Use Of Pillow Research Articles

Prevention of sore heels: evidence and outcomes.

The orthopaedic service at the Sheffield Children’s hospital is a regional, tertiary service providing complex surgical procedures often requiring several days of enforced bed rest. Staff on the orthopaedic ward had become increasingly concerned about the number of children who had developed sore heels postoperatively. Until a few years ago, our care, where surgery permitted, included a regular turning regime to relieve pressure, the use of pillows under the heels and the occasional use of water filled gloves. Clinical effectiveness (DoH 1996) is about ‘doing the right thing in the right way for the right patient at the right time’ (RCN 1998), which is underpinned by evidence-based practice (Le May 1999). With these requirements in mind we attempted to identify from the evidence a suitable heel pressure relieving device and planned to implement the device in practice.

PREVENTION OF HEEL PRESSURE ULCERS IN FRACTURED HIP PATIENTS

In spite of standard prevention practices including the use of pillows to elevate the heel off the bed, our fractured hip population (FHP) continued to suffer heel ulcers. We found the pillows were used inconsistently, usually the human element: patient and family moved them, the pillow was placed under the heel instead of suspending it, staff placed pillows in the chair for patient comfort, or during daily linen changes, the pillows were not replaced to suspend the heels.

Factors relating to the infant’s last sleep environment in sudden infant death syndrome in the Republic of Ireland

Aim: To identify risk factors for sudden infant death syndrome (SIDS) in the sleeping environment of Irish infants. Methods: A five year population based case-control study with parental interviews conducted...

Sleep Environment and the Risk of Sudden Infant Death Syndrome in an Urban Population: The Chicago Infant Mortality Study

To examine risk factors for sudden infant death syndrome (SIDS) with the goal of reducing SIDS mortality among blacks, which continues to affect this group at twice the rate of whites. We analyzed data from a population-based case-control study of 260 SIDS deaths that occurred in Chicago between 1993 and 1996 and an equal number of matched living controls to determine the association between SIDS and factors in the sleep environment and other variables related to infant care. The racial/ethnic composition of the study groups was 75.0% black; 13.1% Hispanic white; and 11.9% non-Hispanic white. Several factors related to the sleep environment during last sleep were associated with higher risk of SIDS: placement in the prone position (unadjusted odds ratio [OR]: 2.4; 95% confidence interval [CI]: 1.7-3.4), soft surface (OR: 5.1; 95% CI: 3.1-8.3), pillow use (OR: 2.5; 95% CI: 1.5-4.2), face and/or head covered with bedding (OR: 2.5; 95% CI: 1.3-4.6), bed sharing overall (OR: 2.7; 95% CI: 1.8-4.2), bed sharing with parent(s) alone (OR: 1.9; 95% CI: 1.2-3.1), and bed sharing in other combinations (OR: 5.4; 95% CI: 2.8-10.2). Pacifier use was associated with decreased risk (unadjusted OR: 0.3; 95% CI: 0.2-0.5), as was breastfeeding either ever (OR: 0.2; 95% CI: 0.1-0.3) or currently (OR: 0.2; 95% CI: 0.1-0.4). In a multivariate model, several factors remained significant: prone sleep position, soft surface, pillow use, bed sharing other than with parent(s) alone, and not using a pacifier. To lower further the SIDS rate among black and other racial/ethnic groups, prone sleeping, the use of soft bedding and pillows, and some types of bed sharing should be reduced.

Clinical Outcomes Related to Interface Type in Patients With Obstructive Sleep Apnea/Hypopnea Syndrome Who Are Using Continuous Positive Airway Pressure

