. A systematic search of the major electronic databases PubMed, CINAHL, Cochrane, MEDLINE, British Nursing Index, EBSCO, OCLC and Proquest between 1950-June 2007 was conducted. Hand searches of selected periodicals, textbooks and checking reference lists and contacting experts was also performed. Eight studies were selected from a potentially relevant 1957 references screened. Analysis incorporated data from 1399 participants in the eight randomised control trials. We found that silver dressings significantly improved wound healing (CI(95): 0.16-0.39, p < 0.001), reduced odour (CI(95): 0.24-0.52, p < 0.001) and pain-related symptoms (CI(95): 0.18-0.47, p < 0.001), decreased wound exudates (CI(95): 0.17-0.44, p < 0.001) and had a prolonged dressing wear time (CI(95): 0.19-0.48, p = 0.028) when compared with alternative wound management approaches. An analysis of sensitivity in these studies by subgroup analysis generally supported these associations. Furthermore, studies indicated an improvement in quality of life (CI(95): 0.04-0.33, p = 0.013) using silver dressings in wound management with no associated severe adverse events. This meta-analysis confirms the effectiveness of silver dressings in wound healing and improving patients' quality of life. However, it also highlights the need for additional well-designed randomised controlled trials to evaluate the effectiveness of silver-related dressings further. The results of this study provide objective data on the effectiveness of silver-related dressing when applied to non-healing chronic wounds.

On-machine precision preparation and dressing of ball-headed diamond wheel for the grinding of fused silica

NASA Astrophysics Data System (ADS)

Chen, Mingjun; Li, Ziang; Yu, Bo; Peng, Hui; Fang, Zhen

2013-09-01

In the grinding of high quality fused silica parts with complex surface or structure using ball-headed metal bonded diamond wheel with small diameter, the existing dressing methods are not suitable to dress the ball-headed diamond wheel precisely due to that they are either on-line in process dressing which may causes collision problem or without consideration for the effects of the tool setting error and electrode wear. An on-machine precision preparation and dressing method is proposed for ball-headed diamond wheel based on electrical discharge machining. By using this method the cylindrical diamond wheel with small diameter is manufactured to hemispherical-headed form. The obtained ball-headed diamond wheel is dressed after several grinding passes to recover geometrical accuracy and sharpness which is lost due to the wheel wear. A tool setting method based on high precision optical system is presented to reduce the wheel center setting error and dimension error. The effect of electrode tool wear is investigated by electrical dressing experiments, and the electrode tool wear compensation model is established based on the experimental results which show that the value of wear ratio coefficient K' tends to be constant with the increasing of the feed length of electrode and the mean value of K' is 0.156. Grinding experiments of fused silica are carried out on a test bench to evaluate the performance of the preparation and dressing method. The experimental results show that the surface roughness of the finished workpiece is 0.03 μm. The effect of the grinding parameter and dressing frequency on the surface roughness is investigated based on the measurement results of the surface roughness. This research provides an on-machine preparation and dressing method for ball-headed metal bonded diamond wheel used in the grinding of fused silica, which provides a solution to the tool setting method and the effect of electrode tool wear.

Functional poly(ε-caprolactone)/chitosan dressings with nitric oxide-releasing property improve wound healing.

PubMed

Zhou, Xin; Wang, He; Zhang, Jimin; Li, Xuemei; Wu, Yifan; Wei, Yongzhen; Ji, Shenglu; Kong, Deling; Zhao, Qiang

2017-05-01

Wound healing dressings are increasingly needed clinically due to the large number of skin damage annually. Nitric oxide (NO) plays a key role in promoting wound healing, thus biomaterials with NO-releasing property receive increasing attention as ideal wound dressing. In present study, we prepared a novel functional wound dressing by combining electrospun poly(ε-caprolactone) (PCL) nonwoven mat with chitosan-based NO-releasing biomaterials (CS-NO). As-prepared PCL/CS-NO dressing released NO sustainably under the physiological conditions, which was controlled by the catalysis of β-galactosidase. In vivo wound healing characteristics were further evaluated on full-thickness cutaneous wounds in mice. Results showed that PCL/CS-NO wound dressings remarkably accelerated wound healing process through enhancing re-epithelialization and granulation formation and effectively improved the organization of regenerated tissues including epidermal-dermal junction, which could be ascribed to the pro-angiogenesis, immunomodulation, and enhanced collagen synthesis provided by the sustained release of NO. Therefore, PCL/CS-NO may be a promising candidate for wound dressings, especially for the chronic wound caused by the ischemia. Serious skin damage caused by trauma, surgery, burn or chronic disease has become one of the most serious clinical problems. Therefore, there is an increasing demand for ideal wound dressing that can improve wound healing. Due to the vital role of nitric oxide (NO), we developed a novel functional wound dressing by combining electrospun polycaprolactone (PCL) mat with NO-releasing biomaterial (CS-NO). The sustained release of NO from PCL/CS-NO demonstrated positive effects on wound healing, including pro-angiogenesis, immunomodulation, and enhanced collagen synthesis. Hence, wound healing process was remarkably accelerated and the organization of regenerated tissues was effectively improved as well. Taken together, PCL/CS-NO dressing may be a promising candidate for wound treatment, especially for the chronic wound caused by the ischemia. Copyright © 2017 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Biophysical effects of repetitive removal of adhesive dressings on peri-ulcer skin.

PubMed

Zillmer, R; Agren, M S; Gottrup, F; Karlsmark, T

2006-05-01

To study the effect of repeated removal of four different adhesive dressings on peri-ulcer skin using quantitative non-invasive techniques. Forty-five patients with open (n = 29) or healed (n = 16) venous leg ulcers were included. Peri-ulcer skin was treated for 14 days with patches of two different hydrocolloid-based adhesive dressings, one polyurethane adhesive and one soft silicone adhesive dressing. Normal skin of the patients' ventral forearm was also treated identically. Adhesive patches of the dressings were replaced every second day. The skin barrier function was assessed by measuring transepidermal water loss and stratum corneum hydration by measuring electrical conductance. Thirty-nine patients completed the study. The hydrocolloid adhesives increased transepidermal water loss and conductance while the polyurethane and soft silicone adhesives did not influence these parameters significantly compared with adjacent non-treated peri-ulcer skin. For normal forearm skin, similar relative effects among the four adhesives were found. Repetitive treatment with hydrocolloid-based adhesive dressings induced major functional alterations of the stratum corneum. In contrast, a polyurethane adhesive and a soft silicone adhesive dressing did not alter transepidermal water loss or conductance of peri-ulcer skin.

Peroxide-based oxygen generating topical wound dressing for enhancing healing of dermal wounds.

PubMed

Chandra, Prafulla K; Ross, Christina L; Smith, Leona C; Jeong, Seon S; Kim, Jaehyun; Yoo, James J; Harrison, Benjamin S

2015-01-01

Oxygen generating biomaterials represent a new trend in regenerative medicine that aims to generate and supply oxygen at the site of requirement, to support tissue healing and regeneration. To enhance the healing of dermal wounds, we have developed a highly portable, in situ oxygen generating wound dressings that uses sodium percarbonate (SPO) and calcium peroxide (CPO) as chemical oxygen sources. The dressing continuously generated oxygen for more than 3 days, after which it was replaced. In the in vivo testing on porcine full-thickness porcine wound model, the SPO/CPO dressing showed enhanced wound healing during the 8 week study period. Quantitative measurements of wound healing related parameters, such as wound closure, reepithelialization, epidermal thickness and collagen content of dermis showed that supplying oxygen topically using the SPO/CPO dressing significantly accelerated the wound healing. An increase in neovascularization, as determined using Von Willebrand factor (vWF) and CD31 staining, was also observed in the presence of SPO/CPO dressing. This novel design for a wound dressing that contains oxygen generating biomaterials (SPO/CPO) for supplying topical oxygen, may find utility in treating various types of acute to chronic wounds. © 2015 by the Wound Healing Society.

Chitosan-based dressing for the treatment of external/accessible bleedings in children with bleeding tendency.

PubMed

Misgav, Mudi; Kenet, Gili; Martinowitz, Uriel

2014-03-01

Bleeding episodes in patients with congenital or acquired bleeding disorders are usually managed with factor concentrates or blood products. However, external and accessible bleeds may effectively be managed with topical hemostasis. After the application of the Hemcon, a Food and Drug Administration-approved chitosan-based hemostatic dressing was used as the "last resort" to successfully control external bleeds in 2 patients with severe bleeding disorders. We describe a single-center experience with this dressing, including its use in pediatric patients as the first mode of therapy. A total of 5 patients (median age 2 y) with severe bleeding disorders were treated with topical chitosan-based dressing for a total of 6 bleeding episodes. The dressing was used either after the failure of extensive systemic therapy or as the first choice of treatment. In 4 of the 6 episodes, bleeding ceased immediately alleviating the need for systemic therapy. There was no rebleeding after the removal of the dressing and no adverse events or local skin reactions were recorded. Hemostatic dressings, such as the chitosan, should be encouraged for the treatment of external/accessible bleeds, especially among the pediatric patients with bleeding tendency.

Plasma treatments of dressings for wound healing: a review.

PubMed

Eswaramoorthy, Nithya; McKenzie, David R

2017-12-01

This review covers the use of plasma technology relevant to the preparation of dressings for wound healing. The current state of knowledge of plasma treatments that have potential to provide enhanced functional surfaces for rapid and effective healing is summarized. Dressings that are specialized to the needs of individual cases of chronic wounds such as diabetic ulcers are a special focus. A summary of the biology of wound healing and a discussion of the various types of plasmas that are suitable for the customizing of wound dressings are given. Plasma treatment allows the surface energy and air permeability of the dressing to be controlled, to ensure optimum interaction with the wound. Plasmas also provide control over the surface chemistry and in cases where the plasma creates energetic ion bombardment, activation with long-lived radicals that can bind therapeutic molecules covalently to the surface of the dressing. Therapeutic innovations enabled by plasma treatment include the attachment of microRNA or antimicrobial peptides. Bioactive molecules that promote subsequent cell adhesion and proliferation can also be bound, leading to the recruitment of cells to the dressing that may be stem cells or patient-derived cells. The presence of a communicating cell population expressing factors promotes healing.

Topical Application of Honey on Surgical Wounds: A Randomized Clinical Trial.

PubMed

Goharshenasan, Peiman; Amini, Shahideh; Atria, Ali; Abtahi, Hamidreza; Khorasani, Ghasemali

2016-01-01

The antimicrobial and anti-inflammatory activity of honey and its ability to accelerate wound healing make it an attractive option in surgical wound care. We performed a randomized clinical trial to compare the efficacy of honey dressing with conventional dressing regarding the aesthetic outcome. Bilateral symmetric incisions in randomly selected plastic surgical patients were randomly covered postoperatively with conventional dressing and honey dressing for five days. The aesthetic outcome of the two sides was rated on a Visual Analog Scale by the surgeon and the patient and compared at month three and six after surgery. Seventy two symmetrical incisions in 52 patients were evaluated during the study. The mean width of the scar after the third and the sixth month was 3.64 +/- 0.83 mm and 3.49 +/- 0.87 mm on the side that received honey dressing and 5.43 +/- 0.05 mm and 5.30+/- 1.35 mm in the control group. Wilcoxon signed-rank test showed significant difference between honey and conventional dressing outcomes at third and sixth month (p < 0.001). The healing process of the surgical wound and its final aesthetic result could be improved by using honey dressing. © 2016 S. Karger GmbH, Freiburg.

Polysaccharide Fabrication Platforms and Biocompatibility Assessment as Candidate Wound Dressing Materials

PubMed Central

Aduba, Donald C.; Yang, Hu

2017-01-01

Wound dressings are critical for wound care because they provide a physical barrier between the injury site and outside environment, preventing further damage or infection. Wound dressings also manage and even encourage the wound healing process for proper recovery. Polysaccharide biopolymers are slowly becoming popular as modern wound dressings materials because they are naturally derived, highly abundant, inexpensive, absorbent, non-toxic and non-immunogenic. Polysaccharide biopolymers have also been processed into biomimetic platforms that offer a bioactive component in wound dressings that aid the healing process. This review primarily focuses on the fabrication and biocompatibility assessment of polysaccharide materials. Specifically, fabrication platforms such as electrospun fibers and hydrogels, their fabrication considerations and popular polysaccharides such as chitosan, alginate, and hyaluronic acid among emerging options such as arabinoxylan are discussed. A survey of biocompatibility and bioactive molecule release studies, leveraging polysaccharide’s naturally derived properties, is highlighted in the text, while challenges and future directions for wound dressing development using emerging fabrication techniques such as 3D bioprinting are outlined in the conclusion. This paper aims to encourage further investigation and open up new, disruptive avenues for polysaccharides in wound dressing material development. PMID:28952482

Controlled Release of Chitosan and Sericin from the Microspheres-Embedded Wound Dressing for the Prolonged Anti-microbial and Wound Healing Efficacy.

PubMed

Aramwit, Pornanong; Yamdech, Rungnapha; Ampawong, Sumate

2016-05-01

One approach in wound dressing development is to incorporate active molecules or drugs in the dressing. In order to reduce the frequency of dressing changes as well as to prolong wound healing efficacy, wound dressings that can sustain the release of the active molecules should be developed. In our previous work, we developed chitosan/sericin (CH/SS) microspheres that released sericin in a controlled rate. However, the difficulty of applying the microspheres that easily diffuse and quickly degrade onto the wound was its limitations. In this study, we aimed to develop wound dressing materials which are easier to apply and to provide extended release of sericin. Different amounts of CH/SS microspheres were embedded into various compositions of polyvinyl alcohol/gelatin (PVA/G) scaffolds and fabricated using freeze-drying and glutaraldehyde crosslinking techniques. The obtained CH/SS microspheres-embedded scaffolds with appropriate design and formulation were introduced as a wound dressing material. Sericin was released from the microspheres and the scaffolds in a sustained manner. Furthermore, an optimized formation of the microspheres-embedded scaffolds (2PVA2G+2CHSS) was shown to possess an effective antimicrobial activity against both gram-positive and gram-negative bacteria. These microspheres-embedded scaffolds were not toxic to L929 mouse fibroblast cells, and they did not irritate the tissue when applied to the wound. Finally, probably by the sustained release of sericin, these microspheres-embedded scaffolds could promote wound healing as well as or slightly better than a clinically used wound dressing (Allevyn®) in a mouse model. The antimicrobial CH/SS microspheres-embedded PVA/G scaffolds with sustained release of sericin would appear to be a promising candidate for wound dressing application.

A prospective, randomised study of a novel transforming methacrylate dressing compared with a silver-containing sodium carboxymethylcellulose dressing on partial-thickness skin graft donor sites in burn patients.

PubMed

Assadian, Ojan; Arnoldo, Brett; Purdue, Gary; Burris, Agnes; Skrinjar, Edda; Duschek, Nikolaus; Leaper, David J

2015-06-01

This prospective, randomised study compares a new transforming methacrylate dressing (TMD) with a silver-containing carboxymethylcellulose dressing (CMC-Ag) after application to split-thickness skin graft (STSG) donor sites. This was an unblinded, non-inferiority, between-patient, comparison study that involved patients admitted to a single-centre burn unit who required two skin graft donor sites. Each patient's donor sites were covered immediately after surgery: one donor site with TMD and the other with CMC-Ag. The donor sites were evaluated until healing or until 24 days post-application, whichever came first. Study endpoints were time to healing, daily pain scores, number of dressing changes, patient comfort and physicians' and patients' willingness to use the dressings in the future. Nineteen patients had both the dressings applied. No statistically significant difference was noted in time to healing between the two dressings (14·2 days using TMD compared with 13·2 days using CMC-Ag). When pain scores were compared, TMD resulted in statistically significantly less pain at three different time periods (2-5 days, 6-10 days and 11-15 days; P < 0·001 at all time periods). Patients also reported greater comfort with TMD (P < 0·001). Users rated TMD as being less easy to use because of the time and technique required for application. Reductions in pain and increased patient comfort with the use of the TMD dressing, compared with CMC-Ag, were seen as clinical benefits as these are the major issues in donor site management. © 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Difficult clinical management of antituberculosis DRESS syndrome complicated by MRSA infection: A case report.

