30796 research outputs found
Sort by
Balancing purity, pragmatism and partnership in occupational therapy clinical research: trials and tribulations of recruiting for a multisite stroke trial
Get PDFPurposeThe REfLECTS trial was a randomised controlled trial (RCT) testing effectiveness of mirror box therapy in upper limb rehabilitation among sub-acute stroke patients. REfLECTS was a large-scale, rigorously planned study; however, implementation was challenging due to low recruitment rates, 803 patients were screened and only 26 were recruited. The purpose of this study is to explore factors and challenges influencing the recruitment of participants to this multisite RCT.Design/methodology/approachA Communities of Practice (CoP) approach was used. Bi-monthly steering meetings were held to address recruitment issues and a focus group was conducted post-recruitment to identify influencing factors. Data from meeting minutes and the focus group were amalgamated and analysed using thematic analysis.FindingsThe trial team (n = 14) comprising academics (n = 5) and clinicians (n = 9) contributed to the steering meetings. The focus group (n = 9) included researchers (n = 5) and clinicians (n = 4). Two major themes were identified: impact of COVID-19, including shorter in-patient stays affecting trial recruitment and clinical trials (and tribulations) highlighting therapist-led dilemmas and patient-related factors leading to patients declining to participate.Research limitations/implicationsThe CoP identifies important contextual clinical service-based and therapist-led factors, which have pragmatic impacts on the design and implementation of high-quality occupational therapy clinical trials. High-quality occupational therapy evidence for stroke rehabilitation is essential, however, there is a need to critically reflect on how clinical research can best be implemented in clinical practice to ensure implementation and subsequent usability of findings. Provision of ongoing support for clinicians during trial implementation is essential to manage the therapist-led clinical dilemma.Originality/valueGood research helps us improve therapy, however, maintaining research purity in the pragmatic “real world” of stroke rehabilitation is challenging. Clinicians encounter ethical dilemmas with randomisation in high-quality clinical trial methodologies and this study identifies the need for ongoing trial implementation support to ensure clinician and patient engagement, enhance recruitment and maintain research integrity
Interventions to improve awareness and reduce the stigma associated with neurodegenerative conditions in minority ethnic communities: A scoping review protocol
Get PDFObjective: This scoping review aims to identify interventions aiming to improve awareness of and reduce stigma related to neurodegenerative conditions within South Asian and Black (African-Caribbean, African, African American, Black British) communities with a focus on synthesising the methods employed for culturally tailoring interventions. Introduction: Minority ethnic communities affected by neurodegenerative conditions often face health and social care disparities. This can lead to delayed diagnosis and poor health outcomes. Interventions that provide relevant, accessible information about neurodegenerative conditions may help reduce disparities in care access. There is limited knowledge about the methods used to culturally tailor interventions for minority ethnic communities and their efficacy. Inclusion criteria: Eligible sources will include interventions specifically tailored for South Asian and Black communities, living with dementia, Parkinson’s disease, Huntington’s disease, or motor neurone disease. Interventions must be conducted in countries that are member states of the Organisation for Economic Co-operation and Development where these two groups constitute minority populations and are likely to face inequalities in care access. Methods: A scoping review guided by the Joanna Briggs Institute Manual for Evidence Synthesis will be conducted. Searches of Medline (EBSCO), APA PsycInfo (EBSCO), and EMBASE (Elsevier) will be conducted. Study selection will be based on 100% agreement between two reviewers. Data will be extracted, charted, and summarised narratively followed by consultation with stakeholders. Implications: This review will identify culturally sensitive strategies for raising awareness and reducing the stigma associated with neurodegenerative conditions among South Asian and Black communities within the Organisation for Economic Co-operation and Development countries. By utilising these inclusive approaches, communities may feel more empowered to seek a diagnosis for symptoms and live better with the condition. The findings of this review will be shared with the public and policymakers to promote awareness and evidence-based policy making
Optimizing Single‐Cell Measurement Using Dynamic Atomic Force Microscopy
Get PDFAdvancements in atomic force microscopy (AFM) have established it as a versatile tool for imaging and characterizing biological samples, including living single cells in physiological conditions. Utilizing higher eigenmodes and harmonics of AFM microcantilevers offers enhanced sensitivity for measuring cells, tissues, and microorganisms. However, achieving accurate measurements in liquid environments poses challenges, particularly in detecting the cantilever's response. Optimizing the optical beam detection system is crucial to improving measurement sensitivity and image quality, especially when using higher‐order vibration modes. This study addresses these challenges by optimizing the optical detection sensitivity of microcantilevers in dynamic and high‐frequency AFM for single‐cell measurements. This study investigates the effect of laser positioning on the cantilever's dynamic response in liquid environments and its impact on imaging resolution. Advanced image analysis techniques, such as natural image quality evaluator, cross‐correlation, and sharpness, are employed to evaluate image quality. This approach provides insights and general guidelines for obtaining high‐resolution images as well as image analysis approaches of biological materials in physiological conditions
