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Investigating the prevalence and associated factors of depression, anxiety, and loneliness among people with type-2 diabetes in Bangladesh: a community-based study
No full textDiabetes mellitus is a major worldwide health concern. Diabetes has been associated with a number of adverse mental health conditions including depression, anxiety, and loneliness that can negatively impact diabetes outcomes. This study aimed to investigate factors associated with depression, anxiety, and loneliness in people, in the community, suffering with diabetes in Bangladesh. A cross-sectional study was conducted with 600 people with type-2 diabetes (54.83% females; mean age: 52.70 ± 11.56 years) between July and September 2022. Purposive sampling method was used to recruit the participants. A validated semi-structured questionnaire was used to collect demographic and other data. Depression, anxiety, and loneliness were measured using the PHQ-9, GAD-7, and UCLA Loneliness scale, respectively. Bivariate and multivariable linear regression analyses were conducted to ascertain factors that were significantly associated with these mental health conditions. The prevalence of depression, anxiety, and loneliness was 31.17%, 21.83%, and 28.00%, respectively. A lack of formal education, and not taking part in physical activities were significantly associated with all three mental health states. Duration of diabetes and being on medication for high cholesterol were also associated with depression and anxiety. Older age and being widowed were significantly associated with loneliness. This study found that depression, anxiety, and loneliness are prevalent among Bangladeshi people with diabetes, with certain sociodemographic and diabetes-related factors associated with increased risk. The findings emphasize the need for targeted interventions to people within the communities, at grassroot levels in order to improve reduce health inequality, and improve the mental health of people living with diabetes.</p
Redefining adjustment after acquired brain injury
No full textBackground: Adjusting to life changes posed by an acquired brain injury (ABI) can be challenging for both individuals with ABI and their families. The current study explores the experience of adjustment, incorporating similarities and differences in this process as reported by the family members and individuals with ABI.
Method: Thirty-nine participants, recruited from a regional brain injury charity group, took part in semi- structured interviews (20/39 individuals with ABI, 19/39 relatives). Transcripts were analyzed using thematic analysis.
Findings: Three main categories of adjustment were developed: adjusted to life after ABI, partially adjusted to life after ABI and not adjusted to life after ABI. However, it is the complexity of experiences within these main categories which uncovers the diversity in individual experience. Of specific interest are adjustment as best case and resigned adjustment responses which indicate a level of burden for the person experiencing these feelings of adjustment.
Conclusions: The categories of grateful acceptance and resigned acceptance were specific to relatives and show the need to look beyond the individual with ABI to identify where support may be required for a family as a whole. On the basis of these findings, we offer an inclusive, family oriented conceptualization of adjustment to brain-injury
Increased survival for resuscitated Utstein-comparator group patients conveyed directly to cardiac arrest centres in a large rural and suburban population in England
No full textAim:
The cohort of patients in which cardiac arrest centres (CAC) in rural and suburban populations confer the greatest survival benefit remains unclear. The aim of this study was to assess whether the transfer of resuscitated Utstein-comparator out-of-hospital cardiac arrest (OHCA) patients direct to a CAC was associated with improved survival to hospital discharge compared to patients conveyed to non-specialist centres.
Methods:
A consecutive sample of adult (≥18 years old) Utstein-comparator patients (witnessed collapse and initial shockable rhythm) were included from the East of England Ambulance Service NHS Trust Utstein resuscitation registry; 2018–2022. Logistic regression was used to compare survival to discharge in patients transported to CACs compared with patients transported to non-specialist centres.
Results:
During the study period, resuscitation was attempted in 18,276 OHCA patients. N = 2448 (13.4%) met the Utstein-comparator definition and 1151 patients were included in the final analysis; per protocol. Survival was greater for patients conveyed directly to a CAC (n = 768, 60.7%) compared to non-specialist centres (n = 383, 47.3%); adjusted OR 1.44 (95%CI 1.07–1.94), p = 0.017. Amongst the centres analysed in this study, there was significant inter-hospital variability in survival between CACs (p = 0.017). There was no association between patient volume and survival (p = 0.850).
