Effect of different flooring types on pressure distribution under the bovine claw - an ex vivo study.

BACKGROUND: Mechanical interactions between hard floorings and the sole of bovine claws can be reasonable to cause traumatic claw lesions. In this ex vivo study, the direct kinetic impact of concrete and three types of rubber mats on the sole of dairy cattle claws was analyzed. In order to apply uniform loads, isolated distal hind limbs of adult Holstein Friesian dairy cows were functionally trimmed according to the Dutch method and attached to a load applicator. Kinetic data were recorded using a thin, foil-based pressure measurement system (Hoof™ System, Tekscan®). RESULTS: On concrete, the load distribution between the lateral and medial claw was less balanced than on the rubber floorings. The loaded area was significantly smaller on concrete (32.2 cm2) compared to all rubber mats (48.3-58.0 cm2). Average pressures (Pav) and maximum pressures (Pmax) were significantly higher on concrete (Pav 44.7 N/cm2; Pmax 130.3 N/cm2) compared to the rubber floorings (Pav 24.9-29.7 N/cm2; Pmax 71.9-87.2 N/cm2). Pressure peaks occurred mainly in plantar and abaxial parts of the lateral claw and in apical and plantar regions of the medial claw. Load distribution displayed a widely unloaded slope region, but considering the pressure distribution under the claw, none of the zones showed a generally lower pressure exposure. CONCLUSIONS: Altogether, rubber floorings lead to a significant mechanical relief of the sole compared to concrete. Furthermore, relevant differences between the tested rubber mats could be determined. Therefore the used system may be applied to compare further flooring types.

Investigation of human body potential measured by a non-contact measuring system.

A human body is occasionally electrified in a room. This charged object will be a source of electrostatic accidents, including the malfunction of electronic equipment. Hence, prevention of these accidents is required. Accidents occasionally occur, even though antistatic clothes and shoes are used. One of the causes for these accidents is that there is a lack of the preventive measures. This situation occurs when using, for example, unconductive wax. In this study, human body potential (voltage) is measured using a non-contact measuring system. An investigation of the human body's voltage when using this system is conducted. The result demonstrates that the voltage of a human body wearing antistatic clothes and shoes or light clothes and slippers exceeds a malfunctioning voltage of a microelectronics device when the body walks on floors. Thus, accidents may occur even if a human body wearing the antistatic clothes walks on flooring. These results will be useful in estimating determination whether electrostatic accidents occur or not.

Study protocol for the Flooring for Injury Prevention (FLIP) Study: a randomised controlled trial in long-term care.

BACKGROUND: A promising strategy for reducing the incidence and severity of fall-related injuries in long-term care (LTC) is to decrease the ground surface stiffness, and the subsequent forces applied to the body parts at impact, through installation of compliant flooring that does not substantially affect balance or mobility. Definitive evidence of the effects of compliant flooring on fall-related injuries in LTC is lacking. The Flooring for Injury Prevention (FLIP) Study is designed to address this gap. METHODS: The FLIP Study is a 4-year, parallel-group, 2-arm, randomised controlled superiority trial of flooring in 150 resident rooms at a LTC site. The primary objective is to determine whether compliant flooring reduces serious fall-related injuries relative to control flooring. Intervention (2.54 cm SmartCells compliant; 74 rooms) and control (2.54 cm plywood; 76 rooms) floorings were installed over the top of existing concrete floors and covered with identical 2.00 mm vinyl. The primary outcome is serious fall-related injury, defined as any impact-related injury due to a fall in a study room that results in Emergency Department visit or hospital admission. Secondary outcomes include minor fall-related injury, any fall-related injury, falls, number of fallers, fractures, and healthcare utilisation and costs for serious fall-related injuries. Randomisation of study rooms, and residents in rooms, was stratified by residential unit, and flooring assignments were concealed. Outcome ascertainment began September 2013. DISCUSSION: Results from the FLIP Study will provide evidence about the effects of compliant flooring on fall-related injuries in LTC and will guide development of safer environments for vulnerable older adults. TRIAL REGISTRATION NUMBER: NCT01618786.