PubMed

Wang, Li; Li, Lin-Feng

2017-03-01

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe drug-induced hypersensitivity reaction characterized by skin rash, fever, blood abnormalities, and multiple organ involvement. The diagnosis of DRESS syndrome is often delayed because of its variable presentation. Prompt withdrawal of the culprit drug is the definitive treatment. DRESS syndrome induced by antituberculosis drugs has rarely been reported. A 50-year-old man admitted to our hospital with recurrent episodes of progressive rash, fever, eosinophilia, lymphadenopathy, hepatic, and pulmonary involvement were experienced after repeat trials of the same antituberculosis drugs. We diagnosed it as DRESS caused by antituberculosis drugs. The case responded well to treatment with systemic corticosteroids and intravenous immunoglobulins. However, repeated bouts of infection with methicillin-resistant Staphylococcus aureus occurred during treatment (clavicular osteomyelitis and knee septic arthritis). He was cured after treatment with linezolid. The patient was discharged on day 112. At 8-month follow-up, there was no relapse of drug eruption and joint swelling. Early diagnosis and prompt withdrawal of all suspected drugs is a key tenet of the treatment of DRESS. Our case report highlights the risks inherent in delayed diagnosis of DRESS and the challenges in the clinical management of this condition. Pulmonary manifestations with radiological changes on chest X-ray and CT can be seen in DRESS. These changes need to be differentiated from those caused by pulmonary infections. Clavicular osteomyelitis infected with MRSA may be caused by iatrogenic injury during subclavian vein catheterization. This type of MRSA infections should be treated for 4 to 6 weeks. Blood eosinophilia could be a useful marker of disease progression and treatment response in patients with DRESS. However, more experience and clinical evidence is needed to confirm this.

Evaluation of a new pressure ulcer preventive dressing containing ceramide 2 with low frictional outer layer.

PubMed

Nakagami, Gojiro; Sanada, Hiromi; Konya, Chizuko; Kitagawa, Atsuko; Tadaka, Etsuko; Matsuyama, Yutaka

2007-09-01

This paper is a report of an evaluation of the effectiveness of a newly developed dressing for preventing persistent erythema and pressure ulcer development and improving the water-holding capacity without increasing the skin pH in bedridden older patients. Shear forces and skin dryness play important roles in persistent erythema and pressure ulcer development. To eliminate these risks, we developed a dressing to reduce shear forces and improve the water-holding capacity. However, the effects of this dressing in clinical settings remain unknown. An experimental bilateral comparison study was conducted at a hospital in Japan in 2004 with 37 bedridden older patients at risk of pressure ulcer development. The dressing was randomly applied to the right or left greater trochanter for 3 weeks. No dressing was applied to the opposite side as a control. The skin was monitored weekly during the 3-week application for persistent erythema and pressure ulcer development. Skin hydration and pH were also assessed during the intervention and for 1 week after dressing removal. The incidence of persistent erythema was significantly lower in the intervention area than the control area [P = 0.007, RR 0.18 (95% CI: 0.05-0.73) and NNT 4.11 (2.50-11.63) ]. No pressure ulcers occurred in either the intervention or control area. Skin hydration increased significantly during dressing application and remained high after removal (P < 0.001) relative to the control area. Skin pH decreased significantly during the application (P < 0.001) but returned to control levels after removal (P = 0.38). This safe and effective dressing can be used for patients with highly prominent bones and dry skin to prevent pressure ulcers.

Patients' attitudes toward the attire of male physicians: a single-center study in Saudi Arabia.

PubMed

Batais, Mohammad Ali

2014-01-01

The doctor-patient relationship has been influenced by the appearance of physicians, and there is an association between a physician's physical appearance and the patients' initial perceptions of physician competence. This study aims to explore patients' preferences toward the attire of a male physician, and to examine if a physician's choice of uniform influences the degree of trust, confidence, and follow-up care among respondents. A cross-sectional survey conducted among patients of the Alwazarat family medicine center in Riyadh, Saudi Arabia. A self-administered questionnaire was completed by 300 patients (50% were male and 83.6% had received a secondary education; the mean age was 33.4 [10.1] years) in the Alwazarat family medicine center in Riyadh. The questionnaire was also customized for the local setting with the inclusion of photos of a male doctor in Saudi Arabian national costume, and 3 other dress styles (Western dress with white coat, scrubs with white coat, and scrubs only). Overall, across all questions regarding physician dress style preferences, participants significantly preferred Western dress (39.9%, P < .001), followed by Saudi national dress (26.3%), a scrub suit with a white coat (22.3%), and scrubs only (11.5%). Respondents reported that they were more likely to follow medical advice and would return for follow-up care if a physician wore Western dress. They were significantly more willing to share their social, sexual, and psychological problems with a physician wearing Saudi national dress (P < .001). The importance of a physician's appearance was ranked significantly higher by older patients (P=.002). Respondents were more likely to favor a physician wearing Western attire with a white coat. However, Saudi national dress, followed by Western dress, is the preferred attire when physicians are dealing with social, sexual, and psychological problems.

Development and formulation of Moringa oleifera standardised leaf extract film dressing for wound healing application.

PubMed

Chin, Chai-Yee; Jalil, Juriyati; Ng, Pei Yuen; Ng, Shiow-Fern

2018-02-15

M.oleifera is a medicinal plant traditionally used for skin sores, sore throat and eye infections. Recently, the wound healing property of the leaves of M. oleifera was has been well demonstrated experimentally in both in vivo and in vitro models. However, there is a lack of research which focuses on formulating M.oleifera into a functional wound dressing. In this study, the M.oleifera leaf standardized aqueous extract with highest potency in vitro migration was formulated into a film for wound healing application. Firstly, M. oleifera leaf were extracted in various solvents (aqueous, 50%, 70% and 100% ethanolic extracts) and standardized by reference standards using UHPLC technique. The extracts were then tested for cell migration and proliferation using HDF and HEK cell lines. M. oleifera leaf aqueous extract was then incorporated into alginate-pectin (SA-PC) based film dressing. The film dressings were characterized for the physicochemical properties and the bioactives release from the M. oleifera leaf extract loaded film dressing was also investigated using Franz diffusion cells. All extracts were found to contain vicenin-2, chlorogenic acid, gallic acid, quercetin, kaempferol, rosmarinic acid and rutin. Among all M. oleifera extracts, aqueous standardized leaf extracts showed the highest human dermal fibroblast and human keratinocytes cells proliferation and migration properties. Among the film formulations, SA-PC (3% w/v) composite film dressing containing M. oleifera aqueous leaf extract was found to possess optimal physicochemical properties as wound dressing. A potentially applicable wound dressing formulated as an alginate-pectin film containing aqueous extracts of M. oleifera has been developed. The dressing would be suitable for wounds with moderate exudates. Copyright © 2017 Elsevier B.V. All rights reserved.

Surgical site infections following colorectal cancer surgery: a randomized prospective trial comparing common and advanced antimicrobial dressing containing ionic silver.

PubMed

Biffi, Roberto; Fattori, Luca; Bertani, Emilio; Radice, Davide; Rotmensz, Nicole; Misitano, Pasquale; Cenciarelli, Sabine; Chiappa, Antonio; Tadini, Liliana; Mancini, Marina; Pesenti, Giovanni; Andreoni, Bruno; Nespoli, Angelo

2012-05-23

An antimicrobial dressing containing ionic silver was found effective in reducing surgical-site infection in a preliminary study of colorectal cancer elective surgery. We decided to test this finding in a randomized, double-blind trial. Adults undergoing elective colorectal cancer surgery at two university-affiliated hospitals were randomly assigned to have the surgical incision dressed with Aquacel Ag Hydrofiber dressing or a common dressing. To blind the patient and the nursing and medical staff to the nature of the dressing used, scrub nurses covered Aquacel Ag Hydrofiber with a common wound dressing in the experimental arm, whereas a double common dressing was applied to patients of control group. The primary end-point of the study was the occurrence of any surgical-site infection within 30 days of surgery. A total of 112 patients (58 in the experimental arm and 54 in the control group) qualified for primary end-point analysis. The characteristics of the patient population and their surgical procedures were similar. The overall rate of surgical-site infection was lower in the experimental group (11.1% center 1, 17.5% center 2; overall 15.5%) than in controls (14.3% center 1, 24.2% center 2, overall 20.4%), but the observed difference was not statistically significant (P = 0.451), even with respect to surgical-site infection grade 1 (superficial) versus grades 2 and 3, or grade 1 and 2 versus grade 3. This randomized trial did not confirm a statistically significant superiority of Aquacel Ag Hydrofiber dressing in reducing surgical-site infection after elective colorectal cancer surgery. Clinicaltrials.gov: NCT00981110.

Application of the Single Use Negative Pressure Wound Therapy Device (PICO) on a Heterogeneous Group of Surgical and Traumatic Wounds

PubMed Central

Payne, Caroline; Edwards, Daren

2014-01-01

Objectives: Traumatic wounds and surgery inherently have their complications. Localized infections, wound dehiscence, and excessive wound leakage can be devastating to the patient with a prolonged recovery, but it is also costly to the hospital with an increased length of stay, extra workload, and dressing changes. The single use PICO (Smith and Nephew Healthcare, Hull, United Kingdom) negative pressure wound therapy (NPWT) dressing has revolutionized our management of various acute, chronic, and high output wounds. It requires fewer dressing changes than conventional practice, is used in the outpatient setting, and is a necessary adjuvant therapy to hasten wound healing. Aims: To observe the efficacy of the PICO vacuum-assisted healing within a cost improvement programme. Settings: Plastic surgery department, Royal London Hospital. Materials and Methods: Twenty-one patients with a diversity of postoperative or posttraumatic wounds were considered suitable for PICO application and treated totally on an outpatient basis once the PICO dressing was applied. All wounds were then subjected to continued PICO dressings until healed. Results: All patients tolerated the PICO well with no dressing failure or failure to comply. The number of dressings per patient ranged from 1 to 7. The cost per patient of treatment ranged from £120 to £1578. Estimated cost of all PICO dressing for 21 patients including plastic surgery dressing clinic appointments = £13,345. Median length of treatment to healing (days) = 16; standard deviation = 9.5. Eight patients would have had an inpatient bed stay with conventional therapy, total 24 bed days saved at Bartshealth @£325 per day. Conclusions: The outpatient application of a disposable NPWT can benefit a wide range of clinical wounds that optimizes patient care, promotes rapid wound healing, and importantly helps manage costs. PMID:24917894

Devices and dressings to secure peripheral venous catheters to prevent complications.

PubMed

Marsh, Nicole; Webster, Joan; Mihala, Gabor; Rickard, Claire M

2015-06-12

A peripheral venous catheter (PVC) is typically used for short-term delivery of intravascular fluids and medications. It is an essential element of modern medicine and the most frequent invasive procedure performed in hospitals. However, PVCs often fail before intravenous treatment is completed: this can occur because the device is not adequately attached to the skin, allowing the PVC to fall out, leading to complications such as phlebitis (irritation or inflammation to the vein wall), infiltration (fluid leaking into surrounding tissues) or occlusion (blockage). An inadequately secured PVC also increases the risk of catheter-related bloodstream infection (CRBSI), as the pistoning action (moving back and forth in the vein) of the catheter can allow migration of organisms along the catheter and into the bloodstream. Despite the many dressings and securement devices available, the impact of different securement techniques for increasing PVC dwell time is still unclear; there is a need to provide guidance for clinicians by reviewing current studies systematically. To assess the effects of PVC dressings and securement devices on the incidence of PVC failure. We searched the following electronic databases to identify reports of relevant randomised controlled trials (RCTs): the Cochrane Wounds Group Register (searched 08 April 2015): The Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 3), Ovid MEDLINE (1946 to March 7 2015); Ovid MEDLINE (In-Process & Other Non-Indexed Citations, March 7 2015); Ovid EMBASE (1974 to March 7 2015); and EBSCO CINAHL (1982 to March 8 2015). RCTs or cluster RCTs comparing different dressings or securement devices for the stabilisation of PVCs. Cross-over trials were ineligible for inclusion, unless data for the first treatment period could be obtained. Two review authors independently selected studies, assessed trial quality and extracted data. We contacted study authors for missing information. We used standard methodological procedures expected by Cochrane. We included six RCTs (1539 participants) in this review. Trial sizes ranged from 50 to 703 participants. These six trials made four comparisons, namely: transparent dressings versus gauze; bordered transparent dressings versus a securement device; bordered transparent dressings versus tape; and transparent dressing versus sticking plaster. There is very low quality evidence of fewer catheter dislodgements or accidental removals with transparent dressings compared with gauze (two studies, 278 participants, RR 0.40; 95% CI 0.17 to 0.92, P = 0.03%). The relative effects of transparent dressings and gauze on phlebitis (RR 0.89; 95% CI 0.47 to 1.68) and infiltration (RR 0.80; 95% CI 0.48 to 1.33) are unclear. The relative effects on PVC failure of a bordered transparent dressing and a securement device have been assessed in only one small study and these were unclear. There was very low quality evidence from the same single study of less frequent dislodgement or accidental catheter removal with bordered transparent dressings than securement devices (RR 0.14, 95% CI 0.03 to 0.63) but more phlebitis with bordered dressings (RR 8.11, 95% CI 1.03 to 64.02) (very low quality evidence). A small single study compared bordered transparent dressings with tape and found very low quality evidence of more PVC failure with the bordered dressing (RR 1.84, 95% CI 1.08 to 3.11) but the relative effects on dislodgement were not clear (very low quality evidence). The relative effects of transparent dressings and a sticking plaster have only been compared in one small study and are unclear. More high quality RCTs are required to determine the relative effects of alternative PVC dressings and securement devices. It is not clear if any one dressing or securement device is better than any other in securing peripheral venous catheters. There is a need for further, independent high quality trials to evaluate the many traditional as well as the newer, high use products. Given the large cost differences between some different dressings and securement devices, future trials should include a robust cost-effectiveness analysis.

The Development of a Code of Ethics: An Online Classroom Approach to Making Connections between Ethical Foundations and the Challenges Presented by Information Technology

ERIC Educational Resources Information Center

Brooks, Rochelle

2010-01-01

In today's organizations, ethical challenges relate to areas like fraud, right to privacy for consumers, social responsibility, and trade restrictions. For Information Technology (IT) specifically, these can translate to considerations on how technology is used to violate people's privacy, how automation leads to job reductions, or how management…

26 CFR 301.6326-1 - Administrative appeal of the erroneous filing of notice of federal tax lien.

Code of Federal Regulations, 2011 CFR

2011-04-01

... on any one of the following allegations: (1) The tax liability that gave rise to the lien, plus any... of lien; (2) The tax liability that gave rise to the lien was assessed in violation of the deficiency procedures set forth in section 6213 of the Internal Revenue Code; (3) The tax liability that gave rise to...

