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In-Center Hemodialysis and Patient Travel Time in Aotearoa New Zealand: A Nationwide Geospatial and Data Linkage Study
Get PDFIntroduction
Prolonged travel time to receive dialysis is associated with decreased quality of life and increased mortality. However, patient travel time is rarely systematically analyzed during health service planning. This study’s aims were as follows: (i) examine spatio-temporal trends in travel time for people commencing dialysis in Aotearoa New Zealand (NZ), (ii) assess the relationship between travel time and dialysis modality, and (iii) create interactive nationwide maps to support renal service planning.
Methods
AcceSS and Equity in Treatment for kidney disease (ASSET), a health-linked data platform, was used to include all people commencing dialysis in NZ from 2006 to 2019 (N = 6690). Patients’ one-way driving times from their residential location to the nearest hemodialysis unit were estimated using geospatial software. Multiple logistic regression modelling explored the association between travel time and dialysis modality, adjusting for demographic, clinical, and service factors.
Results
Median one-way driving time was 14 minutes (interquartile interval [IQI]: 8–31) and was significantly higher for patients living in rural (45 minutes [IQI: 28–62]) than in urban areas (11 minutes [IQI:8–18]; P < 0.001). Patients living farther from a unit were independently less likely to receive in-center hemodialysis (0.62 [95% confidence interval, CI: 0.52–0.72] for driving time ≥ 30 minutes; odds ratio, OR: 0.82 [95% CI:0.68–0.99] for 20–29; reference < 10), as were those in regions with greater hemodialysis unit capacity pressure. Our interactive maps demonstrate marked interregional variation in dialysis modality, patient travel time, and unit capacity.
Conclusion
Innovative service design is needed to reduce the burden of travel time, particularly for rural dialysis patients. We present novel geospatial techniques to support dialysis service planning that is targeted to the areas of greatest need
Creative Practices & Coproduction; a Special Issue for 'Evidence & Policy'
Get PDFIn 2019, Policy Press journal ‘Evidence & Policy‘ called for special issue proposals. Evidence & Policy is an interdisciplinary journal exploring the relationship between researchers and the evidence they produce and the concerns of policy makers and practitioners in areas that include health and social care. A team led by Research Fellow Joe Langley responded to this with a Special Issue titled Creativity & Coproduction.
The creative design practices used in co-design, and the role these play in sharing, synthesising and mobilising knowledge, have been a significant strand of Lab4Living activity, led by Joe Langley, over the past decade. Co-design has been employed within health research to support and enable better translation of research evidence into practice and policy.
Through this co-design work, Joe had established a critical mass of colleagues from around the world with this shared interest, equally driven to continue to challenge, extend and grow the field. Joe convened a small group of interested researchers and describes below how they approached guest editing a special issue
Learning to swim with back pain: a qualitative study of swimmers with chronic low back pain.
Get PDFPurposeSwimming is one form of exercise advised to people with chronic low back pain (CLBP), there is limited research, however, supporting this recommendation and describing the experience and use of swimming in this population. The aim of this study was to explore the experience of people who use swimming to manage CLBP.MethodsSemi-structure interviews were conducted with 14 swimmers who were using swimming to manage CLBP. Thematic analysis was used to analyse the interview data, and the themes were mapped onto the capability, opportunity, motivation and behaviour (COM-B) model to understand the behavioural factors.ResultsFive common themes were developed during the analysis: (1) My back pain journey; (2) Learning to swim with back pain; (3) How swimming looks for me; (4) What I gain from swimming; and (5) Keep calm and carry-on swimming. The themes mapped onto all three COM-B domains.ConclusionsThe participants found that swimming was a valuable self-management tool for CLBP. The findings from the thematic and COM-B analysis indicate that learning to swim with CLBP can be a complex journey, influenced by several interrelated behavioural factors. In the absence of multi-professional support, inclusive swimming communities and accessible swimming venues, swimming participation rates may be affected
Preparation and assessment of polylactic acid-curcumin nanofibrous wound dressing containing silver nanoparticles for burn wound treatment.
