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The use of computer-aided design and manufacture for foot orthoses: a cross-sectional study of orthotic services in the UK
Get PDFObjective: This study aimed to identify how computer aided design and manufacture (CAD/CAM) technologies are currently being used for insole production by UK Orthotic services in the National Health Service (NHS), including any variation in the specific processes and identify barriers to implementation.
Design: A cross-sectional study was undertaken using freedom of information requests sent to all 214 NHS Trusts and Health Boards (HB) across the UK. The request comprised 22 questions relating to CAD/CAM for insole production by UK NHS Orthotic services during the 2021/22 financial year.
Outcome measures: Analysis was undertaken and presented in terms of response rate to individual questions. Where free text responses were provided, thematic analysis was conducted.
Results: Responses were received from 186 (86.9%) Trusts/HBs, those who did not have an orthotic service were excluded, and 131 responses were included in the final analysis. 70.5% (91/129) of Trusts/HBs used CAD/CAM to manufacture bespoke insoles. The most common workflow associated with CAD/CAM insole production was foot-shape capture with a foam-box impression cast (86.8% (79/91)); casts transported to another site (90.8% (79/87)); foam-boxes scanned into a CAD/CAM system (81.6% (71/87)); insoles designed by a technician (73.6% (67/91)) and insole produced with reduction milling (59.1% (SD 37.92)). The greatest barriers to the use of CAD/CAM were those of equipment costs and staff experience and training.
Conclusions: UK orthotic services have widely adopted CAD/CAM insole production, but fully-digital workflow is uncommon. Hybrid-digital workflow involves physical casts and their transportation, generating waste and impacting sustainability. Further research is required to understand how hybrid-digital and fully-digital workflow affect patient treatment outcomes, costs and sustainability. Barriers to CAD/CAM including costs and staff training which should be considered alongside the growing body of research around CAD/CAM technologies
Influence of Acute and Chronic Therapeutic Cooling on Cognitive Performance and Well-being
Get PDFPurpose
Research regarding the effect cold-water immersion (CWI) has on cognitive performance often uses excessive cooling protocols (>1-hour) to measure the detrimental impact prolonged cold exposure has on cognition. Previous studies have not considered shorter CWI protocols, similar to that used in recovery and wellness practices (∼10 min).
Aims
To investigate a more ecologically valid CWI protocol on cognition, well-being and sleep in an acute and chronic manner. It was hypothesised that a therapeutic CWI protocol would improve well-being, and sleep and have no detrimental effect on cognition.
Methods
Thirteen healthy participants (20.85±2.15 years), (169.96±7.77 cm), (72.03±14.92 kg), (27.67±9.55 BF%) volunteered to complete a 4-week CWI protocol. Participants were immersed in cold water (10.42±0.59°C) 3-times a week for 4-weeks. Cognitive performance (Stroop & TMT), well-being (WEMWBS, PSWQ, GAD-7, SHS) and sleep (PSQI) were measured acutely and chronically over the 4-week protocol along with thermoregulatory measures (Tsk, Tco, thermal comfort).
Results
Results show that CWI had no detrimental impact on cognitive performance, with Stroop performance & well-being seeing no differences acutely or chronically. Alternatively, the trail making test showed significant improvement from baseline (TMT-A 15.17±4.81-seconds, TMT-B 39.68±15.12-seconds) to week-3 (TMT-A 11.06±3.29-seconds, TMT-B 26.18±10.23-seconds). A reduction in sleep disturbances was seen from baseline scores of 7.85±3.44 AU to the end of week-3 measures 5.75±3.77 AU.
Conclusion
Therapeutic cooling can improve sleep quality when utilised in short frequent doses (3 times per week, for 4-weeks) and is not detrimental to cognitive performance, improving certain aspects of executive function
Barriers and facilitators to cycling to school for children in the UK: A systematic review.
Get PDFThe benefits of cycling as a means of active transport are well known and there is recent UK Government interest in promoting cycling. Few children in the UK cycle to school and little research has explored the factors that affect this. This systematic review aimed to identify the barriers and facilitators for children cycling to school in the UK.
We searched seven electronic databases and grey literature for sources, from 2010 onwards. In total 16 papers/articles were included. The capabilities approach (CA) was used as a framework for analysis to identify personal, social, and environmental barriers and facilitators. Personal barriers and facilitators centred around gender and age, but also related to concerns about safety or confidence. Social barriers and facilitators related to parental attitudes and wider social norms. Environmental barriers included distance, infrastructure, and deprivation. Using the CA revealed the complex interweaving of factors that must be addressed by interventions seeking to promote children’s cycling to school. For example, parental fears about children’s safety when cycling are linked to prevailing social norms and to local cycling infrastructure. Local authorities can promote cycling by developing well-connected accessible and safe cycle routes, but this alone is likely to be insufficient. Schools can enhance personal, social, and environmental conversion factors by developing and implementing active transport plans, increasing children’s personal competences, reassuring parental fears, and providing secure storage and changing facilities. Further research exploring how barriers can be addressed, together with local and national policies and targeted funding which focus on facilitation
of cycling to school are warranted
Constructing non-hegemonic entrepreneurial masculinity: the case of Black men doing entrepreneurship in a predominantly white context
Get PDFPurpose – The literature on entrepreneurial masculinity has primarily focused on how hegemonic masculinity is constructed and performed in entrepreneurship. Little is known about how non-hegemonic masculinity is performed by male entrepreneurs who do not fit the dominant and traditional form of masculinity in a specific context. Focusing on a cohort of Black male entrepreneurs who practised entrepreneurship in a predominantly white context, this paper explores how non-hegemonic entrepreneurial masculinity is constructed.
