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Evaluation of an e-self-management intervention (Happy Hands app) for hand osteoarthritis: Study protocol for a multicentre randomised controlled trial
Get PDFObjective: This protocol paper describes the rationale and design of a randomised controlled trial (RCT) that aims to evaluate the (cost-)effectiveness of a 12 week e-self-management intervention (Happy Hands app) in people with hand osteoarthritis (HOA). Methods: In this multicentre RCT, 376 people with HOA will be recruited from all four health regions in Norway. Consenting participants will be randomly allocated to either a control group receiving usual care or an intervention group receiving the Happy Hands app in addition to usual care. Primary outcome will be measured at 3-months follow-up as the proportion of participants classified as OMERACT-OARSI responders (a composite score comprising change in pain, function, and disease activity), analysed using logistic regression. Secondary outcomes, including pain, hand function, stiffness, quality-of-care, health-related quality-of-life, grip strength, adherence and healthcare costs will be measured at 3- and 6-months follow-up. Results: Recruitment was initiated in November 2022 with a total of 386 participants recruited by August 2023, 194 in the intervention group and 192 in the control group. Data collection was completed in February 2024. Discussion: To our knowledge, this is one of the first large-scale, multicentre RCTs assessing the (cost-)effectiveness of a self-management program delivered through a smartphone app for people with HOA. The results from this trial can enhance our understanding of the role technology can play in managing HOA. Trial registration: NCT05568875 (https://clinicaltrials.gov/study/NCT05568875, pre-registered October 3, 2022)
Community resilience to flooding in the UK: A study of Matlock, Derbyshire
Get PDFThe United Kingdom has faced recurring floods since 2019, with 5.2 million homes at risk. This has prompted the UK government to prioritise resilience planning in flood prone areas. This study focuses on community resilience in Matlock, Derbyshire, which has experienced intensified flooding since 2018. Using qualitative interviews and a focus group, the research examines evidence of community resilience and the barriers to its development by focusing on community activities during flooding incidents, if and how these were collective efforts and relationships, and what are the perceived challenges to community resilience building. Our findings revealed that residents of Matlock used local action groups and social media, community led warning systems and promotion and engagement in civic participation to foster and enhance community resilience. While bonding and bridging capital were critical to support community resilience building, there were significant barriers to linking social capital, such as the disconnect between community members and formal institutions (i.e. government organisations) that left participants disheartened and frustrated. In conclusion, the study argues that further fostering of linking social capital through policy recommendations and developments such as regular community, small grants for community initiatives and integrating local knowledge into policy frameworks will bridge the gap between communities and these external stakeholders. In doing so, activities that aim to enhance Matlock's flood resilience may inform broader strategies for place-based and devolved policies addressing environmental challenges in a wider context
Type Synthesis and Analysis of Reconfigurable Modules for Closed-Loop Cable-Driven Mechanisms Based on Geometric Constraints
No full textCable-driven mechanisms, particularly in closed-loop configurations, have demonstrated significant advancements in flexible drive systems. However, the cable tension changes caused by the closed-loop configuration cannot be effectively compensated. Relevant con- cerns, such as inadequate responsiveness or compromised control accuracy, consequently emerge. This study presents a method for synthesizing a family of isosceles trapezoid mirror symmetry modules, ensuring stability in cable tension. The geometric properties of an isosceles trapezoid form the fundamental principle for type synthesis. Combined with more geometric configuration, the closed-loop cable-driven mechanisms are con- structed with stable structural constraint. Through mechanical theoretical analysis, the geometric and kinematic properties are thoroughly investigated and precisely formulated, thereby revealing the inherent singularity and bifurcation behaviors. Furthermore, sev- eral prototypes of the proposed modules have been fabricated to validate their kinematic properties. demonstrates that the structural constraint of the cable has no influence on its tension. In addition, the proposed method can be extended to the design and construction of cable-driven manipulators, which hold potential applications in fields such as robotics and aerospace exploration
Techno-Economic analysis of spot price volatility management in energy market incorporating Artificial neural network
No full textRecently, the emergence of distributed energy resources in the consumer premises has given rise to microgrids. Ithas become crucial to consider the impact of microgrids on the operation of existing power systems. Additionally,the reforms in the electricity market also play a major role in the optimal generation and scheduling of electricalenergy in existing systems to avoid power scarcity and power surplus. Hence, in the proposed research, theelectricity market with spot pricing is analyzed through different scenarios, with the microgrid integrated intothe existing modified IEEE 5 bus system. The first step of the proposed work considers the price estimation usingneural networks-based algorithms such as Levenberg-Marquardt, Bayesian Regularization, Scaled ConjugateGradient, machine learning technique namely Random Forest Regressor (RFR), and deep learning techniquenamely Long Short Term Memory (LSTM), and Ensemble (AdaBoost + Levenberg-Marquardt) technique toobtain the estimated price with minimal error. The second step of the proposed work involves the economicdispatch of five generating units to maximize revenue using both the estimated and actual tariffs. The third stepof the proposed work addresses the economic scheduling of power flow between the generators and load-servingentities for different scenarios, such as with/ without power transfer limits and with network and congestion fees.The simulation results of the scenarios show that following the proposed optimal bidding strategy withcongestion fees effectively addresses price volatility issues in spot pricing, achieving less than a 1 % deviationbetween the estimated and actual spot prices with improved profit maximization in the power market
