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'It's helped me to learn to deal with it': a mixed methods service evaluation of a multicomponent fibromyalgia service
No full textOBJECTIVES:
To evaluate the Royal London Hospital for Integrated Medicine (RLHIM) multicomponent fibromyalgia service.
METHODS:
Mixed methods approach consisting of the completion of validated quantitative outcome measures (Patient Health Questionnaire-9; Generalised Anxiety Disorder-7; Pain Catastrophising Scale; Patient Self-Efficacy Questionnaire) pre- and post-treatment to explore the impact of treatment; and qualitative focus groups with patients at their follow-up appointments to explore patients’ experiences and perspectives on the service.
RESULTS:
138 fibromyalgia patients attended the RLHIM group fibromyalgia service during the period of the evaluation. Baseline scores demonstrate that patients were significantly impaired pre-treatment according to all outcome measures. At the end of the course of treatment, scores for all outcome measures showed clinically and statistically significant improvements. These improvements were maintained at both 6- and 9-month follow-up appointments. Qualitative analysis indicated that those participating valued the multicomponent treatment approach, and perceived the service as having a positive impact on their fibromyalgia and overall quality of life, enabling patients to effectively manage their condition.
CONCLUSIONS:
Patients attending the RLHIM multicomponent fibromyalgia service appear to have demonstrable improvements in presenting symptoms, and quality of life. The findings support a multicomponent approach to the treatment of fibromyalgia
Object handling for people with dementia: a scoping review and the development of intervention guidance
Get PDFBackground and Objectives
Among the various psychosocial interventions aiming at improving behavior, quality of life, and the well-being of people with dementia, one that has attracted recent attention has been object handling. This scoping review synthesizes available studies on object handling for people with dementia, their effects, and methodological characteristics and describes its components and likely domains.
Research Design and Methods
The search was conducted using CINAHL, PsycINFO, MEDLINE, PsycARTICLES, Academic Search Elite, and Art Full Text, plus review of reference lists and hand search. Data from the studies included were chattered and reported in narrative form.
Results
Eleven studies were included; of which, 9 described a group intervention and 10 investigated the distinctive value of heritage items. Studies used a mixed-methods or qualitative design and varied in their procedures, including number of sessions and length of intervention. Most studies reported positive effects on well-being, mood, and emotion in those with dementia. Qualitative investigations revealed that the co-construction of an object’s meaning facilitated new learning, social inclusion, and change in attitudes toward dementia. From the review and stakeholder consultations, a definition of object handling is proposed, which includes three components: presenting, receiving, and responding.
Discussion and Implications
The findings suggest that people with dementia may benefit from object handling interventions as a means of improving well-being, mood, and social inclusion. The review highlighted a variety of approaches used and a small number of studies were identified under the term of “object handling.” Further studies are needed to examine the complexity of object handling, its impact within dementia care settings, and that explicitly use the term “object handling.” Given the focus to date on heritage, archive, and museum objects, more studies involving the handling of everyday material objects are needed because these are by definition highly accessible
Midwives experiences are an important factor in identifying and supporting victims of sex trafficking
Get PDFExperimental investigation and flow analysis of clear-water scour around pier and abutment in proximity
Get PDFLocal scour around bridge piers and abutments is one of the most important causes of bridge failure. Despite a plethora of studies on scour around individual bridge piers or abutments, few studies focused on the joint impact of a pier and an abutment in proximity on scour. This study conducted laboratory experiments and flow analyses to examine the interaction of piers and abutments on clear-water scour. The experiments were conducted in a rectangular laboratory flume, including 18 main tests (combination of different types of piers and abutments) and five control tests (individual piers or abutments). Three types of piers (a rectangular pier with a rounded edge, a group of three cylindrical piers, a single cylindrical pier) and two types of abutment (a wing-wall abutment and a semi-circular abutment) were used. Acoustic Doppler Velocimeter (ADV) was used to measure the three-dimensional flow velocity for analyses of streamline, velocity magnitude, vertical velocity, and bed shear stress. The results showed the velocity near the pier and abutment increased by up to 80%. The maximum scour depth around the abutment increased by up to 19%. In contrast, the maximum scour depth around the pier increased significantly by up to l71%. The presence of the pier in the vicinity of the abutment led to an increase in the scour hole volume by up to 87% relative to the case with an individual abutment. The empirical equations were also derived to accurately estimate the maximum scour depth at the pier adjacent to the abutment
