U-Shaped Pillows and Sleep-Related Infant Deaths, United States, 2004-2015.

OBJECTIVES: To describe infant deaths where a u-shaped pillow was under or around an infant and to describe cases classified as Explained Suffocation. METHODS: We examined demographics and circumstances of 141 infant deaths during 2004-2015 in the US National Fatality Review Case Reporting System with u-shaped pillows in the sleep environment. RESULTS: Most infants were < 6 months old (92%), male (58%), non-Hispanic White (53%), and of the nine explained suffocation deaths, four occurred when the u-shaped pillow obstructed the infant's airway; five occurred when the infant rolled off the pillow and their airway was obstructed by another object. CONCLUSIONS FOR PRACTICE: Although infrequent, infant deaths with u-shaped pillows have occurred. Health care providers may include discussion of the importance of caregivers following infant product packaging precautions and warning labels for commonly used consumer products, such as u-shaped pillows in their advice to caregivers.

Automatic RBG-depth-pressure anthropometric analysis and individualised sleep solution prescription.

INTRODUCTION: Sleep surfaces must adapt to individual somatotypic features to maintain a comfortable, convenient and healthy sleep, preventing diseases and injuries. Individually determining the most adequate rest surface can often be a complex and subjective question. OBJECTIVES: To design and validate an automatic multimodal somatotype determination model to automatically recommend an individually designed mattress-topper-pillow combination. METHODS: Design and validation of an automated prescription model for an individualised sleep system is performed through a single-image 2 D-3 D analysis and body pressure distribution, to objectively determine optimal individual sleep surfaces combining five different mattress densities, three different toppers and three cervical pillows. RESULTS: A final study (n = 151) and re-analysis (n = 117) defined and validated the model, showing high correlations between calculated and real data (>85% in height and body circumferences, 89.9% in weight, 80.4% in body mass index and more than 70% in morphotype categorisation). CONCLUSIONS: Somatotype determination model can accurately prescribe an individualised sleep solution. This can be useful for healthy people and for health centres that need to adapt sleep surfaces to people with special needs. Next steps will increase model's accuracy and analise, if this prescribed individualised sleep solution can improve sleep quantity and quality; additionally, future studies will adapt the model to mattresses with technological improvements, tailor-made production and will define interfaces for people with special needs.

Segregación de la ropa hospitalaria en origen usada por el paciente: revisión sistemática / Segregation at source hospital clothing worn by the patient: a systematic review / Segregação no roupahospitalarfonte usada pelo paciente: umarevisãosistemática

ResumenIntroducción. La segregación y procesamiento de la ropa es un asunto vital tanto para los pacientes como para el recurso humano que labora en los hospitales y centros de salud y que manipula este material. El objetivo fue evaluar la efectividad del personal de enfermería respecto de la segregación de la ropa hospitalaria en origen usada por el paciente, para la prevención de infecciones intrahospitalarias.Método. Se trata de una revisión sistemática, aplicando la metodología recomendada por la Colaboración Cochrane. Para la identificación de los estudios se realizó búsquedas electrónicas en MEDLINE, conferencias en línea, alertas semanales de revistas en BioMed Central (e-mail), EBSCO, Clinical Key, PubMed, Journal of infection, Advance of Nursing, Excelencia.net, Journal of Hospital, Cochrane Library Plus.Después de establecer los criterios de inclusión y exclusión y análisis crítico, se seleccionaron 5 documentos que dieran respuesta a la pregunta clínica.Resultado.La segregación de la ropa debe ser realizada en origen (A-III) y recomiendan que la manipulación de la ropa sucia se debe determinar a nivel local, en consulta con el comité local de control de infecciones.Conclusión.No se pudo determinar la efectividad de la segregación de la ropa en origen realizada por el personal de enfermería en relación con la prevención de infecciones intrahospitalarias.

AbstractIntroduction. Segregation and processing of clothing is a vital issue for both patients and human resources working in hospitals and health centers and handling this material. The objective was to evaluate the effectiveness of nursing staff regarding the segregation of hospital origin clothing worn by the patient, for the prevention of nosocomial infections.Method. This is a systematic review, using the recommended by the Cochrane Collaboration methodology. For the identification of studies Electronic searches, online conferences, weekly alerts in BioMed Central journals (e-mail), EBSCO, Clinical Key, PubMed, Journal of infection, Advance of Nursing, Excelencia.net, MEDLINE Journal of Hospital, Cochrane Library Plus. After establishing the criteria for inclusion and exclusion and critical analysis, five documents that would respond to the clinical question they were selected.Result. Segregation of clothing should be made at source (A-III) and recommend handling dirty laundry should be determined locally, in consultation with the local infection control committee.Conclusion. Could not determine the effectiveness of segregation clothing originally performed by nurses in relation to the prevention of nosocomial infections.

