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The use of home-based digital technology to support post-stroke upper limb rehabilitation: A scoping review
Get PDFObjective. To identify, map and synthesize the extent and nature of existing studies on the use of home-based digital technology to support post-stroke upper limb rehabilitation.Data sources. A comprehensive literature search was completed between 30 May 2022 and 05 April 2023, from seven online databases (CINAHL, Cochrane Library, PubMed, ScienceDirect, IEEExplore, Web of Science and PEDro), Google Scholar and the reference lists of already identified articles.Methods. A scoping review was conducted according to Arksey and O’Malley (2005), and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. All English-language studies reporting on the use of home-based digital technology to support upper limb post-stroke rehabilitation were eligible for inclusion.Results. The search generated a total of 1895 records, of which 76 articles met the inclusion criteria. Of these, 52 were experimental studies and the rest, qualitative, case series and case studies. Of the overall 2149 participants, 2028 were stroke survivors with upper limb impairment. The majority of studies were aimed at developing, designing and/or assessing the feasibility, acceptability and efficacy of a digital system for poststroke upper limb rehabilitation in home settings. The thematic analysis found six major categories: Tele-rehabilitation (n = 29), games (n = 45), virtual reality (n = 26), sensor (n = 22), mobile technology (n = 22), and robotics (n = 8).Conclusion. The digital technologies used in post-stroke upper limb rehabilitation were multimodal, and system-based comprising telerehabilitation, gamification, virtual reality, mobile technology, sensors and robotics. Furthermore, future research should focus to determine the effectiveness of these modalities
Clinical and Psychological Factors Associated with Frailty in Patients with Heart Failure
Get PDFBackground/Objectives: Heart failure (HF) is a significant public health issue with high morbidity and mortality rates. This study aims to investigate the interrelationships between frailty, cognitive impairment, and depression in older adults with HF, specifically focusing on how the physical and neuropsychiatric dimensions of frailty contribute to cognitive decline. Methods: This study included 250 patients aged 60 years or older, diagnosed with HF and hospitalized for acute decompensated HF. The patients were assessed using standardized protocols for frailty, cognitive function, and depression. The frailty was evaluated using Fried’s phenotype criteria, cognitive function with MMSE and MoCA, and depression and anxiety with HADS and PHQ-9. Statistical analyses included univariable and multivariable linear regression to identify the predictors of frailty. Results: Of the 250 patients, 151 (60.4%) were identified as frail. The frail patients were older (mean age 73.58 ± 6.80 years) compared to the non-frail patients (mean age 70.39 ± 6.16 years, p = 0.0002). Significant differences were observed in the NYHA class, length of the hospital stay, and prevalence of diabetes mellitus. The frail patients had worse cognitive (MMSE: 27.39 ± 2.12 vs. 28.13 ± 1.72, p = 0.004; MoCA: 24.68 ± 3.65 vs. 25.64 ± 3.98, p = 0.050) and psychological outcomes (higher prevalence of marked depression based on HADS categories: 8.61% vs. 1.01%, p = 0.021; and PHQ-9 categories: severe depression: 2.65% vs. 1.01%, p < 0.001). Conclusions: Age, C-reactive protein (CRP) levels, and anxiety were identified as independent predictors of frailty in the patients with heart failure. Depression, cognitive dysfunction, and the length of the hospital stay showed significant differences between the frail and non-frail patients in the group comparisons but were not independent predictors
Minimum quality regulations and the demand for childcare labor
No full textMinimum quality regulations are often justified in the childcare market because of the presence of information frictions between parents and providers. However, regulations can also have unintended consequences for the quantity and quality of services provided. In this paper, we merge new data on states’ childcare regulations for maximum classroom group sizes and child-to-staff ratios with the universe of online job postings to study the impact of regulations on the demand for and characteristics of childcare labor. Our identification strategy exploits the unprecedented variation in regulatory reform during the COVID-19 pandemic, relying on changes both within states over time and across children's age groups. We find evidence that these regulations reduce the number of childcare job postings and encourage providers to substitute away from higher-skilled postings, thereby increasing the number of positions that are out-of-compliance with states’ teacher education requirements. In sum, the results imply that childcare regulations may reduce the demand for childcare labor, while simultaneously altering the composition of the workforce
AI and Medical Images: Addressing Ethical Challenges to Provide Responsible Access to Historical Medical Illustrations
Get PDFThis article examines the ethical considerations and broader issues around access to digitised historical medical images. These illustrations and, later, photographs are often extremely sensitive, representing disability, disease, gender, and race in potentially harmful and problematic ways. In particular, the original metadata for such images can include demeaning and sometimes racist terms. Some of these images show sexually explicit and violent content, as well as content that was obtained without informed consent. Hiding these sensitive images can be tempting, and yet, archives are meant to be used, not locked away. Through a series of interviews with 10 archivists, librarians, and researchers based in the UK and US, the authors show that improved access to medical illustrations is essential to produce new knowledge in the humanities and medical research, as well as to bridge the gap between historical and modern understandings of the human body. Improving access to medical illustration can also help to address the “gender data gap”, which has acquired mainstream visibility thanks to the work of activists such as Caroline Criado-Perez, the author of Invisible Women: Data Bias in a World Designed for Men. Users of historical medical archives are therefore a diverse group, which includes researchers in medicine, history, and medical and digital humanities, as well as artists, journalists, and activists.In order to improve discoverability and facilitate access to these archives in an ethical way, this article highlights the importance of appropriate metadata, which can be enhanced through the use of artificial intelligence (AI) tools. Indeed, AI can be used to create new metadata when original information is incomplete or is missing altogether, or when it includes problematic language. AI can also help with the disaggregation of data by gender and/or racial ethnicity. Moreover, it can recommend similar images to allow users to explore other parts of the collections. However, AI can also pose issues, for example when it suggests inappropriate metadata or similarity search results. Keeping humans in the loop is therefore essential when applying AI to sensitive medical images. Ultimately, this article argues that access to sensitive images cannot be separated from responsibility. Recommendations are made to help cultural heritage institutions find the right balance, to provide access for research and education, and to also protect children and other vulnerable audiences from encountering images that can be described as shocking and even traumatising
