Healthy Skin Wins: A Glowing Pressure Ulcer Prevention Program That Can Guide Evidence-Based Practice.

BACKGROUND: In 2013, an observational survey was conducted among 242 in-patients in a community hospital with a pressure ulcer (PU) prevalence of 34.3%. An evidence-based pressure ulcer prevention program (PUPP) was then implemented including a staff awareness campaign entitled "Healthy Skin Wins" with an online tutorial about PU prevention. AIMS: To determine the effectiveness of the PUPP in reducing the prevalence of PUs, to determine the effectiveness of the online tutorial in increasing hospital staff's knowledge level about PU prevention, and to explore frontline staff's perspectives of the PUPP. METHODS: This was a mixed methods study. A repeat observational survey discerned if the PUPP reduced PU prevalence. A pre-test post-test design was used to determine whether hospital staff's knowledge of PU prevention was enhanced by the online tutorial. Qualitative interviews were conducted with nurses, allied health professionals, and health care aides to explore staff's perspectives of the PUPP. RESULTS: A comparison of initial and repeat observational surveys (n = 239) identified a statistically significant reduction in the prevalence of PU to 7.53% (p < .001). The online tutorial enhanced staff knowledge level with a statistically significantly higher mean post-test score (n = 80). Thirty-five frontline staff shared their perspectives of the PUPP with "it's definitely a combination of everything" and "there's a disconnect between what's needed and what's available" as the main themes. CONCLUSIONS: Incorporating evidence-based PU prevention into clinical practice greatly reduced the prevalence of PUs among hospital in-patients. Due to the small sample size for the pre-test post-test component, the effectiveness of the online tutorial in improving the knowledge level of PU prevention among hospital staff requires further research. LINKING EVIDENCE TO ACTION: Evidence-based PU prevention strategies are facilitated by using a multidisciplinary approach. Educational tools about PU prevention must target all members of the healthcare team including healthcare aides, patients and families.

Lessons Learned from Designing Visualization Dashboards.

A variety of visualization guidelines, principles, and techniques are available to help create a visualization-based dashboard, but few publications discuss the experience of designing dashboards in the real world. This article discuss the lessons learned from designing applications for small start-up companies and institutions. From their experience as visualization practitioners, the authors confirm the need for tailored and customizable approaches, emphasize the need for a quicker way to create functional prototypes, point out frequent misconceptions on the scope of a functional prototype, discuss how performance can affect prototyping, and discuss the resistance of industrial partners to involve their customers in requirements gathering.

Pain management with acupuncture in osteoarthritis: a systematic review and meta-analysis.

BACKGROUND: The utility of acupuncture in managing osteoarthritis symptoms is uncertain. Trial results are conflicting and previous systematic reviews may have overestimated the benefits of acupuncture. METHODS: Two reviewers independently identified randomized controlled trials (up to May 2014) from multiple electronic sources (including PubMed/Medline, EMBASE, and CENTRAL) and reference lists of relevant articles, extracted data and assessed risk of bias (Cochrane's Risk of Bias tool). Pooled data are expressed as mean differences (MD), with 95% confidence intervals (CI) (random-effects model). RESULTS: We included 12 trials (1763 participants) comparing acupuncture to sham acupuncture, no treatment or usual care. We adjudicated most trials to be unclear (64%) or high (9%) risk of bias. Acupuncture use was associated with significant reductions in pain intensity (MD -0.29, 95% CI -0.55 to -0.02, I2 0%, 10 trials, 1699 participants), functional mobility (standardized MD -0.34, 95% CI -0.55 to -0.14, I2 70%, 9 trials, 1543 participants), health-related quality of life (standardized MD -0.36, 95% CI -0.58 to -0.14, I2 50%, 3 trials, 958 participants). Subgroup analysis of pain intensity by intervention duration suggested greater pain intensity reduction with intervention periods greater than 4 weeks (MD -0.38, 95% CI -0.69 to -0.06, I2 0%, 6 trials, 1239 participants). CONCLUSIONS: The use of acupuncture is associated with significant reductions in pain intensity, improvement in functional mobility and quality of life. While the differences are not as great as shown by other reviews, current evidence supports the use of acupuncture as an alternative for traditional analgesics in patients with osteoarthritis. SYSTEMATIC REVIEW REGISTRATION: CRD42013005405.

Evaluation of static and dynamic visualization training approaches for users with different spatial abilities.

Conflicting results are reported in the literature on whether dynamic visualizations are more effective than static visualizations for learning and mastering 3-D tasks, and only a few investigations have considered the influence of the spatial abilities of the learners. In a study with 117 participants, we compared the benefit of static vs. dynamic visualization training tools on learners with different spatial abilities performing a typical 3-D task (specifically, creating orthographic projections of a 3-D object). We measured the spatial abilities of the participants using the Mental Rotation Test (MRT) and classified participants into two groups (high and low abilities) to examine how the participants' abilities predicted change in performance after training with static versus dynamic training tools. Our results indicate that: 1) visualization training programs can help learners to improve 3-D task performance, 2) dynamic visualizations provide no advantages over static visualizations that show intermediate steps, 3) training programs are more beneficial for individuals with low spatial abilities than for individuals with high spatial abilities, and 4) training individuals with high spatial abilities using dynamic visualizations provides little benefit.