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UK healthcare professionals’ experiences and perceptions of the support needs of men with breast cancer and their informal carers
Get PDFIntroduction: This study aimed to explore UK healthcare professionals’ perspectives on support for male breast cancer patients and their informal carers, and to identify avenues for improvement. Methods: UK-based HCPs involved in the care of breast cancer patients (men and/or women) were invited to complete an online survey about their experiences of explaining diagnoses and treatment, perceptions of current support and areas for improvement. Data were analysed using descriptive statistics and qualitative content analysis. Results: Respondents (N = 62) reported providing a variety of resources and sources of practical and emotional support, but 81% found existing resources inappropriate and insufficient. Recommendations included increased availability of male-specific breast cancer information and support, and training for healthcare professionals working in this field. Conclusion: Increased psychosocial support and enhanced, gender-appropriate resources are crucial for supporting male breast cancer patients and their informal carers and reducing isolation. Healthcare professionals need access to training on this topic
Analysing mobility and environmental impacts of automated ride-sharing services under mixed traffic
Get PDFShared Automated Vehicles (SAVs) hold great promise for the future of urban mobility. Automated ride-sharing services are expected to alleviate traffic congestion, reduce traffic emissions, and significantly improve road safety by combining advanced connected and autonomous vehicle (CAV) technology with the ride and/or car-sharing concept. These benefits, however, are highly dependent on the deployment concept of the service and environment including network characteristics, CAV technology, traffic compositions, population acceptance, etc. This study aims to assess the mobility and environmental impacts of introducing a door-to-door automated ride-sharing (ARS) service under different deployment scenarios. Two calibrated and validated city-scale networks with different characteristics were used: a suburban area in the Greater Manchester (UK) and a city-centre area in Leicester (UK). An optimisation technique for the vehicle routing problem was developed to efficiently operate ARS at a network-level. The customers' preference for individual and shared rides with Willingness to Share (WTS) was investigated to gain a better understanding of the performance indicators (i.e., delay, travel time, speed, kilometres-driven and emissions) The introduction of ARS was investigated under two deployment scenarios: 1) mixed with conventional human-driven vehicles (HDVs) and 2) mixed with HDVs with varying CAV market penetration rates. Findings suggest that introducing ARS can adversely impact mobility and the environment under mixed traffic, especially in suburban areas, and the benefits of an automated ride-sharing system are highly dependent on WTS. The findings will assist local authorities in formulating automated ride-sharing policies to manage the traffic on roads
Uncertainty quantification of dynamic response in wind turbines with a geometric nonlinear tuned mass-damper-inerter
Get PDFThis paper investigates the dynamic response of a monopile wind turbine equipped with a geometric nonlinear tuned mass-damper-inerter (NTMDI) under parametric uncertainties. Several probability distributions, including normal, uniform, and Rayleigh, are used to describe uncertainties in structural stiffness, damping, and wind intensity. Polynomial chaos expansion is employed for uncertainty quantification, offering a computationally efficient alternative to Monte Carlo simulations while maintaining comparable accuracy. The results show that damping uncertainties have minimal impact on the dynamic response, whereas stiffness uncertainties primarily affect the performance in the low-frequency range and resonance regions, with high-frequency responses being more predictable and less sensitive to variation. Wind load uncertainty exhibits a considerable influence across the entire frequency spectrum. In non-resonance regions with a single uncertain parameter, the system response mirrors the distribution of the uncertain input, while in resonance regions, amplified polynomial-type nonlinearity causes deviations from this pattern. When multiple uncertainties are considered, the wind load distribution plays a dominant role in non-resonance regions, and response variability is more sensitive at the first natural frequency than the second. The NTMDI-equipped wind turbine demonstrates enhanced dynamic performance compared to conventional TMDs, particularly in reducing resonant peak amplitudes. However, the compounded effects of nonlinearity and uncertainties in resonance regions make the system highly sensitive to variations in structural properties and environmental conditions. This suggests a need for refinement of the approach for large-scale applications with high-dimensional uncertainties. These findings highlight the critical importance of uncertainty quantification in the design and optimization of wind turbines
Spillover effects in the banking sector of emerging economies: A South Africa case study