Conclusion:
Direct transport to a cardiac arrest centre was associated with a 44% increase in the odds of survival compared to conveyance to a non-specialist centre for resuscitated adult patients presenting with witnessed collapse and initial shockable OHCA rhythm.</p
Walking representation and simulation based on multi-source image fusion and multi-agent reinforcement learning for gait rehabilitation
No full textIn the formulation of strategies for walking rehabilitation, achieving precise identification of the current state and making rational predictions about the future state are crucial but often unrealized. To tackle this challenge, our study introduces a unified framework that integrates a novel 3D walking motion capture method using multi-source image fusion and a walking rehabilitation simulation approach based on multi-agent reinforcement learning. We found that, (i) the proposal achieved an accurate 3D walking motion capture and outperforms other advanced methods. Experimental evidence indicates that, compared to similar visual skeleton tracking methods, the proposed approach yields results with higher Pearson correlation (r=0.93), intra-class correlation coefficient (ICC(2,1)=0.91), and narrower confidence intervals ([0.90,0.95] for r, [0.88,0.94] for ICC(2,1)) when compared to standard results. The outcomes of the proposed approach also exhibit commendable correlation and concurrence with those obtained through the IMU-based skeleton tracking method in the assessment of gait parameters ([0.85,0.89] for r, [0.75,0.81] for ICC(2,1)); (ii) multi-agent reinforcement learning has the potential to be used to solve the simulation task of gait rehabilitation. In mimicry experiment, our proposed simulation method for gait rehabilitation not only enables the intelligent agent to converge from the initial state to the target state, but also observes evolutionary patterns similar to those observed in clinical practice through motor state resolution. This study offers valuable contributions to walking rehabilitation, enabling precise assessment and simulation-based interventions, with potential implications for clinical practice and patient outcomes.</p
Understanding curriculum making by teachers: implications for policy as text and as practice
No full textRecent debates in curriculum studies have focused on the role of teachers as active curriculum makers. In this chapter, we argue for a more systematic approach to curriculum making as social practice. Our particular focus is on micro and nano curriculum making by teachers, that is curriculum making in schools and classrooms respectively, as curricular programmes are developed and enacted into practice. In making sense of these complex practices, we draw upon a theoretical typology for understanding and analysing curriculum making across different sites within education systems, and an ecological understanding of teacher agency. We apply these theoretical insights to the analysis of various influences on micro/nano curriculum, emerging from a range of recent empirical studies in five European education systems. In undertaking this analysis, we challenge prevalent notions of curriculum making as a linear process of delivery or implementation, instead seeking to understand it as interpretation and enactment across sites by multiple social actors, and tracing the multiple and dynamic connections that operate across sites and which shape micro and nano curriculum making in schools.</p
Numerical validation of carbon fibre composite crush absorbers via finite element analysis for dynamic impact energy absorption
No full textThis research aimed to investigate the crashworthiness of carbon fibre composite structures for progressive crush energy absorption to be implemented as crush energy absorbers in the automotive sector. The study employed a combination of finite element simulation, experimental testing, and optimization of material cards and modelling approaches to validate the dynamic crush response behaviour of carbon fibre structures under various loading conditions. Five parametric studies were conducted to explore different aspects of carbon fibre crushing behaviour, material card optimization, sensitivity to changes in strengths and strains-to-failure, and failure mechanisms. The research highlighted the importance of material card selection, specifically the MAT54 card, and its parameters, boundary conditions, mesh quality, and element type on the behaviour of composite materials under crushing loads. The study determined that the MAT54 material card can accurately depict progressive crush behaviour but requires modification according to the failure mode of the composite structure to ensure a reliable representation of the results.Parametric study 1 validated the dynamic crush response behaviour of carbon fibre structures under progressive crushing. The results showed a significant correlation between the experimental and simulation models, establishing that MAT54 material card as an accurate portrayal of the progressive dynamic crush behaviour for unidirectional carbon fibre tubes.Parametric study 2 analysed the crush performance of a bi-directional truncated cylindrical carbon fibre tube with