Real-Time Detection and Counting of Melted Spatter Particles During Deposition of Biomedical-Grade Co-Cr-Mo-4Ti Powder Using the Micro-Plasma Transferred Arc Additive Manufacturing Process
Get PDFSpatters in the powder-based metal additive manufacturing processes influence deposition quality, part surface quality, and internal defects. We developed a novel video analysis method to monitor and count the melted spatter particles of biomedical-grade Co-Cr-Mo-4Ti powder particles in depositing layers using a micro-plasma transferred arc additive manufacturing (M-PTAAM) process. We captured the spatters using a weld-monitoring camera and building datasets of videos and monitored different combinations of M-PTAAM process parameters. We captured videos of the melted spatter particles and counted the melted spatter particles in real time using a Kalman filter. The weld-monitoring camera captured the melted spatter particles and the fumes generated by the evaporated spatter particles. The video processing algorithm was developed in this study to accurately capture melted spatter particles. In images without fumes, nearly all melted spatter particles were successfully detected. Even in images with the presence of fumes, the algorithm maintained a detection accuracy of 90%. The real-time melted spatter count particle exhibited a powder feed rate changing from 30 to 35 g/min and then to 50 g/min. The melted spatter particle count was lowest at a powder feed rate of 30 g/min and increased with the increasing powder feed rate
Accessing and Using Data without Informed Consent: Guiding Principles from Conversation Analysis
Get PDFWe critically reflect on ethical challenges of making, accessing, and using audio/video recordings for social research in which participants have not and/or cannot provide informed consent. We distinguish between two types of data: recordings for which informed consent for use for research purposes would have been feasible but was not obtained, for example, “classic” or “legacy” data collected during the early development of Conversation Analysis; and recordings for which informed consent for use for research purposes was, or will be, impossible to secure, for example, when participants’ contact details are unavailable or seeking consent could pose risks to researchers or other participants. We propose a set of guiding principles for the collection, access, and use of audio/video data for which participants’ consent for use for research purposes is absent
Trends in psychotropic medication across occupation types before and during the Covid-19 pandemic: a linked administrative data study
Get PDFPurposeUsing linked administrative data, this study provides the first longitudinal analysis of mental health among workers across occupational groups prior to and during the Covid-19 pandemic. Eleven years of data were analysed to examinewhether the pandemic period coincided with changes in psychotropic medication for workers across broad occupationalgroupings.MethodsData from Northern Ireland (NI) Enhanced Prescribing Database (EPD) was linked with NI Longitudinal Study(NILS) to examine trends in anti-depressants, anxiolytics and hypnotics (2011–2021) among NI workers (N=200,004)across nine major occupation groups. Quarterly prescriptions were examined prior to and during pandemic restrictions (Q1-2011 to Q4-2019; and Q1-2020 to Q4-2021, respectively). Auto-regressive integrated moving average (ARIMA) modelswere trained to compare ‘forecasted’ and ‘observed’ rates during the pandemic period, stratified by occupational group.ResultsQ2-2020 coincided with lower-than-expected receipt of anxiolytics and anti-depressants for several broad occupation types. Receipt of anxiolytic prescriptions among managers, directors/senior officials dropped below expected levels forthe three quarters from Q3-2020 to Q1-2021. Finally, a notable increase in anti-depressants for a prolonged period was foundamong staff in caring/leisure and related professions, as well as higher rates of hypnotics in Q2-2021.ConclusionOur study provides the first longitudinal examination of variation in mental health across occupation types priorto and during the Covid-19 pandemic, using available linked administrative data. Findings suggest that occupation type wasan important pandemic-related stressor and point to potential higher risk occupations that could be the focus of targetedinterventions in future pandemics
Assessing the Impact of Nutrition Workshops on Nutrition Knowledge, Attitudes, and Practices (KAP) in Uttarakhand
Get PDFThis study evaluates the impact of a nutrition education intervention on the knowledge, attitudes, and practices (KAP) of individuals in Uttarakhand, India. It involved key community stakeholders, including Aanganwadi workers (AWWs), members of the Nari Ekta Federation, Accredited Social Health Activists (ASHAs), and Gram Pradhans. The intervention included two rounds of workshops and poster distributions aimed at increasing nutrition awareness. Each round had workshops for frontline health workers and Federation members, focusing on the benefits of traditional foods for pregnant and lactating mothers, children, and the general population. Materials emphasized grains, pulses, nuts, seeds, and vegetables and assessed KAP changes pre- and post-intervention. Findings indicated increased knowledge and improved attitudes towards traditional food consumption, demonstrating the effectiveness of combining workshops with visual aids. Further research is needed to assess long-term health impacts in the community. This study aims to assess the impact of a nutrition education intervention on the KAP of individuals living in the mountainous region of Uttarakhand, India