26 CFR 301.6326-1 - Administrative appeal of the erroneous filing of notice of federal tax lien.

Code of Federal Regulations, 2010 CFR

2010-04-01

... on any one of the following allegations: (1) The tax liability that gave rise to the lien, plus any... of lien; (2) The tax liability that gave rise to the lien was assessed in violation of the deficiency procedures set forth in section 6213 of the Internal Revenue Code; (3) The tax liability that gave rise to...

Use of Collagen Extracellular Matrix Dressing for the Treatment of a Recurrent Venous Ulcer in a 52-Year-Old Patient.

PubMed

González, Arturo

2016-01-01

This case study describes treatment for a 52-year-old man with a recurrent venous leg ulcer using a collagen dressing with extracellular matrix. The patient was admitted to the wound care service for a 3-week-old recurrent venous ulcer. Treatment included application of a collagen dressing with extracellular matrix twice weekly or as needed by the patient; application of a secondary dressing (4 × 4 gauze); and coverage with an expandable netting or gauze using a conforming stretch gauze bandage and latex-free dressing retention tape. The initial venous leg ulcer in this patient required 10 weeks to achieve closure. Ninety-eight percent resolution of the recurrent ulcer had occurred within 4 weeks of treatment, with complete closure at 7 weeks. The average healing time for recurrent venous ulcers is reported in the literature to be longer than initial venous ulcers. In the case provided, collagen ECM dressings promoted complete wound healing in 49 days.

Application of VitaVallis dressing for infected wounds

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kirilova, N. V., E-mail: n.kirilova@vitavallis.com; Fomenko, A. N., E-mail: alserova@ispms.tsc.ru; Korovin, M. S., E-mail: msk@ispms.tsc.ru

Today there is a growing demand for safe and efficient antimicrobial dressings for infected wound treatment. The antimicrobial sorption material for VitaVallis dressings was produced by one-stage oxidation of aluminum nanopowder in water in the presence of fibrous acetylcellulose matrix. Scanning electron microscopy revealed that the material is made up of fibers of diameter 1.5–3.0 µm with adhered agglomerated alumina nanosheets. An antimicrobial study revealed a high inhibitory effect of VitaVallis against the growth of gram-negative (E.coli, P. aeruginosa) and gram-positive (S. aureus) strains. The antimicrobial activity of the dressing against microbial pathogens on the wound surface was demonstrated in inmore » vivo experiments on male rats. The dressing was also tested on volunteer patients. The testing showed reduction of the wound healing period, accelerated cleaning of the infected wound and enhanced tissue regeneration in the wound. The results demonstrate that the VitaVallis dressing can be used for the treatment of deep infected wounds.« less

A new methodology for evaluating the damage to the skin barrier caused by repeated application and removal of adhesive dressings.

PubMed

Waring, Mike; Bielfeldt, Stephan; Mätzold, Katja; Wilhelm, Klaus-Peter

2013-02-01

Chronic wounds require frequent dressing changes. Adhesive dressings used for this indication can be damaging to the stratum corneum, particularly in the elderly where the skin tends to be thinner. Understanding the level of damage caused by dressing removal can aid dressing selection. This study used a novel methodology that applied a stain to the skin and measured the intensity of that stain after repeated application and removal of a series of different adhesive types. Additionally, a traditional method of measuring skin barrier damage (transepidermal water loss) was also undertaken and compared with the staining methodology. The staining methodology and measurement of transepidermal water loss differentiated the adhesive dressings, showing that silicone adhesives caused least trauma to the skin. The staining methodology was shown to be as effective as transepidermal water loss in detecting damage to the stratum corneum and was shown to detect disruption of the barrier earlier than the traditional technique. © 2012 John Wiley & Sons A/S.

Controlled trial of Iodosorb in chronic venous ulcers.

PubMed Central

Ormiston, M C; Seymour, M T; Venn, G E; Cohen, R I; Fox, J A

1985-01-01

Cadexomer iodine (Iodosorb) is a hydrophilic starch powder containing iodine, which is a suitable dressing for granulating wounds such as venous ulcers. A total of 61 outpatients with chronic venous ulcers participated in a randomised optional crossover trial using cadexomer iodine or a standard dressing for their ulcers. The trial lasted for 24 weeks or until the ulcer had healed. Two patients withdrew during the course of the trial. Both treatments were highly effective, but the epithelium of ulcers dressed with cadexomer iodine grew again significantly faster (p less than 0.001). At the midpoint of the trial (12th week) 13 of 30 patients receiving standard treatment were changed to cadexomer iodine, while only three of 29 receiving cadexomer iodine changed to the standard dressing (p less than 0.02). In most cases ulcers were dressed and rebandaged daily by the patients themselves after instruction and supervision. This may be better than having dressings and bandages applied by professionals less regularly. PMID:3926169

Gelam (Melaleuca spp.) Honey-Based Hydrogel as Burn Wound Dressing

PubMed Central

Mohd Zohdi, Rozaini; Abu Bakar Zakaria, Zuki; Yusof, Norimah; Mohamed Mustapha, Noordin; Abdullah, Muhammad Nazrul Hakim

2012-01-01

A novel cross-linked honey hydrogel dressing was developed by incorporating Malaysian honey into hydrogel dressing formulation, cross-linked and sterilized using electron beam irradiation (25 kGy). In this study, the physical properties of the prepared honey hydrogel and its wound healing efficacy on deep partial thickness burn wounds in rats were assessed. Skin samples were taken at 7, 14, 21, and 28 days after burn for histopathological and molecular evaluations. Application of honey hydrogel dressings significantly enhanced (P < 0.05) wound closure and accelerated the rate of re-epithelialization as compared to control hydrogel and OpSite film dressing. A significant decrease in inflammatory response was observed in honey hydrogel treated wounds as early as 7 days after burn (P < 0.05). Semiquantitative analysis using RT-PCR revealed that treatment with honey hydrogel significantly (P < 0.05) suppressed the expression of proinflammatory cytokines (IL-1α, IL-1β, and IL-6). The present study substantiates the potential efficacy of honey hydrogel dressings in accelerating burn wound healing. PMID:21941590

Drug Reaction with Eosinophilia and Systemic Symptom (DRESS) induced by carbamazepine: a case report and literature review

PubMed Central

EL Omairi, Nissrine; Abourazzak, Sanae; Chaouki, Sanae; Atmani, Samir; Hida, Moustapha

2014-01-01

Drug-induced hypersensitivity or Drug Reaction with Eosinophilia and Systemic Symptom (DRESS) is a severe adverse drug-induced reaction. Diagnosing DRESS is challenging due to the diversity of cutaneous eruption and organs involved. Most of the aromatic anticonvulsants, such as phenytoin, phenobarbital, and carbamazepine, can induce DRESS. Culprit drug withdrawal and corticosteroids constituted the mainstay of DRESS treatment. We describe a 6 year-old boy who presented fever and rash 4 weeks after starting carbamazepine. Investigation revealed leukocytosis, atypical lymphocytosis, and elevated serum transaminases. The diagnosis of DREES syndrome was made, Carbamazepine was stopped and replaced initially by Clobazam and by Valproic acid after discharge, no systemic corticotherapy was prescribed. Symptoms began to resolve within two weeks, and by one month later her laboratory values had returned to normal. The aim of this work is to raise awareness general practitioner and pediatricians to suspect Dress syndrome in patients who present with unusual complaints and skin findings after starting any antiepileptic drug. PMID:25360193

Evaluation of a honey-impregnated tulle dressing in primary care.

PubMed

Stephen-Haynes, Jackie

2004-06-01

Honey has been used for its healing properties for centuries and has been used to dress wounds with favourable results. The emergence of antibiotic resistance and growing interest in "natural" or "complementary" therapies has led to an interest in honey dressings. Much of the research to date has been related to honey's antibacterial properties. However, the healing properties claimed for honey also include stimulating new tissue growth, moist wound healing, fluid handling and promoting epithelialization. Until recently, honey had not been developed as a wound management product and was not a certified pharmaceutical device. Activon Tulle is a sterile, non-adherent dressing impregnated with Leptospermum scoparium hone. The claimed properties of honey dressings would make this a valuable addition to the dressing currently available in the primary care setting. An evaluation was undertaken involving 20 patients with a variety of wounds. A conclusion is drawn that while further research is needed, medical grade honey does appear to be a valuable addition to the wound management formulary.

Effects of wound dressings on cultured primary keratinocytes.

PubMed

Esteban-Vives, Roger; Young, Matthew T; Ziembicki, Jenny; Corcos, Alain; Gerlach, Jörg C

2016-02-01

Autologous cell-spray grafting of non-cultured epidermal cells is an innovative approach for the treatment of severe second-degree burns. After treatment, wounds are covered with dressings that are widely used in wound care management; however, little is known about the effects of wound dressings on individually isolated cells. The sprayed cells have to actively attach, spread, proliferate, and migrate in the wound for successful re-epithelialization, during the healing process. It is expected that exposure to wound dressing material might interfere with cell survival, attachment, and expansion. Two experiments were performed to determine whether some dressing materials have a negative impact during the early phases of wound healing. In one experiment, freshly isolated cells were seeded and cultured for one week in combination with eight different wound dressings used during burn care. Cells, which were seeded and cultured with samples of Adaptic(®), Xeroform(®), EZ Derm(®), and Mepilex(®) did not attach, nor did they survive during the first week. Mepitel(®), N-Terface(®), Polyskin(®), and Biobrane(®) dressing samples had no negative effect on cell attachment and cell growth when compared to the controls. In a second experiment, the same dressings were exposed to pre-cultured cells in order to exclude the effects of attachment and spreading. The results confirm the above findings. This study could be of interest for establishing skin cell grafting therapies in burn medicine and also for wound care in general. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Efficacy of a surfactant-based wound dressing on biofilm control.

PubMed

Percival, Steven L; Mayer, Dieter; Salisbury, Anne-Marie

2017-09-01

The aim of this study was to evaluate the efficacy of both a nonantimicrobial and antimicrobial (1% silver sulfadiazine-SSD) surfactant-based wound dressing in the control of Pseudomonas aeruginosa, Enterococcus sp, Staphylococcus epidermidis, Staphylococcus aureus, and methicillin-resistant S. aureus (MRSA) biofilms. Anti-biofilm efficacy was evaluated in numerous adapted American Standards for Testing and Materials (ASTM) standard biofilm models and other bespoke biofilm models. The ASTM standard models employed included the Minimum biofilm eradication concentration (MBEC) biofilm model (ASTM E2799) and the Centers for Disease Control (CDC) biofilm reactor model (ASTM 2871). Such bespoke biofilm models included the filter biofilm model and the chamberslide biofilm model. Results showed complete kill of microorganisms within a biofilm using the antimicrobial surfactant-based wound dressing. Interestingly, the nonantimicrobial surfactant-based dressing could disrupt existing biofilms by causing biofilm detachment. Prior to biofilm detachment, we demonstrated, using confocal laser scanning microscopy (CLSM), the dispersive effect of the nonantimicrobial surfactant-based wound dressing on the biofilm within 10 minutes of treatment. Furthermore, the non-antimicrobial surfactant-based wound dressing caused an increase in microbial flocculation/aggregation, important for microbial concentration. In conclusion, this nonantimicrobial surfactant-based wound dressing leads to the effective detachment and dispersion of in vitro biofilms. The use of surfactant-based wound dressings in a clinical setting may help to disrupt existing biofilm from wound tissue and may increase the action of antimicrobial treatment. © 2017 by the Wound Healing Society.

N-Halamine Biocidal Materials with Superior Antimicrobial Efficacies for Wound Dressings.

PubMed

Demir, Buket; Broughton, Roy M; Qiao, Mingyu; Huang, Tung-Shi; Worley, S D

2017-09-21

This work demonstrated the successful application of N-halamine technology for wound dressings rendered antimicrobial by facile and inexpensive processes. Four N-halamine compounds, which possess different functional groups and chemistry, were synthesized. The N-halamine compounds, which contained oxidative chlorine, the source of antimicrobial activity, were impregnated into or coated onto standard non-antimicrobial wound dressings. N-halamine-employed wound dressings inactivated about 6 to 7 logs of Staphylococcus aureus and Pseudomonas aeruginosa bacteria in brief periods of contact time. Moreover, the N-halamine-modified wound dressings showed superior antimicrobial efficacies when compared to commercially available silver wound dressings. Zone of inhibition tests revealed that there was no significant leaching of the oxidative chlorine from the materials, and inactivation of bacteria occurred by direct contact. Shelf life stability tests showed that the dressings were stable to loss of oxidative chlorine when they were stored for 6 months in dark environmental conditions. They also remained stable under florescent lighting for up to 2 months of storage. They could be stored in opaque packaging to improve their shelf life stabilities. In vitro skin irritation testing was performed using a three-dimensional human reconstructed tissue model (EpiDerm™). No potential skin irritation was observed. In vitro cytocompatibility was also evaluated. These results indicate that N-halamine wound dressings potentially can be employed to prevent infections, while at the same time improving the healing process by eliminating undesired bacterial growth.

Dressing wear time after breast reconstruction: study protocol for a randomized controlled trial

PubMed Central

2013-01-01

Background One of the major risk variables for surgical site infection is wound management. Understanding infection risk factors for breast operations is essential in order to develop infection-prevention strategies and improve surgical outcomes. The aim of this trial is to assess the influence of dressing wear time on surgical site infection rates and skin colonization. Patients’ perception at self-assessment will also be analyzed. Methods/Design This is a two-arm randomized controlled trial. Two hundred breast cancer patients undergoing immediate or delayed breast reconstruction will be prospectively enrolled. Patients will be randomly allocated to group I (dressing removed on postoperative day one) or group II (dressing removed on postoperative day six). Surgical site infections will be defined by standard criteria from the Centers for Disease Control and Prevention (CDC). Skin colonization will be assessed by culture of samples collected at predefined time points. Patients will score dressing wear time with regard to safety, comfort and convenience. Discussion The evidence to support dressing standards for breast surgery wounds is empiric and scarce. CDC recommends protecting, with a sterile dressing for 24 to 48 hours postoperatively, a primarily closed incision, but there is no recommendation to cover this kind of incision beyond 48 hours, or on the appropriate time to shower or bathe with an uncovered incision. The results of the ongoing trial may support standard recommendations regarding dressing wear time after breast reconstruction. Trial registration ClinicalTrials.gov identifier: http://NCT01148823. PMID:23432779

Influence of hydrophilic polymers on functional properties and wound healing efficacy of hydrocolloid based wound dressings.

PubMed

Jin, Sung Giu; Yousaf, Abid Mehmood; Kim, Kyeong Soo; Kim, Dong Wuk; Kim, Dong Shik; Kim, Jin Ki; Yong, Chul Soon; Youn, Yu Seok; Kim, Jong Oh; Choi, Han-Gon

2016-03-30

The purpose of this study was to investigate the influence of different hydrophilic polymers on the swelling, bioadhesion and mechanical strength of hydrocolloid wound dressings (HCDs) in order to provide an appropriate composition for a hydrocolloid wound dressing system. In this study, the HCDs were prepared with styrene-isoprene-styrene copolymer (SIS) and polyisobutylene (PIB) as the base using a hot melting method. Additionally, numerous SIS/PIB-based HCDs were prepared with six hydrophilic polymers, and their wound dressing properties were assessed. Finally, the wound healing efficacy of the selected formulations was compared to a commercial wound dressing. The swelling ratio, bioadhesive force and mechanical strengths of HCDs were increased in the order of sodium alginate>sodium CMC=poloxamer=HPMC>PVA=PVP, sodium alginate>sodium CMC=poloxamer>PVA>HPMC=PVP and sodium alginate≥PVA>PVP=HPMC=sodium CMC>poloxamer, respectively. Among the hydrophilic polymers tested, sodium alginate most enhanced the swelling capacity, bioadhesive force and mechanical strengths. Thus, the hydrophilic polymers played great role in the swelling, bioadhesion and mechanical strength of SIS/PIB-based HCDs. The HCD formulation composed of PIB, SIS, liquid paraffin and sodium alginate at the weight ratio of 20/25/12/43 gave better wound dressing properties and more excellent wound healing efficacy than the commercial wound dressing. Therefore, the novel HCD formulation could be a promising hydrocolloid system for wound dressings. Copyright © 2016 Elsevier B.V. All rights reserved.

