Prevention of pressure ulcers with a static air support surface : a systematic review

The aims of this study were to identify, assess, and summarise available evidence about the effectiveness of static air mattress overlays to prevent pressure ulcers. The primary outcome was the incidence of pressure ulcers. Secondary outcomes included costs and patient comfort. This study was a systematic review. Six electronic databases were consulted: Cochrane Library, EMBASE, PubMed (Medline), CINAHL (EBSCOhost interface), Science direct, and Web of Science. In addition, a hand search through reviews, conference proceedings, and the reference lists of the included studies was performed to identify additional studies. Potential studies were reviewed and assessed by 2 independent authors based on the title and abstract. Decisions regarding inclusion or exclusion of the studies were based on a consensus between the authors. Studies were included if the following criteria were met: reporting an original study; the outcome was the incidence of pressure ulcer categories I to IV when using a static air mattress overlay and/or in comparison with other pressure-redistribution device(s); and studies published in English, French, and Dutch. No limitation was set on study setting, design, and date of publication. The methodological quality assessment was evaluated using the Critical Appraisal Skills Program Tool. Results were reported in a descriptive way to reflect the exploratory nature of the review. The searches included 13 studies: randomised controlled trials (n = 11) and cohort studies (n = 2). The mean pressure ulcer incidence figures found in the different settings were, respectively, 7.8% pressure ulcers of categories II to IV in nursing homes, 9.06% pressure ulcers of categories I to IV in intensive care settings, and 12% pressure ulcers of categories I to IV in orthopaedic wards. Seven comparative studies reported a lower incidence in the groups of patients on a static air mattress overlay. Three studies reported a statistical (P < .1) lower incidence compared with a standard hospital mattress (10 cm thick, density 35 kg/m(3)), a foam mattress (15 cm thick), and a viscoelastic foam mattress (15 cm thick). No significant difference in incidence, purchase costs, and patient comfort was found compared with dynamic air mattresses. This review focused on the effectiveness of static air mattress overlays to prevent pressure ulcers. There are indications that these mattress overlays are more effective in preventing pressure ulcers compared with the use of a standard mattress or a pressure-reducing foam mattress in nursing homes and intensive care settings. However, interpretation of the evidence should be performed with caution due to the wide variety of methodological and/or reporting quality levels of the included studies

Einstein on the beach: A study in temporality

This is an Author's Accepted Manuscript of an article published in Performance Research, 17(5), 34 - 40, 2012, copyright @ Taylor & Francis, available online at: http://www.tandfonline.com/10.1080/13528165.2012.728438.In this paper I seek to examine and analyse the sense of duration induced by performances of Einstein on the Beach, and the entailed sense of time which its internal structure creates. I initially sketch out the stylistic context and artistic intentions of this work's creators, Glass and Wilson, and I briefly describe the process of its creation. Certain features of this process indicate how the work may be interpreted. Having cited the creators' thoughts on structure and temporality, I address directly aspects of Einstein's temporal effects, comparing it to works of similar lengths. I give the briefest synopsis of its staging and motifs. I then outline three kinds of devices which seem to inform our temporal sense of this work as spectators. In the final section I invoke two ideas which serve as analogies to help characterise this work's overall effect on us: Heidegger's notion of the ‘hermeneutic circle’ and, more speculatively, Nietzsche's ‘theory’ of Eternal Recurrence

Computation with Advice

Computation with advice is suggested as generalization of both computation with discrete advice and Type-2 Nondeterminism. Several embodiments of the generic concept are discussed, and the close connection to Weihrauch reducibility is pointed out. As a novel concept, computability with random advice is studied; which corresponds to correct solutions being guessable with positive probability. In the framework of computation with advice, it is possible to define computational complexity for certain concepts of hypercomputation. Finally, some examples are given which illuminate the interplay of uniform and non-uniform techniques in order to investigate both computability with advice and the Weihrauch lattice

Boron: A key element in radical reactions

Boron derivatives are becoming key reagents in radical chemistry. Here, we describe reactions where an organoboron derivative is used as a radical initiator, a chain-transfer reagent, and a radical precursor. For instance, B-alkylcatecholboranes, easily prepared by hydroboration of alkenes, represent a very efficient source of primary, secondary, and tertiary alkyl radicals. Their very high sensitivity toward oxygen- and heteroatom-centered radicals makes them particularly attractive for the development of radical chain processes such as conjugate addition, allylation, alkenylation, and alkynylation. Boron derivatives have also been used to develop an attractive new procedure for the reduction of radicals with alcohols and water. The selected examples presented here demonstrate that boron-containing reagents can efficiently replace tin derivatives in a wide range of radical reaction

