Safeguarding wanderers from elopement risk is rendered person-centered and humane when goals of care guide intervention choice. Despite limitations, a reasoned, systematized approach to wandering management provides a basis for tailoring a specialized program of care. The need for framework refinement and related research is emphasized.
Purpose Wandering is aimless or repetitive locomotion that may expose persons with dementia to falls, injuries, elopement, and untimely death. Using data from focus groups, this study obtained opinions on the potential effectiveness of existing technologies for managing wandering in persons with dementia living in the community, and on the elements that such technologies should possess from the user's perspective. Design & Methods Cross-disciplinary, consensus-based analysis was applied to data from 6 focus groups consisting of 7 elderly nursing home residents, 7 caregivers of persons with dementia, 9 home healthcare staff, 7 long term care staff, 7 medical surgical staff caring for dementia patients, and 6 engineers working in rehabilitation settings. Each group received a briefing on available technology for wanderer monitoring systems and elopement management systems. Results Participants in all groups wanted flexible systems that would allow for a normal daily life, accommodate to changes over time, and be inexpensive. Inside the home, motion detectors and weight-sensitive mats by doors were preferred over camouflage and other visual deterrents; outside, Global Positioning System based elopement management was preferred. For both technologies, ranges and sensitivities must be programmable and changeable as environmental and human conditions warrant. Policy Implications 60% or more of the 4.5 million Americans with Alzheimer's disease will wander and wandering predicts nursing home entry. The need for effective technologies to manage wandering in home and formal care settings is underscored by the high cost of nursing home care on the caregiver, his or her family, and government healthcare organizations. These technologies promise to delay nursing home entry and improve care but they must perform reliably, simply, effectively and inexpensively.
A study of how mediators might interact with the catabolic pathways of yeast was undertaken with a view towards improving the performance of microbial fuel cells. This work suggests that no single mediator is ideally suited to the task, and that a carefully selected mixture of two targeted mediators (Methylene Blue and Neutral Red) might be optimal. To test this hypothesis a yeast-catalyzed microbial fuel cell was built and empirically evaluated under different mediation conditions. The results clearly show that a judicious mix of the two mediators can indeed achieve significantly superior performance, in terms of power-density, than when either mediator is used singly at the same overall concentration.
Lifting the arms, legs, or head of a patient while prepping these areas for surgery can exert strong forces on the muscles and joints of the shoulders and backs of perioperative team members who perform this task, which may lead to work-related musculoskeletal disorders. AORN Ergonomic Tool 3: Lifting and Holding the Patient's Legs, Arms, and Head While Prepping provides scientifically based determinations of the amount of weight perioperative personnel can safely lift and hold manually for up to one, two, and three minutes using one hand or both. If these weight limits are exceeded, additional staff members or assistive devices are needed to help with the task.
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