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Urgent appeal for expanded initiatives in gastric motility disorders across low and middle-income countries: Illustrating the example of gastroparesis
Get PDFThis paper provides a comprehensive exploration of the current state of gastroparesis management in low and middle-income countries (LMICs), emphasising recent innovations, persistent challenges, and future prospects. Gastroparesis, a condition characterised by delayed stomach emptying, presents debilitating symptoms and is notably linked to neuropathic disorders, including diabetes mellitus. Despite an apparent higher prevalence in LMICs compared to the global average, epidemiological data remains scarce. The paper highlights pioneering research in Pakistan, Brazil, and China, showcasing a transformative shift toward comprehensive studies that delve into nuanced aspects of gastroparesis epidemiology, gender-specific patterns, and innovative therapeutic approaches such as acupuncture. However, challenges impeding clinical management and research in LMICs are identified, encompassing the absence of extensive epidemiological studies, lack of treatment guidelines, and the scarcity of specialised training programs for healthcare professionals. These challenges are intertwined with broader issues such as limited healthcare infrastructure, resource disparities, and healthcare workforce shortages. The paper proposes a multifaceted approach for addressing these challenges, involving international collaboration, capacity building, and the integration of gastroparesis management into primary healthcare services. Strategies to combat brain drain, such as collaborative agreements akin to the UK-South Africa Memorandum of Understanding, are advocated
Is epistemic injustice a worthy application to mental health nurse education?
Get PDFThis paper explores the philosophical concept of epistemic injustice and contends its significance and relevance to mental health nurse education and clinical practice. The term epistemic injustice may be unfamiliar to mental health nurses, yet the effects are readily visible in the dismissing, silencing, and doubting of service users’ knowledge, testimony, and interpretation. Existing professional values and clinical standards lack depth and critical exploration pertaining to epistemology and associated ethical concerns. Despite central tenets of person-centred care and valuing the service users’ voice, epistemic injustice continues to occur. Epistemic injustice cannot be summed up merely by asking nurses to listen to service users. This represents an oversimplification of epistemology, ignoring the complexities of social influence and knowledge exchanges. Epistemic injustice brings something new and innovative to the nursing curriculum and fits within the principles of heutagogy. It encourages deep reflexivity surrounding the ethical issues of power inequalities and intersectionality. Inclusion in mental health nursing education allows for the social and political powers of psychiatric diagnosis as a form of silencing and stigma to be examined. Practical application is made to mental health nursing education and practice with epistemological values and ethical reflexive prompts. These can be utilised by educators and lecturers for pre-registration mental health nurse education, post-registration, and continued professional development
Implementing constraint induced movement therapy (CIMT) into practice in sub-acute stroke: experiences and perceptions of stroke survivors and therapists
Get PDFIntroduction:
Constraint-induced movement therapy has been shown to be effective in a sub-group of sub-acute stroke survivors but has not been widely implemented in the United Kingdom. This study explored therapist and stroke survivor perceptions and experiences of constraint-induced movement therapy and explored the non-agreement (incongruence) and agreement (congruence) of these perspectives.
Method:
Consenting occupational therapists (n = 3) and physiotherapist (n = 5) participated in a focus group discussion. Four-stroke survivors undertook pre- and post-constraint-induced movement therapy interviews. Stroke survivor participants selected and undertook an evidence-based constraint-induced movement therapy protocol. Focus groups and interview audio recordings were independently analysed thematically. Therapist and stroke survivor views were subsequently synthesised using meta-ethnographic principles.
Findings:
Four over-arching themes were identified: motivation and determination to participate in constraint-induced movement therapy; who benefits; which protocol; making constraint-induced movement therapy feasible. The final over-arching theme comprised five sub-themes: fatigue and sleep; pain; transport; need for support; training, support and mentorship for therapists. Stroke survivors and therapists held contrasting views on three themes.