Active Touch During Shrew Prey Capture

Although somatosensation in multiple whisker systems has been studied in considerable detail, relatively little information is available regarding whisker usage and movement patterns during natural behaviors. The Etruscan shrew, one of the smallest mammals, relies heavily on its whisker system to detect and kill its highly mobile insect prey. Here, we tracked whisker and body motion during prey capture. We found that shrews made periodic whisker movements (whisking) with frequencies ranging from 12 to 17 Hz. We compared shrew and rat whisking and found that shrew whisking was smaller amplitude and higher frequency than rat whisking, but that the shrew and rat whisking cycle were similar in that the velocity was higher during retraction than protraction. We were able to identify four phases during the shrew hunting behavior: (i) an immobile phase often preceding hunting, (ii) a search phase upon the initiation of hunting, (iii) a contact phase defined by whisker-to-cricket contact, and (iv) an attack phase, characterized by a rapid head movement directed toward the cricket. During the searching phase, whisking was generally rhythmic and whiskers were protracted forward. After prey contact, whisking amplitude decreased and became more variable. The final strike was associated with an abrupt head movement toward the prey with high head acceleration. Prey capture proceeded extremely fast and we obtained evidence that shrews can initiate corrective maneuvers with a minimal latency <30 ms. While the shrew's rostrum is straight and elongated during most behaviors, we show for the first time that shrews bend their rostrum during the final strike and grip their prey with a parrot beak shaped snout

Stability of invertible, frustration-free ground states against large perturbations

A gapped ground state of a quantum spin system has a natural length scale set by the gap. This length scale governs the decay of correlations. A common intuition is that this length scale also controls the spatial relaxation towards the ground state away from impurities or boundaries. The aim of this article is to take a step towards a proof of this intuition. We assume that the ground state is frustration-free and invertible, i.e. it has no long-range entanglement. Moreover, we assume the property that we are aiming to prove for one specific kind of boundary condition; namely open boundary conditions. This assumption is also known as the "local topological quantum order" (LTQO) condition. With these assumptions we can prove stretched exponential decay away from boundaries or impurities, for any of the ground states of the perturbed system. In contrast to most earlier results, we do not assume that the perturbations at the boundary or the impurity are small. In particular, the perturbed system itself can have long-range entanglement.Peer reviewe

Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis

Background: Infections due to antibiotic-resistant bacteria are threatening modern health care. However, estimating their incidence, complications, and attributable mortality is challenging. We aimed to estimate the burden of infections caused by antibiotic-resistant bacteria of public health concern in countries of the EU and European Economic Area (EEA) in 2015, measured in number of cases, attributable deaths, and disability-adjusted life-years (DALYs). Methods: We estimated the incidence of infections with 16 antibiotic resistance–bacterium combinations from European Antimicrobial Resistance Surveillance Network (EARS-Net) 2015 data that was country-corrected for population coverage. We multiplied the number of bloodstream infections (BSIs) by a conversion factor derived from the European Centre for Disease Prevention and Control point prevalence survey of health-care-associated infections in European acute care hospitals in 2011–12 to estimate the number of non-BSIs. We developed disease outcome models for five types of infection on the basis of systematic reviews of the literature. Findings: From EARS-Net data collected between Jan 1, 2015, and Dec 31, 2015, we estimated 671 689 (95% uncertainty interval [UI] 583 148–763 966) infections with antibiotic-resistant bacteria, of which 63·5% (426 277 of 671 689) were associated with health care. These infections accounted for an estimated 33 110 (28 480–38 430) attributable deaths and 874 541 (768 837–989 068) DALYs. The burden for the EU and EEA was highest in infants (aged <1 year) and people aged 65 years or older, had increased since 2007, and was highest in Italy and Greece. Interpretation: Our results present the health burden of five types of infection with antibiotic-resistant bacteria expressed, for the first time, in DALYs. The estimated burden of infections with antibiotic-resistant bacteria in the EU and EEA is substantial compared with that of other infectious diseases, and has increased since 2007. Our burden estimates provide useful information for public health decision-makers prioritising interventions for infectious diseases

Climatic risks and impacts in South Asia: extremes of water scarcity and excess

This paper reviews the current knowledge of climatic risks and impacts in South Asia associated with anthropogenic warming levels of 1.5°C to 4°C above pre-industrial values in the 21st century. It is based on the World Bank Report “Turn Down the Heat, Climate Extremes, Regional Impacts and the Case for Resilience” (2013). Many of the climate change impacts in the region, which appear quite severe even with relatively modest warming of 1.5–2°C, pose significant hazards to development. For example, increased monsoon variability and loss or glacial meltwater will likely confront populations with ongoing and multiple challenges. The result is a significant risk to stable and reliable water resources for the region, with increases in peak flows potentially causing floods and dry season flow reductions threatening agriculture. Irrespective of the anticipated economic development and growth, climate projections indicate that large parts of South Asia’s growing population and especially the poor are likely to remain highly vulnerable to climate change