Skin integrity breakdown and pressure ulcer formation on the heel are predictable and preventable healthcare occurrences. By minimizing surface contact pressures that can cause heel capillary occlusion, heel off-loading devices help mitigate the risk of decubitus ulceration. The purpose of this study is to investigate the efficacy of six off-loading methods commonly used in clinical settings to decrease heel contact pressure. Pressure mapping is used to evaluate contact pressure at the heel for underweight, normal weight, and overweight simulations. Based upon averages across four trials, it is shown that all devices reduce heel contact pressure when compared to no off-loading. The PRUventor™ boot exhibits significantly lower average pressure values than other off-loading strategies tested, suggesting that the PRUventor™ is the most effective off-loading device. From the analysis of the experimental data and comparison to similar data for respective off-loading alternatives, it is concluded that the PRUventor™ boot is an effective heel off-loading device for use in clinical settings.

This article addresses the need for anticipatory guidance about death and death education with young children. Children often experience the death of an immediate family member before the age of ten. This number increases if one considers the loss of friends, pets, and other loved ones. However, children experience a death with little or no anticipatory guidance or knowledge about death. Anticipatory guidance can assist the child in having a better understanding of a death when it occurs. Talking about death with children can be difficult for adults. However, it is important to address the topic and realize the impact anticipatory guidance in relation to death can have in assisting with childhood bereavement, anticipatory grief, and anticipatory adaptation. By providing anticipatory education related to death symptoms such as grief, anger, and/or fear, regressive or aggressive behaviors can be prevented or lessened when a death occurs. Age appropriate developmental levels for understanding the concept of death, resources for death education, and literature that can be used for death education are presented. Any resource used for death education with children should be carefully reviewed by the adult for its appropriateness prior to its use.

No abstract