Diaper dermatitis, an acute inflammatory reaction of the skin, is one of the most common forms of dermatitis among neonatal and pediatric patients. The problem addressed in this quality improvement project was the absence of an evidence-based practice (EBP) guideline for perineal care which resulted in 4 unexpected cases of diaper dermatitis per 100 hospital days at a non free standing children's hospital. Framed within Rosswurm and Larrabee's model for EBP, the purpose of this project was to develop an educational initiative encompassing an EBP guideline for perineal care, an educational curriculum plan for staff members, and a Power Point presentation to leadership on the educational initiative. A master's prepared pediatric nurse educator served as content expert to evaluate the educational curriculum plan using a dichotomous scale (not met = 1/met = 2) format for the 8 objectives. Each of the 8 items was scored a 2, meaning all objectives were covered in the curriculum. The expert recommended that the methods and procedures used should be placed in the employee orientation process. The educational initiative was presented to the leadership team (n = 11) who evaluated the project using a Likert-type scale ranging from 1 (strongly disagree) to 5 (strongly agree). An average score of 5 was given, revealing that the objectives of the presentation were met. The leadership team recommended that the project be implemented. Positive social change may result from this DNP project by facilitating neonatal/pediatric skin integrity through evidence-based nursing care thus promoting patient well-being and prevention of hospital acquired infections.

In an attempt to provide a more secure and amiable living environment in our homes, there has been constant effort to develop more efficient and suitable intelligent sensor technology for household application. Wireless sensors provide an efficient means of sensing without the need for messy wiring, and are ideally suited for the household environment. Although many sensor products have been developed (e.g. temperature, humidity and smoke), automated detection and reporting of an incidence occurring in places hard to observe or reach, such as wetting of diapers or water seepage under carpets, are still not readily available at low cost. Most of the existing technologies consist of complex design architecture and follow specific communication protocols which can be overkill for many simple household applications. In this thesis, we present a new wireless sensor system which is based on the detection of just the ON or OFF state of a condition. This approach overcomes the need for complex architecture and design, but is still able to achieve the functionality that is required for many household applications such as water leakage, food rotting, diaper wetting etc. and thus can be made available very cheaply. The sensor system consisting of an interrogator and a sensor circuit is implemented using inductive coupling. A passive L-C circuit is used for the sensor design and the system is tested using diaper wetting as an example of a simple household application. The testing results shows that the sensor can detect an ON and OFF condition for sensor and tag separation of 10 cm which is enough for applications like water leakage behind walls and under carpets, diaper wetting, food rotting etc.

Atypical sexual behavior is often viewed from a perspective of pathology and non-clinical samples are not typically used in research. The current exploratory research is a qualitative study that examined the etiological perspectives of Adult Baby/ Diaper Lover (ABDL) behavior from members of an online ABDL community. Archival survey data from an online sample (N = 1,795) of ABDL participants were used. The theories informing this research included attachment theory and the sexual health model. Research questions included an examination of: (a) what we can be learn from the way an ABDL individual perceives the origin of ABDL behavior, (b) differences in the way participants find their ABDL interests, and (c) the origin beliefs of participants from a community sample compare to the results from historical data. Thematic analysis was used to analyze the archival survey data, and grounded theory was used to forward a theory about the etiology of ABDL. Participants suggested that ABDL may not be the result of a mental health condition or a trauma history. The majority of participants believe their ABDL behaviors are connected to childhood experiences, which partially dovetails with current theories on the etiology of paraphilias. Although some participants believe ABDL behaviors are related to toilet training, most do not. Most participants endorse a wide range of explanations for their ABDL interests and behaviors. The environmental shaping theory of ABDL is based on data from this study and both supports and conflicts with historical research on paraphilia. This study contributes to positive social change by allowing clinicians and scholars the opportunity to hear the voices of a stigmatized group and understand them better. An increased awareness of sexual diversity can allow for greater acceptance and less stigmatization in the mental health and medical fields.

