Effects of beside wheelchair seating training on EICU acquired myasthenia in patients with acute respiratory distress syndrome and mechanical ventilation / 中国实用护理杂志

Objective:To explore the application of beside wheelchair seating training in patients with acute respiratory distress syndrome (ARDS) and mechanical ventilation, so as to provide the reference for the nursing of acquired myasthenia in EICU.Methods:A total of 66 ARDS patients with mechanical ventilation treated in Beijing Hospital from July 2017 to July 2019 were assigned to the experimental group and the control group according to the admission time, 33 cases in each group. Patients in the control group received routine nursing, while the experimental group implemented beside wheelchair seating training. The differences in muscle strength, self care ability, duration of mechanical ventilation, length of EICU stay as well as complications between the two groups were compared.Results:The incidence of EICU acquired myasthenia in the experimental group was 18.2% (6 cases), which was significantly lower than that in the control group 42.4% (14 cases), the difference was statistically significant ( χ2=4.59, P<0.05). Out of EICU, the Medical Research Council (MRC) scores and Modified Barthel Index (MBI) scores were (48.27 ± 5.11), (59.67 ± 7.33) points in the experimental group, which were significantly higher than those in the control group (44.88 ± 6.75), (54.06 ± 8.53) points, the differences were statistically significant ( t=2.30, 2.86, both P<0.05). The length of EICU stay and duration of mechanical ventilation were (8.24 ± 1.48) d, (7.15 ± 1.48) d, in the experimental group, which were significantly lower than those in the control group (9.85 ± 2.99) d, (8.24 ± 1.77) d, the differences were statistically significant ( t=2.77, 2.72, both P<0.05). The oxygenation index after 30 minutes of weaning was (296.64 ± 15.45) mmHg (1 mmHg=0.133 kPa), which was significantly higher than that in the control group (288.36 ± 16.75) mmHg, the difference was statistically significant ( t value was 2.09, P<0.05). Conclusions:The beside wheelchair seating training can effectively decrease the incidence of EICU acquired myasthenia as well as shorten the duration of mechanical ventilation and length stay in EICU of patients with ARDS. It is safe and effective, and has good clinical application value.

Efectividad del uso de seating de posicionamiento en niños con parálisis cerebral discinética: revisión sistemática / Effectiveness of the use of seating devices in children with dyskinetic cerebral palsy: a systematic reviewx

Introduction: To assess the effectiveness of seating devices during the sitting position on postural stability and upper limb functionality in users with dyskinetic type cerebral palsy. Method: A systematic review that included randomized, quasi-randomized, cohort, and pre-post intervention clinical trials with evaluation before and after the intervention. This review included studies of chil-dren with a diagnosis of cerebral palsy, mainly of the dyskinetic type, with ages between 2 and 10 years old. The databases of CINAHL Plus, Cochrane (Central), EMBASE (Via Ovid), Virtual Health Library, OT Seeker, Medline (Via PubMed) and OpenGrey were used. Results: Two studies met the inclusion criteria; however, the analysis was carried out qualitatively due to the methodological quality for these, with presence of a high risk of bias. The study by Cimolin described greater trunk stability and smooth upper extremity movements with the use of a dynamically configured seat. Nwaobi described better upper extre-mity functionality in a seat inclined at 0º and 30º, not referring to trunk stability. Conclusion: From the review of the results it is concluded that there is not enough scientific evidence to determine that the use of seating devices favors the postural control and the functionality of upper extremities in children with cerebral dyskinesia type cerebral palsy.