Can we make a carpet smart enough to detect falls?

In this paper, we have enhanced smart carpet, which is a floor based personnel detector system, to detect falls using a faster but low cost processor. Our hardware front end reads 128 sensors, with sensors output a voltage due to a person walking or falling on the carpet. The processor is Jetson TK1, which provides more computing power than before. We generated a dataset with volunteers who walked and fell to test our algorithms. Data obtained allowed examining data frames (a frame is a single scan of the carpet sensors) read from the data acquisition system. We used different algorithms and techniques, and varied the windows size of number of frames (WS ≥ 1) and threshold (TH) to build our data set, which later used machine learning to help decide a fall or no fall. We then used the dataset obtained from applying a set of fall detection algorithms and the video recorded for the fall pattern experiments to train a set of classifiers using multiple test options using the Weka framework. We measured the sensitivity and specificity of the system and other metrics for intelligent detection of falls. Results showed that Computational Intelligence techniques detect falls with 96.2% accuracy and 81% sensitivity and 97.8% specificity. In addition to fall detection, we developed a database system and web applications to retain these data for years. We can display this data in realtime and for all activities in the carpet for extensive data analysis any time in the future.

Validation of Mobility of Pedestrians with Low Vision Using Graphic Floor Signs and Voice Guides.

Some people with low vision or elderly persons tend to walk while watching a nearby floor, therefore, they often overlook or hard to read suspended signs. In this study, we propose two kinds of voice guides, and an experiment is conducted by participants with low vision using these voice guides and graphic floor signs in order to investigate effectiveness of these combinations. In clock position method (CP), each direction of near facilities are described in using an analogy of a 12-hour clock. Meanwhile, in numbering method (NU), near facilities are put the number in clockwise order, however, each direction are only illustrated in a crossing sign. As a result of an experiment, it is showed that both voice guides are effective for pedestrians with low vision. NU is used as a complement of graphic floor signs. Meanwhile, CP is used independently with graphic floor signs, however, there is a risk in the case of using in the environment where pedestrians are easy to mistake the reference direction defined by the sounding speaker.

Effects of rubber flooring during the first 2 lactations on production, locomotion, hoof health, immune functions, and stress.

Some housing systems on dairy farms can result in long-term chronic pain. The effects of acute pain on immunity have been explored, but chronic pain's influence on immune responses is still poorly understood. Therefore, the objective of this research was to determine chronic effects of flooring on immune responses and production in freestall housing for dairy cows. Thirty heifers were studied from before calving as first-calf heifers until d 180 of their second lactation. Treatments were rubber (Kraiburg; Agromatic Inc., Fond du Lac, WI) flooring or concrete with diamond grooves in a freestall barn, each in 2 quadrants of the barn. Heifers entered the treatments after calving, so the system was dynamic and each cow was considered an experimental unit. At the end of the first lactation, cows were housed in a bedded pack barn with pasture access until calving was imminent. At that time, they returned to their assigned treatment, but not necessarily into the same quadrant. Production, reproduction, cortisol, acute-phase proteins, and health data were recorded throughout lactation 1, locomotion was scored weekly, and hoof scoring and care was conducted on d 60 and 180 of lactations 1 and 2, and quantitative real-time-PCR of blood leukocytes was analyzed in mid lactation of lactation 1. Mature-equivalent milk fat, milk protein, and protein percentages during the first lactation were greater for cows on the rubber flooring. Hoof and leg therapy treatments per cow were fewer for rubber floor-housed cows. Locomotion scores were less for cows housed on rubber during the second lactation. White blood cell counts were less for cows housed on rubber, and caused by greater lymphocyte counts for cows housed on concrete. The possibility of chronic inflammation was substantiated by less IL-1ß and more IL-1 receptor antagonists for cows housed on rubber at d 150 in the second lactation. Cortisol and acute-phase proteins did not differ between the treatments. Interferon-γ, IL-12, the modulator of tissue reconstruction (B-cell-transforming growth factor 1), and pain-modulating neurokinin (tachykinin 1) were not different at d 105. These data show indicators of chronic inflammation for cows housed on the concrete flooring compared with those housed on rubber. Implications for the use of rubber flooring in freestall barns are broader than just lameness and may affect many aspects of cow physiology and production.

