Results from the National Taskforce for Humanity in Healthcare's Integrated, Organizational Pilot Program to Improve Well-Being.

Background: In health care, burnout remains a persistent and significant problem. Evidence now exists that organizational initiatives are vital to address health care worker (HCW) well-being in a sustainable way, though system-level interventions are pursued infrequently.

Methods: Between November 2018 and May 2020, researchers engaged five health system and physician practice sites to participate in an organizational pilot intervention that integrated evidence-based approaches to well-being, including a comprehensive culture assessment, leadership and team development, and redesign of daily workflow with an emphasis on cultivating positive emotions.

Promoting safe use of equipment for neurogenic bowel management.

Nurses have a responsibility to monitor patient safety related to the use of equipment. Existing bowel care/shower chairs used by persons with neurogenic bowel can pose serious safety risks for patients. Twenty-four percent of persons with spinal cord dysfunction reported development of pressure ulcers and cuts from the seats, and 35% reported a history of falls from bowel care/shower chairs.

Iterative design and evaluation of new prone carts for individuals with SCDs: a technical note.

This paper summarizes a series of projects funded since 1992 to address the compelling need to improve the quality of life for persons with spinal cord dysfunctions who use prone carts. Specifically, Veterans Services Organization, National Institute on Disability and Rehabilitation Research (NIDRR), and the VA Rehabilitation Research and Development funded studies to develop new consumer-driven designs for prone carts. Using an iterative approach, this team of clinicians and designers (1) evaluated existing prone carts; (2) designed a new manual prone cart; (3) designed a new motorized prone cart, including a standing model; and (4) are collaborating with manufacturers to market and commercialize the new prone carts.

Design of the advanced commode-shower chair for spinal cord-injured individuals.

The purpose of this development project was to design a new commode-shower chair that can be safely used by individuals with spinal cord injuries (SCI) and their caregivers. The need for this new design was consumer-driven. Patients and caregivers identified the following fatal flaws in the commode-shower chairs used in Spinal Cord Injury (SCI) centers: 1) risk for patient falls during transfers, propelling, and while leaning over for showering; 2) risk for pressure ulcers due to inadequate padding and seat positioning for lengthy bowel care regimes; 3) inadequate caregiver access to the perianal area of the patient to perform bowel care procedures; and, 4) wheel-related inability to properly position the chair directly over the toilet.

Patient evaluation of prone carts used in spinal cord injury.

Prone carts are used for mobility by individuals with spinal cord injury who cannot use a wheelchair due to the risk of aggravating existing pressure ulcers. A prone cart is a flat/horizontal cart with a fixed height, propelled by the user while laying in a prone position. Patients reported that prolonged use of a prone cart resulted in chronic neck, shoulder and back pain.

Toward the design of a new bowel care chair for the spinal cord injured: a pilot study.

Bowel care is a critical aspect of daily living for person with disabilities; ineffective bowel care can lead to severe and costly complications. Staff, patients, and caregivers have often found existing bowel care chairs to be inadequate. These chairs are frequently unsafe, inconvenient, and ineffective for showering and bowel elimination.

Descriptive study of bowel care practices and equipment in spinal cord injury.

46% of the 277 SCI veterans responding to the survey used bowel care/shower chairs at home. Of those who regularly used these chairs (N = 147), over 66% felt their safety was compromised by their use. Caregivers reported similar dissatisfaction with existing bowel care/shower chairs.

Time-of-day variations in oculomotor function: II. Steady-state accommodation to square-wave gratings.

Time-of-day variations in both tonic accommodation and steady-state accommodation to a grating were assessed for 16 observers who were tested once in the morning and again 12 hours later. The mean night-time tonic accommodation was +0.5 D greater than the morning value.

Time-of-day variations in oculomotor function: I. Tonic accommodation and tonic vergence.

Time-of-day variations were studied both in tonic accommodation and in tonic vergence. Thirty-six male volunteers were measured once in the morning and at one other time on the same day. The mean baseline value of tonic accommodation was 2.

Perceived loudness and visually-determined auditory distance.

Three experiments were conducted to determine whether variations in the perceived distance to a test sound could influence its loudness in the absence of physical changes in sound-level. The phenomenon of visual capture provided the means for manipulating apparent distance. A 'dummy' loudspeaker was used to vary the apparent source location of a short noise stimulus while the true source of this sound remained fixed (and hidden) with respect to the observer.

Stability of measures of the dark focus of accomodation.

Without visual stimulation, the eye tends to assume an individually-determined intermediate state of accommodation (the "dark focus"). The present study examined the stability of these individual dark focus values over time. Two sets of measurements were obtained with a laser-Badal optometer for each of 39 college-age subjects.