An app to support oral hygiene care: Increasing attitudes, knowledge, and confidence in identifying oral health problems among caregivers of persons living with dementia.

PURPOSE: To develop and pilot test an App to help family and paid caregivers perform high quality oral hygiene care. METHODS: A prototype of the App was refined based on stakeholder feedback (e.g., dental care professionals, direct care providers, nursing home administrator, family caregivers). The refined App was pilot tested with 16 family caregivers and 15 paid care providers of persons living with dementia (PLWD). Participants completed a pre-test, watched an App demonstration, used it for 2 weeks, and completed a post-test. Surveys included both structured and open-ended questions. RESULTS: Phase 1 data informed the refinement of the App that led to high acceptability and usability by the Phase 2 participants. Both family and paid caregivers reported a significant increase in attitudes toward providing oral hygiene care to frail older adults (p = .05 and p = .02 for family and paid providers, respectively), knowledge about oral health and care (p = .01 and p = .02), and ability to identify oral health problems (p = .005 and p = .01). Additionally, paid caregivers reported increase in perceived support available in providing oral hygiene care (p < .001). CONCLUSION: Stakeholder engaged approach helped increase the acceptability and usability of the App that successfully increase caregivers' attitude, knowledge, and abilities in oral hygiene care provision.

A review of peeper passive sampling approaches to measure the availability of inorganics in sediment porewater.

Sediment porewater dialysis passive samplers, also known as "peepers," are inert containers with a small volume of water (usually 1-100 mL) capped with a semi-permeable membrane. When exposed to sediment over a period of days to weeks, chemicals (typically inorganics) in sediment porewater diffuse through the membrane into the water. Subsequent analysis of chemicals in the peeper water sample can provide a value that represents the concentrations of freely-dissolved chemicals in sediment, a useful measurement for understanding fate and risk. Despite more than 45 years of peeper uses in peer-reviewed research, there are no standardized methods available, which limits the application of peepers for more routine regulatory-driven decision making at sediment sites. In hopes of taking a step towards standardizing peeper methods for measuring inorganics in sediment porewater, over 85 research documents on peepers were reviewed to identify example applications, key methodological aspects, and potential uncertainties. The review found that peepers could be improved by optimizing volume and membrane geometry to decrease the necessary deployment time, decrease detection limits, and provide sufficient sample volumes needed for commercial analytical laboratories using standardized analytical methods. Several methodological uncertainties related to the potential impact of oxygen presence in peeper water prior to deployment and oxygen accumulation in peepers after retrieval from sediment were noted, especially for redox-sensitive metals. Additional areas that need further development include establishing the impact of deionized water in peeper cells when used in marine sediment and use of pre-equilibration sampling methods with reverse tracers allowing shorter deployment periods. Overall, it is expected that highlighting these technical aspects and research needs will encourage work to address critical methodological challenges, aiding in the standardization of peeper methods for measuring porewater concentrations at contaminated regulatory-driven sediment sites.

Estimation of Interstitial Velocity Using a Direct Drive High-Resolution Passive Profiler.

The fate and transport of groundwater contaminants depends partially on groundwater velocity, which can vary appreciably in highly stratified aquifers. A high-resolution passive profiler (HRPP) was developed to evaluate groundwater velocity, contaminant concentrations, and microbial community structure at ∼20 cm vertical depth resolution in shallow heterogeneous aquifers. The objective of this study was to use mass transfer of bromide (Br- ), a conservative tracer released from cells in the HRPP, to estimate interstitial velocity. Laboratory experiments were conducted to empirically relate velocity and the mass transfer coefficient of Br- based on the relative loss of Br- from HRPP cells. Laboratory-scale HRPPs were deployed in flow boxes containing saturated soils with differing porosities, and the mass transfer coefficient of Br- was measured at multiple interstitial velocities (0 to 100 cm/day). A two-dimensional (2D) quasi-steady-state model was used to relate velocity to mass transfer of Br- for a range of soil porosities (0.2-0.5). The laboratory data indicate that the mass transfer coefficient of Br- , which was directly-but non-linearly-related to velocity, can be determined with a single 3-week deployment of the HRPP. The mass transfer coefficient was relatively unaffected by sampler orientation, length of deployment time, or porosity. The model closely simulated the experimental results. The data suggest that the HRPP will be applicable for estimating groundwater velocity ranging from 1 to 100 cm/day in the field at a minimum depth resolution of 10 cm, depending on sampler design.