The influence of body mass index and gender on the impact attenuation properties of flooring systems.

The biomechanical effectiveness of safety floors has never been assessed during sideways falls with human volunteers. Furthermore, the influence of body mass index (BMI) and gender on the protective capacity of safety floors is unknown. The purpose of this study was to test whether safety floors provide greater impact attenuation compared with traditional flooring, and whether BMI and gender modify their impact attenuation properties. Thirty participants (7 men and 7 women of low BMI; 7 men and 9 women of high BMI) underwent lateral pelvis release trials on 2 common floors and 4 safety floors. As a group, the safety floors reduced peak force (by up to 11.7%), and increased the time to peak force (by up to 25.5%) compared with a traditional institutional grade floor. Force attenuation was significantly higher for the low BMI group, and for males. Force attenuation was greatest for the low BMI males, averaging 26.5% (SD = 3.0) across the safety floors. These findings demonstrate an overall protective effect of safety floors during lateral falls on the pelvis, but also suggest augmented benefits for frail older adults (often with low body mass) who are at an increased risk of hip fracture.

Effect of aluminum sulfate on litter composition and ammonia emission in a single flock of broilers up to 42 days of age.

New alternatives are necessary if the environmental impact linked to intensive poultry production is to be reduced, and different litter handling methods should be explored. Among these, acidifying amendments added to poultry litters has been suggested as a management practice to help reduce the potential environmental effect involved in multiple flock cycles. There have been several studies on the use of aluminum sulfate (alum) and its benefits, but almost no data are available under farm conditions in Europe. An experiment with Ross 308 broilers from 1 to 42 days of age was conducted to evaluate the effect of alum on litter composition, the solubility of some mineral elements and NH3 emission during a single flock-rearing period in commercial houses located in southeast Spain. Broilers were placed on clean wood shavings in four commercial houses, containing 20 000 broilers each. Before filling, alum was applied at a rate of 0.25 kg/m2 to the wood shavings of two poultry houses, whereas the remaining two were used as control. Litter from each poultry house was sampled every 3 to 5 days. Ammonia emissions from the poultry houses were monitored from 37 to 42 days of age. In comparison with the control group, alum treatment significantly reduced the pH level of the litter (P < 0.001) with an average difference of 1.32 ± 0.24 units. Alum-treated litter showed, on average, a higher electrical conductivity than the control litter (5.52 v. 3.63 dS/m). The dry matter (DM) and total N and P contents did not show differences between the treatments (P > 0.05). Regarding the NH4 +-N content, alum-treated litter showed a higher value than the untreated litter, with an average difference of 0.16 ± 0.07% (on a DM basis). On average, alum-treated litter had lower water-soluble P, Zn and Cu contents than the untreated litter. Alum noticeably reduced the in-house ammonia concentration (P < 0.001), with an average of 4.8 ppm at 42 days of age (62.9% lower than the control), and ammonia emissions from 37 to 42 days of age were significantly reduced by the alum treatment (P < 0.001), representing a reduction of 73.3%. The lower pH values might have reduced ammonia volatilization from the litter, with a corresponding positive effect on the building environment and poultry health. For these reasons, litter amendment with alum could be recommended as a way of reducing the pollution potential of European broiler facilities during a single flock cycle.

Use of different areas of pen by growing rabbits depending on the elevated platforms' floor-type.