ResumoIntrodução.Segregação e processamento de roupas é umaquestão vital para os doentes e os recursos humanos que trabalhamemhospitais e centros de saúde e manuseiodeste material. O objetivo foiavaliar a eficácia do pessoal de enfermagememrelação à segregação de roupaorigemhospitalar usada pelo paciente, para a prevenção das infecçõeshospitalares.Método. Esta é umarevisão sistemática, usando o recomendado pela metodologia Cochrane Collaboration. Para a identificação de estudos de investigações electrónicas, conferências on-line, alertas semanais na BioMed Central revistas (e-mail), EBSCO, Key Clínica, PubMed, Jornal de infecção, a Advance of Nursing, Excelencia.net, MEDLINE Jornal do Hospital, Biblioteca Cochrane Plus. Depois de estabelecer os critérios de inclusão e exclusão e análise crítica, cinco documentos que respondam à questão clínica que foramselecionados.Resultado.Segregação de roupadeve ser feita na fonte (A-III) e recomendar a manipulaçãoroupa suja deve ser determinado localmente, em consulta com a comissão de controle de infecção local.Conclusão.Nãofoipossível determinar a eficácia de roupasegregação originalmente realizada por enfermeirosemrelação à prevenção das infecçõesnosocomiais.

Testing sleeping bags according to EN 13537:2002: details that make the difference.

The European Standard on sleeping bag requirements (EN 13537:2002) describes a procedure to determine environmental temperature limits for safe usage of sleeping bags regarding their thermal insulation. However, there are several possible sources of error related to this procedure. The main aim of this work was to determine the influence of the various measuring parameters on the acuity of the respective parameters in order to judge the requirements. The results indicated that air velocity, mattress insulation and time between unpacking the bag and measurement had a significant impact on the result, with a difference of up to 5-15% in thermal insulation between minimum and maximum allowable parameter levels. On the other hand, manikin weight, thickness of the artificial ground and presence of a face mask were found to have a negligible influence. The article also discusses more general aspects of the standard including the calculation methods used.

Influence of free-stall base on tarsal joint lesions and hygiene in dairy cows.

The objective was to quantify the incidence of tarsal lesions and level of hygiene by stall bed type. Cows were scored on 100 dairies from Wisconsin, Minnesota, Indiana, Iowa, and New York in the fall and winter. Thirty-eight dairies used rubber-filled mattresses (RFM), 27 had sand beds, 29 had waterbeds, and 6 used compost packs (CPk). Stocking density, stall dimensions, bedding amount, bedding frequency, and type of bedding were recorded. One pen of early-lactation multiparous cows on each dairy was scored based on injury of the tarsal joints at the lateral and medial surfaces and tuber calcis at the dorsal, lateral, and medial surfaces. A tarsal score of 1 represented hair loss, 2 was moderate, and 3 indicated severe swelling. Differences between bed types in the percentages of cows with lesions were tested with one-way ANOVA by lesion severity and incidence, with farm as the experimental unit. Cows on sand beds or waterbeds had fewer lesion scores of 1, 2, and 3 than those on RFM. The percentages of score 1 were 54.6 +/- 4.4 (RFM), 22.5 +/- 4.7 (sand), and 29.8 +/- 4.3 (waterbed), whereas the percentages of score 2 were 14.0 +/- 1.4, 2.3 +/- 1.5, and 5.0 +/- 1.4, and of score 3 were 3.0 +/- 0.4, 0.2 +/- 0.4, and 0.4 +/- 0.4. Cows on CPk had no lesions. Hygiene scores ranged from 1 to 5, with 1 being clean and 5 soiled. The percentages of hygiene score 1 were 0 (compost), 0.4 (RFM), 0.4 (sand), and 0.4 (waterbeds); those with score 2 were 79.0, 84.0 +/- 0.01, 73.2 +/- 0.01, and 80.4 +/- 0.01; with score 3 were 20.3, 15.2 +/- 0.01, 23.8 +/- 0.01, and 18.6 +/- 0.01; with score 4 were 0.8, 0.005 +/- 0.001, 0.006 +/- 0.001, and 0.025 +/- 0.003; and with score 5 was 0 for all bed types. Cows on RFM and waterbeds had improved hygiene compared with cows on sand beds. There was no difference in somatic cell count (SCC) by bed type. The percentage of cows in fourth lactation or greater on waterbeds (19.8 +/- 1.8) was greater than those on RFM (13.3 +/- 1.6) or on sand (13.5 +/- 1.8). The percentage culled was lower for cows on waterbeds than on RFM (22.8 +/- 1.5 vs. 29.4 +/- 1.4). Score 3 tarsal lesions were correlated (r = 0.60) with SCC. The length of the sand bed was correlated with a greater percentage of mature cows. The SCC was correlated with the percentage of cows reported lame on the day of the visit (r = 0.45) and with neck rail height (r = -0.26). On dairies with RFM, severe lesions (r = 0.60), death losses (r = 0.52), and percentage of the herd reported lame on the day of the visit (r = 0.52) were all correlated with the SCC. Dairies with higher percentages of lesions had higher SCC, death losses, lameness, and culling rates. Adding bedding several times per week may reduce the incidence of lesions.