“ We need more guidance, more encouragement and empowerment for what our bodies are capable of ”, pregnant and postpartum women’s knowledge and experiences of receiving physical activity guidance and support on the island of Ireland: an online survey study
Get PDFBackground: Physical activity (PA) during pregnancy provides maternal and foetal health benefits such as improving mental wellbeing, cardiometabolic and delivery outcomes. However, little is known about pregnant and postpartum individuals’ PA knowledge or guidance and support received during maternity care on the island of Ireland. This study aimed to assess knowledge of PA guidelines and explore experiences of receiving PA guidance and support during maternity care. Methods: Pregnant (≥ 8 weeks gestation, post-initial maternity appointment) or postpartum (birthed and received maternity care within three years previous) adults who received antenatal care on the island of Ireland completed an online survey. Descriptive analysis and frequencies were performed with the principles of thematic analysis applied to the concluding open-text question. Results: Of the 430 women surveyed only 7% (n = 30) correctly stated the PA guidelines for pregnancy and postpartum. 28% (n = 120) received PA advice from a healthcare practitioner (HCP) during maternity care. Overall, few felt timely (24%, n = 103) or clear and easy to follow (25%, n = 107) advice was received. 22% (n = 96) felt confident in the advice received and only 17% (n = 74) felt supported to engage in PA. Two themes and seven subthemes relating to women’s experiences of PA guidance and support during pregnancy and future needs were generated. Using study findings, five actionable steps were created. Conclusions: 93% of women surveyed could not accurately state the PA guidelines for pregnancy and postpartum. Largely, maternity care delivered on the island of Ireland does not include PA guidance or support. Recommendations are proposed to improve PA guidance and support provided during pregnancy and following childbirth on the island of Ireland
Energy decarbonisation of wastewater treatment plants in Murcia- case study
Get PDFEnergy is a critical input for wastewater treatment plants (WWTPs) and a major source of greenhouse gasemissions. In the Region of Murcia, Spain, where precipitation is low and water resources are limited, a significant portion of treated wastewater is reused for agricultural irrigation. This necessitates advanced levels oftreatment, which are highly energy intensive. According to ISO 50001 guidelines on Energy Management Systems, it is essential for organisations to identify energy-intensive processes, reduce energy wastage, andimplement energy-efficient technologies to improve overall energy performance. In line with this, the currentstudy conducts an energy assessment of two WWTPs, Molina de Segura and Alcantarilla. This assessment,referred to as a Low-Carbon Polygeneration System (LCPS) analysis, includes (i) Evaluation of energy consumption and associated emissions, (ii) Identification of energy-intensive treatment stages and equipment, (iii)Assessment of renewable energy generation from sector-specific sources (e.g., hydropower from wastewater flowand biogas from sludge via anaerobic digestion), and (iv) Evaluation of non-sector-specific renewable energysources such as solar PV.The study further evaluates the techno-economic and environmental feasibility of these decarbonisationstrategies through multiple scenarios that reflect both current and projected future conditions. Solar PV is aviable option for energy generation, whereas hydropower technology remains limited due to the low hydraulichead (less than 1 m). The high investment cost of battery storage also restricts its use for energy storage. Thesechallenges could be mitigated by offering incentives, such as renewable energy subsidies to WWTPs
Equitable Healthcare Access for Type 2 Diabetes Patients Under a Low-Income Group Health Care Scheme: A Sustainable Development Goal Perspective
Get PDFObjective: The purpose of this study is to explore the factors influencing access to healthcare services among Type 2 Diabetes Mellitus (T2DM) patients enrolled in the PEKA B40 programme at a public health clinic in Melaka, Malaysia. It aims to examine how key dimensions—availability, accessibility, accommodation, and acceptance—affect patients’ experiences and the utilisation of diabetes-related healthcare services. This study also seeks to identify gaps and challenges within the current healthcare delivery system, particularly for low-income populations, to inform strategies for improving equitable and sustainable access to care. Methods: This study was conducted in a public health clinic in Melaka, Malaysia. Purposive sampling was used among T2DM patients under the “Health Care Scheme for Group B40” programme in a public health clinic in Melaka, Malaysia. The study included participants with at least a 6-month history of T2DM to ensure substantial experience in accessing healthcare services. Results: Fifteen patients participated in this study. Elderly individuals, retirees, and those with average incomes demonstrated higher healthcare service utilisation. Ethnic diversity was crucial, revealing its impact on health behaviours and healthcare-seeking patterns. Primary or secondary education levels among participants highlighted the necessity for targeted health literacy efforts. Conclusions: This study highlighted notable awareness and satisfaction among patients concerning the availability, accessibility, and accommodation of services, particularly emphasising the importance of geographical proximity in healthcare services. However, challenges faced by elderly individuals in accessing social support are also highlighted. The potential of enhancing the amenities of healthcare facilities to improve patient experiences is also reflected in our results. These insights provide evidence for the effectiveness of the Malaysian healthcare system in catering to a diverse demographic and can also be helpful in refining healthcare strategies and further optimising patient-centred care in Malaysia