To evaluate the effect of interface on objective compliance, patient satisfaction, adverse effects, quality of life, and residual sleep-disordered breathing in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS) using continuous positive airway pressure (CPAP). Randomized, cross-over. Two suburban community-based hospital sleep laboratories. Data were collected on 39 patients with OSAHS (mean age, 48.7 years), in whom CPAP was a novel treatment. Interventions were nasal pillows (Breeze; Mallinckrodt Corporation; Minneapolis, MN) and nasal mask (Contour; Respironics; Murrysville, PA). Outcomes assessed at the completion of each 3-week treatment period were objective compliance, adverse effects, and satisfaction with CPAP (CPAP questionnaire), daytime sleepiness (Epworth sleepiness scale [ESS]), quality of life (Functional Outcomes of Sleep Questionnaire [FOSQ]), sleep diary, and residual sleep-disordered breathing (apnea-hypopnea index [AHI]). Patients were randomly assigned to use the nasal pillows or the nasal mask following laboratory titration and initiated on CPAP (pressure range, 5 to 14 cm H(2)O). The percentage of days utilized favored the nasal pillows (94.1% vs 85.7%; p = 0.02), but minutes of use per night did not differ (nasal pillows, 223 min; nasal mask, 288 min). ESS scores were lower and the FOSQ total scores were higher following CPAP treatment (p < 0.001), but no differential treatment effects were noted. Fewer adverse effects, less trouble getting to sleep and staying asleep, and less air leak were reported with nasal pillows (p < 0.04). The mean +/- SD pretreatment AHI (47.1 +/- 35.1/h) was significantly lower following treatment with CPAP for both types of interface (nasal pillows, 10.2 +/- 9.8/h; nasal mask, 7.0 +/- 7.7/h; p < 0.001). Nasal pillows are a well-tolerated and effective interface for OSAHS patients receiving CPAP at < or = 14 cm H(2)O. Use of nasal pillows was associated with fewer adverse effects and better sleep quality during the first 3 weeks of CPAP therapy. Further investigation is needed to determine whether interface type affects long-term CPAP use.

脳卒中片麻ひ患者の肩関節亜脱臼防止についての検討

Many hemiplegic patients suffer from subluxation of the shoulder joint and show severe damage to rotator cuff and humerus. There were 12 hemiplegic patients with pain and subluxation of the shoulder. Application of triangular sling did not prevent subluxation. Radiological examination revealed some flexion and abduction (45 degrees abduction in the scapular plane) reduced not only subluxation but also pain in 11 patients. Pain remained in one patient whose shoulder was not reduced by flexion and abduction. The use of pillow, slings or other ways to keep the shoulder in some flexion and abduction was effective in reducing the subluxated shoulder joint.

Sleep deprivation following total hip arthroplasty

Standard protocol following total hip arthroplasty dictates that the hip is kept in a position of abduction until soft tissue healing is sufficient to provide stability. This is maintained by use of an abduction pillow while in bed, meaning that the patient must sleep on their back. Many patients find this position uncomfortable and have significant difficulty in sleeping. Aims: To assess the impact of sleep deprivation on recovery of the patient and quality of life in the peri-operative period. Methods: Patient cohort consisted of elective admissions for total hip replacement. All were assessed using the Epworth sleep scale, SF-36 as well as the Hospital Anxiety and depression score. Body mass index and history of insomnia or obstructive sleep apnoea were recorded. Baseline oxygen saturation was compared with postoperative overnight saturation and request for night sedation. Results: 64 consecutive patients undergoing total hip arthroplasty surgery were eligible for inclusion in the study. Mean age 68 (43 to 85), 42 females, 22 males, 62 patients were satisfied with the result of surgery, 1 patient with hip dysplasia had a persistent leg length inequality and one complained of back pain. All patients were nursed according to standard protocol with abduction pillow while in hospital and instructions to sleep on their back while at home. 18 patients did not fully comply with this instruction while at home. There were no early dislocations with a mean follow up of 5.4 months. Mean hospital anxiety and depression scores were significantly increased following surgery mean pre-operatively (5.2), to highest level (3.4) at two weeks, (8.5) at six weeks, returning to normal levels after three months (4.2). Epworth sleep scores were similarly increased with sleep patterns returning to normal at the three month stage. Increasingly, body mass index correlated significantly with poor scores and low oxygen saturation readings. This group of patients had a predisposition to obstructive sleep apnoea, which was predicated by sleeping on their backs, they require more night sedation and analgesia. Conclusions: Standard precautions following total hip arthroplasty are not without morbidity. Sleep deprivation leading to increased anxiety and decreased satisfaction. Increased demand for night sedation and analgesia with their resultant costs and dependence. Sleeping in the supine position may also precipitate obstructive sleep apnoea in at risk patients.