A Wireless Electroceutical Dressing Lowers Cost of Negative Pressure Wound Therapy

PubMed Central

Ghatak, Piya Das; Schlanger, Richard; Ganesh, Kasturi; Lambert, Lynn; Gordillo, Gayle M.; Martinsek, Patsy; Roy, Sashwati

2015-01-01

Objective: To test whether the use of a wireless electroceutical dressing (WED) (Procellera®) in conjunction with a 5-day negative pressure wound therapy (NPWT) may reduce the number of dressing changes required per week with this therapy. Approach: At the Ohio State University Comprehensive Wound Center, chronic wound patients (n=30) undergoing NPWT were randomized into two arms following consent as approved by the institutional review board. The control arm received standard of care NPWT, where the dressing change was performed thrice a week. The test arm received the same care except that the WED was added as an interface layer and dressing change was limited to twice a week. Results: A reduced cost of care was achieved using the WED in conjunction with NPWT. Despite fewer dressing changes in wounds dressed with the WED, closure outcomes were comparable with no overt signs of any wound complication, including infection. The cost of NPWT care during the week was significantly lower (from $2918 to $2346) in the WED-treated group compared with patients in the control arm. Innovation: This work introduces a novel technology platform involving a WED, which may be used in conjunction with NPWT. If used as such, NPWT is effective in decreasing the frequency of dressing change and lowering the cost of care. Conclusion: This work points toward the benefit of using the WED combined with NPWT. A larger clinical trial investigating the cost-effectiveness of WED in wound care is warranted. PMID:26005596

DEVELOPMENT OF A NEXT-GENERATION ANTIMICROBIAL WOUND DRESSING.

PubMed

Metcalf, Daniel; Parsons, David; Bowler, I Philip

2016-03-01

Delayed wound healing due to infection is a burden on healthcare systems, and the patient and caregiver alike. An emerging factor in infection and delayed healing is the presence development of biofilm in wounds. Biofilm is communities of microorganisms, protected by an extracellular matrix of slime in the wound, which can tolerate host defences and applied antimicrobials such as antibiotics or antimicrobial dressings. A growing evidence base exists suggesting that biofilm exists in a majority of chronic wounds, and can be a precursor to infection while causing delayed healing itself. In vivo models have demonstrated that the inflammatory, granulation and epithelialization processes of normal wound healing are impaired by biofilm presence. The challenge in the development of a new antimicrobial wound dressing was to make standard antimicrobial agents more effective against biofilm, and this was answered following extensive biofilm research and testing. A combination of metal chelator, surfactant and pH control displayed highly synergistic anti-biofilm action with 1.2% ionic silver in a carboxymethylcellulose dressing. Its effectiveness was challenged and proven in complex in vitro and in vivo wound biofilm models, followed by clinical safety and performance demonstrations in a 42-patient study and 113 clinical evaluations. Post-market surveillance was conducted on the commercially available dressing, and in a 112-case evaluation, the dressing was shown to effectively manage exudate and suspected biofilm while shifting difficult-to-heal wounds onto healing trajectories, after an average of 4 weeks of new dressing use in otherwise standard wound care protocols. This was accompanied by a low frequency of dressing related adverse events. In a second evaluation, clinical signs of infection and wound dimension data, before and after the evaluations, were also available. Following an average of 5.4 weeks of dressing use, all signs of clinical infection were reduced, from an average frequency of 36% to 21%. An average of 62% wound size reduction was achieved, with 90% of wounds reducing in size and 10 wounds healing completely. The new clinical evidence for this next-generation antimicrobial wound dressing suggests it is safe and effective at managing exudate, infection and biofilm, while it can shift established, stubborn wounds onto healing trajectories. The scientific rationale for this new dressing technology is supported by in vitro and in vivo evidence, so now further comparative, randomized and outcome-based clinical studies are required to fully understand the clinical and economic benefits this new dressing technology can bring.

Use of a copolymer dressing on superficial and partial-thickness burns in a paediatric population.

PubMed

Everett, M; Massand, S; Davis, W; Burkey, B; Glat, P M

2015-07-01

Despite extensive research into the treatment of partial-thickness burns, to date there has not been the emergence of a preeminent modality. This pilot study, the first such study to be performed in a burn unit in the US, was designed to evaluate the efficacy and outcomes of the application of copolymer dressing (Suprathel; PolyMedics Innovations Corporation, Stuttgart, Germany) for both superficial and deeper partial-thickness burns. The copolymer dressing was used as a primary wound dressing to treat superficial and deep partial-thickness burns (average 5% total body surface area) in paediatric patients. Burns were debrided within 24 hours, at bedside, in the burn unit or in the operating room. The copolymer dressing was then applied directly to the wound and covered with a non-adherent second layer and an absorptive outer dressing. After discharge, patients were seen every 5-7 days until healed. Parameters evaluated included average hospital length of stay, average number of intravenous doses of narcotics administered, pain score at first follow-up visit, average time to complete re epithelialisation, incidence of burn wound infection, and patient/parent satisfaction on a 4-point scale. We also evaluated our experience with the dressing. Data were evaluated retrospectively under an Investigational Review Board approved protocol. Of the 17 patients assessed the average hospital length of stay was 1.4 days during which the average number of intravenous narcotic doses administered before copolymer dressing application was 1.5 and after was 0.1 doses. At the first follow-up visit, average pain score was 1.2 on a 10-point scale and the average time to re epithelialisation was 9.5 days. There was no incidence of burn wound infection. Patient/parent satisfaction was average of 3.66 on a 4-point scale. The staff had found that the self-adherence and elasticity of the dressing made it easy to apply and stay adherent, especially in areas of difficult contour. There were no readmissions for further debridement or skin grafting. Our experience shows that patients may be discharged shortly after the application of the copolymer dressing, with manageable pain scores and ease of use as determined by the caretakers high satisfaction. This new, fully synthetic copolymer dressing is easy to apply, does not require any additional antimicrobial coverage and may be used to successfully manage deeper partial-thickness burns, donor sites or burns in areas of contour, where many other dressings might not be considered or be appropriate. None declared.

12. Influence of Wound Dressing on the Fracture Healing Effect of Low-Intensity Pulsed Ultrasound (LIPUS).

PubMed

Naruse, Koji; Uchino, Masataka; Hirakawa, Noriko; Toyama, Masahiro; Miyajima, Genyo; Mukai, Manabu; Urabe, Ken; Uchida, Kentaro; Itoman, Moritoshi

2016-08-01

We have conducted a basic study on the influences on ultrasonic properties when LIPUS is applied through wound dressing. According to the results of ex vivo experiments conducted to date, LIPUS showed ultrasonic properties such as transmittance, coefficient of transmission, and a non-uniformity ratio through film wound dressing better than other wound dressing, and it was considered that LIPUS's effect for fracture healing was not influenced by film wound dressing. Then, we discussed the influence on the effect of LIPUS through film wound dressing. Thirty male 8-week-old Sprague-Dawley rats were used for the trial. After creating close transverse femoral fractures on the right legs of these 30 rats, they were divided into 3 groups of 10; LIPUS through wound dressing (Group A), LIPUS without wound dressing (Group B), and No LIPUS treatment (Group C). OPSITE Wound, which was thought to have the least influence on ultrasound properties, was used for this trial. Group A and B received LIPUS for 20 minutes a day from the first day after the fractures. LIPUS was generated from Teijin Pharma's device for a basic experiment. When treating Group A, the wound dressing was pasted on the ultrasound terminal in order to apply LIPUS through the dressing. We assessed the time-oriented morphological change of each group in anesthetized condition using simple radiographs on the 8th, 16th, and 24th day after the fractures. Six rats in Group A, 2 in Group B, and 1 in Group C died in anesthesia, and we discussed the remaining 4 rats in Group A, 8 in Group B, and 9 in Group C. We defined more than one teleost callus bridging as bone-union. We also counted a bone remodeling when we recognized the absorption of existing cortical bone and the transformation of new bone to cortical bone in simple radiographs. As a result, compared with Group C, we recognized that both bone union and remodeling accelerated remarkably in Group B, but not in Group A. It suggested that LIPUS through wound dressing had negative influences on both period shorting of fracture healing and bone remodeling. When LIPUS was conducted through film wound dressing, transmittance and coefficient of transmission were unchanged; however, the non-uniformity ratio changed slightly. The non-uniformity ratio of the ultrasound transducer had a significant influence on the effect of LIPUS on fracture healing.

Aeroacoustic Simulation of a Nose Landing Gear in an Open Jet Facility Using FUN3D

NASA Technical Reports Server (NTRS)

Vatsa, Veer N.; Lockard, David P.; Khorrami, Mehdi R.; Carlson, Jan-Renee

2012-01-01

Numerical simulations have been performed for a partially-dressed, cavity-closed nose landing gear configuration that was tested in NASA Langley s closed-wall Basic Aerodynamic Research Tunnel (BART) and in the University of Florida s open-jet acoustic facility known as UFAFF. The unstructured-grid flow solver, FUN3D, developed at NASA Langley Research center is used to compute the unsteady flow field for this configuration. A hybrid Reynolds-averaged Navier-Stokes/large eddy simulation (RANS/LES) turbulence model is used for these computations. Time-averaged and instantaneous solutions compare favorably with the measured data. Unsteady flowfield data obtained from the FUN3D code are used as input to a Ffowcs Williams-Hawkings noise propagation code to compute the sound pressure levels at microphones placed in the farfield. Significant improvement in predicted noise levels is obtained when the flowfield data from the open jet UFAFF simulations is used as compared to the case using flowfield data from the closed-wall BART configuration.

Coherent state coding approaches the capacity of non-Gaussian bosonic channels

NASA Astrophysics Data System (ADS)

Huber, Stefan; König, Robert

2018-05-01

The additivity problem asks if the use of entanglement can boost the information-carrying capacity of a given channel beyond what is achievable by coding with simple product states only. This has recently been shown not to be the case for phase-insensitive one-mode Gaussian channels, but remains unresolved in general. Here we consider two general classes of bosonic noise channels, which include phase-insensitive Gaussian channels as special cases: these are attenuators with general, potentially non-Gaussian environment states and classical noise channels with general probabilistic noise. We show that additivity violations, if existent, are rather minor for all these channels: the maximal gain in classical capacity is bounded by a constant independent of the input energy. Our proof shows that coding by simple classical modulation of coherent states is close to optimal.

Identification of Workplace Dress by Low-Income Job Seekers

ERIC Educational Resources Information Center

Saiki, Diana

2013-01-01

The author examined how low-income job seekers participating in a workplace dress program identified traditional business and business casual dress. Seventy low-income job seekers identified clothing items as traditional business (e.g., suits, ties), similar to identifications made by professionals and image consultants in previous literature.…

Counterconformity: An Attribution Model of Adolescents' Uniqueness-Seeking Behaviors in Dressing

ERIC Educational Resources Information Center

Ling, I-Ling

2008-01-01

This article explores how an attribution model will illustrate uniqueness-seeking behavior in dressing in the Taiwanese adolescent subculture. The study employed 443 senior high school students. Results show that the tendency of uniqueness-seeking behavior in dressing is moderate. However, using cluster analysis to segment the counterconformity…

21 CFR 878.4018 - Hydrophilic wound dressing.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Hydrophilic wound dressing. 878.4018 Section 878.4018 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4018 Hydrophilic wound dressing...

21 CFR 878.4018 - Hydrophilic wound dressing.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Hydrophilic wound dressing. 878.4018 Section 878.4018 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4018 Hydrophilic wound dressing...

21 CFR 878.4020 - Occlusive wound dressing.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Occlusive wound dressing. 878.4020 Section 878.4020 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4020 Occlusive wound dressing...

21 CFR 878.4020 - Occlusive wound dressing.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Occlusive wound dressing. 878.4020 Section 878.4020 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4020 Occlusive wound dressing...

21 CFR 878.4018 - Hydrophilic wound dressing.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Hydrophilic wound dressing. 878.4018 Section 878.4018 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4018 Hydrophilic wound dressing...

21 CFR 878.4020 - Occlusive wound dressing.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Occlusive wound dressing. 878.4020 Section 878.4020 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4020 Occlusive wound dressing...

9 CFR 108.9 - Dressing rooms and other facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Dressing rooms and other facilities. 108.9 Section 108.9 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT... REQUIREMENTS FOR LICENSED ESTABLISHMENTS § 108.9 Dressing rooms and other facilities. Each licensed...

Advanced Hemostatic Dressing Development Program: Animal Model Selection Criteria and Results of a Study of Nine Hemostatic Dressings in a Model of Severe Large Venous Hemorrhage and Hepatic Injury in Swine

DTIC Science & Technology

2003-09-01

Pharmaceuticals, Inc. (Westlake, OH), submitted the Hemarrest dressing. This dressing was a thin, sheet-like pad with a mixture of epsilon aminocaproic acid ...chloric acid salt purified bovine corium collagen. It was prepared in a compacted nonwoven web form (7.0 7.0 cm). Ethicon, Inc. (Somerville, NJ...may be related to enhanced platelet procoagulant activity and annexin V binding.46 Another derivative of gallic acid , bis- muth subgallate, appears to

An evaluation of a silicone adhesive shaped heel dressing.

PubMed

Hampton, Sylvie

Tissue breakdown is complex and involves many factors. Pressure ulcer development in the heels is subject to extrinsic factors such as pressure, shear, friction and moisture. The heels are the most common sites for friction and shear damage, which can lead to blistering, skin erosion and tissue breakdown (Grey et al, 2006). To address the issues of wounds that are painful on dressing removal and friable skin, Smith & Nephew has introduced a soft silicone adhesive dressing to its Allevyn dressing range. Silicone does not adhere to wounded areas and can be removed gently without trauma to the periwound area. This paper discusses the findings of a 20-patient multi-site evaluation examining the performance and acceptability of Allevyn Gentle Border Heel dressing in the management of heel wounds.

The use of prophylactic dressings in the prevention of pressure ulcers: a literature review.

PubMed

Cornish, Lynn

2017-06-02

Pressure ulcers pose a significant burden to both patients and health care resources. There are an increasing number of studies that have examined the use of prophylactic dressings, and their ability to redistribute pressure and protect the skin from shear and friction damage. This literature review examines six studies conducted on this controversial subject. Brindle and Wegelin ( 2012 ; Chaiken, 2012 ; Cubit et al, 2012 ; Santamaria et al, 2012) all examined the role of dressings to prevent pressure ulcers, and Call et al (2013a ; 2013b ), conducted in vitro research into the mode of dressings. Current research suggests that while further research is required, the use of prophylactic dressings have a place alongside standard measures, in helping to prevent pressure, shear and friction damage.

Wound dressings from naturally-occurring polymers: A review on homopolysaccharide-based composites.