Comparison of three strategies for preventing hypothermia in critically injured casualties during aeromedical evacuation.

Critically injured patients are at risk for hypothermia. This study determined the efficacy of three hypothermia prevention strategies: the ChillBuster warming blanket, ChillBuster with a reflective blanket, and two wool blankets. A quasi-experimental design was used to compare changes in core temperature. Following resuscitation from hypovolemic shock, 20 swine were assigned to one of the three interventions, placed in an environmental chamber set to reproduce in-flight conditions onboard a military cargo aircraft (50 degrees F/airspeed 0.2 m/s), and monitored for 6 hours. A repeated measures analysis of variance and least-squared difference post hoc were performed. The ChillBuster/reflective blanket group was significantly warmer than the ChillBuster only group and the wool blanket group (p < 0.01). After 6 hours of cold exposure, the ChillBuster/reflective blanket group remained warm while the ChillBuster only and wool blanket groups developed mild hypothermia. Combined use of a warming blanket and reflective blanket was effective in preventing hypothermia over 6 hours and is feasible in a deployed military environment.

Knowledge of malaria influences the use of insecticide treated nets but not intermittent presumptive treatment by pregnant women in Tanzania.

BACKGROUND: To reduce the intolerable burden of malaria in pregnancy, the Ministry of Health in Tanzania has recently adopted a policy of intermittent presumptive treatment for pregnant women using sulphadoxine-pyrimethamine (IPTp-SP). In addition, there is strong national commitment to increase distribution of insecticide treated nets (ITNs) among pregnant women. This study explores the determinants of uptake for both ITNs and IPTp-SP by pregnant women and the role that individual knowledge and socio-economic status has to play for each. METHODS: 293 women were recruited post-partum at Kibaha District Hospital on the East African coast. The haemoglobin level of each woman was measured and a questionnaire administered. RESULTS: Use of both interventions was associated with a reduced risk of severe anaemia (Hb<8 g/dL) compared to women who had used neither intervention (OR 0.31, 95% CI 0.14-0.67). In a logistic regression model it was found that attendance at MCH health education sessions was the only factor that predicted IPTp-SP use (OR 1.8, 95% CI 1.1-2.9) while high knowledge of malaria predicted use of ITNs (OR 2.3, 95% CI 1.1-4.9). CONCLUSION: Individual knowledge of malaria was an important factor for ITN uptake, but not for IPTp-SP use, which was reliant on delivery of information by MCH systems. When both these interventions were used, severe anaemia postpartum was reduced by 69% compared to use of neither, thus providing evidence of effectiveness of these interventions when used in combination.

Evaluation of Olyset insecticide-treated nets distributed seven years previously in Tanzania.

BACKGROUND: Insecticide-treated nets represent currently a key malaria control strategy, but low insecticide re-treatment rates remain problematic. Olyset nets are currently one of two long-lasting insecticidal nets recommended by WHO. An assessment was carried out of the effect of Olyset nets after seven years of use in rural Tanzania. METHODS: A survey of Olyset nets was conducted in two Tanzanian villages to examine their insecticide dosage, bioassay efficacy and desirability compared with ordinary polyester nets. RESULTS: Of 103 randomly selected nets distributed in 1994 to 1995, 100 could be traced. Most nets were in a condition likely to offer protection against mosquito biting. Villagers appreciated mainly the durability of Olyset trade mark nets and insecticide persistence. People disliked the small size of these nets and the light blue colour and preferred a smaller mesh size, features that can easily be modified. At equal price, 51% said they would prefer to buy an Olyset net and 49% opted for an ordinary polyester net. The average permethrin content was 33%-41% of the initial insecticide dose of 20,000 mg/Kg. Bioassay results indicated high knock-down rates at 60 minutes, but the mosquito mortality after 24 hours was rather low (mean: 34%). No significant correlation was found between bioassay results and insecticide concentration in and on the net. CONCLUSIONS: Olyset nets are popular, durable and with a much longer insecticide persistence than ordinary polyester nets. Hence, Olyset nets are one of the best choices for ITN programmes in rural malaria-endemic areas.

An assessment of the clinical effectiveness of surgical drapes.

Questioning whether a 'sterile' material is actually sterile is something that many clinicians may not have considered. The equipment that comprises a sterile field for a major surgical or invasive procedure may also be taken for granted as the sterile pack would normally include sterile drapes. Under discussion is whether using sterile drapes is more effective than not using them. In furthering the debate, examination of the literature is centred on the degree of effectiveness of sterile drapes.