Conclusion:
Participating stroke survivors successfully undertook a self-selected, evidence-based constraint-induced movement therapy protocol. The identified enablers and barriers should inform future constraint-induced movement therapy protocol development. The contrasting views held by therapists and stroke survivors reinforce the need for collaborative communication and opportunity for choice during constraint-induced movement therapy
Cu-MOF loaded chitosan based freeze-dried highly porous dressings with anti-biofilm and pro-angiogenic activities accelerated Pseudomonas aeruginosa infected wounds healing in rats
Get PDFMetal-organic frameworks (MOFs)-based therapy opens a new area for antibiotic-drug free infections treatment. In the present study, chitosan membranes (CS) loaded with two concentrations of copper-MOF 10 mg/20 ml (Cu-MOF10/CS) & 20 mg/20 ml (Cu-MOF20/CS) were prepared by a simple lyophilization procedure. FTIR spectra of Cu-MOF10/CS and Cu-MOF20/CS dressings confirmed absence of any undesirable chemical changes after loading Cu-MOF. The SEM images of the synthesized materials (CS, Cu-MOF10/CS & Cu-MOF20/CS) showed interconnected porous structures. Cytocompatibility of the materials was confirmed by fibroblasts cells culturing and the materials were hemocompatible, with blood clotting index <5 %. Cu-MOF20/CS showed comparatively higher effective antibacterial activity against the tested strains; E. coli (149.2 %), P. aeruginosa (165 %) S. aureus (117.8 %) and MRSA (142 %) as compared to Amikacin, CS and Cu-MOF10/CS membranes. Similarly, Cu-MOF20/CS dressing significantly eradicated the biofilms; P. aeruginosa (37 %) and MRSA (52 %) respectively. In full thickness infected wound rat model, on day 23, Cu-MOF10/CS and Cu-MOF20/CS promoted wound healing up to 87.7 % and 82 % respectively. H&E staining of wounded tissues treated with Cu-MOF10/CS & Cu-MOF20/CS demonstrated enhanced neovascularization and re-epithelization along-with reduced inflammation, while trichrome staining exhibited increased collagen deposition. Overall, this study declares Cu-MOFs loaded chitosan dressings a multifunctional platform for the healing of infected wounds. [Abstract copyright: Copyright © 2024 Elsevier B.V. All rights reserved.
Star Formation in the Milky Way and Beyond in the Era of JWST and ALMA
Get PDFStar formation is much studied, but not thoroughly understood. However, a new generation of instrumentation promises an explosion of delicious data. Kate Pattle and Derek Ward-Thompson report
Other Everests: One mountain, many worlds
Get PDFA hundred years after the tragic 1924 British Everest expedition, this collection explores the wider social and cultural history of the mountain.
Mount Everest looms large in the popular imagination. Since the deaths of mountaineers George Mallory and Andrew Irvine in 1924, histories of the mountain have overwhelmingly focused on the mythologies of western male adventure and conquest. But there are many more stories waiting to be told.
Other Everests brings together new voices and perspectives on the historical and cultural significance of Everest in the modern world. The book shines a light on the overlooked role of local people and high-altitude workers, while also revealing the significant contributions women have made to climbing the mountain and writing its history. It explores the depiction of Everest in a range of media and investigates how the forces of nationalism and commercialism have shaped many different 'Everests'.