M.Tech. / Diaper dermatitis (Nappy Rash) is an acute inflammation of the skin in the diaper area and is the most common cutaneous disease among infants and children (Concannon et al., 2001). It is estimated that 7% - 35% of diaper wearing infants are affected by Diaper dermatitis during the period of wearing diapers (Barkin and Rosen, 2003). The exact prevalence is not known as many cases are selfmedicated by parents or guardians (Wolf et al., 2000). Diaper dermatitis causes severe discomfort to the infants as well as anxiety and worry for the parents. Diaper dermatitis is characterised by redness, inflammation, dryness, scaling, itching, irritability, pain, satellite lesions, papulovesicular or pustular eruptions, and in severe cases ulceration of the skin (Visscher and Hoath, 2006). This study aimed to assess the efficacy of a Homoeopathic complex cream as a topical treatment for Diaper dermatitis. The complex consisted of Atropa belladonna 6cH, Calendula officinalis D1 and Sulphuricum acidum 6cH. Madaji milking cream was used as a base which contained: chlorhexidene; vitamin E; and lanolin. The treatment group received the medicated Madaji milking cream whereas the control group received the unmedicated Madaji milking cream. The Diaper dermatitis was evaluated using a 4-Point Grading Scale (Appendix D) and The Modified Lund and Browder Chart (Appendix E). Forty participants who met the inclusion and exclusion criteria were recruited to participate in this double blind control study by means of advertisements (Appendix A) that were placed on notice boards at the various campuses of the University of Johannesburg, nursery schools and hospitals, with relevant permission given. Participants were also recruited via word of mouth. Once participants were accepted into the study they were allocated to either Group A or Group B using matched pairs according to severity in order to ensure equal v distribution in both groups. There were 20 participants in each group. Group A was the treatment group which received the medicated Madaji milking cream. Group B was the control group which received the unmedicated Madaji cream. The study was completed over a seven day period. The ten areas most commonly affected by Diaper dermatitis were evaluated on the initial visit, day two, day four and day seven.

Un des objectifs de la restauration structurale, sujet de cette thèse, est de mettre en évidence les défauts d'interprétation ou les zones potentiellement fracturées. L'extension de cette technique en volume nécessite la définition a priori des propriétés des matériaux utilisés, notamment lorsque ces propriétés sont définies à une échelle fine. Une première partie, ce travail propose une méthode de mise à l'échelle des propriétés mécaniques utilisées pour les calculs de restauration en volume. La principale hypothèse repose sur la loi de comportement utilisée pour les matériaux définis à l'échelle grossière, supposés isotropiques transverses élastiques. Le calcul des propriétés équivalentes se fait par identification, après simulation par Éléments Finis. Cette technique a l'avantage d'assurer la conservation de l'énergie pour le même type de chargement. Dans une dernière partie, ce travail traite la gestion de la tectonique salifère lors de la restauration structurale. Les diapirs de sel présentent des topologies, des rhéologies, et des séquences de dépôt très caractéristiques. Ce mémoire présente une méthodologie de restauration multi-cartes, dont la prise en compte des relations inter-horizons est respectée dans les séquences halocinétiques. Une application de cette méthode est présentée sur le bassin de La Popa (Mexique) où les différentes interprétations réalisées au travers de leurs restaurations sont comparées / Structural restoration of geological models is undertaken to evaluate the geometrical and geological coherency of an interpretation. It can be used to determine deformation rates in different tectonic regimes. In addition, this technique has been used to evaluate high strain zones, and thus, potential fractured zones. Structural restoration attempts to reverse the effects of deformation history to an assumed initial pre-deformation state. Volumetric restoration techniques generally employ entirely continuum mechanic methods. The continuum mechanic model behaviors are dependent on the definition of the materials for which it is imposed reversibility by using elasticity behavior laws. This property is chosen based upon the predominant rock type in the fault block, generally at small scales. To overcome this issue, a methodology to upscale elastic isotropic materials has been implemented by treating upscaled materials as elastic transversely isotropic materials. This insures energy conservation for the same types of loading. Another focus of this work has been the management of salt tectonics in restoration procedures. A multi-surfaces restoration methodology has been developped based on the conservation of apparent thicknesses between stratigraphic layers and an iso-parametric restoration. This technique avoids the dependence of the volumetric restoration on a material model, while properly treating the restoration of unconformities and halokinetic sequences that characterize the flanks of salt structures. This technique has been tested on a field data set over a salt-withdrawal basin in the La Popa Basin (northeastern Mexico)

Uppsatsen är ett examensarbete på 15 hp inom produktdesignprogrammet på Malmö högskola. Projektet hanterar blöjors utformning med ett resulterande förslag på hur denna produkt kan förbättras, med en fördjupning inom hållbar utveckling. Resultatet blev en blöja med inlägg, för den mer omedvetna konsumenten, som minskar antalet byten och därmed mängden miljöpåfrestande material som behöver tillverkas och slängasI fördjupningen intervjuades Olof Kolte, framträdande industridesigner som verkar inom hållbar utveckling, och en litteratursökning på området utfördes. Förundersökningen angående blöjor baserades främst på kvalitativa intervjuer, och konceptualiseringen baserades främst på ett antal brainstorms och en metod som kallas bakåtmetoden, utvecklad av Edward de Bono, författare och konsult inom lateralt tänkande. / The essay is a thesis of 15 credits in the product design program at Malmö University. The project manages diapers design with a resulting suggestion on how this product can be improved, with a specialization in sustainable development. The result was a diaper with inserts, for the more unconscious buyer, which reduces the number of changes and consequently the amount of eco-wracking materials needed to be manufactured and disposedIn the focus area Olof Kolte, prominent industrial designer working with sustainable development, was interviewed and a literature search was conducted in the area. The preliminary investigation regarding diapers were based primarily on qualitative interviews, and the conceptualization was based primarily on a number of brainstorms and a method called the backward method, developed by Edward de Bono, author and consultant in lateral thinking.

