Assessing real-time performances of N95 respirators for health care workers by simulated workplace protection factors

To assess performances of N95 respirators for Health Care Workers (HCWs) in a simulated health-care setting, we measured the Simulated Workplace Protection Factors (SWPFs) in real-time from the volunteers. A total of 49 study subjects, wearing 3 M respirator Model N95 1860 and 1860S, were fit tested using the OSHA Exercise Regimen. The test subjects were asked to perform simulated scenarios, including patient assessments, suction, and intravenous injection (IV) treatment. Two TSI PortaCount instruments continuously measured concentrations in the respirator and the room concentration. For Quantitative Fit Testing (QNFT), 36 out of 49 (73.5%) passed the fit factor (FF) criteria set at 100 and 13 (26.5%) failed. The results of QNFT were found to have a low correlation with SWPF, with R²=0.32. The geometric means (GM) and geometric standard deviations (GSD) of SWPF were 68.8 (1.1) for those subjects who passed and 39.6 (1.3) for those who failed. Real-time assessments of SWPF showed that lower SWPFs were; moving head up and down, and bending at the waist. This study identifies the needs for providing different sizes of respirators for HCWs and the importance of performing fit tests for HCWs regularly. And particular movements were identified as attributing factors affecting more on SWPFs.     

Interactive virtual reality Wii in geriatric day hospital: A study to assess its feasibility,acceptability and efficacy

Aim: Rehabilitation using interactive virtual reality Wii (Wii‐IVR) was shown to be feasible in patients with different medical problems, but there was no study examining its use in a geriatric day hospital (GDH). The aim of the present study was to test the feasibility, acceptability and efficacy of Wii‐IVR in GDH. Methods: It was a clinical trial with matched historic controls. Patients of a GDH were recruited to participate in Wii‐IVR by playing “Wii Fit”. Participants used a Wii controller to carry out movements involved in an arm ergometer. Each participant received eight sessions of Wii‐IVR in addition to conventional GDH rehabilitation. Feasibility was assessed by the total time receiving Wii‐IVR, the percentage of maximal heart rate reserve (%MHR) and Borg perceived exertion scale (BS) after participating in Wii‐IVR. %MHR and BS were compared with those after carrying out an arm ergometer for the same duration. Acceptability was assessed by an interviewer‐administered questionnaire. Efficacy was assessed by comparing improvements in Functional Independence Measure (FIM) between participants and matched historic controls, who received conventional GDH rehabilitations only. Results: A total of 30 patients completed the study. Participants completed a total of 1941 min of event‐free Wii‐IVR. The mean %MHR was 15.9% ± 9.9% and the mean BS was 7.9 ± 2.3. There was no significant difference in %MHR and BS between participating in Wii‐IVR and arm ergometer. Most participants found Wii‐IVR similar to the arm ergometer, and would like to continue Wii‐IVR if they had Wii at home. Improvements in FIM of participants were significantly more than that of historic controls. Conclusions: Wii‐IVR in GDH was feasible and most participants accepted it. Participants had more improvements in FIM. Geriatr Gerontol Int 2012; ??: ??–??.     

Three-dimensional fit of CAD/CAM-made zirconia copings

Objectives

CAD/CAM-technologies aim for a standardized, accurate production of dental restorations out of high strength materials (zirconia). The three-dimensional internal fit of CAD/CAM-manufactured zirconia copings was evaluated in vitro to verify the realizability of this aim.

Methods

The analysis was based on ceramic master dies of prepared teeth and corresponding virtual CAD surfaces. Five copings per die were manufactured with two different CAD/CAM-technologies: milling and grinding. The internal fit was determined by a three-dimensional replica technique by optical digitization and computer-assisted analysis.

Results

Mean internal gaps were 134/84 μm (SD 78/28) for molar and 93/69 μm (SD 56/35) for premolar copings (milling/grinding) using a digitizable silicone for the replicas representing the cement space; they were statistically significant regarding tooth and CAD/CAM-system (p < 0.001).

Significance

All zirconia copings showed an internal accuracy of fit where the gap widths ranged within the current clinical recommendations. However, there still is room for improvement and further standardization of CAD/CAM-technologies.     

Enabling people with developmental disabilities to actively follow simple instructions and perform designated physical activities according to simple instructions with Nintendo Wii Balance Boards by controlling environmental stimulation

The latest researches have adopted software technology turning the Nintendo Wii Balance Board into a high performance standing location detector. This study extended Wii Balance Board functionality to assess whether two people with developmental disabilities would be able to actively perform designated physical activities according to simple instructions by controlling their favorite environmental stimulation using Nintendo Wii Balance Boards. This study was carried out according to an A-B-A-B design. Data showed that both participants significantly increased their target response (performing a designated physical activity) by activating the control system to produce their preferred environmental stimulation during the intervention phases.     