Inflatable Pillows as Axillary Support Devices During Surgery Performed in the Lateral Decubitus Position Under Epidural Anesthesia

The lateral decubitus position can cause dependent shoulder discomfort or result in traction on the brachial plexus. We measured pressure beneath the dependent shoulder and lateral angulation of the cervical spine in patients positioned in the lateral decubitus position for total hip replacement under epidural anesthesia. Inflatable pillows (Shoulder-Float) beneath the chest wall and head reduced pressure beneath the dependent shoulder from 66 to 12 mm Hg (P < 0.001) and lateral angulation of the cervical spine from 14 degrees to 4 degrees (P < 0.001). In a randomized crossover study of a further 15 patients, the use of inflatable pillows resulted in significantly less pressure beneath the dependent shoulder and chest wall than either a gel-pad or a 1000-mL lactated Ringer's bag. Inflatable pillows placed beneath the chest wall and head in the lateral decubitus position provided lower pressure beneath the dependent shoulder than other support devices and facilitated alignment of the cervical spine. When patients lie on their side, this results in pressure beneath the shoulder and tilting of the head and neck to one side. These problems were effectively corrected with an inflatable pillow (Shoulder-Float).

Preliminary traction and the use of under-thigh pillows to prevent avascular necrosis of the femoral head in Pavlik harness treatment of developmental dysplasia of the hip

One hundred and sixty-one hips of 145 patients were treated with the Pavlik harness for developmental dysplasia of the hip. The patients were divided into two groups. Group A consisted of 65 patients (70 hips) who were treated between 1980 and 1987. The harness was applied immediately after the diagnosis. Group B consisted of 80 patients (91 hips) who were treated between 1988 and 1992. These patients received preliminary traction, and small pillows supported the lower extremities from just above the knee to the foot to prevent extreme abduction when the harness was applied. When the distance from the middle point of the proximal metaphyseal border of the femur to the Y-line (distance “a”) was 8mm or more on the initial X-ray picture, the rate of avascular necrosis in group A was 11% and that in group B was 0%; the difference was significant. However, when distance “a” was less than 8mm, the rate of avascular necrosis in group A was 13% and that in group B was 12%, and there was no significant difference. Thus, we suggest that the Pavlik harness is indicated for developmental dysplasia of the hip in which distance “a” is 8mm or more. Traction should precede application of the harness, and pillows placed under the thigh must be used during application.

Synthetic pillows contain higher levels of cat and dog allergen than feather pillows.

The use of non-feather pillows has increased over the last few decades. Recently, we found significantly higher levels of dust mite allergens in synthetic pillows than in feather ones. This study investigated the levels of pet allergens in feather and synthetic pillows. Dust samples were collected from 14 pairs of pillows (consisting of one synthetic fibre-filled and one feather-filled). Each pair of pillows had been on the same bed for at least 2 years. The pillows were vacuumed for 1 min on each side through a 355-microm diameter mesh onto a 5-microm vinyl filter, producing a sample of fine dust. Samples were extracted, and cat (Fel d 1) and dog (Can f 1) allergens determined using monoclonal antibody-based enzyme-linked immunosorbent assay (ELISA). Results were expressed both as total amount of allergen recovered and concentration of allergen per unit weight (ng/g). Total levels of pet allergens were significantly higher in the synthetic pillows (Fel d 1: 6.7-fold difference [95% CI 1.5-29.7], p=0.01; Can f 1: 8-fold difference [95% CI 1.6-39.5], p=0.01). Similarly, when the results were expressed as ng/g, synthetic pillows contained significantly more allergens than feather pillows (Fel d 1: 3.7-fold difference [95% CI 1.3-10.1], p=0.01); Can f 1: 4.4-fold difference [95% CI 1.5-13.2], p=0.01). We have therefore demonstrated that synthetic pillows contain significantly more pet allergens than feather pillows, supporting the view that tightly woven encasements surrounding feather pillows act as a barrier for allergens.

Prevalence of rhinitis, pillow type and past and present ownership of furred pets.