Continuous development and improvement of the modern disposable diaper is crucial for the optimization of product performance. Several methods are used for evaluation and improvements to sustain high quality diapers being produced. The aim of this thesis was to develop a new test method that follows liquid distribution in real time by combining two pre-existing measurement systems. Rewet is the amount of liquid that returns to the surface of diapers when subjected to pressure. Distribution of absorption material is examined by exposing the product core to radiation. These two measurement systems don’t convey anything about the course of the liquid in the diaper when tested separately. This method development is meant to be beneficial for research and development purposes at SCA, working as a complement to the pre-existing methods being used in the laboratory. The following questions are of interest: • Can the rewet test method be performed on a baby diaper while simultaneously exposing the product core to radiation so the course of the liquid can be followed in real time? • Is the liquid distribution (wet area) affected by different product compositions e.g. SAP or thickness? By modifying the current methods, rewet can be performed inside the x-ray equipment while studying the consistency of absorption material and following the liquid behavior in the product core. The developed method was verified by testing on handmade products with different compositions. The developed method’s rewet value has proved to be equivalent to the one tested outside, showing no significant difference between the two.

A Dermatite Associada à Incontinência (DAI) representa um grande desafio para os profissionais de saúde que prestam assistência aos pacientes no Centro de Terapia Intensiva. A ocorrência desta reação inflamatória da pele associada à umidade predispõe a pessoa à dor representando um impacto negativo na qualidade de vida dos pacientes, aumentam o tempo de internação hospitalar e consequentemente o custo do tratamento. Os objetivos do estudo foram: identificar e descrever as características sociodemográficas e clinicas dos pacientes com incontinência e daqueles com DAI internados em um Centro de Terapia Intensiva de um hospital privado; identificar os índices de prevalência pontual da incontinência e da DAI; descrever as características da DAI e os produtos usados para o cuidado da pele perineal dos pacientes; verificar a associação entre a presença da DAI e as variáveis demográficas e clínicas. Trata-se de um estudo transversal, descrito e analítico, quantitativo, aprovado pelo Comitê de Ética em Pesquisa. A coleta de dados aconteceu em um único dia, no Centro de Terapia Intensiva, com 93 participantes. A maioria deles (78,5%) tinha idade acima de 60 anos (média 72, DP 18,2), sexo feminino (50,5%), pele branca (80%). Dentre os diagnósticos médicos, as doenças do aparelho respiratório e circulatório representaram 29% e 19,4%, respectivamente. O tempo de internação médio foi de 18,3 dias (DP 24,4). A prevalência da incontinência urinária foi de 33,3% e a fecal, 51,6%. O cateter vesical estava sendo utilizado em 24,7% dos pacientes e a fralda em 66,7%.Quanto a eliminação das fezes, a maioria dos pacientes internados na UTI (83,3%) apresentou fezes semilíquidas e líquidas, com a ocorrência de diarreia em 20,4% dos pacientes. A prevalência pontual da DAI foi de 40,9% e a prevalência da DAI em pacientes incontinentes, 59,2%. O local onde a DAI apresentou maior prevalência nos pacientes incontinentes foi a UTI. O eritema da pele lidera a lista de manifestação mais prevalente (89,4%), seguida pela erosão (21,1%). A maioria (76,3%) das DAI ocorreu na região perianal, seguida pela região perineal (39,5%) e região interglútea (34,2%). A presença da DAI apresentou associação estatisticamente significante quanto à alteração do nível de consciência, uso de antibiótico, corticoide, jejum ou uso da via enteral para suporte nutricional, uso de tubo orotraqueal para oxigenação, restrição mecânica, presença da incontinência, frequência evacuatória, consistência das fezes, emprego de cateter vesical de demora e/ou fralda. Adotou-se película líquida em 40% dos pacientes para prevenção da DAI e em 47,3% para o tratamento. Empregou-se o limpador sem enxague em 36,8% dos pacientes com DAI. A prescrição de ao menos um produto preventivo não foi encontrada em 34,5% dos pacientes. Não houve