Reinforced concrete design with stainless steel
No full textIn the design of reinforced concrete structures, the bond property is crucial. This is important for achieving the composite action between the two materials constituents, allowing loads to be efficiently transmitted. The higher strain hardening and ductility capacity of stainless steel over mild steel are one of its major benefits. International design codes, such as Eurocode 2, do not provide a separate design model for concrete structures with stainless reinforcing bars. The background paper to Eurocode 2 highlighted that there is no technical reason of why the Eurocode 2 design model cannot be used in conjunction with other types of reinforcement, provided allowance is made for their properties and behaviour. While this notion is valid when using a mild steel reinforcing bar, it produces erroneous results when a stainless reinforcing bar with a lap splice is used in a reinforced concrete section. Even though there has been a large number of studies on the behaviour of structure with stainless steel in recent years, most of it has been on plain stainless-steel members rather than reinforced concrete or stainless-steel reinforced concrete with lap splice. As a result, the purpose of this chapter is to evaluate and compare the behaviour of stainless and mild steel reinforced concrete with and without lap splices
Blockchain-empowered AI for 6G-enabled Internet of Vehicles
Get PDFThe 6G communication technologies are expected to provide fast data rates and incessant connectivity to heterogeneous networks, such as the Internet of Vehicles (IoV). However, the resulting unprecedented surge in data traffic, massive increase in the number of nodes with high mobility, and low-latency requirements give rise to serious security, privacy, and trust challenges. The blockchain could potentially ensure trust and security in IoV due to its features, including consensus for credibility and immutability for tamper proofing. In parallel, federated learning (FL) is a privacy-preserving artificial-intelligence paradigm that does not require to share data for model training in machine learning. It can reduce data traffic and resolve privacy challenges of intelligent IoV networks. The blockchain can also complement FL by ensuring the decentralization and securing distribution of incentives. This article reviews the trends and challenges of the blockchain and FL in 6G IoV networks. Then, the impact of their combination, challenges in implementation, and future research directions are highlighted. We also evaluate our proposal of blockchain-based FL to protect IoV security and privacy that utilizes smart contract and secure transactions of incentives via the blockchain to protect FL. Compared with other solutions, the failure rate of the proposed solution was at least 5% lower with 30% malicious nodes in the network
2020 COVID-19-related lockdown: the relationships between coping strategies, psychological adjustment and resilience among a non-clinical sample of British adults
Get PDFBackground and objectives
To curb COVID-19 infections, the British government enforced a series of lockdowns resulting in restrictions on movement and socialisation. This study assessed which groups may have been at higher risk of emotional distress among a non-clinical sample of British adults. It also examined which coping strategies, if any, related to more positive psychological adjustment and higher resilience scores.
Methods
A cross-sectional, correlational study was carried out. Using a convenience sample, an online survey was conducted in April-June 2020. 194 participants completed the Brief COPE (coping), the GAD-7 (anxiety), the PHQ-9 (depression), the CD-RISC (resilience) and provided demographic information.
Results
Participants used mainly coping strategies considered to be adaptive. They exhibited mild/moderate anxiety and depression symptoms, and moderate resilience scores. However, some individuals displayed significantly higher distress symptoms and lower resilience scores than others, especially those aged under 35 (particularly 18-24), those not working, those who were single and/or childless. Results also show that coping strategies including substance use, behavioural disengagement and self-blame were associated with anxiety and/or depression symptoms. Conversely, positive reframing related to lower anxiety symptomatology.