A Study into Building Surveying Practice with Regards to the Evaluation of Marine Degradation in Building Fabric
Get PDFThe World is surrounded by approximately 193,000 miles of coastline (Small & Nicholls, 2003). The United Kingdom is an island located off the northwestern coast of mainland Europe. The United Kingdom comprises the whole of the island of Great Britain (Hastings, Josephson, Morrill, Frere, Ravenhill, Gilbert, 2020). There are 29 million homes in the United Kingdom, including England, Scotland, Wales and Northern Ireland (Committee on Climate Change, 2019) with a vast amount of housing stock on the United Kingdom facing the sea and further inland. This research explores building surveying practice with regards to the evaluation of marine degradation in building fabric. The research is based on, and studies, the effects of the marine environment on the built environment of Llandudno, which has been selected as the method test area due to locality and the subject interest of the building surveying practitioner researcher. In achieving this, the research makes a contribution to knowledge by using a mixed method approach to compare and contrast methods for marine degradation on a building façade, developing a framework for the identification and assessment of differing methods of marine degradation assessment. The methods could be adopted by building surveying practice when carrying out a Royal Institution of Chartered Surveyors survey on a building by the coastline of United Kingdom, Europe, or the World, and following this, to make recommendations and validate with practitioners in a focus group. The information produced during both exercises is scrutinised, and synthesised with existing literature. The results point to a new proposed method that detects salts on a building, salts being known as a chemical property in marine aerosols, with research discovering salts being known to cause a disruptive effect on a building’s façade, therefore, causing marine degradation. The new method was considered to not have the ability to detect marine degradation, however the new method detected salts that are linked to marine degradation. The results, from the experienced Chartered Building Surveyors focus group validation of the methods, highlighted little knowledge was known of marine degradation, further, during the focus group the research uncovered the RICS Isurv report template had no sections within the report template to report on marine degradation. The research concludes by summarising the findings and making proposals, which will help to support the development of Building Surveying Practice and the Royal Institution of Chartered Surveyors Isurv reporting template, whilst assessing a building’s façade for marine degradation. Further, future climate change act 2008 and climate change strategy 2021 – 2024 policy updates could benefit from this research.Keywords: Building surveying, marine degradation, methods, professional practice, defect
One-Stop Shop Solution for Housing Retrofit at Scale in the United Kingdom
Get PDFRetrofitting the existing housing stock to a high level of energy efficiency will not be limited to achieving the decarbonisation of 80.3 MtCO2e residential emissions and reducing fuel poverty in 4.16 million households, but also improving the health and well-being of UK residents and their overall quality of life. The current progress of housing retrofitting is poor, at less than 1%. The UK expects to achieve net zero by 2050, and the challenge is immense as there are more than 30 million houses. The challenge is similar in other global contexts. Even if the required technology, supply chain, skilled labour, and finance could have been provided, the retrofitting would not move forward without positive engagement from the clients. Proper strategies are required to retrofit at scale. Focusing on the challenges of stakeholder engagement in housing retrofitting, this study focused on developing a hybrid one-stop shop solution through design science research. A theoretical artefact and an empirical system requirement specification document were developed to propose a one-stop shop solution. This was tested through retrofit industry stakeholders. Findings reveal that the one-stop shop model will be a good answer to retrofitting at scale, providing the resident engagement of 30.1 million households. The model can support residents with or without computer literacy due to its hybrid approach. The proposed theoretical and industrial models can be used as base models for developing one-stop shops for housing retrofitting by adapting them for context-specific requirements
Unlocking the secrets of Cardiovascular Disease: A DNA code adventure for public engagement and outreach events
No full textGenetics play a key role in cardiovascular disease, but this is often challenging to explain at outreach and/or public engagement events.Familial hypercholesterolemia (FH) is a genetic condition which affects 1 in 250 people, and patients typically have mutations in the genes which play an important role in controlling cholesterol levels in the blood. One of these key genes is low density lipoprotein receptor (LDLR).In this interactive activity, the public and/or students will become a detective and solve two mystery DNA codes using a standard DNA>amino acid decoder (several are available online to print).LDLR (1) will translate to 'START-H-E-A-R-T'; this represents the healthy LDLR gene.LDLR (2) will translate to 'START-H-STOP-A-R-T'; this represents the mutated LDLR gene with an early stop codon. For this patient with FH, the fully functional LDLR protein is not generated and this patient will develop elevated LDL ('bad' cholesterol) levels from an early age.For outreach or public engagement events, this activity works very well alongside a DNA extraction activity, e.g. extracting DNA from strawberries. The DNA cards can also be laminated and re-used if using wipeable board markers
