Skin occlusion is a condition encountered with various articles as part of everyday life and resulting changes in skin barrier physiology often remain unnoticed. In the present study we aimed to understand the impact of absorbent feminine hygiene articles, one vapor-permeable and one vapor-impermeable, on skin hydration in response to exposure time and different environmental climatic conditions. Using a forearm model, volunteers were patched with moistened vapor-permeable and -impermeable articles in parallel for 1, 3, and 6 h and under different climatic conditions (i.e. 20°C/30% relative humidity, 25°C/50% relative humidity, 30°C/ 75% relative humidity). The physiological changes in the skin barrier function were measured via skin hydration, evaporation of superficial water (skin surface water loss, SSWL) and relative humidity in the microclimate between skin and occlusive article (RHmc). The results show that skin hydration, SSWL, and RHmc under a vapor-permeable article are reduced versus the vapor-impermeable article for all exposure times at 25°C and 50% relative humidity. SSWL and RHmc decrease from their 1-hour peak values with increasing exposure time, while skin hydration decreases only after 3 h of exposure. Lower environmental temperature (20°C) and lower relative humidity (30%) have little impact on the reduction of SSWL and RHmc, but more so on the reduction of skin hydration. Higher temperature (30°C) and higher relative humidity (75%) increase RHmc and skin hydration under both vapor-permeable and -impermeable articles while SSWL is reduced under the vapor-impermeable article under these conditions. In conclusion, vapor-permeability is the key factor for physiological changes in the barrier function of the skin under occlusion, exposure time and climatic conditions being modulating factors. These findings have been integrated into a model of skin hydration under occlusion in the context of absorbent hygiene articles. While current vapor-impermeable articles are effective in reducing the excessive moisture on the skin due to bodily discharge, vapor permeability adds a further measurable benefit in reducing skin overhydration.
The Michigan Academic Consortium of academic nurse-managed primary care centers supported member sites to venture into computer-based advances with the potential to improve quality of health services and students' educational experiences. The experiences of this consortium as it incorporated electronic health records in tandem with an electronic patient management system at several of its member sites reveal the benefits and challenges of such an endeavor. The processes of selection, adoption, and implementation of the electronic health record are discussed in this article. Many lessons learned in the process are discussed.
The wealth of nations depends on the quality of their infrastructure. Often, however, infrastructure suffers from ineffective investments and poor maintenance. Proposed solutions, such as New Public Management or Public-Private Partnerships (PPPs) tend to develop into Politicians-Private Partnerships as politicians collude with private firms to exploit present and future tax-payers. Therefore, it is necessary to give citizens better control over collective decision making. While there is a significant economic literature on empowering citizens via decentralization and direct democratic institutions, the role of electoral rules has thus far been rather neglected. An interesting case in point is Switzerland, which is well known for its high-quality infrastructure, extensive decentralization, and direct democracy. However, this paper argues that there is an additional and previously neglected institution that moves Swiss politicians away from client politics towards better serving public interest: Switzerland’s unique electoral institutions which effectively combine proportional elections with multi-seat majority elections. We explain how these institutions work, how they enhance the relationships between citizens and public and private entities, and we argue that they could be implemented in other countries.
Background Standardized patient (SP) simulation is used to teach geropsychiatry. This project tested feasibility and effectiveness of video-enabled SP simulation to teach interprofessional (IP) late-life depression screening.Methods and findings Nurse practitioner, pharmacy, and medical students (N=177) participated in remote (n = 27) and on-site (n = 150) SP simulation. Linear mixed-effect model determined the effects of time and setting on pretest and posttest Interprofessional Education Collaborative Competencies Attainment Survey (ICCAS) data. Overall, no significant difference was observed in degree of change on ICCAS domains, indicating both modalities produced equally beneficial outcomes. Small sample size and focus on late-life depression screening limits generalizing results.Conclusions Video-enabled SP simulations can be incorporated to prepare students with IP competencies for late-life depression screening.
<h4>Using Tai Chi to Teach Gerontology</h4>
<p>To prepare for the projected growth of the older adult population, schools of nursing are designing innovative experiences that incorporate healthy lifestyle changes during their clinical rotations. In a unique approach to health promotion and maintenance, now ongoing for five semesters, senior nursing students at the University of Arkansas for Medical Sciences, College of Nursing, participate with older adults in a tai chi class during their clinical rotation. The class is held at the community center in a rural community. [more...]</p>
Democratic politics suffers from numerous diseases such as lack of inclusiveness, time-inconsistency, short-termism, negative campaigning, lack of trust in and between governments, and many more. These diseases affect all countries, albeit to a differing extent. How can they be cured? From a politico-economic perspective, an institutional approach is required. We look at a country where these political diseases seem to play a relatively minor role: Switzerland. So far, Switzerland is renowned for its extensive direct democracy and federalism. However, its electoral system has been largely neglected. It uniquely combines proportional representation and majoritarian elections on all government levels. In contrast to the international standard, Swiss majority votes do not take place in single-member districts but in multi-member districts. We analyze how the interplay of majoritarian elections in multi-member districts and proportional representation mitigates many of the political diseases.
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