Conclusions
Interventions promoting positive reframing may be helpful. Similarly, interventions promoting connection to others, a factor known to enhance resilience, may be beneficial. This is particularly relevant to groups who may be more at risk of psychological distress, such as young individuals
A multi-criteria risk-based approach for optimal planning of SuDS solutions in urban flood management
Get PDFThis paper presents a multi-criteria risk-based approach for managing urban flood hazards by using a combination of conventional measures and contemporary Sustainable Drainage Systems (SuDS). A multi-objective optimisation model coupled with a simulation model of UDS in the SWMM software is developed with the three objectives of minimising total costs, the risk of flooding and pollution discharged into receiving waters. K-means clustering technique is used to group the optimal solutions. A few optimal solutions and individual SuDS solutions are then ranked together by using the compromise programming (CP) method. The methodology is demonstrated by its application on a case study of the
Golestan city UDS in Iran. The results obtained show there are indirect correlations between nondominated solutions that minimise the risk of either flooding or pollution. The results also show the selected optimal solutions can provide cost-effective strategies that reduce both flood and pollution risks by at least 27% and 50%, respectively
Numerical modeling and parametric analysis of thermal performance for the large-scale seasonal thermal energy storage
Get PDFSeasonal thermal energy storage (STES) systems are a key component in expanding the share of renewables in energy programs because they provide schedulability and flexibility. However, such a large-scale system requires careful planning to avoid high investment costs. Therefore, numerical models are becoming increasingly important as an alternative. This paper develops a numerical model of STES coupled with solar collector. The model was verified based on the experimental data of the Huangdicheng Project in China. The results show that the relative error in the charging mode and discharging mode is only 1.57% and 0.46%, respectively. Then, the effects of different charging and discharging mode on the heat storage efficiency of the tank and the efficiency of solar collector systems in STES were studied. The study found that in the initial charging stage, the water temperature rise curve caused by different flow rates is very different. In the design of the collector-storage area ratio, the relatively economical collector-storage ratio of this model is around 3768L/m2. The selection of different proportions of discharging energy in the discharge stage has a great impact on the heat storage efficiency of the system in the next year. Moreover, the influence of different depth-diameter ratios of the tank on the system heat storage efficiency is discussed in detail, which has important guiding significance for model application and system analysis. This paper provides some references for the scale design and operation optimization of cylindrical STES
Artificial intelligence as a service for immoral content detection and eradication
Get PDFSocial media is referred to as active global media because of its seamless binding thanks to COVID-19. Connecting software such as Facebook, Twitter, WhatsApp, WeChat, and others come with a variety of capabilities. They are well-known for their low-cost, quick, and effective communication. Because of the seclusion and travel constraints caused by COVID-19, concerns, such as low physical involvement in many possible activities, have arisen. Depending on their information, knowledge, nature, experience, and way of behavior, various types of human beings have diverse responses to any scenario. As the number of net subscribers grows, inappropriate material has become a major concern. The world's most prestigious and trustworthy organizations are keenly interested in conducting practical research in this field. The research contributes to using Artificial Intelligence (AI) as a service (AIaaS) for preventing the spread of immoral content. As software as a service (SaaS) and infrastructure as a service (IaaS), AIaaS for immoral content detection and eradication can use effective cloud computing models to leverage this service. It is highly adaptable and dynamic. AIaaS-based immoral content detection is mostly effective for optimizing the outcomes based on big data training data samples. Immoral content is identified for semantic and sentiment evaluation, and content is divided into immoral, cyberbullying, and dislike components. The suggested paper's main issue is the polarity of immoral content that can be processed using an AI-based optimization approach to control content proliferation. To finish the class and statistical analysis, support vector machine (SVM), selection tree, and Naive Bayes classifiers are employed