PubMed

Naseri-Nosar, Mahdi; Ziora, Zyta Maria

2018-06-01

Wound dressings are designed to support the wound bed and protect it from the factors that may delay or impede its healing such as contaminations and moisture-loss, thereby facilitating and accelerating the healing process. The materials used to prepare wound dressings include natural and synthetic polymers, as well as their combinations, in the forms of films, sponges and hydrogels. Polysaccharides are naturally-occurring polymers that have been extensively used as wound dressing materials. Homopolysaccharides are a class of polysaccharides consist of only one type of monosaccharide. The current review intends to overview the studies in which wound dressings from naturally-occurring polymers, based on homopolysaccharides, were prepared and evaluated. Homopolysaccharides such as cellulose, chitosan, chitin, pullulan, starch and β-glucan were considered. Copyright © 2018 Elsevier Ltd. All rights reserved.

She Wears the Pants: The Reform Dress as Technology in Nineteenth-Century America.

PubMed

Mas, Catherine

This article examines the American dress-reform movement, detailing the ways in which reformers conceptualized clothing as a social and bodily technology. In the mid-nineteenth century, women began making and wearing the "reform dress"-a costume consisting of pants and shortened, lightweight skirts-as an alternative to burdensome feminine fashions. When ridiculed in public for wearing overtly masculine garments, dress reformers insisted their clothing was healthful, functional, and natural. This article discusses women's use of medical science and technical knowledge in their rejection of fashion, promotion of sexual equality, and efforts to change mainstream clothing practices. When approached from a technological perspective, the reform dress reveals broader tensions in an industrializing American society, such as changing gender relations and new understandings of the relationship between humans and technology.

Low Grade Elastic Compression Regimen for Venous Leg Ulcers-An Effective Compromise for Patients Requiring Daily Dressing Changes

PubMed Central

Dabiri, Ganary; Hammerman, Scott; Falanga, Vincent

2014-01-01

Venous leg ulcers affect millions of patients worldwide and are a tremendous financial burden on our healthcare system. The hallmark of venous disease of the lower extremities is venous hypertension, and compression is the current mainstay of treatment. However, many patients are noncompliant, in part because of the complexity of the dressings and the difficulties with application and removal. The aim of our study was to determine an effective compression dressing regimen for patients with venous leg ulcers who require changing the ulcer primary dressing twice daily. We used two layers of a latex free tubular elastic bandage for compression. The primary endpoint of our study was increased wound healing rate and our secondary endpoint was complete wound closure. All active study subjects had positive healing rates at week 4 and week 8. Two subjects achieved complete wound closure by week 8. We conclude that compression with a latex-free tubular elastic bandage can be safely used in patients with venous leg ulcers requiring frequent dressing changes. This type of compression allows for daily inspection of wounds, dressing changes at home, flexibility in the context of clinical trials, and is a compromise for patients that are intolerant to compression dressings. PMID:24267477

Effect of music intervention on burn patients' pain and anxiety during dressing changes.

PubMed

Hsu, Kuo-Cheng; Chen, Li Fen; Hsiep, Pi Hsia

2016-12-01

For burn patients, the daily dressing process causes pain and anxiety. Although drugs can relieve them, the degree of pain during dressing changes is often moderate to severe. Therefore, relevant supporting interventions, like music as an ideal intervention, could alleviate the patient's pain. This study investigated the impact of music intervention at dressing change time on burn patients' pain and anxiety. This was a prospective, randomized clinical trial; patients were randomly assigned into control (standard intervention) and experimental groups (crystal music intervention) for five consecutive days (35 patients in each group). Patients' pain and anxiety measurements were collected before, during, and after dressing changes and morphine usage was recorded. The study period was October 2014 to September 2015. There was no difference in morphine dosage for both groups. By the fourth day of music intervention, burn patients' pain before, during, and after dressing changes had significantly decreased; anxiety on the fourth day during and after dressing changes had also significantly decreased. Nurses may use ordered prescription analgesics, but if non-pharmacological interventions are increased, such as providing timely music intervention and creating a friendly, comfortable hospital environment, patients' pain and anxiety will reduce. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Combined effects of oregano essential oil and salt on the growth of Escherichia coli in salad dressing.

PubMed

Cattelan, Marília Gonçalves; Nishiyama, Yara Paula de Oliveira; Gonçalves, Tânia Maria Vinturim; Coelho, Alexandre Rodrigo

2018-08-01

There is a broad research interest in the search for alternatives to chemical additives for use as natural food preservatives. Although many natural compounds have biological in vitro properties evidenced, in situ studies are still scarce. This study evaluated the effect of oregano essential oil (OEO) and salt (NaCl) concentrations against Escherichia coli (ATCC 8739), in salad dressing, using the response surface methodology. The experiment included a 2 2 central composite rotatable design (CCRD) in a total of 11 formulations of salad dressings. Oregano essential oil was characterized by gas chromatography and salad dressings by ash, lipids, proteins and moisture. OEO was composed mainly by carvacrol (65.1%) and p-cymene (12.0%). Salad dressings showed similar chemical profiles. A mathematical model for the prediction of the antibacterial activity in salad dressing was obtained. The results revealed that the interaction between OEO and salt showed effect on the bacterial count. However, the effect of salt was negative suggesting that the highest NaCl concentrations decreases the bacterial count. Therefore, within the parameters studied, the use of OEO to control E. coli in salad dressing can be considered promising and allows reduction in the levels of salt to be incorporated in food. Copyright © 2018 Elsevier Ltd. All rights reserved.

Guanidine hydrochloride embedded polyurethanes as antimicrobial and absorptive wound dressing membranes with promising cytocompatibility.

PubMed

Sahraro, Maryam; Yeganeh, Hamid; Sorayya, Marziyeh

2016-02-01

Preparation and assessments of novel absorptive wound dressing materials with efficient antimicrobial activity as well as very good cytocompatibility were described in this work. An amine terminated poly(hexamethylene guanidine hydrochloride) was prepared and used as curing agent of different epoxy-terminated polyurethane prepolymers. The structures of prepared materials were elucidated by evaluation of their (1)H NMR and FTIR spectra. The recorded tensile strength of membranes confirmed the excellent dimensional stability of the film type dressings even at fully hydrated conditions. Therefore, these dressings could protect the wound bed from external forces during the healing period. The structurally optimized dressing membranes could preserve the desired moist environment over the wounded area, as a result of their balanced equilibrium, water absorption and water vapor transmission rate. Therefore, a very good condition for stimulation of self-healing of wound bed was attained. Also, owing to the presence of guanidine hydrochloride moieties embedded into the structure of dressings, efficient antimicrobial activity against Staphylococcus aureus, Pseudomonas aeruginosa and Candida albicans were detected. In vitro cytotoxicity assay of the prepared dressings revealed cytocompatibility of these materials against fibroblast cells. Therefore, they could support cell growth and proliferation at the wounded area. Copyright © 2015 Elsevier B.V. All rights reserved.

Feasibility of monomodal analgesia with IV alfentanil during burn dressing changes at bedside (in spontaneously breathing non-intubated patients).

PubMed

Fontaine, Mathieu; Latarjet, Jacques; Payre, Jacqueline; Poupelin, Jean-Charles; Ravat, François

2017-03-01

The severe pain related to repeated burn dressing changes at bedside is often difficult to manage. However these dressings can be performed at bedside on spontaneously breathing non-intubated patients using powerful intravenous opioids with a quick onset and a short duration of action such as alfentanil. The purpose of this study is to demonstrate the efficacy and safety of the protocol which is used in our burn unit for pain control during burn dressing changes. Cohort study began after favorable opinion from local ethic committee has been collected. Patient's informed consent was collected. No fasting was required. Vital signs for patients were continuously monitored (non-invasive blood pressure, ECG monitoring, cutaneous oxygen saturation, respiratory rate) all over the process. Boluses of 500 (±250) mcg IV alfentanil were administered. A continuous infusion was added in case of insufficient analgesia. Adverse reactions were collected and pain intensity was measured throughout the dressing using a ten step verbal rating scale (VRS) ranging from 0 (no pain) to 10 (worst pain conceivable). 100 dressings (35 patients) were analyzed. Median age was 45 years and median burned area 10%. We observed 3 blood pressure drops, 5 oxygen desaturations (treated with stimulation without the necessity of ventilatory support) and one episode of nausea. Most of the patients (87%) were totally conscious during the dressing and 13% were awakened by verbal stimulation. Median total dose of alfentanil used was 2000μg for a median duration of 35min. Pain scores during the procedure were low or moderate (VRS mean=2.0 and maximal VRS=5). Median satisfaction collected 2h after the dressing was 10 on a ten step scale. Pain control with intravenous alfentanil alone is efficient and appears safe for most burn bedside repeated dressings in hospitalized patients. It achieves satisfactory analgesia during and after the procedure. It is now our standard analgesic method to provide repeated bedside dressings changes for burned patients. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Neighborhood Inequalities in Retailers' Compliance With the Family Smoking Prevention and Tobacco Control Act of 2009, January 2014-July 2014.

PubMed

Lee, Joseph G L; Baker, Hannah M; Ranney, Leah M; Goldstein, Adam O

2015-10-08

Retailer noncompliance with limited US tobacco regulations on advertising and labeling was historically patterned by neighborhood in ways that promote health disparities. In 2010, the US Food and Drug Administration (FDA) began enforcing stronger tobacco retailer regulations under the Family Smoking Prevention and Tobacco Control Act of 2009. However, recent research has found no differences in compliance by neighborhood characteristics for FDA advertising and labeling inspections. We sought to investigate the neighborhood characteristics associated with retailer noncompliance with specific FDA advertising and labeling inspections (ie, violations of bans on self-service displays, selling single cigarettes, false or mislabeled products, vending machines, flavored cigarettes, and free samples). We coded FDA advertising and labeling warning letters (n = 718) for type of violations and geocoded advertising and labeling inspections from January 1 through July 31, 2014 (N = 33,543). Using multilevel models, we examined cross-sectional associations between types of violations and neighborhood characteristics previously associated with disparities (ie, percentage black, Latino, under the poverty line, and younger than 18 years). Retailer advertising and labeling violations are patterned by who lives in the neighborhood; regulated tobacco products are more likely to be stored behind the counter as the percentage of black or Latino residents increases, and single cigarettes are more often available for purchase in neighborhoods as the percentage of black, poor, or young residents increases. Contrary to previous null findings, noncompliance with FDA advertising and labeling regulations is patterned by neighborhood characteristics, sometimes in opposite directions. Given the low likelihood of self-service violations in the same neighborhoods that have high likelihood of single cigarette sales, we suggest targeted approaches to FDA retailer inspections and education campaigns.

Neighborhood Inequalities in Retailers’ Compliance With the Family Smoking Prevention and Tobacco Control Act of 2009, January 2014–July 2014

PubMed Central

Baker, Hannah M.; Ranney, Leah M.; Goldstein, Adam O.

2015-01-01

Introduction Retailer noncompliance with limited US tobacco regulations on advertising and labeling was historically patterned by neighborhood in ways that promote health disparities. In 2010, the US Food and Drug Administration (FDA) began enforcing stronger tobacco retailer regulations under the Family Smoking Prevention and Tobacco Control Act of 2009. However, recent research has found no differences in compliance by neighborhood characteristics for FDA advertising and labeling inspections. We sought to investigate the neighborhood characteristics associated with retailer noncompliance with specific FDA advertising and labeling inspections (ie, violations of bans on self-service displays, selling single cigarettes, false or mislabeled products, vending machines, flavored cigarettes, and free samples). Methods We coded FDA advertising and labeling warning letters (n = 718) for type of violations and geocoded advertising and labeling inspections from January 1 through July 31, 2014 (N = 33,543). Using multilevel models, we examined cross-sectional associations between types of violations and neighborhood characteristics previously associated with disparities (ie, percentage black, Latino, under the poverty line, and younger than 18 years). Results Retailer advertising and labeling violations are patterned by who lives in the neighborhood; regulated tobacco products are more likely to be stored behind the counter as the percentage of black or Latino residents increases, and single cigarettes are more often available for purchase in neighborhoods as the percentage of black, poor, or young residents increases. Conclusion Contrary to previous null findings, noncompliance with FDA advertising and labeling regulations is patterned by neighborhood characteristics, sometimes in opposite directions. Given the low likelihood of self-service violations in the same neighborhoods that have high likelihood of single cigarette sales, we suggest targeted approaches to FDA retailer inspections and education campaigns. PMID:26447548

Jewish holidays and their associated medical risks.

PubMed

Urkin, Jacob; Naimer, Sody

2015-02-01

Religiosity is inherent in human cultures. Being different in many aspects, all have rules regarding appropriate behavior and rituals. Celebrations of social events and of holidays prevail in all major religions. These include code of dress, prayers, special food and activities which may have negative health implications. The Jewish religion is 'blessed' with an abundance of holidays each with its unique health implications. In this paper we provide an outline of the character of these festivals and possible medical repercussions on those celebrating them. Observant members of the Jewish religion and teams treating this population should be knowledgeable of potentially associated risks. Pre-holiday periods should be specifically targeted for educational and preventive activity in order diminish injury or morbidity.

A study of long-term stability and antimicrobial activity of chlorhexidine, polyhexamethylene biguanide, and silver nanoparticle incorporated in sericin-based wound dressing.

PubMed

Ampawong, Sumate; Aramwit, Pornanong

2017-09-01

In this study, three kinds of antiseptics which were 0.05% chlorhexidine, 0.2% polyhexamethylene biguanide (PHMB), or 200 ppm silver nanoparticle was introduced to incorporate in the sericin-based scaffold to produce the antimicrobial dressing for the treatment of infected chronic wound. The effects of antiseptic incorporation on the stability, release of sericin, and short-term and long-term (6 months) antimicrobial activity of the sericin dressing against gram-negative and gram-positive bacteria were investigated. We showed that the incorporation of each antiseptic did not have significant effect on the internal morphology (pore size ~ 73-105 μm), elasticity (Young's modulus ~ 200-500 kPa), and the sericin release behavior of the sericin-based dressing. The release of sericin from the dressing was prolonged over 120 h and thereafter. Comparing among three antiseptics, 0.05% chlorhexidine incorporated in the sericin dressing showed the highest immediate and long-term (6 months) antimicrobial effect (largest inhibition zone) against most bacteria either gram-positive or gram-negative bacteria. The in vivo safety test following ISO10993 standard (Biological evaluation of medical devices - Part 6: Tests for local effects after implantation) confirmed that the sericin dressing incorporating 0.05% chlorhexidine did not irritate to tissue, comparing with the commercial material used generally in clinic (Allevyn®, Smith & Nephew). We suggested the sericin dressing incorporating 0.05% chlorhexidine for the treatment of infected chronic wound. Chlorhexidine would reduce the risk of infection while the sericin may promote wound healing.

The effect of inhalation aromatherapy with damask rose (Rosa damascena) essence on the pain intensity after dressing in patients with burns: A clinical randomized trial.

PubMed

Bikmoradi, Ali; Harorani, Mehdi; Roshanaei, Ghodratollah; Moradkhani, Shirin; Falahinia, Golam Hossein

2016-01-01

Pain is one of the common problems encountered by patients with burns, which increases after each dressing. This study aimed to investigate the effect of inhalation aromatherapy with damask rose essence on the pain of patients with burns that is caused after dressing. A randomized clinical trial was conducted on 50 patients with second- and third-degree burn wounds. The baseline pain of the patients was assessed 30 min before they entered into the dressing room on the first and second days of intervention. The patients in the experimental group inhaled five drops of damask rose essence 40% in distilled water, while those in the control group inhaled five drops of distilled water as placebo. The pain intensity was assessed using Visual Analogue Scale at 15 and 30 min after the patients exited from the dressing room. Data were analyzed by SPSS (version 18) using descriptive and inferential statistics. There was significant difference between the mean of pain intensity before and after intervention at 15 and 30 min after dressing (P < 0.001). Moreover, there was significant difference in reduction of pain intensity before and after aromatherapy in the experimental group (P < 0.05). Also, there was a significant reduction in severity of pain after dressing in the experimental group compared with the control group (P < 0.05). Inhalation aromatherapy with damask rose could be effective for relieving the pain caused after dressing in patients with burns. Therefore, it could be suggested as a complementary therapy in burn patients for pain relief.