Introducción: Evaluar la eficacia del posicionamiento sedente en la estabilidad postural y funcionalidad de extremidades superiores, en ni-ños con parálisis cerebral discinética, comparando el uso y el no uso de seating de posicionamiento. Método: Revisión siste-mática incluyendo ensayos clínicos de tipo aleatorio, cuasialeatorizado, de cohorte y casos con evaluación antes y después de la intervención. Se incluyó niños con parálisis cerebral discinético, entre 2 y 10 años de edad. Se utilizó bases de datos de CI-NAHL Plus, Cochrane (Central), EMBASE (Vía Ovid), Biblioteca Virtual de la Salud, OT Seeker, Medline (Via PubMed) y Open Grey. Resultados: Dos estudios cumplieron criterios de inclusión, aunque el análisis se realizó de forma cualitativa por la calidad metodológica de estos. Cimolin detectó mayor estabilidad de tronco y suavidad en los movimientos de extremidades superiores con el uso de un asiento de configuración dinámica. Nwaobi describió mejor funcionalidad de extremidad superior en un asiento inclinado a 0º y 30º, no haciendo referencia a la estabilidad de tronco. Conclusión: De la revisión de los resulta-dos, se concluye que no existe evidencia científica suficiente que determine que el uso de seating favorezca o no el control postural y la funcionalidad de extremidades superiores en niños y jóvenes con parálisis cerebral de tipo discinética.

The Study Of Seating Pressure On Car Seat Between Two National Cars

@#The main objective of this research is to compare the seating pressure during the driving session between two different types of national cars. The objective of this research is to conduct object pressure distribution study on two different types of car seat using CONFORMat (model 5330) with system model CER2, compare and analyse the results based on object pressure between both car seat. Twelve respondents participated a driving session with TekscanCONFORMat (model 5330) setup using the same route for both national car. We select two types of national cars equipped with automatic transmission for this research. The seat pressure on the subject along the journey is recorded using TekscanCONFORMat Research 7.60 software. Later, comparison made with respect to the seat pressure experiencedby twelve respondents. The results shows different values of backand seat pressure recorded among the twelve subjects. Lastly, the results are analysedand discussed at the end of this paper. Model B seat design has better ability to distribute evenly the pressure to both seat and back. However, results for Model A showed the pressure is more concentrated on the seat area.

The Study of Seating Pressure on Car Seat between Two National Cars

The main objective of this research is to compare the seating pressure during the driving session between twodifferent types of national cars. The objective of this research is to conduct object pressure distribution study ontwo different types of car seat using CONFORMat (model 5330) with system model CER2, compare and analyse theresults based on object pressure between both car seat. Twelve respondents participated a driving session withTekscanCONFORMat (model 5330) setup using the same route for both national car. We select two types of nationalcars equipped with automatic transmission for this research. The seat pressure on the subject along the journey isrecorded using TekscanCONFORMat Research 7.60 software. Later, comparison made with respect to the seatpressure experiencedby twelve respondents. The results shows different values of backand seat pressure recordedamong the twelve subjects. Lastly, the results are analysedand discussed at the end of this paper. Model B seatdesign has better ability to distribute evenly the pressure to both seat and back. However, results for Model Ashowed the pressure is more concentrated on the seat area.

Shear bond strength of luting cements to fixed superstructure metal surfaces under various seating forces

PURPOSE: In this study, the shear bond strengths (SBS) of luting cements to fixed superstructure metal surfaces under various seating forces were investigated. MATERIALS AND METHODS: Seven different cements [Polycarboxylate (PCC), Glass-Ionomer (GIC), Zinc phospahate (ZPC), Self-adhesive resin (RXU), Resin (C&B), and Temporary cements ((RXT) and (TCS))] were bonded to a total number of 224 square blocks (5×5×3 mm) made of one pure metal [Titanium (CP Ti) and two metal alloys [Gold-Platinum (Au-Pt) and Cobalt-Chrome (Co-Cr)] under 10 N and 50 N seating forces. SBS values were determined and data were analyzed with 3-way ANOVA. Pairwise comparisons and interactions among groups were analyzed with Tukey's simultaneous confidence intervals. RESULTS: Overall mean scores indicated that Co-Cr showed the highest SBS values (1.96±0.4) (P .05). The PCC cement showed the highest mean SBS score (3.59±0.07) among all cements tested (P < .00), while the resin-based temporary luting cement RXT showed the lowest (0.39±0.07) (P < .00). CONCLUSION: Polycarboxylate cement provides reliable bonding performance to metal surfaces. Resin-based temporary luting cements can be used when retrievability is needed. GIC is not suitable for permanent cementation of fixed dental prostheses consisting of CP Ti or Au-Pt substructures.