After years of exploitation, Indigenous people are now reclaiming Mount Everest in the twenty-first century. Other Everests re-examines the past and present of the world's highest peak, presenting an exciting vision of what Everest might become in the future
Exploring MRR in Wire EDM of Titanium Grade 5: A Statistical Analysis
Get PDFThe present study delves into exploring how various parameters of the WEDM process influence the material removal rate (MRR) behavior of Titanium grade 5 alloy, employing Taguchi methodology. Four key process parameters, namely pulse on time (Ton), pulse off time (Toff), wire feed (WF), and gap voltage (V), each with three levels, are chosen to effective MRR. Utilizing the L9 orthogonal array (OA), the study examines the impact of these input parameters and their interactions. S/N ratio analysis is employed to pinpoint the optimal conditions for maximizing MRR within the experimental range. Analysis of variance (ANOVA) is conducted to assess the significance of the process parameters. Subsequently, a confirmation test is carried out to validate the efficacy of the chosen design. Results indicate that at the optimal condition, the S/N ratio of MRR has improved by 13.5% compared to the initial condition
TOWARDS A UNIFIED MODEL OF CYBERSECURITY LITERACY: BLENDING PEDAGOGICAL, PROFESSIONAL, CONCEPTUAL AND EMPIRICAL INSIGHTS
Get PDFRecent technological advances illuminate the perplexing nature of cybersecurity which prevails as a rapidly expanding scientific field and a growing social concern, alike. Despite the wide diffusion of mobile technologies and wireless Internet connectivity, fundamental challenges and gaps still exist in terms of end-users’ cybersecurity awareness, knowledge, skills, and behaviours. This study portrays a holistic understanding of cybersecurity literacy among non-experts, specifically in Wi-Fi contexts, by blending (i) innovative pedagogical approaches, (ii) professional cybersecurity frameworks, (iii) core cybersecurity knowledge areas and skills, and (iv) empirical insights gathered in the field from end-users, administrators of Wi-Fi networks, and cybersecurity experts. This four-tiered approach has informed the development of a unified model which can serve as a foundation for self-directed and personalised educational endeavours aiming to promote cybersecurity literacy among novice end-users
Optimizing the Steering of Driverless Personal Mobility Pods with a Novel Differential Harris Hawks Optimization Algorithm (DHHO) and Encoder Modeling
Get PDFThis paper aims to improve the steering performance of the Ackermann personal mobility scooter based on a new meta-heuristic optimization algorithm named Differential Harris Hawks Optimization (DHHO) and the modeling of the steering encoder. The steering response in the Ackermann mechanism is crucial for automated driving systems (ADS), especially in localization and path-planning phases. Various methods in the literature are used to control the steering, and meta-heuristic optimization algorithms have achieved prominent results. Harris Hawks optimization (HHO) algorithm is a recent algorithm that outperforms state-of-the-art algorithms in various optimization applications. However, it has yet to be applied to the steering control application. The research in this paper has been conducted in three stages. First, practical experiments were performed on the steering encoder sensor that measures the steering angle of the Landlex mobility scooter, and supervised learning was applied to model the results obtained for the steering control. Second, the DHHO algorithm is proposed by introducing mutation between hawks in the exploration phase instead of the Hawks perch technique, improving population diversity and reducing premature convergence. The simulation results on CEC2021 benchmark functions showed that the DHHO algorithm outperforms the HHO, PSO, BAS, and CMAES algorithms. The mean error of the DHHO is improved with a confidence level of 99.8047% and 91.6016% in the 10-dimension and 20-dimension problems, respectively, compared with the original HHO. Third, DHHO is implemented for interactive real-time PID tuning to control the steering of the Ackermann scooter. The practical transient
response results showed that the settling time is improved by 89.31% compared to the original response with no overshoot and steady-state error, proving the superior performance of the DHHO algorithm compared to the traditional control methods. The MATLAB source code and the result files for the proposed algorithm are available at https://github.com/MohamedRedaMu/DHHO
Experiences and impacts of psychological support following adverse neonatal experiences or perinatal loss: A qualitative analysis
Get PDFPoor parental mental health in the perinatal period has detrimental impacts on the lives and relationships of parents and their babies. Parents whose babies are born premature and/or sick and require neonatal care or those who experience perinatal loss are at increased risk of adverse mental health outcomes. In 2021 a North-West charity received funding to offer psychological support to service users of infants admitted to neonatal care or those who had experienced perinatal loss, named the Family Well-being Service (FWS). The FWS offered three different types of support – ad hoc support at the neonatal units or specialist clinics; one-to-one person-centred therapy or group counselling. Here we report the qualitative findings from an independent evaluation of the FWS