Prophylactic Sacral Dressing for Pressure Ulcer Prevention in High-Risk Patients.

PubMed

Byrne, Jaime; Nichols, Patricia; Sroczynski, Marzena; Stelmaski, Laurie; Stetzer, Molly; Line, Cynthia; Carlin, Kristen

2016-05-01

Patients in intensive care units are likely to have limited mobility owing to hemodynamic instability and activity orders for bed rest. Bed rest is indicated because of the severity of the disease process, which often involves intubation, sedation, paralysis, surgical procedures, poor nutrition, low flow states, and poor circulation. These patients are predisposed to the development and/or the progression of pressure ulcers not only because of their underlying diseases, but also because of limited mobility and deconditioned states of health. To assess whether treating high-risk patients with a prophylactic sacral dressing decreases the incidence of unit-acquired sacral pressure ulcers. An evidence-based tool for identifying patients at high risk for pressure ulcers was used in 3 intensive care units at an urban tertiary care hospital and academic medical center. Those patients deemed at high risk had a prophylactic sacral dressing applied. Incidence rates were collected and compared for the 7 months preceding use of the dressings and for 7 months during the trial period when the dressing was used. After the sacral dressing began being used, the number of unit-acquired sacral pressure ulcers decreased by 3.4 to 7.6 per 1000 patient days depending on the unit. A prophylactic sacral dressing may help prevent unit-acquired sacral pressure ulcers. Implementation of an involved care team with heightened awareness and increased education along with a prophylactic sacral dressing in patients deemed high risk for skin breakdown are all essential for success. ©2016 American Association of Critical-Care Nurses.

Selection of Levels of Dressing Process Parameters by Using TOPSIS Technique for Surface Roughness of En-31 Work piece in CNC Cylindrical Grinding Machine

NASA Astrophysics Data System (ADS)

Patil, Sanjay S.; Bhalerao, Yogesh J.

2017-02-01

Grinding is metal cutting process used for mainly finishing the automobile components. The grinding wheel performance becomes dull by using it most of times. So it should be reshaping for consistent performance. It is necessary to remove dull grains of grinding wheel which is known as dressing process. The surface finish produced on the work piece is dependent on the dressing parameters in sub-sequent grinding operation. Multi-point diamond dresser has four important parameters such as the dressing cross feed rate, dressing depth of cut, width of the diamond dresser and drag angle of the dresser. The range of cross feed rate level is from 80-100 mm/min, depth of cut varies from 10 - 30 micron, width of diamond dresser is from 0.8 - 1.10mm and drag angle is from 40o - 500, The relative closeness to ideal levels of dressing parameters are found for surface finish produced on the En-31 work piece during sub-sequent grinding operation by using Technique of Order Preference by Similarity to Ideal Solution (TOPSIS).In the present work, closeness to ideal solution i.e. levels of dressing parameters are found for Computer Numerical Control (CNC) cylindrical angular grinding machine. After the TOPSIS technique, it is found that the value of Level I is 0.9738 which gives better surface finish on the En-31 work piece in sub-sequent grinding operation which helps the user to select the correct levels (combinations) of dressing parameters.

Medical workers' cognition of using 50% nitrous oxide in children with burns: a qualitative study.

PubMed

Wang, Hai-Xia; Li, Yu-Xiang; Zhou, Ru-Zhen; Zhao, Ji-Jun

2015-09-01

Pain caused by dressing among children with burns is an issue worth discussing. Medical workers' understanding of pain during dressing in children with burns is correlated with the quality of pain management. Effective pain management is significant to improve anxiety and reduce pain and psychological distress during dressing for children with burns. We aimed to investigate medical workers' understanding of current pain management during dressing among children with burns and their attitudes toward the application of 50% nitrous oxide in pain management. Interviews were conducted with seven doctors and nurses from a burn center in East China. Data were collected by in-depth interviews and qualitative description after full transcription of each interview. Three themes were identified: (1) Medical workers felt sympathy for children with burns and believed that a gap existed between the current and expected situation in pain management. In addition, the prescription of analgesics during dressing for children with burns was not favored. (2) Given the fact that 50% nitrous oxide is effective in pain management for adult patients with burns, medical workers tended to apply it to children with burns during dressing after being provided the literature on the use of 50% nitrous oxide in children. (3) Guidelines for the application of 50% nitrous oxide during dressing for children with burns require further modification. Medical workers deemed the pain management for children with burns unsatisfactory, and they supported the application of 50% nitrous oxide during dressing for children with burns. Meanwhile, they hoped that administrators would also support it. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Designing cellulosic and nanocellulosic sensors for interface with a protease sequestrant wound-dressing prototype: Implications of material selection for dressing and protease sensor design.

PubMed

Fontenot, Krystal R; Edwards, J Vincent; Haldane, David; Pircher, Nicole; Liebner, Falk; Condon, Brian D; Qureshi, Huzaifah; Yager, Dorne

2017-11-01

Interfacing nanocellulosic-based biosensors with chronic wound dressings for protease point of care diagnostics combines functional material properties of high specific surface area, appropriate surface charge, and hydrophilicity with biocompatibility to the wound environment. Combining a protease sensor with a dressing is consistent with the concept of an intelligent dressing, which has been a goal of wound-dressing design for more than a quarter century. We present here biosensors with a nanocellulosic transducer surface (nanocrystals, nanocellulose composites, and nanocellulosic aerogels) immobilized with a fluorescent elastase tripeptide or tetrapeptide biomolecule, which has selectivity and affinity for human neutrophil elastase present in chronic wound fluid. The specific surface area of the materials correlates with a greater loading of the elastase peptide substrate. Nitrogen adsorption and mercury intrusion studies revealed gas permeable systems with different porosities (28-98%) and pore sizes (2-50 nm, 210 µm) respectively, which influence water vapor transmission rates. A correlation between zeta potential values and the degree of protease sequestration imply that the greater the negative surface charge of the nanomaterials, the greater the sequestration of positively charged neutrophil proteases. The biosensors gave detection sensitivities of 0.015-0.13 units/ml, which are at detectable human neutrophil elastase levels present in chronic wound fluid. Thus, the physical and interactive biochemical properties of the nano-based biosensors are suitable for interfacing with protease sequestrant prototype wound dressings. A discussion of the relevance of protease sensors and cellulose nanomaterials to current chronic wound dressing design and technology is included.

The efficacy of music therapy protocols for decreasing pain, anxiety, and muscle tension levels during burn dressing changes: a prospective randomized crossover trial.

PubMed

Tan, Xueli; Yowler, Charles J; Super, Dennis M; Fratianne, Richard B

2010-01-01

The purpose of this study was to explore the efficacy of two music therapy protocols on pain, anxiety, and muscle tension levels during dressing changes in burn patients. Twenty-nine inpatients participated in this prospective, crossover randomized controlled trial. On two consecutive days, patients were randomized to receive music therapy services either on the first or second day of the study. On control days, they received no music. On music days, patients practiced music-based imagery (MBI), a form of music-assisted relaxation with patient-specific mental imagery before and after dressing changes. Also, on music days during dressing changes, the patients engaged in music alternate engagement (MAE), which consisted of active participation in music making. The dependent variables were the patients' subjective ratings of their pain and anxiety levels and the research nurse's objective ratings of their muscle tension levels. Two sets of data were collected before, three sets during, and another two sets after dressing changes. The results showed significant decrease in pain levels before (P < .025), during (P < .05), and after (P < .025) dressing changes on days the patients received music therapy in contrast to control days. Music therapy was also associated with a decrease in anxiety and muscle tension levels during the dressing changes (P < .05) followed by a reduction in muscle tension levels after dressing changes (P < .025). Music therapy significantly decreases the acute procedural pain, anxiety, and muscle tension levels associated with daily burn care.

#TheDress: Categorical perception of an ambiguous color image.

PubMed

Lafer-Sousa, Rosa; Conway, Bevil R

2017-10-01

We present a full analysis of data from our preliminary report (Lafer-Sousa, Hermann, & Conway, 2015) and test whether #TheDress image is multistable. A multistable image must give rise to more than one mutually exclusive percept, typically within single individuals. Clustering algorithms of color-matching data showed that the dress was seen categorically, as white/gold (W/G) or blue/black (B/K), with a blue/brown transition state. Multinomial regression predicted categorical labels. Consistent with our prior hypothesis, W/G observers inferred a cool illuminant, whereas B/K observers inferred a warm illuminant; moreover, subjects could use skin color alone to infer the illuminant. The data provide some, albeit weak, support for our hypothesis that day larks see the dress as W/G and night owls see it as B/K. About half of observers who were previously familiar with the image reported switching categories at least once. Switching probability increased with professional art experience. Priming with an image that disambiguated the dress as B/K biased reports toward B/K (priming with W/G had negligible impact); furthermore, knowledge of the dress's true colors and any prior exposure to the image shifted the population toward B/K. These results show that some people have switched their perception of the dress. Finally, consistent with a role of attention and local image statistics in determining how multistable images are seen, we found that observers tended to discount as achromatic the dress component that they did not attend to: B/K reporters focused on a blue region, whereas W/G reporters focused on a golden region.

What #theDress reveals about the role of illumination priors in color perception and color constancy

PubMed Central

Aston, Stacey; Hurlbert, Anya

2018-01-01

The disagreement between people who named #theDress (the Internet phenomenon of 2015) “blue and black” versus “white and gold” is thought to be caused by individual differences in color constancy. It is hypothesized that observers infer different incident illuminations, relying on illumination “priors” to overcome the ambiguity of the image. Different experiences may drive the formation of different illumination priors, and these may be indicated by differences in chronotype. We assess this hypothesis, asking whether matches to perceived illumination in the image and/or perceived dress colors relate to scores on the morningness-eveningness questionnaire (a measure of chronotype). We find moderate correlations between chronotype and illumination matches (morning types giving bluer illumination matches than evening types) and chronotype and dress body matches, but these are significant only at the 10% level. Further, although inferred illumination chromaticity in the image explains variation in the color matches to the dress (confirming the color constancy hypothesis), color constancy thresholds obtained using an established illumination discrimination task are not related to dress color perception. We also find achromatic settings depend on luminance, suggesting that subjective white point differences may explain the variation in dress color perception only if settings are made at individually tailored luminance levels. The results of such achromatic settings are inconsistent with their assumed correspondence to perceived illumination. Finally, our results suggest that perception and naming are disconnected, with observers reporting different color names for the dress photograph and their isolated color matches, the latter best capturing the variation in the matches. PMID:28793353

#TheDress: Categorical perception of an ambiguous color image

PubMed Central

Lafer-Sousa, Rosa; Conway, Bevil R.

2017-01-01

We present a full analysis of data from our preliminary report (Lafer-Sousa, Hermann, & Conway, 2015) and test whether #TheDress image is multistable. A multistable image must give rise to more than one mutually exclusive percept, typically within single individuals. Clustering algorithms of color-matching data showed that the dress was seen categorically, as white/gold (W/G) or blue/black (B/K), with a blue/brown transition state. Multinomial regression predicted categorical labels. Consistent with our prior hypothesis, W/G observers inferred a cool illuminant, whereas B/K observers inferred a warm illuminant; moreover, subjects could use skin color alone to infer the illuminant. The data provide some, albeit weak, support for our hypothesis that day larks see the dress as W/G and night owls see it as B/K. About half of observers who were previously familiar with the image reported switching categories at least once. Switching probability increased with professional art experience. Priming with an image that disambiguated the dress as B/K biased reports toward B/K (priming with W/G had negligible impact); furthermore, knowledge of the dress's true colors and any prior exposure to the image shifted the population toward B/K. These results show that some people have switched their perception of the dress. Finally, consistent with a role of attention and local image statistics in determining how multistable images are seen, we found that observers tended to discount as achromatic the dress component that they did not attend to: B/K reporters focused on a blue region, whereas W/G reporters focused on a golden region. PMID:29090319

A prospective randomized trial comparing silver sulfadiazine cream with a water-soluble polyantimicrobial gel in partial-thickness burn wounds.

PubMed

Black, Jonathan S; Drake, David B

2015-01-01

The lipid base of silver sulfadiazine (SSD) makes removal of the product painful for the patient and difficult for the physician to accurately assess particularly in partial-thickness burn injuries. As an alternative, a water-soluble antimicrobial gel is used at the University of Virginia. We present a prospective, randomized comparison of these two therapies using pain with dressing changes and time to perform dressing changes as our primary endpoints. Adult inpatients with partial-thickness burn wounds were randomized to begin therapy with either SSD cream or the water-soluble burn wound gel (BWG), and then therapies were alternated daily. Pain assessments, time to complete dressing care, total narcotic medication administered, and the number of personnel required for dressing changes were recorded. Eight patients were enrolled resulting in 13 pairs (26 points) of data comparison between the two therapies. Four of the eight enrolled patients (50%) refused to continue receiving SSD because of pain associated with dressing changes and voluntarily withdrew from the study. The amount of time to perform dressing changes was an average of 79 nurse-minutes longer for SSD. A 6.08 greater morphine equivalent was delivered to those having BWG removed.A water-soluble polyantimicrobial gel was superior to SSD in the parameters measured as exhibited by our patient dropout rate and differential time to perform dressing care. Limiting the time to perform dressing care will reduce the cumulative pain experience, improve patient satisfaction, and reduce the resources to deliver care.

Improving the Automated Detection and Analysis of Secure Coding Violations

DTIC Science & Technology

2014-06-01

eliminating software vulnerabilities and other flaws. The CERT Division produces books and courses that foster a security mindset in developers, and...website also provides a virtual machine containing a complete build of the Rosecheckers project on Linux . The Rosecheckers project leverages the...Compass/ROSE6 project developed at Law- rence Livermore National Laboratory. This project provides a high-level API for accessing the abstract syntax tree

Rape Myth Acceptance at the US Air Force Academy: A Preliminary Look

DTIC Science & Technology

2015-11-01

USAFA) came under the national spotlight due to its mishandling of approximately 142 alleged sexual assaults that occurred over a ten year time span... sexual assault cases, significant underreporting due to cadet concerns regarding Honor Code violations1, and organizational socialization that...was cited as, “contributing to an environment that tolerates sexual misconduct” and its climate as marred with ongoing sexual harassment (Fowler et

Environmental Compliance Audit Handbook (ECAH): U.S. Fish and Wildlife Service (FWS) (Revision)

DTIC Science & Technology

1999-09-01

with FWS, began research on this handbook. The concept was to combine the Code of Federal Regulations with good management practices and risk... The numbers of environmental laws and regulations have continued to grow in the United States, making compliance with these regulations increasingly...violations by the U.S. Environmental Protection Agency (USEPA). Beginning in 1993, the U.S. Army Construction Engineering Research Laboratory, in cooperation

Environmental Compliance Assessment Management Program (ECAMP) - U.S. Fish and Wildlife Service (FWS)

DTIC Science & Technology

1994-06-01

and Wildlife Service, began research on the Environmental Compliance Assessment and Management Program (ECAMP). The concept was to combine Code of ... The number of environmental laws and regulations have continued to grow in the United States and worldwide, making compliance with these regulations...Service has adopted an environmental compliance program that identifies compliance problems before they are cited as violations by the U.S

Environmental Compliance Assessment for Army Reserves (ECAAR)

DTIC Science & Technology

1991-11-01

The number of environmental laws and regulations has continued to grow in the United States and worldwide, making compliance with these regulations...they became notices of violation. The concept was to combine Code of Federal Regulations and Army environmental regulations, with good management...items or operations to review, and would list a point of contact for that item to help assessors review the questions, or protocols, quickly and easily

Fashion as Argument: Nineteenth-Century Dress Reform.