A standing location detector enabling people with developmental disabilities to control environmental stimulation through simple physical activities with Nintendo Wii Balance Boards

This study evaluated whether two people with developmental disabilities would be able to actively perform simple physical activities by controlling their favorite environmental stimulation using Nintendo Wii Balance Boards with a newly developed standing location detection program (SLDP, i.e., a new software program turning a Nintendo Wii Balance Board into a standing location detector). This study was carried out using to an ABAB design. The data showed that both participants significantly increased their simple physical activity (target response) to activate the control system to produce environmental stimulation during the B (intervention) phases. The practical and developmental implications of the findings are discussed.     

Effect of span length on the fit of zirconia framework fabricated using CAD/CAM system

PURPOSE

The purpose of this study was to evaluate the effect of the span length on the fit of zirconia framework fabricated using CAD/CAM system.

MATERIALS AND METHODS

Abutments for single, 4-unit and 6-unit fixed partial prostheses were fabricated. Ten zirconia frameworks were fabricated for each group. The marginal and internal gap were presented by means of replica technique and measured by measuring microscope (AXIO®, Carl Zeiss, Rochester, NY) and software (I-solution®, IMT i-solution Inc., Vancouver, BC, Canada). The results were statistically analyzed by multivariate analysis test and Dunnett T3 test for post hoc test (α=.05).

RESULTS

There were statistically significant differences at 2, 4, 7, 8 points (mesio-distal section) and b, d, e, f, g (labio-lingual section). In some marginal reference points of 6-unit group (P<.05), the marginal gap were larger than 120 µm.

CONCLUSION

Span length of zirconia core may have an influence on marginal and internal fit. Within the limitation of this study, the increase of span length of zirconia framework of 6 or more-unit fixed partial denture may decrease the marginal and internal fit.     

Psychometric properties of the Caregiver Preparedness Scale in caregivers of stroke survivors

ObjectiveTo evaluate the psychometric characteristics of the Caregiver Preparedness Scale (CPS) in caregivers of stroke survivors.BackgroundCaregiver preparedness can have an important impact on both the caregiver and the stroke survivor. The validity and reliability of the CPS has not been tested for the stroke-caregiver population.MethodsWe used a cross-sectional design to study a sample of 156 caregivers of stroke survivors. Construct validity of the CPS was evaluated by confirmatory factor analysis (CFA). Internal consistency and test-retest reliability were also evaluated.ResultsCaregivers were, on average, 54 year old (SD = 13.2) and most were women (64.7%). CFA supported the unidimensionality of the scale (comparative fit index = 0.98). Reliability was also supported: item-reliability index and item–total correlations above 0.30; composite reliability index = 0.93; Cronbach's alpha = 0.94; factor score determinacy = 0.97; and test-retest reliability = 0.92.ConclusionThe CPS is valid and reliable in caregivers of stroke survivors. Scores on this scale may assist health-care providers in identifying caregivers with less preparedness to provide specific interventions.     

Commercially available interactive video games in burn rehabilitation: therapeutic potential

Commercially available interactive video games (IVG) like the Nintendo Wii™ (NW) and PlayStation™II Eye Toy (PE) are increasingly used in the rehabilitation of patients with burn. Such games have gained popularity in burn rehabilitation because they encourage range of motion (ROM) while distracting from pain. However, IVGs were not originally designed for rehabilitation purposes but rather for entertainment and may lack specificity for achieving rehabilitative goals. Objectively evaluating the specific demands of IVGs in relation to common burn therapy goals will determine their true therapeutic benefit and guide their use in burn rehabilitation. Upper extremity (UE) motion of 24 normal children was measured using 3D motion analysis during play with the two types of IVGs most commonly described for use after burn: NW and PE. Data was analyzed using t-tests and One-way Analysis of Variance. Active range of motion for shoulder flexion and abduction during play with both PE and NW was within functional range, thus supporting the idea that IVGs offer activities with therapeutic potential to improve ROM. PE resulted in higher demands and longer duration of UE motion than NW, and therefore may be the preferred tool when UE ROM or muscular endurance are the goals of rehabilitation. When choosing a suitable IVG for application in rehabilitation, the user's impairment together with the therapeutic attributes of the IVG should be considered to optimize outcome.     

Job stress and coping: self-employed versus organizationally employed professionals

In order to examine job stress and coping among self‐employed and organizationally employed professionals, job‐related stressors and coping strategies were assessed among self‐employed (n = 149) and organizationally employed (n = 159) professionals working as accountants, lawyers, pharmacists and psychologists. Results indicate that although self‐employed workers complained about lack of security and organizationally employed workers complained about lack of autonomy, no differences were found in overall stress levels or overload. Examination of workers' coping strategies provided a partial explanation for these findings. Stress levels negatively correlated with active coping and positively correlated with passive/avoidance coping; self‐employed workers were found to cope by confronting problems, whereas organizationally employed workers were found to cope by avoiding them. These findings qualify previous research findings on self‐employed and organizationally employed workers. Copyright © 2011 John Wiley & Sons, Ltd.