The addition of platforms to rabbit cages increases their accessible area and provides rabbits greater freedom and mobility. Different types of platforms enable rabbits to situate themselves where they are most comfortable. The objective of this experiment was to analyse preference of growing rabbits between different areas of the pen depending on the elevated platforms' floor-type. Pens with a basic area of 0.84 m2 were equipped with platforms of 0.42 m2. Three types of flooring of the elevated platforms were used as treatments: deep-litter floor and an open wire-net floor (Experiment 1), and a deep-litter floor and a wire-net floor with a manure tray beneath it (Experiment 2). Growing rabbits (n = 168; 42 per treatment) between the ages of 5 and 11 weeks were studied, based on 24 h video recordings from infra-red cameras (one recording per week) applying scan sampling method with a frequency of 30 min. When the platform was deep-litter, significantly (P < 0.001) more rabbits used the area under the platform (53.7% and 54.3% in Experiments 1 and 2, respectively) than stayed on the platform (16.7% and 7.6%). In treatments of wire-net platform with and without tray beneath the platform also significantly (P < 0.001) more rabbits stayed under the platform (43.7% and 34.7%, respectively) than on the platform (19.5% and 29.9%, respectively). The differences from the expected 33.3% staying on the platform or under the platform were significant at least at the level of P < 0.05. The results show that the wire-net platform with the manure tray provides the optimal environment as it leads to the rabbits spreading themselves more evenly in the pen (i.e. the platform expands available floor area) without the risk of soiling from above, and without adverse effects on heat dissipation, and with the possibility of seeking cover when desired.

Pilot cluster randomised controlled trial of flooring to reduce injuries from falls in elderly care units: study protocol.

UNLABELLED: Falls are an issue disproportionately affecting older people who are at increased risk of falls and injury. This protocol describes a pilot study investigating shock-absorbing flooring for fall-related injuries in wards for older people. OBJECTIVES: To inform future research by evaluating fall-related injuries on the intervention and existing flooring, assessing the sustainability of the flooring in ward environments, estimating the cost-effectiveness of the floor and assessing how the floor affects patients and other users. DESIGN: This study uses mixed methods a pilot cluster randomised controlled trial, observation via mechanical testing and interviews. Eight participating wards (clusters) are randomised using a computer-generated list. No blinding is incorporated into the study. Each site has a baseline period of approximately 6 months. Then, four sites receive the intervention floor, while four continue using standard floors. Sites are then followed up for approximately 1 year. PARTICIPANTS: Any person admitted to a bed in the 'study area' of a participating ward can be entered into the trial. Orientated patients, visitors and any hospital staff who use the floor in a study area are eligible for inclusion in an interview. INTERVENTION: An 8.3 mm thick vinyl floor covering with polyvinyl chloride foam backing (Tarkett Omnisports EXCEL). OUTCOMES: The primary outcome is fall-related injuries. Severity of injuries, falls, cost-effectiveness, user views and mechanical performance (shock absorbency and slip resistance) are also being assessed.

Effects of neoprene mat on diarrhea, mortality and foreleg abrasion of pre-weaning piglets.