Get PDFThis article aims to identify the presence of knowledge transfer and spillover effects and investigate the mechanism in which they materialise through efficiency and performance gained resulting from two foreign banks' majority and minority ownership in the South African (SA) banking sector. To achieve these objectives, performance and efficiency indicators of ABSA and the Standard Bank are collected and computed using the t-statistics model. The results are analysed in light of interview outputs with several SA banking actors. The findings suggest that not only these two banks became more efficient after foreign participation in their ownership structure, but also the level of knowledge transfer depends on the type of ownership. In addition, the emergence of Capitec bank, a relatively new player in the SA banking sector contributed to the competition effect in the segment of retail-banking whereas the new entity Barclays/ABSA, a majority FDI, became a catalyst to competition effect in the segment of investment banking
Gaining prescription rights: A qualitative survey mapping the views of UK counselling and clinical psychologists
Get PDFObjective: The British Psychological Society (BPS) has been exploring whether its practitioner members are interested in gaining prescription rights for psychiatric drugs and what such a privilege might look like. This qualitative study aimed to survey the views of UK-based, qualified counselling and clinical psychologists. Method: Qualitative data was collected from 82 participants via an online survey (37 counselling and 45 clinical psychologists). Along with the survey items, the last question asked participants to select one of three answers (yes/no/unsure) in relation to whether they supported prescription rights for psychologists. The qualitative data was analysed using thematic analysis, from a critical realist perspective, to develop 3 themes. Results: Theme 1 explores how psychologists grapple with their professional identity within structures dominated by the medical model of distress, and constructions of the prescription rights debate as a crossroads for both discipline and profession. Theme 2 explores participants’ assumptions about psychiatric drugs as they seem to serve as a springboard to their views on prescription rights. Theme 3 examines the belief that gaining prescription rights will result in increased status and power for psychologists and what might be gained or lost as a result. Regarding the final question: 18 participants answered yes; 42 no; and 22 were unsure. Conclusion: We advocate for increased criticality in how UK psychology continues to consider this issue. We caution against an optionality approach that might risk obscuring wider implications for psychology beyond the preferences of individual practitioners
Prospective real world data evaluation of clinical outcomes in metastatic hormone sensitive prostate cancer (MHSPC) patients treated as part of triplet therapy with darolutamide: UK multicenter RECOMMEND study
No full text89 Background: Darolutamide has authorisation for treatment of metastatic hormone sensitive prostate cancer (MHSPC) in combination with docetaxel chemotherapy and androgen deprivation therapy (triplet therapy) based on ARASENS trial results. The RECOMMEND study is a prospective real-world evaluation (RWE) of clinical outcomes in patients with MHSPC treated with this regimen in the UK. Methods: 318 patients were enrolled from 21 UK centres over 20 months from November 2022. Data cut-off was 14 August 2024. Disease characteristics were evaluated. Descriptive statistics have been used for patient demographics and PSA changes with treatment were analysed. Results: Patients on the study had a median age of 67 (range 38-84) years. Majority of the patients were de novo metastatic (91.2%). 68.2% have a Gleason score ≥8. 76 patients (23.9%) had next generation imaging (NGI) at diagnosis. Performance score was 0 (62.7%) or 1 (37.3%). The distribution of metastases (%) were: bone (84.9), nodal (60.4), lung (12.6) and liver (2.5). The median PSA level was 134 (range 1 to 5628) ng/mL at diagnosis. At the end of docetaxel chemotherapy median PSA was 0.35 ng/mL. PSA response see in the 226 patients who had completed 6 cycles of docetaxel chemotherapy at the data cut-off, PSA 50 was seen in 87.6% (198/226) and PSA 90 in 53.2%. PSA responses in those who only completed 4/5 cycles of docetaxel (n=14) did not significantly differ compared to those who completed all 6 cycles (PSA 50 p=0.445 and PSA 90 p-0.664). At 6 months from darolutamide initiation, quality of life (QoL) data is currently available for 173 patients, of these 88.4% reported either stable or improved QoL and 11.6% had a decline in QoL at the end of chemotherapy. Conclusions: The tolerability and efficacy profile of treatment with ADT+Darolutamide+Docetaxel in MHSPC in the RECOmMEnD study is similar to that reported in the ARASENS trial. The QoL data available for 173 patients to date reports either stable or improved QoL at 6 months for 88.4% cases. This provides important prospective RWE data, enabling patients and clinical teams to make informed choices in this setting
Re-routing game: The inadequacy of mean-field approach in modeling the herd behavior in path switching