The Enhancement Of Driver Seat Comfort For Small Size Car: A Preliminary Study

Seating comfort is one of the important indicators while driving especially for a long hour drive. The objective of this study was to execute a preliminary study of survey and identify the discomfort of body while driving and after driving session by conductinga survey. The questionnaire developed was tested for its reliability. By using Cronbach’s Alpha, this paper’s contribution was found to be significant in which it provides a survey with acceptable test reliability in which the alpha (α) was 0.887. The survey was conducted on 30 students of University Malaysia Pahang (20 male and 10 female) with driving experience and valid driving license. The subjects should have experiences in driving small size car or mini car as well. The results showed that the body area that the drivers felt discomfort while driving and after driving should be known. The findings showed that the discomfort was intense at the neck, upper back, and lumbar while and after driving.

An evaluation of retention and marginal seating of Ni-Cr alloy cast restorations using three different luting cements: An in vitro study.

Context: Clinical and laboratory studies regarding performance of recently introduced luting cements: Adhesive resin cement and resin-modified glass ionomer cement (GIC), are limited. Aims: To compare the retention and marginal seating of Ni-Cr alloy restorations using newer luting cements: Resin-modified GIC and adhesive resin cement with those of the oldest cement, zinc phosphate. Materials and Methods: Thirty maxillary premolars of similar sizes were prepared to receive cast metal copings. Copings were placed on the prepared teeth and the marginal opening was examined using a Nikon Measuroscope. The specimens were randomly assigned to three groups. Group I castings were luted with zinc phosphate, Group II castings luted with resin-modified GIC, and Group III castings luted with adhesive resin cement. After cementation marginal seating was measured. Tensile loads required to dislodge the crowns were obtained using MTS machine. Statistical Analysis Used: Tukey's test, Analysis of Variance (ANOVA). Results: For zinc phosphate cement, mean marginal seating was 31 microns. Mean retentive strength was 287 Newtons. For resin-modified GIC, mean marginal seating was 29.6 microns. Mean retentive strength was 610 Newtons. For adhesive resin cement, mean marginal seating was 49 microns. Mean retentive strength was 613 Newtons. Conclusions: Marginal seating of adhesive resin cement was significantly greater than that of zinc phosphate and resin-modified GIC. Retentive strength of adhesive resin cement and resin-modified GIC was significantly greater than that of zinc phosphate There was no significant difference of retentive strength between adhesive resin cement and resin-modified GIC.

Analysis of the Relationship between Students' Seating Preferences and Academic Achievement in Medical School / 한국의학교육

PURPOSE: This study aimed to explore the relationship between students' seating preferences and academic achievement in medical school. METHODS: The subjects of this study were 109 second-year students in C medical school. The pattern of seat selection of 109 students was surveyed by participant observation for 48 days, and a questionnaire was administered to determine the factors that were considered by students. Using SPSS version 12.0, we analyzed the factors that students considered with regard to seat selection and seat preference and the frequency of seat movements between areas. We performed one-way ANOVA to analyze the differences in academic achievement between students who moved seats versus those who did not. RESULTS: The most common reasons for seat selection were to focus better on the lecture (60 students), to focus better on lecture, and to feel familiar with the same seat (60 students). Students' preferred seats were in rows A4, A7, A5, and A3 (in descending order), which are primarily the central sections, and columns B15, B1, B14, B19 (in descending order), which are primarily both ends of the division. The difference in academic achievement between students who moved seats and those who did not was not significant (p>0.05). Among students who did not move seats, the difference in academic achievement between 9 seating areas was not significant in 6 subjects (p>0.05). CONCLUSION: The results of this study suggest that we should reconsider a professor's general perception regarding academic achievement according to seat location.