Modern commercial swine farrowing crates are typically equipped with slatted iron floor to improve management efficiency (e.g., ease of manure handling, cleanliness of the farrowing crates and hence improved animal hygiene). However, the bare and hard floor surface can impair the welfare of the sow-litter because of some undesirable impacts on the pigs, such as foreleg abrasion, large temperature gradients between the cold floor surface and the abdomen of the piglets (hence higher susceptibility to diarrhea), and higher pre-weaning mortality or morbidity. Although straw bedding has been shown to be conducive to providing better environment for the sow-litter, use of straw creates challenges in terms of economics, hygiene and manure handling. This study investigates the use of neoprene mat (NM) in key areas of the farrowing crates - underneath the sow and in the piglet suckling area to improve the microenvironment and hence welfare of the sow-litter. Two experiments were conducted, each involving 12 sow-litters. The first experiment was to evaluate the thickness of a rectangular-shaped NM (7, 10 or 13 mm) vs. the slatted iron floor (control or Ctrl) and collect the corresponding animal response data; while the second follow-up experiment was to verify the benefits of supplying an improved, double concave (or H)-shaped NM with 10mm thick (CNM10) vs. Ctrl for the farrowing operation. Results of both experiments demonstrated considerable benefits of the NM placement in the farrowing crates. Specifically, the NM reduced the piglet foreleg lesion area and joint swellings (0% for NM vs. 8-10% for Ctrl during suckling periods in both Expts 1 and 2, P<0.001); reduced pre-weaning piglet crushing mortality (18.5+/-5.0%, 6.7+/-3.3% and 9.1+/-5.2% and for Ctrl, NM7 and NM10 and in Expt 1, P<0.05); and reduced piglet diarrhea morbidity (0.6+/-0.2% for CNM10 vs. 2.7+/-0.3% for Ctrl in Expt 2, P<0.01). Piglets in the NM litters had smaller temperature gradients between the abdomen and the contact floor surface (3.8+/-2.3 degrees C for NM vs. 7.6+/-0.5 degrees C for Ctrl in Expt 1, P<0.001; 9.2+/-0.5 degrees C for CNM10 vs. 15.9+/-0.5 degrees C for Ctrl in Expt 2, P<0.001). Moreover, sows in the NM regimens showed longer transition time when changing from standing to lying position (7.4+/-0.3s for CNM10 vs. 4.5+/-0.2s for Ctrl in Expt 2, P<0.05), indicative of more floor comfort for the NM condition. Results of this study suggest that supply of NM underneath the sow and in the piglet suckling area is conducive to enhancing comfort, health and welfare of the sow and litter.

Effect of different flooring systems on weight and pressure distribution on claws of dairy cows.

Weight and pressure distribution on the claw were studied in Swedish Holsteins housed in different flooring systems. A total of 127 cows housed in different sections of the experimental barn were used. Each section had different flooring in the walking and standing areas. There were rubber mats or abrasive mastic asphalt flooring on the alleys or a low-abrasive slatted concrete floor. Some sections had feed-stalls equipped with rubber mats; other sections did not. The vertical ground reaction force, contact area, and average contact pressure were determined on the left hind foot using the I-Scan system and analyzed with the F-scan system. These determinations were made in each of the following 3 zones of the claw: bulb, wall, and sole. Most of the weight on claws exposed to concrete floors was carried by the bulb (37.4 +/- 3.5 and 18.3 +/- 2.9% of weight exerted on the foot in the lateral and medial claw, respectively) and the wall zone (20.0 +/- 2.6 and 13.4 +/- 2.4% on lateral and medial claw, respectively). The weight and pressure distribution in cows kept on sections with rubber covered alleys but passing daily over the asphalt floor on their way to the milking parlor did not differ in any zones, except for lateral bulbs, compared with those exposed to slatted concrete alone. Still, the weight bearing of the sole zone in cows kept on rubber mats without access to asphalt was less than that of cows kept on concrete slatted floors (5.1 +/- 0.7 vs. 12.7 +/- 1.1% and 1.1 +/- 0.5 vs. 8.7 +/- 0.7% in lateral and medial claws, respectively). In cows kept on asphalt flooring without feed-stalls, most weight was exerted to the sole zone (36.2 +/- 2.9 and 22.2 +/- 1.8% in lateral and medial claws, respectively). Feed-stalls in combination with asphalt flooring yielded a decreased total contact area (30.1 +/- 1.2 cm(2)) compared with asphalt floors without feed-stalls (35.7 +/- 1.2 cm(2)). The largest total contact area was obtained on the asphalt floor without feed-stalls, resulting in a lower contact pressure (39.8 +/- 2.3 N/cm(2)) than in claws exposed to concrete (66.0 +/- 2.7 N/ cm(2)) or rubber mats (56.7 +/- 1.7 N/cm(2)). In conclusion, housing with abrasive floors resulted in claws with increased contact area at the sole surface and therefore, decreased contact pressure, but reduced the weight-bearing role of the strongest part of the claw capsule, the claw wall.

A probabilistic neural network model for lameness detection.