an angled crush trigger mechanism. The results showed that delamination and fibre fracture through axial compression were the primary modes of failure with an average stabilised crush force of 24 kN and that the FE model was effective in correlating the crush behaviour. Key parameters XC and DFAILC significantly influence element failure and average crush force, especially in 0° ply deletion. Lower DFAILC values reduce peak stress before ultimate strength, whereas higher values lead to plastic deformation until ply deletion. Similarly, smaller XC values result in plasticity under compression.Parametric study 3 evaluated the crush performance of carbon fibre tubes under dynamic impact with crush trigger from the base and exhibited an average stabilised crush force of 35 kN. The results indicated that modifications to the material card definition will be necessary to correlate tensile shear fibre fracture failure mechanism as in the FE model the failure mode was observed to be changing from brittle to ductile behaviour. Notably, XT represents the stabilized crush force, and the reduced stabilized crush force observed suggests an inaccurate representation of failure mechanisms. Therefore, for composite structures that fails due to laminate tearing or fibre fracture, lower XT values are not recommended. Additionally for this failure mode DFAILC values must be kept low to avoid higher initial peak loads.Parametric study 4 analysed the crush performance of a group of thin-walled carbon fibre tubes with an angled crush trigger which exhibited an average stabilised crush force of 18 kN. The findings demonstrated a strong correlation between the finite element (FE) and experimental models when triangular elements were excluded from the crush trigger zone, highlighting a significant insight. Consequently, for crush structures with crush triggers, optimal correlation capturing the initial peak load is achieved by employing quad meshing in the crush trigger region.Parametric study 5 highlighted the challenges of manufacturing homogeneous carbon fibre samples with varying surface thickness. The results showed that carbon fibre parts with varying surface thicknesses can be effective energy absorbers in crush applications as the initial peak load is considerably lower than any other crush structure investigated. However, with an average stabilised crush force of 17.5 kN the results exhibited discrepancies and were unsuitable for accurate correlation with the FE model due to the inhomogeneity of the experimental test samples.The research findings contribute constructive insights to simulation parameters for carbon fibre composite structures for progressive crush energy absorption. The insights gained from this study have the potential to be applied in the design and development of safer, more efficient vehicles with enhanced energy-absorbing capabilities.</p
The effectiveness of eye-movement desensitisation and reprocessing and imagery on self-efficacy, confidence and anxieties of elite academy footballers (soccer) and 1st team goal-keepers
No full textA limited number of studies have explored the effectiveness of Eye-Movement Desensitisation and Reprocessing (EMDR) on reducing anxieties, small-t-traumas in sports, and confidence. The aim of this thesis is to evaluate the effectiveness of EMDR on General Self-Efficacy (GSE), Goal-Keeper specific Self-Efficacy (GKSE), and measures of the Competitive State Anxiety Inventory (CSAI-2R) in elite academy footballers (soccer) and 1st team goal-keepers. Qualitative approaches explore the experiences of EMDR and Imagery sessions applied with positive memories and the resolution of small-t-traumas. Further, different modalities of face-to-face delivery and online sessions are compared. An RTC, multi-subject, mixed-methods, multiple baseline research design across participants was employed. Sessions were delivered by the principal investigator who held a dual role as the club’s sport psychologist, therefore providing testimony on navigating challenges in the delivery of EMDR in a professional club setting. Three experimental studies provide evidence of feasibility and acceptance of EMDR in enhancing positive memories (GSE, p<0.05, η2p= 0.66; GKSE, p< 0.05; η2p=0.59), effectiveness of EMDR and Imagery Rescripting (ImRs) in working with negative memories (GKSE, p<0.05; η2p=0.65), and the applied value of the GKSE. Qualitative and quantitative analyses support EMDR to be as effective as Imagery. Reflexive Thematic Analyses outline professional footballers’ experiences of receiving EMDR, transfer-to-practice effects to football, and showcase mental images related to self-efficacy, thereby providing support for Bandura’s self-efficacy theory (1977). Alongside, the GKSE questionnaire was developed, validated and tested for reliability. The GKSE assesses goal-keeping specific self-efficacy beliefs in relation to zone defense, goal defense and offense play. Results and findings are the first to establish EMDR as an effective alternative to Imagery. Further, this thesis successfully filled the lack of position-specific self-efficacy questionnaires in football. Goalkeepers face distinct psychological and technical challenges; a position-specified assessment allows to provide tailored support and training.</p