ERIC Educational Resources Information Center

Torrens, Kathleen M.

1999-01-01

Examines the place of the body in the dress-reform movement, a social movement that focused on fashion as a vehicle for achieving social and political equality. Discusses how fashion became one arena in which definitions of gender were contested. Suggests the dress-reform movement's failure in redefining femininity indicates the depth of…

The Effect of Academics' Dress and Gender on Student Perceptions of Instructor Approachability and Likeability

ERIC Educational Resources Information Center

Chatelain, Amber M.

2015-01-01

This study sought to discover student perceptions of academics' dress and gender and their impact on perceived instructor approachability and likeability. Three categories of dress were examined: casual, business casual and professional. The results of this study suggest students at career-arts institutions perceive female teachers as less…

Media Frames regarding Teacher Dress: Implications for Career and Technical Education Teacher Preparation

ERIC Educational Resources Information Center

Freeburg, Beth Winfrey; Workman, Jane E.

2010-01-01

The purpose of this study was to explore teacher dress in United States schools as presented in the newspaper. Twenty-nine articles were examined to answer three questions. Results revealed: (a) the newspaper provided four contexts for processing information about teacher dress--roles, control, impression management, and educational learning…

Dress-Related Responses to the Columbine Shootings: Other-Imposed and Self-Designed.

ERIC Educational Resources Information Center

Ogle, Jennifer Paff; Eckman, Molly

2002-01-01

An inductive content analysis approach was used to examine 155 dress-related newspaper articles following the Columbine High School shootings in 1999. Analysis revealed two dress-related responses: (1) other-imposed regulation to protect students and deter them from expressing hatred and (2) self-designed acts of resistance for grieving. (Contains…

Fashion in the Classroom: Effects of Attire on Student Perceptions of Instructors in College Classes.

ERIC Educational Resources Information Center

Morris, Tracy L.; And Others

1996-01-01

Finds that more formal dress (business suits, dress shoes) was associated with increased ratings of teaching assistants' competence, particularly for female students rating female instructors. Shows, however, that contrary to common assumptions, the most positive influences of instructor dress were found in the highly casual condition (faded…

Attraction Effect in Risky Choice Can Be Explained by Subjective Distance Between Choice Alternatives.

PubMed

Mohr, Peter N C; Heekeren, Hauke R; Rieskamp, Jörg

2017-08-21

Individuals make decisions under risk throughout daily life. Standard models of economic decision making typically assume that people evaluate choice options independently. There is, however, substantial evidence showing that this independence assumption is frequently violated in decision making without risk. The present study extends these findings to the domain of decision making under risk. To explain the independence violations, we adapted a sequential sampling model, namely Multialternative Decision Field Theory (MDFT), to decision making under risk and showed how this model can account for the observed preference shifts. MDFT not only better predicts choices compared with the standard Expected Utility Theory, but it also explains individual differences in the size of the observed context effect. Evidence in favor of the chosen option, as predicted by MDFT, was positively correlated with brain activity in the medial orbitofrontal cortex (mOFC) and negatively correlated with brain activity in the anterior insula (aINS). From a neuroscience perspective, the results of the present study show that specific brain regions, such as the mOFC and aINS, not only code the value or risk of a single choice option but also code the evidence in favor of the best option compared with other available choice options.

Effect of Andrographis paniculata leaf extract on wound healing in rats.

PubMed

Al-Bayaty, Fouad Hussain; Abdulla, Mahmood Ameen; Abu Hassan, Mohamed Ibrahim; Ali, Hapipah Mohd

2012-01-01

This work was carried out to study the effect of topical application of Andrographis paniculata on the rate of wound enclosure and its histological features. A wound was created in four groups of rat in posterior neck region. Blank placebo was applied topically to the wounds of Group 1. Groups 2 and 3 were dressed with placebo containing 5% and 10% extracts of A. paniculata, respectively. Intrasite gel was applied topically to the wounds of Group 4. Macroscopical examination revealed that the rate of wound healing was significantly accelerated in the wound dressed with A. paniculata extract compared to the blank placebo. The wounds dressed with 10% extract or Intrasite gel healed earlier compared to the wounds dressed with placebo containing 5% A. paniculata extract. Histologically, wounds dressed with A. paniculata extracts showed markedly less scar width and contained large amounts of fibroblast proliferation. More collagen and less angiogenesis with absence of inflammatory cells were seen for wounds dressed with 10% A. paniculata compared to the blank placebo. Conclusion, A. paniculata extracts significantly enhanced rate of wound healing in rats.

An in vitro test of the efficacy of an anti-biofilm wound dressing.

PubMed

Said, Jawal; Walker, Michael; Parsons, David; Stapleton, Paul; Beezer, Anthony E; Gaisford, Simon

2014-10-20

Broad-spectrum antimicrobial agents, such as silver, are increasingly being formulated into medicated wound dressings in order to control colonization of wounds by opportunistic pathogens. Medicated wound dressings have been shown in-vitro to be effective against planktonic cultures, but in-vivo bacteria are likely to be present in biofilms, which makes their control and eradication more challenging. Recently, a functional wound dressing (AQUACEL(®) Ag+ Extra™ (AAg + E)) has been developed that in addition to silver contains two agents (ethylenediaminetetraacetic acid (EDTA) and benzethonium chloride (BC)) designed to disrupt biofilms. Here, the efficacy of AAg + E is demonstrated using a biofilm model developed in an isothermal microcalorimeter. The biofilm was seen to remain viable in the presence of unmedicated dressing, silver-containing dressing or silver nitrate solution. In the presence of AAg + E, however, the biofilm was eradicated. Control experiments showed that neither EDTA nor BC alone had a bactericidal effect, which means it is the synergistic action of EDTA and BC disrupting the biofilm with silver being bactericidal that leads to the product's efficacy. Copyright © 2014 Elsevier B.V. All rights reserved.

Dispersive detection of radio-frequency-dressed states

NASA Astrophysics Data System (ADS)

Jammi, Sindhu; Pyragius, Tadas; Bason, Mark G.; Florez, Hans Marin; Fernholz, Thomas

2018-04-01

We introduce a method to dispersively detect alkali-metal atoms in radio-frequency-dressed states. In particular, we use dressed detection to measure populations and population differences of atoms prepared in their clock states. Linear birefringence of the atomic medium enables atom number detection via polarization homodyning, a form of common path interferometry. In order to achieve low technical noise levels, we perform optical sideband detection after adiabatic transformation of bare states into dressed states. The balanced homodyne signal then oscillates independently of field fluctuations at twice the dressing frequency, thus allowing for robust, phase-locked detection that circumvents low-frequency noise. Using probe pulses of two optical frequencies, we can detect both clock states simultaneously and obtain population difference as well as the total atom number. The scheme also allows for difference measurements by direct subtraction of the homodyne signals at the balanced detector, which should technically enable quantum noise limited measurements with prospects for the preparation of spin squeezed states. The method extends to other Zeeman sublevels and can be employed in a range of atomic clock schemes, atom interferometers, and other experiments using dressed atoms.

The effect of semirigid dressings on below-knee amputations.

PubMed

MacLean, N; Fick, G H

1994-07-01

The effect of using semirigid dressings (SRDs) on the residual limb of individuals who have had below-knee amputations as a consequence of peripheral vascular disease was investigated, with the primary question being: Does the time to readiness for prosthetic fitting for patients treated with the SRDs differ from that of patients treated with soft dressings? Forty patients entered the study and were alternately assigned to one of two groups. Nineteen patients were assigned to the SRD group, and 21 patients were assigned to the soft dressing group. The time from surgery to readiness for prosthetic fitting was recorded for each patient. Kaplan-Meier survival curves were generated for each group, and the results were analyzed with the log-rank test. There was a difference between the two curves, and an examination of the curves suggests that the expected time to readiness for prosthetic fitting for patients treated with the SRDs would be less than half that of patients treated with soft dressings. The results suggest that a patient may be ready for prosthetic fitting sooner if treated with SRDs instead of soft dressings.

Afraid of being "witchy with a 'b'": a qualitative study of how gender influences residents' experiences leading cardiopulmonary resuscitation.

PubMed

Kolehmainen, Christine; Brennan, Meghan; Filut, Amarette; Isaac, Carol; Carnes, Molly

2014-09-01

Ineffective leadership during cardiopulmonary resuscitation ("code") can negatively affect a patient's likelihood of survival. In most teaching hospitals, internal medicine residents lead codes. In this study, the authors explored internal medicine residents' experiences leading codes, with a particular focus on how gender influences the code leadership experience. The authors conducted individual, semistructured telephone or in-person interviews with 25 residents (May 2012 to February 2013) from 9 U.S. internal medicine residency programs. They audio recorded and transcribed the interviews and then thematically analyzed the transcribed text. Participants viewed a successful code as one with effective leadership. They agreed that the ideal code leader was an authoritative presence; spoke with a deep, loud voice; used clear, direct communication; and appeared calm. Although equally able to lead codes as their male colleagues, female participants described feeling stress from having to violate gender behavioral norms in the role of code leader. In response, some female participants adopted rituals to signal the suspension of gender norms while leading a code. Others apologized afterwards for their counternormative behavior. Ideal code leadership embodies highly agentic, stereotypical male behaviors. Female residents employed strategies to better integrate the competing identities of code leader and female gender. In the future, residency training should acknowledge how female gender stereotypes may conflict with the behaviors required to enact code leadership and offer some strategies, such as those used by the female residents in this study, to help women integrate these dual identities.

The Use of Vacuum-Assisted Closure and GranuFoam Silver® Dressing in the Management of Diabetic Foot Ulcer.

PubMed

Günal, Özgür; Tuncel, Umut; Turan, Aydin; Barut, Sener; Kostakoglu, Naci

2015-10-01

The aim of this retrospective study was to evaluate the efficacy of vacuum-assisted closure (VAC) and GranuFoam Silver® dressing (KCI, San Antonio, TX) compared with conventional GranuFoam® dressing in the management of diabetic foot ulcers. Twenty-one consecutive patients treated with conventional or silver-coated foam dressing were reviewed retrospectively. The wound duration was 6 mo. Group 1 (n=10) received conventional foam dressing (GranuFoam) and group 2 (n=11) received silver-coated foam dressing (GranuFoam Silver). The wound surface area, duration of treatment, bacteriology, and recurrence were compared between the groups. The mean age of the patients was 61.70±10.52 y in group 1 and 67.27±11.28 y in group 2. In group 1, the average surface area of the wounds was 45.30±46.96 cm2 and 18.40±23.48 cm2 in the pre-treatment and post-treatment periods, respectively. There was a statistically significant difference between two measurements (p=0.005). Average duration of the treatment was 25.50±27.13 d in this group. In group 2, average surface area of the wounds in the pre-treatment and post-treatment periods were 41.55±36.03 cm2 and 7.64±3.91 cm2, respectively. There was a statistically significant difference between two measurements (p=0.003). Average duration of the treatment was 10.09±3.51 d in this group. The patients treated with silver-impregnated polyurethane foam dressing had reduced recurrence (2 vs. 7 wounds, p=0.030) and increased number of the culture-negative cases at the end of the treatment. With the results of the study, it was concluded that VAC GranuFoam silver dressing can be superior to conventional GranuFoam dressing in reducing the recurrence rate of infected diabetic foot ulcers.

The role of silver sulphadiazine in the conservative treatment of partial thickness burn wounds: A systematic review.

PubMed

Heyneman, A; Hoeksema, H; Vandekerckhove, D; Pirayesh, A; Monstrey, S

2016-11-01

For more than 40 years, silver sulphadiazine 1% (SSD) is considered as standard therapy for the conservative treatment of burn wounds. However, in the last 10 years, substantial disadvantages of SSD have been reported in the literature and probably as a result of this, several new dressings for burn wounds have been developed and put on the market. The objective of this systematic review is to evaluate the available evidence on SSD in the conservative treatment of burns, specifically in comparison with the newer burn dressings that are increasingly being used nowadays. A search filter was composed to select randomized controlled trials (RCTs) from the MEDLINE database. Only RCTs studying the effect of conservative treatment on burns were selected. At least one of the two comparative groups was treated with SSD. Each included article was analysed and relevant data (baseline parameters, interventions, outcomes and methodological parameters) were registered using Microsoft Office Excel 2007. Many dressings showed superior healing properties compared to SSD, but no dressing was able to show a clear benefit over SSD regarding infection. The number of dressing changes, pain and patient's satisfaction are more favourable in the newer dressings, especially with solid and biological dressings. The results of this systematic review clearly demonstrate that a faster wound healing is obtained with the newly developed burn dressings. Additionally, these new dressings tend to be more comfortable for the patients and easier to use for care givers. The minor differences in antibacterial activity between SSD and the new products did not seem to have any influence on the rate of wound healing. Since rapid wound closure is essential to obtain an optimal functional and aesthetic outcome, it can be concluded from the results of this systemic review that the standard use of SSD in the conservative treatment of burn wounds can no longer be supported. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Enforcing dust mass conservation in 3D simulations of tightly coupled grains with the PHANTOM SPH code

NASA Astrophysics Data System (ADS)

Ballabio, G.; Dipierro, G.; Veronesi, B.; Lodato, G.; Hutchison, M.; Laibe, G.; Price, D. J.

2018-06-01

We describe a new implementation of the one-fluid method in the SPH code PHANTOM to simulate the dynamics of dust grains in gas protoplanetary discs. We revise and extend previously developed algorithms by computing the evolution of a new fluid quantity that produces a more accurate and numerically controlled evolution of the dust dynamics. Moreover, by limiting the stopping time of uncoupled grains that violate the assumptions of the terminal velocity approximation, we avoid fatal numerical errors in mass conservation. We test and validate our new algorithm by running 3D SPH simulations of a large range of disc models with tightly and marginally coupled grains.

Dynamical Casimir-Polder force on a partially dressed atom near a conducting wall

DOE Office of Scientific and Technical Information (OSTI.GOV)

Messina, Riccardo; Vasile, Ruggero; Passante, Roberto

2010-12-15

We study the time evolution of the Casimir-Polder force acting on a neutral atom in front of a perfectly conducting plate, when the system starts its unitary evolution from a partially dressed state. We solve the Heisenberg equations for both atomic and field quantum operators, exploiting a series expansion with respect to the electric charge and an iterative technique. After discussing the behavior of the time-dependent force on an initially partially dressed atom, we analyze a possible experimental scheme to prepare the partially dressed state and the observability of this new dynamical effect.

Enforcing the Courant–Friedrichs–Lewy condition in explicitly conservative local time stepping schemes

DOE PAGES

Gnedin, Nickolay Y.; Semenov, Vadim A.; Kravtsov, Andrey V.