A 4-balance system for measuring the leg-load distribution of dairy cows during milking to detect lameness was developed. Leg weights of 73 cows were successfully recorded during almost 10,000 robotic milkings over a period of 5 mo. Cows were scored weekly for locomotion, and lame cows were inspected clinically for hoof lesions. Unsuccessful measurements, caused by cows standing outside the balances, were removed from the data with a special algorithm, and the mean leg loads and number of kicks during milking were calculated. To develop an expert system to automatically detect lameness cases, a model was needed, and a classifying probabilistic neural network model was chosen for the task. The data were divided into 2 parts and 5,074 measurements from 37 cows were used to train a classifying probabilistic neural network model. The operation of the model was evaluated for its ability to detect lameness in the validating data set, which had 4,868 measurements from 36 cows. The model was able to classify 96.2% of the measurements correctly as sound or lame cows, and 100% of the lameness cases in the validation data were identified. The number of measurements (equal to the number of milkings) causing false alarms was 1.1%. The model developed has the potential to be used as an on-farm decision aid and can be used in a real-time lameness monitoring system.

Association between floor type and behaviour, skin lesions, and claw dimensions in group-housed fattening bulls.

Rubber mats covering concrete slatted flooring are a developing market in dairy barns but remain rare in beef cattle facilities. The aim of this study was to investigate the effects of covering slatted concrete floor with perforated rubber mats on behaviour and occurrence of skin and claw lesions in fattening bulls. The groups of six bulls each with a total average age of 9.8 months were kept over 1 year on either slatted concrete (CONCRETE PEN) or on slatted concrete covered completely (RUBBER PEN) or partially (CHOICE PEN) with perforated rubber mats. Every quarter-year, behaviour (preference of flooring, lying, aggression, mounting) was recorded. In two-weekly intervals the incidence of skin lesions was examined. At 12 and 18 months of age the rising time of the bulls was measured. At the beginning of the study and after slaughter claw dimensions were recorded. Bulls in the CHOICE PEN preferred (P<0.01) the rubber coated area throughout the experiment. Animals in the RUBBER and the CHOICE PENS showed more lying periods (P<0.01) and had a lesser incidence of skin lesions (P<0.01) compared to bulls in the CONCRETE PEN. Bulls in the CHOICE PEN needed less time for rising (2.7+/-0.3s) than bulls in the CONCRETE PEN (4.4+/-0.5s, P<0.01). Net claw growth differed significantly between all pens (RUBBER>CHOICE>CONCRETE; P<0.05). In conclusion, the results of this study indicate that rubber coated slatted flooring has a positive influence on the housing conditions of beef cattle.

Concrete floor-bovine claw contact pressures related to floor roughness and deformation of the claw.

The intention of this research was to study the impact of concrete floor surface roughness on a bovine claw model and to assess the deformation of the bovine claw model under load. The pressure distribution between the floor and the claw is the key method in this research. Monitoring foot-to-ground pressure distributions may provide insight into the relation between high local pressures and foot lesions. Concrete floor samples were made with 5 different finishing methods. Their roughness was determined by measuring the heights of the "peaks and the valleys" of the surface with a high-precision laser beam. The smoothest surface was the sample finished with a metal float (surface roughness R(a) = 0.062 mm) and the roughest surface occurred with the heavily sandblasted sample (surface roughness R(a) = 0.488 mm). The roughness of the concrete floor samples was related to the mean and peak contact pressures that can occur in a laboratory test bench between floor and bovine claw. It was found that the claw itself has approximately 2 times more effect on these contact pressures than the surface roughness. Peak pressures found were high enough (up to 111 MPa) to cause damage to the bovine claw sole horn. The strains occurring in the horn wall were measured and related to the floor-finishing method and the load. Strain gauge measurements indicated that it is difficult to predict what kind of deformation of the claw wall will occur at a certain location. Different strains will occur for different floor-finishing methods. The corresponding stresses in the horn wall did not exceed the yield stress (14 and 11 MPa for dorsal and abaxial wall horn, respectively).

Effects of roughness and compressibility of flooring on cow locomotion.

