Older Adults' Perceptions About Using Intelligent Toilet Seats Beyond Traditional Care: Web-Based Interview Survey.

BACKGROUND: In contemporary society, age tech (age technology) represents a significant advancement in health care aimed at enhancing patient engagement, ensuring sustained independence, and promoting quality of life for older people. One innovative form of age tech is the intelligent toilet seat, which is designed to collect, analyze, and provide insights based on toileting logs and excreta data. Understanding how older people perceive and interact with such technology can offer invaluable insights to researchers, technology developers, and vendors. OBJECTIVE: This study examined older adults' perspectives regarding the use of intelligent toilet seats. Through a qualitative methodology, this research aims to unearth the nuances of older people's opinions, shedding light on their preferences, concerns, and potential barriers to adoption. METHODS: Data were collected using a web-based interview survey distributed on Amazon Mechanical Turk. The analyzed data set comprised 174 US-based individuals aged ≥65 years who voluntarily participated in this study. The qualitative data were carefully analyzed using NVivo (Lumivero) based on detailed content analysis, ensuring that emerging themes were coded and classified based on the conceptual similarities in the respondents' narratives. RESULTS: The analysis revealed 5 dominant themes encompassing the opinions of aging adults. The perceived benefits and advantages of using the intelligent toilet seat were grouped into 3 primary themes: health-related benefits including the potential for early disease detection, continuous health monitoring, and seamless connection to health care insights. Technology-related advantages include the noninvasive nature of smart toilet seats and leveraging unique and innovative data collection and analysis technology. Use-related benefits include ease of use, potential for multiple users, and cost reduction owing to the reduced need for frequent clinical visits. Conversely, the concerns and perceived risks were classified into 2 significant themes: psychological concerns, which included concerns about embarrassment and aging-related stereotypes, and the potential emotional impact of constant health monitoring. Technical performance risks include concerns centered on privacy and security, device reliability, data accuracy, potential malfunctions, and the implications of false positives or negatives. CONCLUSIONS: The decision of older adults to incorporate intelligent toilet seats into their daily lives depends on myriad factors. Although the potential health and technological benefits are evident, valid concerns that need to be addressed remain. To foster widespread adoption, it is imperative to enhance the advantages while simultaneously addressing and mitigating the identified risks. This balanced approach will pave the way for a more holistic integration of smart health care devices into the routines of the older population, ensuring that they reap the full benefits of age tech advancements.

Digital bathroom scales with open source software provide valid dynamic ground reaction force data for assessment and biofeedback.

BACKGROUND: Measuring dynamic vertical ground reaction force allows for assessment of important clinical and physical capacity factors such as weight bearing asymmetry, force distribution, and rate of force development. However, current technologies for accurately assessing ground reaction force are typically expensive. RESEARCH QUESTION: The aim of this study was to examine the validity and reliability of obtaining static and dynamic ground reaction force data from low-cost modified digital bathroom scales. METHODS: Four modified bathroom scales, two units each of two different brands, were examined. Repeated mechanical loading trials were performed with known loads ranging from 0.01 to 65 kg, with acquired data compared against the known loading to calculate accuracy, hysteresis, and non-linearity. Dynamic trials consisting of 5 times sit-to-stand and weight-shifting were performed by 32 adults. Absolute and relative agreement intraclass correlation coefficient, and Pearson's and Spearman's correlations were performed to determine validity and reliability for the mechanical tests. Bland-Altmann plots were created for each comparison. Mean absolute error (MAE) and unbiased cross-correlation were performed on the dynamic data, comparing the calibrated data to the known values from a Bertec force platform. RESULTS: Hysteresis and non-linearity were excellent (<0.2 % full-scale), and mechanical test results showed excellent reliability and validity. Cross-correlation results for the dynamic data were excellent, however MAE for the more rapid sit-to-stand task was higher than the slower weight-shifting test. This may have been due to the low default sampling rate for the lowest noise setting of the HX711 amplifier (10 Hz). SIGNIFICANCE: In summary, our results suggest that digital bathroom scales can be easily and inexpensively modified to obtain accurate vertical ground reaction force data, with sensitivity to detect changes of as little as 0.01 kg.