Design/methodology/approach – The study uses Interpretative Phenomenological Analysis (IPA) to analyse qualitative data collected through semi-structured interviews with nine Black male entrepreneurs living and doing business in the Northeast of England.
Findings – The study found that Black male entrepreneurs construct a distinct form of entrepreneurial masculinity by leveraging the identity of White women to construct a respectable entrepreneurial masculinity. The form of masculinity the men engaged in is theorised as transactional masculinity. This is enacted through relationships with White women which is seen as a symbol of respect and social acceptance, and as a “rite of passage” in entrepreneurship. The study presents a model of entrepreneurial masculinity to explain how transactional masculinity is constructed in relation to femininity and other forms of masculinity.
Originality/value – The study theorises how non-hegemonic entrepreneurial masculinity is enacted through the concept of transactional masculinity. It presents a model of entrepreneurial masculinity and gives voice to the experiences of male entrepreneurial actors with non-hegemonic masculinity
The Value of Whole‐Face Procedures for the Construction and Naming of Identifiable Likenesses for Recall‐Based Methods of Facial‐Composite Construction
No full textTraditional methods of facial-composite construction rely on a witness recalling features of an offender’s face. We assess the value of (1) the addition of a trait-recall mnemonic to a Cognitive-type Interview, and (2) perceptually stretching presented composites, to aid image recognition. Participant-constructors intentionally or incidentally encoded a target face, were interviewed about its facial features 3-4 hours or 2 days later, made a series of trait attributions (or not) about the face and constructed a feature-based composite. Regardless of encoding manipulation, faces constructed after 3-4 hours were twice as likely to be correctly named (cf. after two days) both when the trait-recall mnemonic was applied and composites were viewed stretched. Thus, the research indicates that benefit should be afforded when trait-recall mnemonics are employed for feature composites constructed on the same day as the crime, and composites are presented to potential recognisers with an instruction to view the face side-on
Tidally distorted stars are triaxial pulsators
Get PDFStars in close binaries are tidally distorted, and this has a strong effect on their pulsation modes. We compute the mode frequencies and geometries of tidally distorted stars using perturbation theory, accounting for the effects of the Coriolis force and the coupling between different azimuthal orders m of a multiplet induced by the tidal distortion. For tidally coupled dipole pressure modes, the tidal coupling dominates over the Coriolis force and the resulting pulsations are ``triaxial", with each of the three modes in a multiplet ``tidally tilted" to be aligned with the one of the three principal axes of the star. The observed amplitudes and phases of the dipole modes aligned orthogonal to the spin axis are modulated throughout the orbit, producing doublets in the power spectrum that are spaced by exactly twice the orbital frequency. Quadrupole modes have similar but slightly more complex behavior. This amplitude modulation allows for mode identification which can potentially enable detailed asteroseismic analyses of tidally tilted pulsators. Pressure modes should exhibit this behavior in stellar binaries close enough to be tidally synchronized, while gravity modes should remain aligned with the star's spin axis. We discuss applications to various types of pulsating stars, and the relationship between tidal tilting of pulsations and the ``single-sided" pulsations sometimes observed in very tidally distorted stars
Understanding how Physical Education can be taught effectively to d/Deaf pupils in mainstream settings: an ethnographic study.
No full textResearch highlights d/Deaf pupils frequently experience isolation and exclusion in mainstream Physical Education (PE) (Reich & Lavay, 2009; Tanure Alves, de Souza, Grenier & Lieberman, 2021). However, research on d/Deaf pupils’ experiences of mainstream PE is sparse (Reich & Lavay, 2009; Tanure Alves et al., 2021; Maher & Haegele, 2022) and lacks d/Deaf pupils’ perspectives (with the exemption of Tanure Alves et al., 2021). Additionally, research more broadly investigating PE teacher effectiveness has neglected teaching pupils with SEND, particularly d/Deaf pupils. More specifically, whilst papers have proposed PE teaching strategies for educating d/Deaf pupils, their effectiveness is unknown (Barboza, Ramos, Abreu & Castro, 2019; Maher & Haegele, 2022). To address this gap in knowledge, this study investigates how d/Deaf pupils can be taught effectively in mainstream PE at ‘Buttermere Primary School’ in England.