We examined the effects of roughness and degree of compressibility of flooring on the locomotion of dairy cows. We observed 16 cows walking down specially constructed walkways with materials that differed in surface roughness and degree of compressibility. Use of a commercially available soft rubber flooring material decreased slipping, number of strides, and time to traverse the corridor. These effects were most apparent at difficult sections of the corridor, such as at the start, at a right-angle turn, and across a gutter. Covering the walkway with a thin layer of slurry increased frequency of slipping, number of strides, and time taken to traverse the walkway. Effects of adding slurry were not overcome by increasing surface roughness or compressibility. Placing more compressible materials under a slip-resistant material reduced the time and number of steps needed to traverse the corridor but did not reduce slips, and the effects on cow locomotion varied nonlinearly with the degree of compressibility of the floor. Use of commercially available rubber floors improved cow locomotion compared with concrete floors. However, standard engineering measures of the floor properties may not predict effects of the floor on cow behavior well. Increasing compressibility of the flooring on which cows walk, independently of the roughness of the surface, can improve cow locomotion.

Does a rolling floor reduce the physical work demands and workload, and increase the productivity of truck drivers handling packed goods?

A PCM rolling floor (RF) was developed to reduce the risk of musculoskeletal complaints among truck drivers. The RF can be used to move packed goods automatically in and out of the cargo space. The efficacy of this intervention on physical work demands, energetic and perceived workload and productivity was evaluated by comparing nine truck drivers working with a RF and a traditional, non-moving floor during a working day. Since the RF was not used during the loading process, no effects were found. The RF reduced the unloading process by 8 min, decreased the frequency of lifting and setting down goods by 24%, decreased the frequency of handling goods below knee level by 79%, and decreased the frequency of entering the cargo space by 45%. No effect was found on the energetic and perceived workload. The RF resulted in a small increase in productivity.

Reducing employee slips, trips, and falls during employee-assisted patient activities.

Following a remodeling of patient care rooms at Mary Free Bed Rehabilitation Hospital, the nursing staff reported frequent slipping in patient care areas. Data were analyzed and revealed that most slips were occurring during transfer of patients from shower chairs. An extensive literature review was done, and solutions to slipping were sought from areas outside of the healthcare industry. Specifically, ideas were borrowed from the commercial fishing industry and the restaurant industry. Both industries rely heavily on footwear to reduce slipping in the workplace. A trial was initiated with nursing staff members wearing positive-grip shoe covers that can be worn over regular footwear. No slips occurred during the trial. The purpose of this article is to motivate nurses who are involved in transferring patients from shower chairs (often used in rehabilitation settings) to consider the role their footwear has in reducing slips and potential injury.

Prevalence of claw disorders in Dutch dairy cows exposed to several floor systems.

Claw health was examined in an observational study on Dutch dairy farms with either a slatted floor (SL), slatted floor with manure scraper (SL-SCR), solid concrete floor (SCF), a straw yard (SY), or a zero-grazing feeding system (ZG). Hooves of cows' hind legs were examined for the presence and severity of claw disorders during hoof trimming events at the end of the pasture (P-study) and housing period (H-study). The number of cows in each study was 3078 (49 herds) and 3190 (47 herds), respectively. Due to a different hoof trimming strategy, data collected during both observation periods in SY herds (638 cows; 16 herds) were combined. Cows in straw yards (SY) had by far the lowest numbers of claw disorders. Over 80% of cows exposed to concrete flooring had at least one claw disorder at the time of observation, whereas on SY surfaces, this percentage was between 55 and 60. Cows on SL-SCR were less frequently affected by interdigital dermatitis/heel erosion (IDHE) and digital dermatitis (DD) than cows on SL (reference floor system). Little difference in claw health was found between SF and SL. The ZG cows were at higher risk (OR > 2) for most claw disorders in the P-study, whereas in the H-study, ZG cows showed less IDHE, sole hemorrhage, and sole ulcer. All herds on concrete flooring (SL, SL-SCR, SCF, ZG) were infected by DD, resulting in an average cow level prevalence of 30%. This indicates that the level of DD infection has increased considerably over the last 10 yr in The Netherlands.