Notes on [post] human nursing: What It MIGHT Be, What it is Not
Get PDFWith this paper, we walk out some central ideas about posthumanisms and the ways in which nursing is already deeply entangled with them. At the same time, we point to ways in which nursing might benefit from further entanglement with other ideas emerging from posthumanisms. We first offer up a brief history of posthumanisms, following multiple roots to several points of formation. We then turn to key flavors of posthuman thought to differentiate between them and clarify our collective understanding and use of the terms. This includes considerations of the threads of transhumanism, critical posthumanism, feminist new materialism, and the speculative, affirmative ethics that arise from critical posthumanism and feminist new materialism. These ideas are fruitful for nursing, and already in action in many cases, which is the matter we occupy ourselves with in the final third of the paper. We consider the ways nursing is already posthuman—sometimes even critically so—and the speculative worldbuilding of nursing as praxis. We conclude with visions for a critical posthumanist nursing that attends to humans and other/more/nonhumans, situated and material and embodied and connected, in relation
Timber and Fire Building Regulations
No full textThe legislative system underpinning fire safety intends to protect life through each stage of the design, construction, and occupation of a building. This results in a reasonable level of protection for the building’s occupants and firefighters in the event of a fire
Dance of the Seasons
No full textOur collaborative film project, Dance of the Seasons, deploys the South Indian classical dance form of Bharatanatyam, to address issues of climate change.Based on an epic Sanskrit poem, Ritu Samhara (The March of the Seasons) by Kalidasa (circa 400AD), the dancer communes with nature, understanding it deeply and becoming one with it. This lies in sharp contrast to what is happening ecologically today. Using the affordances of film, the dancer celebrates India’s six seasons of yester-year and contrasts it with today’s very sad reality. The film is inter-cut with the narrative of R S Pandit’s 1942 translation, created as he languishes in solitary confinement, fighting for Indian independence against British rule. Dance of the Seasons hopes to touch audiences emotionally and culturally, demanding that we respect our earth and its climate
Comparative analysis of residential building envelopes newly implementing the building insulation code in Damascus
Get PDFThe selection of envelope construction technique has the highest impact on sustaining indoor thermal comfort while reducing energy consumed for heating and cooling. Numerous insulation codes are implemented worldwide to improve building envelope modification. Each country has set envelope transmittances criteria, materials, techniques and simulation tools differently based on its climate zones and construction sector adaptability. The housing sector in Syria is the focus of energy conservation being responsible of half of the energy consumption in the country. Syrian post-conflict residential buildings are challenged by the new implementation of Building Insulation Code. This code has opted for a “fabric first” dwellings design approach with mandatory U-value standards. Hence, like many energy-related regulations in Syria it has been dropped because the construction sector has not been able to cope with them, forced by speculators to keep costs low. Another reason is that building thermal performance modeling has not been used to comply with the new insulation code in Syria. The research aims to examine the potential relevance of the Insulation Code in informing post-war social housing envelope structures in Damascus. It evaluates compliant building envelope structures compared to conventional building in terms of transmittance properties, simulated thermal loads (IESVE) and cost–energy trade-off. The research findings reveal an improvement in U-values of 78.5%, 31.5%, 92.7% and 90.2% achieved in compliant cases 1, 3, 4 and 5, respectively, compared to conventional case-2. The simulation demonstrated best improvement in total heating loads up to 85% achieved in case-4. Hence, the improved U-value lead to improvement in winter heating loads but overheating in summertime. The simulation was found useful but not enough to optimize envelope performance through interdisciplinary decision that contributes positively to Syrian post-war circumstances. The cost analysis found an increase in wall initial construction costs, amounting to 36.4%, 27.3%, 54.6% and 45.5% in cases 1, 3, 4 and 5 with long payback periods. These findings spark a new agenda for Insulation Code improvement. The proposed simplified criteria offer practitioners more understanding to customize their own list of envelope structure parameters based on the climatic zone resulting in a shift in envelope selection from input to a more output oriented
Lecturer's pedagogical attributes and teaching quality for construction and engineering education in UK universities: mediating effect of research informed teaching
Get PDFPurposeResearchers have opined that the quality of commitment to pedagogical approaches by lecturers is one of the most important factors in determining student academic success. The purpose of this paper is to analyse the mediating effect of research informed teaching on the relationship between lecturer commitment to use of pedagogical approaches and teaching quality, with a view towards enabling delivery of high quality teaching and learning in HEIs.Design/methodology/approachThe research is based on an online survey of the perception of 186 undergraduate and postgraduate students in four major UK universities. Covariance-based structural equation modelling (SEM) methodology was used to quantity and clarify the influence of lecturers' pedagogical attributes on teaching quality, mediated by research-informed teaching.FindingsFindings reveal that: lecturers' pedagogical attributes have significant positive effect on teaching quality, research-informed teaching have significant positive effect on teaching quality, lecturers' pedagogical attributes have weak positive effect on research-informed teaching, and research-informed teaching partially mediates (indirect effect) the relationship between lecturers' pedagogical attributes and teaching quality.Practical implicationsStructural equation models are useful for clarifying concepts in pedagogy and have implications for education managers on how to improve teaching and learning in HEIs.Originality/valueThe paper presents a unique quantitative model for measuring the degree of teaching quality in universities
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