prescrição de tratamento em 13,1% dos pacientes com DAI. Os resultados encontrados contribuem para o diagnóstico situacional da ocorrência da DAI. Este estudo poderá contribuir para a sistematização das práticas clínicas e adoção de protocolos assistenciais visando a qualidade e segurança do paciente / Incontinence-associated dermatitis (IAD) represents a significant health challenge for professionals who provide care to patients in the Intensive Care Unit (ICU). The occurrence of moisture-associated skin damage can cause pain with a negative impact on quality of life and can increase the length of hospital stay and the cost of treatment. The objectives of this study were to: identify and describe the sociodemographic and clinical characteristics of patients with incontinence and with IAD admitted to the ICU of a private hospital; Identify the prevalence rate of incontinence and IAD; Describe the characteristics of IAD and the perineal skin care products; Verify the association between the presence of IAD and the demographic and clinical variables. This cross sectional, descriptive, analytical, quantitative study was approved by a Research Ethics Committee. Data were collected on a single day, in the intensive care unit, totaling 93 patients. Most patients were female (50.5%), with white skin (80%) and mean age 72 +/- 18.2 years. Among medical diagnoses, respiratory and circulatory diseases accounted for 29%, and 19.4%, respectively. mean hospitalization time was 18.3 +/- 24.4 days. The overall prevalence of urinary incontinence was 33.3% and fecal in 51.6%. Urinary catheter was being used in 24.7% and diaper in 66.7% of the patients. Regarding stool elimination, the majority of patients admitted to the ICU (83.3%) had semi-liquid and liquid stools, with diarrhea occurring in 20.4% of the patients. The point prevalence of IAD was 40.9% and the prevalence of IAD in incontinent patients was 59.2%. The ICU was the site that DAI was most prevalent in incontinent patients. Erythema was the most common skin manifestation (89.4%), followed by erosion (21.1%). Most of the IAD (76.3%) occurred in the perianal region, followed by the perineal one (39.5%) and intergluteal area (34.2%). The presence of IAD was associated with the change in the level of consciousness, use of antibiotic, corticoid, fasting or enteral nutritional support, orotracheal tube, mechanical restriction, presence of incontinence, stools frequency and consistency, urinary catheter and / or diaper. Liquid film was used in 40% of patients for IAD prevention and 47.3% for treatment. The cleaner without rinsing was used in 36.8% of patients with IAD. Prescription of a preventive product was not found in 34.5% of patients. There was no prescription of treatment in 13.1% of patients with IAD. The results found contribute to the situational diagnosis of the occurrence of IAD. This study may contribute to the systematization of clinical practices and adoption of assistance protocols aiming at the quality and safety of the patient

A Dermatite Associada à Incontinência (DAI) representa um grande desafio para os profissionais de saúde que prestam assistência aos pacientes no Centro de Terapia Intensiva. A ocorrência desta reação inflamatória da pele associada à umidade predispõe a pessoa à dor representando um impacto negativo na qualidade de vida dos pacientes, aumentam o tempo de internação hospitalar e consequentemente o custo do tratamento. Os objetivos do estudo foram: identificar e descrever as características sociodemográficas e clinicas dos pacientes com incontinência e daqueles com DAI internados em um Centro de Terapia Intensiva de um hospital privado; identificar os índices de prevalência pontual da incontinência e da DAI; descrever as características da DAI e os produtos usados para o cuidado da pele perineal dos pacientes; verificar a associação entre a presença da DAI e as variáveis demográficas e clínicas. Trata-se de um estudo transversal, descrito e analítico, quantitativo, aprovado pelo Comitê de Ética em Pesquisa. A coleta de dados aconteceu em um único dia, no Centro de Terapia Intensiva, com 93 participantes. A maioria deles (78,5%) tinha idade acima de 60 anos (média 72, DP 18,2), sexo feminino (50,5%), pele branca (80%). Dentre os diagnósticos médicos, as doenças do aparelho respiratório e circulatório representaram 29% e 19,4%, respectivamente. O tempo de internação médio foi de 18,3 dias (DP 24,4). A prevalência da incontinência urinária foi de 33,3% e a fecal, 51,6%. O cateter vesical estava sendo utilizado em 24,7% dos pacientes e a fralda em 66,7%.Quanto a eliminação das fezes, a maioria dos pacientes internados na UTI (83,3%) apresentou fezes semilíquidas e líquidas, com a ocorrência de diarreia em 20,4% dos pacientes. A prevalência pontual da DAI foi de 40,9% e a prevalência da DAI em pacientes incontinentes, 59,2%. O local onde a DAI apresentou maior prevalência nos pacientes incontinentes foi a UTI. O eritema da pele lidera a lista de manifestação mais prevalente (89,4%), seguida pela erosão (21,1%). A maioria (76,3%) das DAI ocorreu na região perianal, seguida pela região perineal (39,5%) e região interglútea (34,2%). A presença da DAI apresentou associação estatisticamente significante quanto à alteração do nível de consciência, uso de antibiótico, corticoide, jejum ou uso da via enteral para suporte nutricional, uso de tubo orotraqueal para oxigenação, restrição mecânica, presença da incontinência, frequência evacuatória, consistência das fezes, emprego de cateter vesical de demora e/ou fralda. Adotou-se película líquida em 40% dos pacientes para prevenção da DAI e em 47,3% para o tratamento. Empregou-se o limpador sem enxague em 36,8% dos pacientes com DAI. A prescrição de ao menos um produto preventivo não foi encontrada em 34,5% dos pacientes. Não houve prescrição de tratamento em 13,1% dos pacientes com DAI. Os resultados encontrados contribuem para o diagnóstico situacional da ocorrência da DAI. Este estudo poderá contribuir para a sistematização das práticas clínicas e adoção de protocolos assistenciais visando a qualidade e segurança do paciente / Incontinence-associated dermatitis (IAD) represents a significant health challenge for professionals who provide care to patients in the Intensive Care Unit (ICU). The occurrence of moisture-associated skin damage can cause pain with a negative impact on quality of life and can increase the length of hospital stay and the cost of treatment. The objectives of this study were to: identify and describe the sociodemographic and clinical characteristics of patients with incontinence and with IAD admitted to the ICU of a private hospital; Identify the prevalence rate of incontinence and IAD; Describe the characteristics of IAD and the perineal skin care products; Verify the association between the presence of IAD and the demographic and clinical variables. This cross sectional, descriptive, analytical, quantitative study was approved by a Research Ethics Committee. Data were collected on a single day, in the intensive care unit, totaling 93 patients. Most patients were female (50.5%), with white skin (80%) and mean age 72 +/- 18.2 years. Among medical diagnoses, respiratory and circulatory diseases accounted for 29%, and 19.4%, respectively. mean hospitalization time was 18.3 +/- 24.4 days. The overall prevalence of urinary incontinence was 33.3% and fecal in 51.6%. Urinary catheter was being used in 24.7% and diaper in 66.7% of the patients. Regarding stool elimination, the majority of patients admitted to the ICU (83.3%) had semi-liquid and liquid stools, with diarrhea occurring in 20.4% of the patients. The point prevalence of IAD was 40.9% and the prevalence of IAD in incontinent patients was 59.2%. The ICU was the site that DAI was most prevalent in incontinent patients. Erythema was the most common skin manifestation (89.4%), followed by erosion (21.1%). Most of the IAD (76.3%) occurred in the perianal region, followed by the perineal one (39.5%) and intergluteal area (34.2%). The presence of IAD was associated with the change in the level of consciousness, use of antibiotic, corticoid, fasting or enteral nutritional support, orotracheal tube, mechanical restriction, presence of incontinence, stools frequency and consistency, urinary catheter and / or diaper. Liquid film was used in 40% of patients for IAD prevention and 47.3% for treatment. The cleaner without rinsing was used in 36.8% of patients with IAD. Prescription of a preventive product was not found in 34.5% of patients. There was no prescription of treatment in 13.1% of patients with IAD. The results found contribute to the situational diagnosis of the occurrence of IAD. This study may contribute to the systematization of clinical practices and adoption of assistance protocols aiming at the quality and safety of the patient