Technology acceptance within sustainable logistics of public health emergencies: a study of the UAE public health sector
No full textThis study critically examines the role of IoT technology acceptance in sustainable logistics during medical emergencies, considering individual and institutionally held norms in the UAE public sector. Sustainable logistics management of medical emergencies has been severely challenged, as evidenced by the COVID-19 global pandemic. The Ministry of Presidential Affairs (MoPA, UAE) in charge of pandemic management faced logistical challenges attributable to the size of resources, number of stakeholders involved, urgency and agility in managing medical emergencies. Questions of technology acceptance and innovation diffusion exist regarding the use of existing IoT blockchain technology infrastructure to address these challenges.The study considers the post-positivist research philosophy and the quantitative-deductive-survey research design, considering the population of all MoPA employees [n=1500] as well as stakeholder institutions [n=2000] related to medical logistics management under the auspices of MoPA. A sample of 347 was originally considered, following the stratified proportions sampling technique. The survey questionnaire was used as the primary data collection tool, and analysis followed the non-parametric structural equation modelling analytical technique with the help of IBM SPSS Statistics version 25 and SMART PLS version 4.As part of the first research question, findings reveal that both individual and organisational norms are instrumental to technology acceptance. With regard to the second research question, there is a generally acceptable level of readiness to accept IoT for medical emergencies despite the need for some improvements in the overall intention to use. Finally, results supporting the third research question reveal that intention and attitude positively influence sustainable logistics ‘economic’ performance.IoT blockchain technology holds the potential to revolutionise the economic efficiency of logistics management in medical emergencies. Evidence places it as critical to the optimization of UAE’s logistics management of future pandemics.</p
2D Kinematic Analysis of the Esbarrada and Volta Sobre Patas Manoeuvres of Criollo Breed Horses Competing in Freio de Ouro
No full textThe esbarrada and volta sobre patas manoeuvres are critical in Criollo horse equestrian activities, yet their kinematics remain largely unexplored. This observational study aimed to kinematically describe the manoeuvres in Criollo breed horses and explore the relationship between static goniometry and dynamics. A 2D kinematic analysis was conducted on 31 Criollo horses performing the manoeuvres using high-speed cameras. Joint angles were measured using static goniometry and analysed in relation to dynamic performance. The esbarrada covered a distance of 4.28 ± 0.99 m in 1.15 ± 0.11 s at a velocity of 3.77 ± 0.55 m/s. Joint angles showed a mean fetlock extension of 75.4° ± 5.3° and hock flexion of 43.2° ± 4.1°. In the volta sobre patas, significant differences were found in turn duration (first: 0.96 ± 0.07 s, second: 1.12 ± 0.09 s, p = 0.03) and thoracic limb suspension (first: 0.23 ± 0.02 s, second: 0.28 ± 0.03 s, p = 0.02). Static goniometry indicated that limb conformation did not significantly correlate with protraction angles during the esbarrada (p = 0.27). The volta sobre patas demonstrated prolonged duration and increased thoracic limb suspension in the second turn. Also, the findings suggest that static conformation does not predict dynamic limb movement during the esbarrada
HRM's Response to Workplace Bullying: Complacent, Complicit and Compounding
No full textPerceptions of human resource (HRM) management’s response to worker bullying were investigated through a netnographic analysis of written comments concerning an on-line ‘TEDx’ talk called “Bullying and Corporate Psychopaths at Work” to help determine whether HRM are seen as supportive of bullied workers. This research utilized a qualitative, ethnographic approach deemed to be highly valid in researching sensitive areas such as that of workplace bullying. Findings align with, deepen, and extend previous theory and knowledge in that a key finding that emerges is that HRM is deemed by workers to be capable of, but unwilling to deal effectively with, bullying managers. HRM are seen as complacent in that they do little about psychopathic bullies, complicit in that they support managerial bullies and compounding in that they worsen outcomes from workers’ point of view. It appears that HRM has therefore lost the trust of this sample of bullied workers. The paper is a first to apply a netnographic analysis to the problem of workplace bullying and reveals HRM fails to deal with it to worker’s satisfaction. Implications include that the ubiquitous prevalence of workplace bullying around the world could continue unabated unless strict, clear codes of conduct are established and policed by HRM or non-HRM related forms of intervention are mobilized
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