Locally Made Paediatric Rehabilitation and Seating Systems for Cerebral Palsy Children in Sarawak

Children with cerebral palsy (CP) are often prescribed Rehabilitation and Seating Systems (RSS) to assist in daily activities, posture improvement and prevention of muscular-skeletal complications. In Sarawak, a special project to produce RSS was started under a partnership of a Japanese physiotherapist, health department and the community using local material.To document the RSS project and to determine usefulness and costaffordability of these systems for cerebral palsy children and their families. The details of RSS manufactured were retrieved from the clinic notes and secretary file. Parents of children who received the seating systems between July 2004 and September 2008 were invited to complete a 5-point Global Parental Perception Questionnaire (GPPQ) between December 2008 and January 2009.277 RSS were manufactured between July 2004 and February 2011 (which included modified wheel chair, wooden chair, corner chair, buggy chair and standing frame), and used by children all over Sarawak. Parents of 73 children who used the seating systems completed the 5-points GPPQ. Ten families required full sponsorship. Children spent more time sitting up and brought outdoor more often after the systems became available. Majority of parents reported positive experience in their children with sitting ability, smiles, interaction with people, learning skills and easiness of doing physiotherapy. No change was noted with passing of motion drooling / oral secretion. Most parents agreed that the cost was affordable and worth paying.A community based initiative to manufacture RSS by using locally available material and skill, at affordable price for the parents was feasible and useful for the family/children with CP.

Increase of Independence in a Hemipelvectomy Patient with a Custom-Molded Supportive Seating and a Cosmetic Prosthesis : A case report

We report a case of hemipelvectomy, which was successfully treated with custom-molded supportive seating and a cosmetic prosthesis. A 32-year-old woman with a history of right traumatic hemipelvectomy, 24 years ago, visited our outpatient clinic for proper prosthetic rehabilitation. After injury, she was not able to use functional prostheses because of persistent skin problems of the hemipelvectomy site. She was able to perform all activities of daily living independently, but had to rely on crutch walking and was not able to sit on an even surface for longer periods of time. With the molded supportive seating the patient was able to perform outdoor activities for up to 10 hours. This case shows an approach in amputee rehabilitation, in which the ultimate goal of prosthetic fitting is not independent walking, but the improvement of independence and hence the improvement of quality of life.

Impact of Sitting Time on Seat-Interface Pressure of Spinal Cord Injured Patients

OBJECTIVE: To examine changes in seat-interface pressure in wheelchair seated spinal cord injured patients. METHOD: Twenty-six spinal cord injured patients, who were motor complete tetraplegic and paraplegic patients, were included in this study. After 5 cm air-filled cushion (ROHO(R)) was placed on their own wheelchair seat, patients were seated on wheelchair with neutral position for sixty minutes. The interface pressure and contact area of buttock was measured every 5 minutes. RESULTS: Significant increases of interface pressure were found in maximal and mean interface pressure during 0 to 25 minutes of sitting (p<0.05). An increased tendency of contact area of buttock was observed during sitting time but it was not significant. CONCLUSION: There were no significant changes of interface pressure after 25 minutes of sitting in spinal cord injured patients. Therefore, twenty-five minutes may be a reasonable sitting time before interface pressure is recorded.

The Effects of Pressure Relief Methods at Wheelchair Seated Spinal Cord Injured Patients

OBJECTIVE: To find most effective pressure relief method in wheelchair seated spinal cord injured patients and to evaluate effectiveness of trunk lateral bending, trunk pulling and trunk forward flexion methods in practical environment METHOD: Twenty spinal cord injury patients were included in this study. After 5 cm air-filled cushion (ROHO(R)) was placed on wheelchair seat, patients were seated on wheelchair with neurtal position and interface pressure of buttock was measured by X-sensor 4.0 system. Patients took a posture lateral bending, trunk pulling, forward flexion methods. Mean and maximal pressure of buttock were measured at each pressure relief methods. RESULTS: Mean and maximal pressure of buttock were reduced by 90degrees trunk forward flexion (p<0.05). In trunk lateral bending method, pressure was reduced in non-weight bearing side of buttock, but pressure was highly elevated in weight bearing side. In trunk pulling method, pressure was elevated in both weigth bearing and non-weight bearing side. CONCLUSION: 90degrees trunk forward flexion method can be recommended to wheelchiar seated spinal cord injured patients for pressure relief of buttock.