Simultaneous recovery of ammonium and total phosphorus from toilet tail water by modified palygorskite-bentonite clay.

Suitable treatment of toilet sewage is a worldwide challenge. The anaerobic baffled reactor (ABR)-microbial fuel cell (MFC)-microbial electrolysis cell (MEC) (AMM) coupling treatment system has been constructed achieving effective removal of carbon, nitrogen, and phosphorus from toilet sewage and resource recovery; however, ammonium (NH4 + -N) and total phosphorus (TP) accumulation in tail water is a found problem of the system. In this study, acid-modified and alkali-heat modified palygorskite-bentonite (Pal-Ben) were used to recover NH4 + -N and TP from the AMM toilet tail water simultaneously. The higher adsorption capacity of the modified clay is attributed to the changes of surface structure of the material. The modified clay Pal-Ben (mass ratio 1:3) activated with alkali performed the highest NH4 + -N and TP recovery rates of 83.6% and 85.5%, respectively. The adsorption of NH4 + -N was more in line with the pseudo-second-order kinetic model and confirmed to be a chemical adsorption process, while the adsorption of TP was more in line with the pseudo-first-order kinetics and a physical adsorption process; the adsorption capacity of NH4 + -N accelerated with decrease of TP removal when pH increased. This study developed a low cost and high capacity of alkaline thermally modified clay removing/recovering NH4 + -N and TP from toilet tail water simultaneously. PRACTITIONER POINTS: A cheap composite clay was developed to recover nitrogen and phosphorus from toilet tail water simultaneously. The low costs and high capacity of alkaline thermally modified clay make it stand out in NH4 + -N and TP removal of toilet tail water. The process mechanism of simultaneous nitrogen and phosphorus recovery was clarified with characterization and kinetic model fitting. The used clay loaded with nutrients could be applied as a slow-release compound fertilizer for soil improvement.

Experiencia cubana en la vigilancia de la seguridad del consumo de productos naturales y acupuntura / Cuban experience in monitoring the safety of the consumption of natural products and acupuncture

La Vigilancia en Salud es una de las fortalezas del Sistema Nacional de Salud Cubano, en el cual los profesionales sanitarios desempeñan una labor fundamental en cada nivel del mismo como ente activo de dicha vigilancia. Tal empeño demanda de una formación académica con un enfoque biopsicosocial, acompañado del desarrollo de un pensamiento salubrista desde el mismo inicio de su formación.

Recovery of phosphates as struvite from urine-diverting toilets: optimization of pH, Mg:PO4 ratio and contact time to improve precipitation yield and crystal morphology.

Phosphate (P) recovery from urban wastewaters is an effective strategy to address environmental protection and resource conservation, aiming at an effective circular economy. Off-grid wastewater treatment systems like urine-diverting toilets (UDT) can contribute to source separation towards nutrient recovery, namely phosphorus recovery. Effectiveness of P precipitation requires a process-based knowledge regarding pH, Mg:PO4, contact time and their interactions in P recovery and crystal morphology. Several studies failed to see the process as a whole and how factors influence both morphology and P recovery for UDT hydrolysed urine. This study addressed the above-mentioned factors and their interactions, and results showed that pH and Mg:PO4 ratio are the key factors for struvite precipitation, whereas contact time is relevant for crystal growth. The recommended set of factors proposed (pH 8.5, Mg:PO4 ratio of 1.2:1 and 30 minutes contact time) not only promotes a high precipitation yield - 99% of P with co-precipitation of at least 21% of ammonium (NH4 +) - but also leads to larger crystals with lower water solubility (10% less crystals dissolved in water after 3 days). The obtained outcome facilitates the downstream process and leads to a more efficient slow-release fertiliser, as less P is wasted to receiving waters by leaching, minimising eutrophication processes.

Hydrothermal carbonization of dry toilet residues as an added-value strategy - Investigation of process parameters.