Epidemiology of Vascular Thrombosis in the Eastern Province of Saudi Arabia: A Single Center Study and Comparison with National Data
Get PDFBackground: Despite the growing evidence on the thrombophilia in Saudi population along its diverse regions, there have been no studies on thrombotic events in the Eastern Province of Saudi Arabia. This single-center study aimed to investigate the prevalence of venous thromboembolism (VTE) in a hematology clinic in the Eastern Province of Saudi Arabia between January 2015 and May 2023. The objective of this study was to investigate the clinical characteristics of VTE and compare them with national data. Methods: This is a retrospective, observational, single-center study conducted in the Eastern Province from January 2015 to May 2023. After applying the inclusion and exclusion criteria and the prevalence rate calculation an analysis of n = 170 patients was conducted to compare the epidemiological results of the current study with national data published in other provinces of Saudi Arabia. Data collected included demographics, comorbidities and location with thrombosis recurrence. Result: The prevalence rate of VTE in this cohort was 3.16%. Women made up 70% of the population. About 80.5% of cases were obese or overweight, 37.6% of cases had comorbidities that may increase the risk of thrombosis, and 12.9% of cases were associated with smoking. The most common site of VTE (56.5%) and the site of higher recurrence of VTE (21.8%) was the lower extremities. In addition, recurrent VTE was observed in 28.2% of cases, reflecting a significantly higher recurrence rate compared with other national studies (p = 0.001). Compared with other national statistics, the most significant risk factors for thrombosis in the Eastern Province were smoking, obesity and family history (p = 0.000). Compared with national statistics, this study demonstrated significantly higher rates of VTE in pregnancy, patients on hormonal therapy, and patients with rheumatological/autoimmune diseases (p = 0.001). Conclusion: The incidence of VTE can be reduced by changing lifestyles and creating educational programs to educate people about the dangers of obesity and smoking
Impact of an intervention for osteoarthritis based on exercise and education on metabolic health: a register-based study using the SOAD cohort
Get PDFObjective: This study evaluated the effects of a 6-week osteoarthritis (OA) exercise and education intervention on metabolic health markers, including blood pressure (BP), glycated haemoglobin (HbA1c), high-density lipoprotein (HDL), cholesterol levels and weight in individuals with both OA and diabetes. Methods: Data originated from the Swedish Osteoarthritis and Diabetes cohort, which is composed of the Swedish Osteoarthritis Register (SOAR) and National Diabetes Register. We included individuals diagnosed with OA and diabetes who underwent the intervention between January 2008 and December 2019, matched with controls with diabetes who did not based on birth year, sex, OA site (hip/knee) and OA diagnosis year. Outcomes included BP, HbA1c, HDL, total cholesterol levels and weight measured up to 3 years before and after SOAR enrolment. Statistical analyses used two-way fixed-effect models. Results: The study included 4571 individuals with OA and diabetes (mean age: 69.5, SD: 7.8; women: 52.7%; knee OA: 71.2%) and 7925 controls. The intervention group showed a systolic BP decrease of approximately 1.0 mm Hg at 6 and 12 months compared with the control group. HDL levels increased by about 0.02 mmol/L at 12, 18 and 24 months. Weight decreased by approximately 0.5 kg at 6, 18 and 30 months. HbA1c levels increased by approximately 0.5 mmol/mol at 6 months. No essential differences were found in the total cholesterol levels. Conclusion: An OA exercise and education intervention designed following OA clinical practice guidelines led to small and unlikely clinically relevant improvements in metabolic health markers in individuals with OA and diabetes
Jumping and Landing Kinematics in Spanish Female Soccer Players: A Comparison Between Elite and Non-Elite Athletes
Get PDFLanding from a jump has been identified as a common situation of increased risk in sport and the tuck jump assessment (TJA) has been proposed for a comprehensive examination of landing mechanics. However, group-specific data on female athletes are limited. The purpose of this study was to examine the movement mechanics during a TJA in Spanish female soccer players and to explore potential differences between players of different performance levels. A total of 96 (elite and non-elite) female soccer players performed a TJA, and a rater visually graded the technique using the modified 10-item scoring system (0, 1, or 2 for “none”, “small”, or “large” flaws). Descriptive statistics were calculated. The association between the flaws and performance groups was assessed using the chi-square test. Almost 90% of all players involved were categorized with small and large flaws for the item “Lower extremity valgus at landing”. The proportion of players categorized with technical flaws was also high for “Foot contact timing not equal” (85%) and “Does not land in same footprint” (82%). Differences between elite and non-elite players were only found for “Foot placement not parallel” and “Excessive landing contact noise” (p < 0.008). These results reveal the importance of implementing training programs to reduce jumping and landing deficits in female soccer players, independently of the players’ level of performance
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