Elevating the head of bed (HOB) reduces risks for aspiration and ventilator associated pneumonia (VAP) in the adult population. Educational interventions have resulted in improvements in achieving a target HOB elevation of 30° in adults. Limited research has addressed this intervention in the pediatric intensive care unit (PICU). The aim of this study was to determine if an educational intervention for the PICU staff would result in improvement in the HOB elevation in the PICU. Four research questions were studied: 1) What is the common practice related to the elevation of the HOB in the PICU? 2) Is there a difference in the mean HOB elevation before and after an education intervention? 3) Is there a difference in the percent of time the HOB is at or above 30° after the intervention? and 4) What factors influence HOB elevation in the PICU? A quasi-experimental, pre, and post measurement, with nonequivalent comparison group design was used. The angle of the HOB elevation was measured with the “Pitch and Angle Locator” (PAL) (Johnson, Mequon, WI). Baseline measurements (n = 99) were obtained for patients admitted to a PICU at various days and times over a 2-week period. An educational intervention was done for the staff members in the PICU, with a focus on the importance of keeping the HOB up and strategies for measuring the HOB elevation. Posters to reinforce the information were placed on the unit. Post-intervention, measurements (n = 98) were obtained for another 2-week period. At the time of data collection, staff members caring for the PICU patients were asked to provide responses for what influenced them to place the patient at the documented HOB elevation. Children were older in the post-intervention group than in the pre-intervention (8.8 yrs, vs. 3.7, yrs, respectively, t = -6.67, df = 195, p= .000). The children also weighed more in the post-intervention group than in the pre-intervention (32.0 kg vs. 19.7 kg, respectively, t = -4.19, df= 195, p = .000). The mean HOB elevation was 23.5° before the intervention. After the intervention, the mean HOB increased to 26.5° (t = -1.19, df 195, p = .033). For ventilated patients, the mean HOB elevation went from 23.6° to 29.1° (t = -3.25, df 95, p= .001), and for patients mechanically ventilated and in an adult bed, the mean increased from 26° ± 7.89°, pre- intervention to 30° ± 8.59° postintervention (t = -1.80, df 63, p = .038). The percent of the time the measures were greater than 30° increased from 26% to 44% pre- and post-intervention respectively (χ2 6.71, df 1, p= .005). Responses (n = 230) related to the factors that influenced positioning were categorized as follows: physician order (3%), safety (7%), found this way (11%), therapeutic intervention (16%), comfort (24%), and patient condition (39%). An educational intervention can impact the practice of elevation of the HOB in a PICU, thus decreasing the risks of developing aspiration and VAP. Although the mean HOB increased statistically, the HOB was less than 30° in more than half of the post intervention measurements, indicating the need for ongoing reinforcement of the education. The PAL device was a new, reliable method for recording HOB elevation in both adult beds and cribs. Follow-up research is needed to determine if these gains in HOB elevation have been sustained over time and their impact on VAP.

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An optimal automotive seat backrest angle has not been identified, and currently, no universal method for analyzing sitting discomfort exists. The purposes of this study were to: (1) identify an optimum seat backrest angle or range of angles based on objective and subjective discomfort measures, and (2) evaluate existing methods for analyzing sitting discomfort data. Eight participants (4 male 4 female) completed three, two hour test sessions in a driving simulator. Results showed that subjective and objective measures were moderately correlated. The 120° seat backrest angle (measured from horizontal) resulted in less discomfort than the 105° and 135° seat backrest angles. Time weighted subjective discomfort ratings were the most effective subjective measure of sitting discomfort. Results also indicated that participants were able to identify discomfort differences for few body regions.

This study aims to evaluate the importance of proper back support for patients with spinal damage after long-term sitting in a mechanical wheelchair. The subject of this thesis was to analyze Czech and foreign literature and offer the most accurate and still missing information when selecting and compiling the selection of mechanical wheelchair seating unit. The thesis describes the differences between right and wrong sitting posture of mechanical wheelchair users. It analyzes the available information on the possibility of objective assessment, as well as trying to justify the importance of the support of the trunk on the resulting stability and functionality during activities of daily living. It refers to the most common secondary changes and their chaining caused by poor sitting posture. A subjective evaluation of the comfort of users sitting in mechanical wheelchairs in the form of a questionnaire was chosen to assess the urgency of the theme. The research carried out confirmed the hypotheses of clinical practice, which are included in the work. Based on the collected information, this work may allow occupational therapists, physiotherapists and doctors to more easily determine in a broader context whether an indication of the fixed backrest is appropriate and desirable (required) when dealing...

Work chair is considered as an important element for the users to improve comfort in work environment. An ergonomic chair design and engineering is therefore considered very important for its usability and comfort view of point for the users. The aim of the thesis is to improve the mobility and ergonomics of the existing chair in all aspects. Ergonomically designed chairs are important for long time seated workers to increase their productivity and also to reduce low back injuries which arise due to the poor design chairs in ergonomic aspects. In addition, ergonomically designed chairs help to increase the seating comfortability of the chair users. QFD and waterfall model was followed for the work execution. In this paper, we discuss a design of an ergonomically efficient chair with simple adjustments which gives more comfortability. This will give us a better likelihood to stay in a neutral position. The Ergonomics of the chair is improved in various steps. This thesis focuses on many ideas in which some of them are implemented and evaluated.