No full textCoordination of vehicle routes is a feasible way to ease traffic congestion issues amid a fixed road infrastructure. Nevertheless, even when optimal route configurations are provided to individual drivers, it is hard to achieve due to the fact that greedy drivers may switch to other routes to lower individual costs. Recent research uses a mean-field cavity approach from spin glass studies to analyze the impact of path switching in optimized transportation networks. However, this method only provides a mean-field approximation, which does not account for the collective herd behavior in path switching due to uncoordinated individual decisions. In this study, we propose an exhaustive cavity approach to investigate the impact of uncoordinated path switching in a re-routing game and reveal that greedy drivers’ decisions can be highly correlated, leading to the failure of mean-field approaches. Our theoretical results fit well with simulations, and our developed framework can be generalized to analyze other games with multiple players and rounds. Our results shed light on the impact of herd behavior among uncoordinated human drivers in suppressing congestion through path coordination
BIM, IoT, and GIS integration in construction resource monitoring
Get PDFIn recent years, the advancement of digital technologies such as building information modeling (BIM), internet of things (IoT), and geographic information system (GIS) has had many impacts on the construction industry. However, limited research has been conducted on the integration of BIM, IoT, and GIS technologies, especially in construction resource monitoring. Therefore, this paper presents a state-of-the-art review of BIM, IoT, and GIS integration by focusing on their applications, challenges, research gaps, and future research directions. A systematic literature review and science mapping analysis were adopted in this study. The results identified the gaps in BIM, IoT, and GIS integration in construction resource monitoring, which include interoperability, data security, real-time dynamic monitoring, complex environmental data processing, environmental sustainability studies, prediction models, and convenience for the users. Moreover, challenges and future research directions were proposed. This paper contributes to extending the integrated applications of digital technologies in construction resource monitoring
Evaluating the interaction between human and paediatric robotic lower-limb exoskeleton: A model-based method
Get PDFLower-limb exoskeletons (LLEs) have shown potential in improving motor function in patients for both clinical rehabilitation and daily life. Despite this, the development and control of pediatric exoskeletons remain notably underserved. This study focuses on a unique pediatric robotic lower limb exoskeleton (PRLLE), tailored particularly for children aged 8–12. Each leg of the robot has 5 Degrees of Freedom (DOFs)—three at the hip and one each at the knee and ankle. The interaction between the child user and the PRLLE is intricate, necessitating adherence to essential requirements of comfort, safety, and adaptability. Testing numerous prototype variations against diverse user profiles, particularly for children with neurological disorders where each child differs, is impractical. Model-based methods offer a virtual testbed that is useful in the design stage. This study uses MATLAB® to simulate and evaluate the interaction between users and PRLLE after deriving the nonlinear dynamic model of the PRLLE, which is simplified through multiple layers. To verify the accuracy of the derived dynamic model, a Computed Torque Control method is employed. The study provides detailed outcomes for children aged 8, 10, and 12 years, for passive and active users along with variations in PRLLE assistance levels. The study shows significant reductions in human joint torques, up to 56%, alongside substantial actuator powers, reaching up to 98W, for a 10-year-old child user. Furthermore, examining 8 and 12-year-old child users revealed variations in interaction forces, with changes up to 29.5%. Consequently, meticulous consideration of the human user’s limitations is crucial during the PRLLE’s design and conceptualization phases, particularly for PRLLEs
Sexual health, pleasure, justice, and well-being in people with rheumatic and musculoskeletal diseases: A scoping review protocol
Get PDFIntroductionSexual health, pleasure, justice (equity in sexual rights and experiences), and well-being are crucial determinants of health and life quality, yet often overlooked in the rheumatic and musculoskeletal diseases (RMD) field. However, this topic has received more attention recently, and there is a need to map the current literature to inform the direction of future studies. Hence, this protocol outlines a scoping review to systematically map existing evidence on sexual health in people with RMD, exploring key themes and identifying evidence gaps across multiple dimensions, including sexual well-being, justice and pleasure.Method and AnalysisThis scoping review will follow the methodological guidance of the Joanna Briggs Institute and be reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews. The search strategy will involve PubMed, Embase, Cochrane Central, CINAHL, PsychInfo, LGBTQIA+ Source, Web of Science, and the grey literature. Identified articles will be reviewed based on the eligibility criteria. The results will be narratively synthesised and aligned with the framework proposed by Mitchel et al. (2021), identifying four pillars of comprehensive public health for sexuality: ‘Sexual Health’, ‘Sexual Pleasure’, ‘Sexual Justice’, and ‘Sexual Well-Being’.DisseminationThe scoping review will synthesise the scientific literature published on sexual health, pleasure, justice and well-being in people with RMD. This review will provide an understanding of how sexual health is addressed in the literature to inform future research and clinical practices. The findings will be disseminated as research publications, including peer-reviewed article(s), conference abstract(s)/presentation(s), and plain language summaries