Supporting the scholar role in intensive care nursing.

This study investigates how future informatics applications can support and challenge intensive care nurses (ICU nurses) to grow and learn continuously. To this end a research-and-design tool is introduced which is based on a model of the nursing process that starts from the idea that a nurse fulfills three different roles: the role of practitioner (using information immediately to base actions upon), the role of scholar (using information later on to learn from) and the role of human (coping with stress and dealing with emotions). In this paper the focus is on the scholar role. Twenty-eight intensive care staff members from six different hospitals were asked to recount an imposing experience from the perspective of each role. Regarding the scholar role, the participants mentioned 77 learning strategies they adopt for individual as well as organizational learning. Individual learning concerned reflection on former patient cases, reflection on current patient cases to anticipate a change in the patient's condition and reflection on personal behavior and decisions. Organizational learning concerned reflection on former patient cases. Examples of specific strategies were formal team evaluations focused on procedure and understanding the perspective of team members, being present at autopsies, and giving feedback on the nursing skills of colleagues. Based on these strategies design implications are defined for future nursing informatics applications, which will be presented.

A fatal case of human babesiosis in Portugal: molecular and phylogenetic analysis.

We report the first case of human babesiosis in Portugal. A 66-year-old splenectomized man was admitted to a Lisbon hospital after 1 week of fever, abdominal pain, anorexia and nausea. A high parasitaemia (30%) of Babesia parasites was found in Giemsa-stained blood smears and, despite treatment, the patient died several weeks later of renal failure. Ethylenediaminetetraacetic acid blood samples were processed for polymerase chain reaction (PCR) and reverse line blot hybridization to confirm and characterize the Babesia infection. The amplified PCR product was cloned and subsequently sequenced. Molecular analysis showed that the infection was caused by Babesia divergens and that other blood parasites were not involved. Phylogenetic analysis showed that the 18 S ribosomal RNA gene sequence was similar to three other European isolates of B. divergens. In view of the high risk for splenectomized individuals, strict measures should be taken to avoid tick bites.

Transgenerational design of "smart products", a checklist of guidelines. Part of the Delft Gerontechnology Project.

Elderly users have been observed using their own appliances and consumer electronics in their homes. From this, design guidelines have been derived, focussing on the durables as well as their manuals. The guidelines consist of recommendations for design methods, requirements for manuals and product requirements, mainly concerning usability.

Seabather's eruption.

BACKGROUND: Seabather's eruption is an annoying pruritic dermatitis that appears on the areas covered by the bathing suit as an erythematous macular or papular dermatitis, with or without urticaria. It occurs sporadically in Florida, the Caribbean, and as far north as Bermuda. The cause is not known. METHODS: We collected information in Nassau County, Long Island, New York, about cases of all types of water-related dermatitis reported by beach personnel, health providers, and affected swimmers from 1970 through 1991. Concurrently, we surveyed all Nassau County swimming waters, especially during the summer season (June through September), for the presence of organisms capable of causing dermatitis. In 1980 a sudden epidemic of a severe, unfamiliar dermatitis in ocean bathers prompted increased surveillance of cases and waters. Planula larvae of the phylum Cnidaria were collected from the ocean and beaches and inside bathing suits. They were examined, photographed, tested on healthy subjects, and observed in the laboratory for metamorphosis. RESULTS: Three outbreaks of seabather's eruption have occurred on Long Island since 1975. The first, in August 1975, affected a small number of swimmers on the eastern end of Long Island. In 1980 there were thousands of cases along the entire south shore of the island, and in 1990 there were hundreds in the same area. In nonepidemic years, five or fewer cases have been reported yearly. Surveillance for larvae revealed them to be present during the swimming season in epidemic years, but in nonepidemic years they did not appear until autumn, after the swimming season. Applying larvae to the skin of healthy subjects produced a dermatitis indistinguishable from seabather's eruption. All larvae metamorphosed in the laboratory to the adult sea anemone Edwardsiella lineata. CONCLUSIONS: Seabather's eruption, previously reported only as sporadic cases in southern climates, has occurred sporadically and in outbreaks 1000 miles north of most previously described cases. These Long Island episodes were probably caused by the planula larvae of E. lineata.

The effect on sitting posture of a desk with a ten-degree inclination using an adjustable chair and table.

By means of continuous recording of the positions of the trunk and head, an investigation was carried out to examine the effect of the Erasmus office-desk - a desk with a 10 degrees inclination - on sitting posture whilst reading and writing, sitting in an adjustable chair at an adjustable table. The posture assumed by a person who is doing mixed reading and writing work at a table with the Erasmus office-desk is more upright than the posture of the same person doing the same work without the desk. This applies for both the head and the trunk. The average position of the trunk was changed from 26.0 degrees to 18.2 degrees when working with the desk placed on the table. The moment of force caused by gravity is proportional to the sine of the angle. Therefore the change of angle results in a decrease of the average moment of force on the back at L5-S1 of 29%. The largest individual decrease found was 86%. The average change of the position of the head was changed from 38.5 degrees to 29.6 degrees , resulting in an average decrease of the moment of force, on C7-T1, of 21%. The largest individual decrease was 51%. Lateroflexion of the back was less often assumed when the subjects were using the desk. The posture assumed by the subjects when they were doing writing work only was generally more upright when working at a desk with a 10 degrees inclination than when working at a flat desk. Marked differences were found between the postures of the subjects. The change of posture while using the desk also showed marked differences for each subject individually.