Get PDFThis study aims to produce and evaluate nanofibrous wound dressings through the electrospinning method, utilizing polylactic acid (PLA), curcumin (Cur), and silver nanoparticles (AgNPs). For this purpose, five types of wound dressings with PLA, PLA+Cur, PLA+Cur+ 1 %AgNPs, PLA+Cur+ 2 %AgNPs and PLA+Cur+ 3 %AgNPs were produced using the electrospinning method. Analysis of the Fourier transform infrared spectroscopy and scanning electron microscopic observations indicated successful fabrication, with nanometer diameters achieved in all electrospun samples. Examination of water absorption of wound dressings revealed that over 40 h the electrospun samples had variable water absorption between 0 % and 0.25 %. The results of the curcumin release test over one week showed that the nanofibers with PLA+Cur+ 2 %AgNPs exhibited the lowest release rate, while those with PLA+Cur+ 3 %AgNPs showed the highest release. Assessment of mechanical properties revealed that the tensile strength of the nanofibers increased by adding curcumin to polylactic acid, while the addition of a high content of AgNPs led to a decrease in tensile strength. Also, the PLA+Cur dressing demonstrated 84.06 % and the PLA+Cur+ 3 %AgNPs dressing exhibited 99.12 % antibacterial properties. The cell culture test demonstrated that the incorporation of curcumin and AgNPs increasedboth the growth and proliferation, as well as the adhesion on the nanofibrous wound dressing. Thus, the PLA+Cur+ 1 %AgNPs nanofibrous scaffold, as a multipurpose dressing, presented considerable promise for wound healing and burn treatment
A real-time A* algorithm for trajectories generation and collision avoidance in uncertain environments for assembly applications
No full textIn assembly processes, generating paths and avoiding collisions are crucial for efficiency and safety. This paper presents a novel approach that integrates the A* pathfinding (PF) algorithm into FreeCAD, an open-source Computer-Aided Design (CAD) platform. The main contribution of this work is enabling PF and collision detection directly within the CAD environment during the design phase, helping detect potential collisions early and improving the design process. The A* algorithm has been adapted to handle both static and dynamic obstacles inside FreeCAD. This integration allows for better planning of paths in complex assembly environments. The integration process, algorithm modifications and system functionality are described in detail. A case study simulating an assembly line demonstrates the algorithm’s effectiveness in generating collision-free trajectories while adapting to dynamic changes in the environment. This work paves the way for further advancements in AI-driven CAD systems for industrial applications, enabling more intelligent and adaptive assembly processes during the design phase
Data Study Group Final Report: University College London Hospital. Morbidity Prediction Using Preoperative Cardiopulmonary Exercise Test Results. 9 September 2024-13 September 2024.
Get PDFHydration Products and Properties of Nanocellulose Fibre-Reinforced Mortar
Get PDFThis study investigates the influence of nanocellulose fibre (CF) derived from wood pulp on the hydration, mechanical, shrinkage, and pore properties of ordinary Portland cement (OPC) mortar. The CF was incorporated into mortar mixes at varying dosages (0.15–1.5% by weight of mortar) to evaluate its effect on physical, mechanical, and microstructure properties. X-ray diffraction (XRD), thermogravimetric analysis (TGA/DTG), and mercury intrusion porosimetry (MIP) were employed to assess the hydration phases and microstructural changes induced by the CF addition. Experimental results indicate that CF alters the hydration kinetics of cement mortar by influencing the formation of hydration products such as calcium silicate hydrate (C-S-H), portlandite (CH), and carbonate phases. The introduction of CF enhances crack resistance and shrinkage control, particularly at an optimal dosage of 0.45%, which exhibited reduced drying shrinkage and improved phase stability. While CF incorporation had minimal impact on compressive and flexural strength at lower dosages (≤0.45%), higher CF contents (>0.99%) caused pore structure modifications, leading to an increase in total porosity and a reduction in strength. The XRD analysis revealed that CF does not introduce new hydration phases but modifies the crystallinity of existing phases. The hydration behaviour, as indicated by TGA/DTG, showed an increase in bound water content at moderate CF dosages, suggesting enhanced internal curing and prolonged hydration. Overall, the findings demonstrate that CF is a viable sustainable additive for cementitious materials, offering advantages in shrinkage control, hydration enhancement, and durability improvement. The results suggest that an optimal CF dosage of 0.45% provides a balance between workability, mechanical properties, and durability, making it an effective additive for enhancing the performance of OPC mortars in sustainable construction applications
How Human–Robot Interaction Can Influence Task Performance and Perceived Cognitive Load at Different Support Conditions.
Get PDFCognitive load refers to the mental resources used for executing simultaneous tasks. Since these resources are limited, individuals can only process a specific amount of information at a time. Daily activities often involve mentally demanding tasks, which is why social robots have been proposed to simplify them and support users. This study aimed to verify whether and how a social robot can enhance the performance and support the management of cognitive load. Participants completed a baseline where a cognitive activity was carried out without support, and three other conditions where similar activities of increasing difficulty were collaboratively made with the NAO robot. In each condition, errors, time, and perceived cognitive load were measured. Results revealed that the robot improved performance and perceived cognitive load when compared to the baseline, but this support was then thwarted by excessive levels of cognitive load. Future research should focus on developing and designing collaborative human–robot interactions that consider the user’s mental demand, to promote effective and personalized robotic help for independent living