There has been no previous work investigating the effects of furred pet ownership and pillow type on the risk of developing rhinitis. Recently, unexpected and unexplained associations of asthma with nonfeather pillows have been reported. We developed a questionnaire-based cross-sectional survey to determine whether the past or present ownership of cats or dogs, or the use of nonfeather pillows contributes to the development of seasonal or perennial rhinitis. We surveyed 2555 accompanying friends and relatives of patients attending the outpatients departments at one London hospital in 1996. Individuals with rhinitis were defined as those suffering with three or more symptoms of rhinitis either throughout the year (perennial) or for part of the year (seasonal). Present or childhood ownership of cats or dogs was recorded. A strong association was seen with nonfeather pillow use and both seasonal [odds ratio (OR) 1.85; 95% confidence interval (CI) 1.43-2.5] and perennial (OR 2.63; CI 1.67-5. 0) rhinitis. However, more than one-third of rhinitics had changed their pillow type. After restricting the data to exclude subjects who changed their pillow to avoid allergies, the strong association of nonfeather pillow use with perennial rhinitis remained (OR 2.44; CI 1.25-5.0). Adjusting the data to the extreme situation where all former pillow type was feather changes the apparent risk to 0.99 (CI 0.67-1.43). No associations for either seasonal or perennial rhinitis were seen for feather pillows. A weak association of current dog ownership is demonstrated for seasonal rhinitis (OR 1. 47; CI 1.01-2.14). No associations were seen for childhood dog ownership or cat ownership at any time with either type of rhinitis. Feather pillow use and the ownership of furred pets appears unlikely to increase the risk of developing perennial or seasonal rhinitis. In fact, in contrast with currently held views, there is evidence that the use of nonfeather pillows may increase the risk.

Feather or synthetic? That is the question

Feather or synthetic? That is the question

Pillow talk: the use of props to encourage repose

Methods of encouraging repose are presented which may be useful with the apprehensive client as well as with those who are unable to relax. Muscular relaxation is prerequisite to the success of many manual therapy skills as well as being a desired outcome for most massage techniques. Three standards are presented to help gauge the quality of repose. These consist of: 1) determination of the degree of support of the client by the treatment surface upon which they rest; 2) observation of respiration; and 3) noting the quality of passive movements. The use of pillows or props may be useful or even necessary as a catalyst for repose. Fourteen approaches to prop placement are presented for inducing repose in the recumbent client.

The home environment and asthma symptoms in childhood: two population based case-control studies 13 years apart.

BACKGROUND: Prevalence surveys of asthma and/or wheezing among all children aged between 7 1/2 and 8 1/2 attending state and private schools in the London Borough of Croydon were conducted...

Are bedding and rebreathing suffocation a cause of SIDS?

Suffocation by bedclothes became a popular diagnosis in the 1940s but gradually became replaced with the diagnostic label of Sudden Infant Death Syndrome (SIDS). In 1991 a paper purported that, instead of SIDS, pillows filled with polystyrene beads had caused death by rebreathing suffocation; this conclusion was reached on the basis of experiments with anesthetized rabbits breathing through a doll's head that was placed face down on the pillow. Because of the anesthesia, rabbits could not change their face down position. The doll's nares could not collapse, which would have resulted in rapid death due to conventional suffocation. The rabbits required up to 3 hours or more to die of hypercarbia and hypoxia. Studies in normal infants revealed that they turned from the face-down position after only 2 minutes. (The only infant who retained CO2 soon died of a fatal neurologic disorder, with central hypoventilation). Using the rabbit/doll's head and mechanical models, a wide range of bedding was indicted, including cushions, sheepskins, pillows, comforters, foam mattresses, and even simple blankets and sheets as potentially causing fatal rebreathing. Except for the use of pillows in general, as well as mattresses filled with kapok and bark, there has been no epidemiologic support for these indictments. Although normal infants are unlikely to succumb to rebreathing suffocation, infants with blunted ventilatory responsiveness and delayed arousal due to prior hypoxia were hypothesized to be at increased risk. Support for this concept was found in the pathology of the brain stem in victims of SIDS that was attributed to prior hypoxic injury. In infants who survived prolonged apnea, less than 20% have demonstrated a diminished ventilatory responsiveness to hypercarbia, but, more significantly, none had an absent response. Arousal to hypercarbia, an abnormality which is crucial to the hypothesis of rebreathing suffocation, is regularly present in normal subjects, but the threshold is higher in near-SIDS infants; however, no instances of failure to arouse have been reported in near-SIDS. If the infant is placed on his or her back or side, the issue of bedding could become moot; unfortunately, a sizable percentage of infants are still being placed prone for sleep. Instead of confusing parents with an ever-expanding list of "dangerous bedding," the message "Back to Sleep" should be emphasized.