Excessive Wear of a Polyethylene Insert Caused by IncompleteSeating of a Metal Wire Retaining Ring: A Case Report / 대한정형외과학회잡지

We report a case of excessive wear of a polyethylene insert after the incomplete seating of the acetabular metal wire retaining ring in the Omnifit modular noncemented acetabular component (Osteonics Corporation, Allendale, NJ, U.S.A.). Seventy-five months after a primary total hip arthroplasty, metal fragments generated by metal wire breakage in the incompletely seated ring induced excessive abrasive third-body wear at the inner articulating surface and the liner-backing interface. Marked periprosthetic osteolytic lesions, which necessitated revision surgery, were observed. This case suggests that when this type of locking mechanism is used, an intraoperative radiograph should be taken to confirm the proper seating of the retaining ring. When incomplete seating is noticed postoperatively, the patient should be followed up carefully, particularly when the wire is broken.

Usefulness of Deep Seating Technique for Transradial Coronary Intervention

BACKGROUND: Smaller guiding catheter had a problem with poor backup support during the transradial coronary intervention which resulted in higher failure rate. This study sought to prove the usefulness of deep seating technique which improves the backup support of the guiding catheter required to deliver interventional materials during the transradial coronary intervention. METHODS: Thirthy-five patients(23 males) were included in this study since March 1998 to August 1999. Clinical presentation of these patients were stable angina(7 patients), unstable angina(17 patients), acute myocardial infarction(11 cases). The mean age was 68+/-8 years. The treated vessel was left anterior descending artery in 22, left circumflex artery in 2 and right coronary artery in 11 of 35 vessels. RESULT: Twenty-six lesions were treated with stents, 3 with PTCA, and 6 with rotablator. Procedural success were achieved in 33 out of 35 cases(94%). Guiding catheters were used mostly with 6 Fr(30/35). In the left coronary system, usual Judkins left type was used in most of the patients(24/26, 92%), and in right coronary Judkins, Amplatz and multipurpose catheters were used similiarly. Hypotension and sinus bradycardia was encountered in one case without clinical significance and there was no dissection in all patients. CONCLUSION: Deep seating technique is a safe and effective technique without major adverse event during the transradial coronary intervention in selected cases.

Usefulness of Deep Seating Technique for Transradial Coronary Intervention

BACKGROUND: Smaller guiding catheter had a problem with poor backup support during the transradial coronary intervention which resulted in higher failure rate. This study sought to prove the usefulness of deep seating technique which improves the backup support of the guiding catheter required to deliver interventional materials during the transradial coronary intervention. METHODS: Thirthy-five patients(23 males) were included in this study since March 1998 to August 1999. Clinical presentation of these patients were stable angina(7 patients), unstable angina(17 patients), acute myocardial infarction(11 cases). The mean age was 68+/-8 years. The treated vessel was left anterior descending artery in 22, left circumflex artery in 2 and right coronary artery in 11 of 35 vessels. RESULT: Twenty-six lesions were treated with stents, 3 with PTCA, and 6 with rotablator. Procedural success were achieved in 33 out of 35 cases(94%). Guiding catheters were used mostly with 6 Fr(30/35). In the left coronary system, usual Judkins left type was used in most of the patients(24/26, 92%), and in right coronary Judkins, Amplatz and multipurpose catheters were used similiarly. Hypotension and sinus bradycardia was encountered in one case without clinical significance and there was no dissection in all patients. CONCLUSION: Deep seating technique is a safe and effective technique without major adverse event during the transradial coronary intervention in selected cases.