Human faeces from a dry toilet are converted via hydrothermal carbonization to obtain a sterilized carbonaceous material. During this process the original material undergoes consecutively hydrolysis, water elimination and polymerization reactions. Consequently, the oxygen content is reduced, leading to a material with a better dewaterability and an attractive higher heating value (HHV = 22-28 MJ kg-1). The influence of pH-value, set by the addition of citric acid, the reaction time and the reaction temperature are investigated. By thermogravimetric analysis it is shown that especially higher acid concentration as well as higher reaction temperatures and longer reaction times are necessary to fully convert the feedstock into a stable carbon-rich material. As pathogens are destroyed by hydrothermal carbonization, nutrient recovery becomes a relevant aspect. The analysis shows that alkali salts such as sodium and potassium are dissolved in the aqueous phase, but an important proportion of the phosphorus and nitrogen remain in the hydrochar. This finding is the basis for phosphorus recycling or to produce an organic fertilizer.

Percepciones y expectativas del usuario respecto a la calidad del servicio en un Hospital de Chile / Perceptions and expectations of the user regarding the quality of service in a Hospital

Resumen Introducción: Actualmente, la calidad de servicio es un pilar fundamental en los sistemas sanitarios, ya que permite garantizar a los usuarios externos un conjunto de condiciones mínimas en las prestaciones de salud. Objetivo: Evaluar las percepciones y expectativas del usuario externo respecto a la calidad del servicio del Hospital Comunitario de Salud Familiar de Quirihue. Material y Método: Estudio descriptivo comparativo, transversal, basado en modelo SERVQUAL. Las variables sociodemográficas fueron analizadas mediante estadística descriptiva, las brechas se calcularon mediante la diferencia existente entre las percepciones y expectativas, las que se analizaron con las pruebas T pareada y Wilcoxon. Resultados: La variable con mayor insatisfacción en Atención Abierta (AA) fue "difícil acceso a horas médicas o de otro profesional"; en Atención Cerrada (AC) "personal no orienta ni explica de manera clara y adecuada la atención durante la hospitalización"; y en Atención de Urgencia "demora en la atención en el box de admisión". Conclusión: El tipo de atención con menor calidad de servicio fue la AA, le sigue AU y finalmente la AC. En la AA los mayores problemas se presentaron en la obtención de horas para atenderse con médico y también en el NO cumplimiento de los horarios programados. En la AU los usuarios refieren mayor insatisfacción en la atención inmediata a su llegada al servicio. En la AC los pacientes señalan que los funcionarios NO brindan el tiempo necesario para contestar las dudas o preguntas sobre el problema de salud por el cual se encuentran hospitalizados.

Abstract Introduction: Currently, quality of service is fundamental in healthcare systems, since it allows external users to be guaranteed a set of minimum conditions in health services. Objective: To evaluate the perceptions and expectations of the external user regarding the quality of the service of the Community Health Family Hospital of Quirihue. Material and Method: Cross-sectional descriptive study, based on the SERVQUAL model. The sociodemographic variables were analyzed by means of descriptive statistics, the gaps were calculated by means of the difference between perceptions and expectations, and those were tested with paired T and Wilcoxon. Results: The variable with the greatest dissatisfaction in Open Care (OC) it was "difficult access to medical or other profesional appointment "; in Closed Care (CC) "personnel without orientation or explanation in a clear and adequate manner during hospitalization"; and in Emergency Care (EC) "delay in attention in the admission box". Conclusion: The type of care with the lowest quality of service was OC, followed by EC and finally CC. In the OC, the greatest problems arise in obtaining an appointment to be seen by the doctor and also in the NO fulfillment with the scheduled appointments. In the EC, users refer to great discontent with the immediate attention to their arrival at the service. In the CC, the patients pointed out that the staff DO NOT provide the necessary time to answer the questions or clarify doubts about the health problem for which they are hospitalized.

Toward a Safer and Cleaner Way: Dealing With Human Waste in Healthcare.

Organizations must evaluate their infection control plans in a holistic and inclusive manner to continue reducing healthcare-associated infection (HAI) rates, including giving consideration to the manner of collecting and disposing of patient waste. Manual washing of bedpans and other containers poses a risk of spreading infection via caregivers, the environment, and the still-contaminated bedpan. Several alternative disposal methods are available and have been tested in some countries for decades, including options such as bedpan washer-disinfector machines, macerator machines, and disposable bedpans. This article reviews methods and issues related to human waste disposal in healthcare settings. Healthcare organizations must evaluate the options thoroughly and then consistently implement the option most in line with its goals and culture.