Utilising an ethnographic approach, the study employed various research methods including participant observation, analysis of school documentation, semi-structured interviews, informal/ formal conversations, narrative inquiry and drawing elicitation. Drawing upon theories from cultural studies, Deaf Studies and the work of Bourdieu this thesis offers new insight to PE literature investigating d/Deaf pupils’ education. Data was analysed utilising abductive reflexive thematic analysis. Findings revealed that an accessible and inclusive PE environment where all pupils could fulfil their potential was strongly connected to outcomes of effective teaching. To uncover how to achieve outcomes of effective teaching, the study identified teaching strategies for educating d/Deaf pupils, appropriate considerations to accompany them and their perceived effectiveness from stakeholders’ perspectives. Findings emphasised the necessity of challenging hegemonic phonocentrism to establish an inclusive PE environment. Also, collaborative working between mainstream teachers and DRB staff was identified as vital to ensure that d/Deaf pupils’ needs were appropriately supported to facilitate their inclusion and development in PE. Finally, this study identified social interactions and relationships between d/Deaf pupils, mainstream teachers, DRB staff and hearing peers as a key determinant of a positive PE experience for d/Deaf pupils. Despite discovering some positive social interactions and friendships between d/Deaf and hearing pupils, most d/Deaf pupils reported feeling isolated in mainstream PE. Taken together, this study’s findings share good practice across the PE field and highlight necessary improvements to enhance mainstream PE for d/Deaf pupils
Methods of assessment of zinc status in humans: an updated review and meta-analysis
Get PDFBackground: The assessment of zinc status is difficult, but vitally important for the identification of zinc deficiency and evaluation of interventions to improve zinc status. Objective: The purpose of this systematic review (SR) and meta-analysis was to update the previously published SR of biomarkers of zinc status, conducted by the European Micronutrient Recommendations Aligned (EURRECA) network in 2009, to answer the question: which putative measures (biomarkers) of zinc status appropriately reflect a change in zinc intake over a period of at least two weeks.
Methods: A structured search strategy was used to identify articles published between January 2007 and September 2022 from MEDLINE (OVID), Embase (OVID), Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials (CENTRAL). Relevant articles were identified using previously defined eligibility criteria. Data were extracted and combined with data from the previous SR. A random-effect model was used to calculate pooled mean differences using STATA. The risk of bias and the certainty of evidence for all outcomes were assessed.
Results: Additional data on 7 of the 32 previously reported biomarkers were identified, along with data on an additional 40 putative biomarkers from studies published since 2007. Pooled data analysis confirmed that in healthy participants, both plasma/serum zinc concentration, and urinary zinc excretion responded to changes in zinc intake [plasma/serum: mean effect, (95% CI), controlled studies: 2.17 µmol/L (1.73, 2.61), p<0.005, I2 =97.8; before and after studies: 2.87 µmol/L (2.45, 3.30), p <0.005, I2=98.1%; urine zinc: 0.39 mmol/mol creatinine (0.17, 0.62), p<0.005, I2= 81.2; 3.09 µmol/d (0.16, 6.02), p=0.039, I2= 94.3].
Conclusions: The updated analyses support the conclusion that plasma/serum and urinary zinc respond to changes in zinc intake in studies of healthy participants. Several additional putative biomarkers were identified, but more studies are needed to assess the sensitivity and reliability
Developing a Joint Master’s Degree Programme in Agroecosystem Resilience for Sri Lanka
No full textThis chapter details, analyses, and reflects upon the development of a joint master’s degree programme in agroecosystem resilience. The aim of the programme was to increase understanding of food security, awareness of climate change impacts, and increase sustainable approaches to agriculture in the host country and wider area. Led by universities in Sri Lanka, in partnership with institutions from Estonia, Lithuania, and the United Kingdom, the work created a course based on established methods, best practice, national policy and local needs. Comprising four different stages, and methods, of research, the process of identifying and refining the individual elements of the programme is examined in depth. This research occurred during a period of dramatic change in the Sri Lankan government’s agricultural strategy. The challenges, and opportunities, afforded by this, diverse institutional research bases, regional variations, and the impact of Covid-19 lockdown are discussed
The impact of patients and student mental health nurses sharing time together in forensic units
Get PDFStudent mental health nurses have greater patient contact than registered nurses, and this is appreciated by patients. This phenomenological study explored the impact of patients and student mental health nurses’ time shared on forensic units for men carrying a personality disorder diagnosis. Phenomenology was the underpinning philosophy of this research. Patients and student mental health nurses in forensic hospitals participated in unstructured hermeneutic interviews. The time students and patients shared together was considered a gift, enabling them to feel that they were ‘just people’ and valued, strongly impacting on their sense of person. The impact the students have on patients’ quality of life is meaningful. When the students and patients connected, it had powerful implications for their sense of humanness and value, highlighting the reciprocal impact they each have on another and the importance of having student nurse clinical placements in forensic wards and facilities.
Implications for Clinical Forensic Nursing Practice: This article offers a unique contribution to forensic practice by exploring the experiences of the time patients and students share together in forensic units. Students, who often have the greatest contact with patients, represent the present and future of nursing, and their time is appreciated by patients. Previous research focuses on attitudes and therapeutic relationships, rather than the impact of shared contact. In addition to this, patients in forensic services with personality disorder diagnoses can be the most stigmatised group in mental health care and exploration of their experiences is lacking. These experiences must be shared