House dust mite allergen levels in two cities in Canada: effects of season, humidity, city and home characteristics

The homes of 120 patients with asthma, 57 in Vancouver and 63 in Winnipeg, were studied. The characteristics of the homes were assessed by a questionnaire. Dust samples were collected and the indoor relative humidity was measured four times during the year covering all four seasons in both cities. Mite allergen levels were determined using monoclonal antibodies against Der p I and Der f I by the ELISA method. The mean levels of both mite allergens in mattress and floor samples in the homes in Vancouver and in Winnipeg were relatively low for all seasons. Mite allergen levels were found to be associated with city, season and individual home differences. They were significantly higher in Vancouver than in Winnipeg. Der p I and Der f I in mattress samples in both cities and Der f I in floor samples in Vancouver, varied by season. The indoor relative humidity level in the homes in Vancouver were also significantly higher than those in Winnipeg. There was, however, no significant association between the levels of indoor relative humidity and the levels of mite allergens after adjusting for variations in city, season and individual home. Although individual home differences were highly associated with mite allergen levels, only a few home characteristics were found to be related to mite allergen levels such as the type and the age of the home, the type of heating, the use of feather pillows and the number of occupants in the homes. Whether low levels of mite allergens are partially responsible for the relatively low prevalence of childhood asthma in Canada remains to be investigated.

Aromatherapy: Evidence for Sedative Effects of the Essential Oil of Lavender after Inhalation

The sedative properties of the essential oil of Lavender (Lavandula angustifolia Miller) and of its main constituents--linalool and linalyl acetate--were investigated in mice followed up in a series of experimental procedures. The significant decrease in the motility of female and male laboratory animals under standardized experimental conditions is found to be closely dependent on the exposure time to the drugs. Nevertheless after an injection of caffeine into mice a hyperactivity was observed which was reduced to nearly a normal motility only by inhalation of these fragrance drugs. In particular the correlation of the motility of the animals to linalool in serum is experimentally proven, thus furnishing evidence of the aromatherapeutical use of herbal pillows employed in folk medicine since ancient times in order to facilitate falling asleep or to minimize stressful situations of man.

Pillow talk.

I am a Registered General Nurse presently undertaking English National Board Course No 100 (on General Intensive Care Nursing at Guy's Hospital, London. I was most intersted in the article entitled 'Take Away Pillows' which appeared in the Nursing Standard week ending October 3,1987.1 have therefore decided, as my major assignment project, to research into people's attitudes and opinions on the use of pillows as head and neck support when attempting resuscitation procedures.

The use of snow-pillow data for melt rate input to the streamflow synthesis and reservoir regulation watershed model

A split watershed version of the streamflow synthesis and reservoir regulation (SSARR) model was calibrated and verified for Marmot Creek, a small forested research watershed located in the Rocky Mountains west of Calgary, Alberta. The model is used for forecasting runoff rates. Melt-rate data from five snow pillows, located at sites of different elevation and exposure on the basin, were applied to the model. The melt-rate factor expressed in millimetres per degree-day was the only input parameter changed in the model, which was run for the months of April, May, and June over an 8-year period, 1973–1980.An average melt rate from the snow-covered area as determined from the five snow pillows provided the best runoff simulation. Measured melt rates from just one snow pillow, located at the middle elevation of the basin in a heavily forested area, provided a comparable simulation. Snow pillows located at lower elevations in either open or closed areas and snow pillows located at higher elevations in open areas yielded poor simulations. The characteristics and problems associated with the use of snow pillow for modelling snowmelt are also discussed. Key words: snowmelt, snow pillows, watershed models, runoff forecasting.

Use of water pillows in reducing head shape distortion in preterm infants.

The purpose of this study was to determine the effectiveness of a water-pillow treatment in reducing bilateral head flattening of preterm infants. The subjects were 21 healthy infants of less than 36 weeks gestational+ age. Care of the experimental babies included supporting the head on a small water pillow and supporting the torso at the same level to avoid flexion or curvature of the spine; the control group received customary care. The ratios of the anterior-posterior diameter to the biparietal diameter were significantly different for the two groups (p less than .0005). The heads of the control infants became flattened on both sides, while those of the experimental babies maintained the round shape they had at admission to the unit. The findings support the use of a small water pillow, in combination with support for the torso, as a means of alleviating bilateral head flattening in preterm infants.