2018-01-30

In this study, an optimally efficient explicit numerical scheme for solving fluid dynamics equations, or any other parabolic or hyperbolic system of partial differential equations, should allow local regions to advance in time with their own, locally constrained time steps. However, such a scheme can result in violation of the Courant-Friedrichs-Lewy (CFL) condition, which is manifestly non-local. Although the violations can be considered to be "weak" in a certain sense and the corresponding numerical solution may be stable, such calculation does not guarantee the correct propagation speed for arbitrary waves. We use an experimental fluid dynamics code that allows cubicmore » "patches" of grid cells to step with independent, locally constrained time steps to demonstrate how the CFL condition can be enforced by imposing a condition on the time steps of neighboring patches. We perform several numerical tests that illustrate errors introduced in the numerical solutions by weak CFL condition violations and show how strict enforcement of the CFL condition eliminates these errors. In all our tests the strict enforcement of the CFL condition does not impose a significant performance penalty.« less

Marketing breast milk substitutes: problems and perils throughout the world

PubMed Central

Brady, June Pauline

2012-01-01

On 21 May 1981 the WHO International Code of Marketing Breast Milk Substitutes (hereafter referred to as the Code) was passed by 118 votes to 1, the US casting the sole negative vote. The Code arose out of concern that the dramatic increase in mortality, malnutrition and diarrhoea in very young infants in the developing world was associated with aggressive marketing of formula. The Code prohibited any advertising of baby formula, bottles or teats and gifts to mothers or ‘bribery’ of health workers. Despite successes, it has been weakened over the years by the seemingly inexhaustible resources of the global pharmaceutical industry. This article reviews the long and tortuous history of the Code through the Convention on the Rights of the Child, the HIV pandemic and the rare instances when substitute feeding is clearly essential. Currently, suboptimal breastfeeding is associated with over a million deaths each year and 10% of the global disease burden in children. All health workers need to recognise inappropriate advertising of formula, to report violations of the Code and to support efforts to promote breastfeeding: the most effective way of preventing child mortality throughout the world. PMID:22419779

Marketing breast milk substitutes: problems and perils throughout the world.

PubMed

Brady, June Pauline

2012-06-01

On 21 May 1981 the WHO International Code of Marketing Breast Milk Substitutes (hereafter referred to as the Code) was passed by 118 votes to 1, the US casting the sole negative vote. The Code arose out of concern that the dramatic increase in mortality, malnutrition and diarrhoea in very young infants in the developing world was associated with aggressive marketing of formula. The Code prohibited any advertising of baby formula, bottles or teats and gifts to mothers or 'bribery' of health workers. Despite successes, it has been weakened over the years by the seemingly inexhaustible resources of the global pharmaceutical industry. This article reviews the long and tortuous history of the Code through the Convention on the Rights of the Child, the HIV pandemic and the rare instances when substitute feeding is clearly essential. Currently, suboptimal breastfeeding is associated with over a million deaths each year and 10% of the global disease burden in children. All health workers need to recognise inappropriate advertising of formula, to report violations of the Code and to support efforts to promote breastfeeding: the most effective way of preventing child mortality throughout the world.

Randomized Clinical Trial of the Innovative Bilayered Wound Dressing Made of Silk and Gelatin: Safety and Efficacy Tests Using a Split-Thickness Skin Graft Model

PubMed Central

Hasatsri, Sukhontha; Angspatt, Apichai

2015-01-01

We developed the novel silk fibroin-based bilayered wound dressing for the treatment of partial thickness wounds. And it showed relevant characteristics and accelerated the healing of full-thickness wounds in a rat model. This study is the clinical evaluation of the bilayered wound dressing to confirm its safety and efficacy for the treatment of split-thickness skin donor sites. The safety test was performed using a patch model and no evidence of marked and severe cutaneous reactions was found. The efficacy test of the bilayered wound dressing was conducted on 23 patients with 30 split-thickness skin graft donor sites to evaluate healing time, pain score, skin barrier function, and systemic reaction in comparison to Bactigras. We found that the healing time of donor site wounds treated with the bilayered wound dressing (11 ± 6 days) was significantly faster than those treated with Bactigras (14 ± 6 days) (p = 10−6). The wound sites treated with the bilayered wound dressing showed significantly less pain and more rapid skin functional barrier recovery than those treated with Bactigras (p = 10−5). Therefore, these results confirmed the clinical safety and efficacy of the bilayered wound dressing for the treatment of split-thickness skin graft donor sites. PMID:26221170

Economic impact of Tegaderm chlorhexidine gluconate (CHG) dressing in critically ill patients.

PubMed

Thokala, Praveen; Arrowsmith, Martin; Poku, Edith; Martyn-St James, Marissa; Anderson, Jeff; Foster, Steve; Elliott, Tom; Whitehouse, Tony

2016-09-01

To estimate the economic impact of a Tegaderm TM chlorhexidine gluconate (CHG) gel dressing compared with a standard intravenous (i.v.) dressing (defined as non-antimicrobial transparent film dressing), used for insertion site care of short-term central venous and arterial catheters (intravascular catheters) in adult critical care patients using a cost-consequence model populated with data from published sources. A decision analytical cost-consequence model was developed which assigned each patient with an indwelling intravascular catheter and a standard dressing, a baseline risk of associated dermatitis, local infection at the catheter insertion site and catheter-related bloodstream infections (CRBSI), estimated from published secondary sources. The risks of these events for patients with a Tegaderm CHG were estimated by applying the effectiveness parameters from the clinical review to the baseline risks. Costs were accrued through costs of intervention (i.e. Tegaderm CHG or standard intravenous dressing) and hospital treatment costs depended on whether the patients had local dermatitis, local infection or CRBSI. Total costs were estimated as mean values of 10,000 probabilistic sensitivity analysis (PSA) runs. Tegaderm CHG resulted in an average cost-saving of £77 per patient in an intensive care unit. Tegaderm CHG also has a 98.5% probability of being cost-saving compared to standard i.v. dressings. The analyses suggest that Tegaderm CHG is a cost-saving strategy to reduce CRBSI and the results were robust to sensitivity analyses.

Silver deposition and tissue staining associated with wound dressings containing silver.

PubMed

Walker, Michael; Cochrane, Christine A; Bowler, Philip G; Parsons, David; Bradshaw, Peter

2006-01-01

Argyria is the general term used to denote a clinical condition in which excessive administration and deposition of silver causes a permanent irreversible gray-blue discoloration of the skin or mucous membranes. The amount of discoloration usually depends on the route of silver delivery (ie, oral or topical administration) along with the body's ability to absorb and excrete the administered silver compound. Argyria is accepted as a rare dermatosis but once silver particles are deposited, they remain immobile and may accumulate during the aging process. Topical application of silver salts (eg, silver nitrate solution) may lead to transient skin staining. To investigate their potential to cause skin staining, two silver-containing dressings (Hydrofiber and nanocrystalline) were applied to human skin samples taken from electively amputated lower limbs. The potential for skin discoloration was assayed using atomic absorption spectroscopy. When the dressings were hydrated with water, a significantly higher amount of silver was released from the nanocrystalline dressing compared to the Hydrofiber dressing (P <0.005), which resulted in approximately 30 times more silver deposition. In contrast, when saline was used as the hydration medium, the release rates were low for both dressings and not significantly different (silver deposition was minimal). Controlling the amount of silver released from silver-containing dressings should help reduce excessive deposition of silver into wound tissue and minimize skin staining.

Efficacy and cost-effectiveness of octenidine wound gel in the treatment of chronic venous leg ulcers in comparison to modern wound dressings.

PubMed

Hämmerle, Gilbert; Strohal, Robert

2016-04-01

The aim of this study was to determine the efficacy, safety and cost-effectiveness of an octenidine-based wound gel in the treatment of chronic venous leg ulcers. For this purpose, 49 wounds were treated with either modern wound-phase-adapted dressings alone (treatment arm 1; n = 17), octenidine wound gel plus modern wound-phase-adapted dressings (treatment arm 2; n = 17) or octenidine wound gel alone (treatment arm 3; n = 15). During the study period of 42 days with dressing changes every 3-5 days, wound healing characteristics and treatment costs of different dressings were analysed. Wound size reduction was significantly better (P = 0·028) in both octenidine wound gel treatment arms compared to modern dressings alone with total reductions of 14·6%, 64·1% and 96·2% in treatment arms 1-3. Early wound healing was merely observed under octenidine wound gel treatment (n = 9), whereby lowest treatment costs were generated by octenidine wound gel alone (€20·34/dressing change). As a result, the octenidine wound gel is cost-effective and well suitable for the treatment of chronic venous leg ulcers, considering both safety and promotion of wound healing. © 2014 The Authors. International Wound Journal © 2014 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Development of novel wound care systems based on nanosilver nanohydrogels of polymethacrylic acid with Aloe vera and curcumin.

PubMed

Anjum, Sadiya; Gupta, Amlan; Sharma, Deepika; Gautam, Deepti; Bhan, Surya; Sharma, Anupama; Kapil, Arti; Gupta, Bhuvanesh

2016-07-01

This study is aimed at the development of a composite material for wound dressing containing nanosilver nanohydrogels (nSnH) along with Aloe vera and curcumin that promote antimicrobial nature, wound healing and infection control. Nanosliver nanohydrogels were synthesized by nanoemulsion polymerization of methacrylic acid (MAA) followed by subsequent crosslinking and silver reduction under irradiation. Both the polymerization and irradiation time had significant influence on the nanoparticle shape, size and its formation. Polyvinyl alcohol/polyethylene oxide/carboxymethyl cellulose matrix was used as gel system to blend with nSnH, A. vera, curcumin and coat it on the hydrolysed PET fabric to develop antimicrobial dressings. The cumulative release of silver from the dressing was found to be ~42% of the total loading after 48h. The antimicrobial activity of the dressings was studied against both Staphylococcus aureus and Escherichia coli. In vivo wound healing studies were carried out over a period of 16d on full-thickness skin wounds created on Swiss albino mice. Fast healing was observed in Gel/nSnH/Aloe treated wounds with minimum scarring, as compared to other groups. The histological studies showed A. vera based dressings to be the most optimum one. These results suggest that nSnH along with A. vera based dressing material could be promising candidates for wound dressings. Copyright © 2016 Elsevier B.V. All rights reserved.

Spatial filtering, color constancy, and the color-changing dress.

PubMed

Dixon, Erica L; Shapiro, Arthur G

2017-03-01

The color-changing dress is a 2015 Internet phenomenon in which the colors in a picture of a dress are reported as blue-black by some observers and white-gold by others. The standard explanation is that observers make different inferences about the lighting (is the dress in shadow or bright yellow light?); based on these inferences, observers make a best guess about the reflectance of the dress. The assumption underlying this explanation is that reflectance is the key to color constancy because reflectance alone remains invariant under changes in lighting conditions. Here, we demonstrate an alternative type of invariance across illumination conditions: An object that appears to vary in color under blue, white, or yellow illumination does not change color in the high spatial frequency region. A first approximation to color constancy can therefore be accomplished by a high-pass filter that retains enough low spatial frequency content so as to not to completely desaturate the object. We demonstrate the implications of this idea on the Rubik's cube illusion; on a shirt placed under white, yellow, and blue illuminants; and on spatially filtered images of the dress. We hypothesize that observer perceptions of the dress's color vary because of individual differences in how the visual system extracts high and low spatial frequency color content from the environment, and we demonstrate cross-group differences in average sensitivity to low spatial frequency patterns.

Stimulation of Wound Healing by Electroactive, Antibacterial, and Antioxidant Polyurethane/Siloxane Dressing Membranes: In Vitro and in Vivo Evaluations.

PubMed

Gharibi, Reza; Yeganeh, Hamid; Rezapour-Lactoee, Alireza; Hassan, Zuhair M

2015-11-04

A series of novel polyurethane/siloxane-based wound dressing membranes was prepared through sol-gel reaction of methoxysilane end-functionalized urethane prepolymers composed of castor oil and ricinoleic methyl ester as well as methoxysilane functional aniline tetramer (AT) moieties. The samples were fully characterized and their physicochemical, mechanical, electrical, and biological properties were assayed. The biological activity of these dressings against fibroblast cells and couple of microbes was also studied. It was revealed that samples that displayed electroactivity by introduction of AT moieties showed a broad range of antimicrobial activity toward different microorganisms, promising antioxidant (radical scavenging) efficiency and significant activity for stimulation of fibroblast cell growth and proliferation. Meanwhile, these samples showed appropriate tensile strength and ability for maintaining a moist environment over a wound by controlled equilibrium water absorption and water vapor transmission rate. The selected electroactive dressing was subjected to an in vivo assay using a rat animal model and the wound healing process was monitored and compared with analogous dressing without AT moieties. The recorded results showed that the electroactive dressings induced an increase in the rate of wound contraction, promoted collagen deposition, and encouraged vascularization in the wounded area. On the basis of the results of in vitro and in vivo assays, the positive influence of designed dressings for accelerated healing of a wound model was confirmed.

Cross Dressing and Gender Dysphoria in People with Learning Disabilities: A Descriptive Study

ERIC Educational Resources Information Center

Parkes, Georgina; Hall, Ian; Wilson, Daniel

2009-01-01

We aimed to determine the characteristics of people with learning disability who cross-dress or who have gender dysphoria. Using a retrospective review of anonymised data from clinical records about people referred to a specialist service. All 13 participants cross-dressed and 12 were biological males. Only one person was in a core transsexual…

21 CFR 878.4015 - Wound dressing with poly (diallyl dimethyl ammonium chloride) (pDADMAC) additive.

Code of Federal Regulations, 2010 CFR

2010-04-01

... ammonium chloride) (pDADMAC) additive. 878.4015 Section 878.4015 Food and Drugs FOOD AND DRUG...) additive. (a) Identification. A wound dressing with pDADMAC additive is intended for use as a primary... Dressing With Poly (Diallyl Dimethyl Ammonium Chloride) (pDADMAC) Additive.” See § 878.1(e) for...

21 CFR 878.4015 - Wound dressing with poly (diallyl dimethyl ammonium chloride) (pDADMAC) additive.

Code of Federal Regulations, 2014 CFR

2014-04-01

... ammonium chloride) (pDADMAC) additive. 878.4015 Section 878.4015 Food and Drugs FOOD AND DRUG...) additive. (a) Identification. A wound dressing with pDADMAC additive is intended for use as a primary... Dressing With Poly (Diallyl Dimethyl Ammonium Chloride) (pDADMAC) Additive.” See § 878.1(e) for...

21 CFR 878.4015 - Wound dressing with poly (diallyl dimethyl ammonium chloride) (pDADMAC) additive.

Code of Federal Regulations, 2012 CFR

2012-04-01

... ammonium chloride) (pDADMAC) additive. 878.4015 Section 878.4015 Food and Drugs FOOD AND DRUG...) additive. (a) Identification. A wound dressing with pDADMAC additive is intended for use as a primary... Dressing With Poly (Diallyl Dimethyl Ammonium Chloride) (pDADMAC) Additive.” See § 878.1(e) for...

21 CFR 878.4015 - Wound dressing with poly (diallyl dimethyl ammonium chloride) (pDADMAC) additive.

Code of Federal Regulations, 2011 CFR

2011-04-01

... ammonium chloride) (pDADMAC) additive. 878.4015 Section 878.4015 Food and Drugs FOOD AND DRUG...) additive. (a) Identification. A wound dressing with pDADMAC additive is intended for use as a primary... Dressing With Poly (Diallyl Dimethyl Ammonium Chloride) (pDADMAC) Additive.” See § 878.1(e) for...

21 CFR 878.4015 - Wound dressing with poly (diallyl dimethyl ammonium chloride) (pDADMAC) additive.

Code of Federal Regulations, 2013 CFR

2013-04-01

... ammonium chloride) (pDADMAC) additive. 878.4015 Section 878.4015 Food and Drugs FOOD AND DRUG...) additive. (a) Identification. A wound dressing with pDADMAC additive is intended for use as a primary... Dressing With Poly (Diallyl Dimethyl Ammonium Chloride) (pDADMAC) Additive.” See § 878.1(e) for...