3,104 research outputs found
Foam dressings: a review of the literature and evaluation of fluid-handling capacity of four leading foam dressings
No full textPosnett and Franks (2008) have calculated that 200,000 people in the UK have a chronic
wound, with an estimated treatment cost of between £2.3 billion and £3.1 billion per
year. With an ever-increasing ageing population, it can be assumed that costs associated
with the management and treatment of wounds will also continue to rise. The Business
Service Authority (2014) reported that in 2013 between £160 and £185 million was
spent on wound care dressings within primary care services in England, of which foam
dressings accounted for £22.6 million of the overall spend. Foam dressings are frequently
used in wound care to assist with the management of wound exudate, helping to prevent
maceration of the wound bed, protect the surrounding skin and prevent cross-infection
caused by strikethrough. The aim of dressings is to provide an optimum environment
at the interface with the wound bed to promote wound healing. With limited financial
resources within health care, the cost-effectiveness of each type of wound dressing is high
on the agenda. It is, however, important that costs are not considered in isolation; the
outcomes (general health benefits) associated with interventions (e.g. wound healing and
reduction in wound pain) must also be taken into account alongside close collaboration
with the patient, and in some cases the carer (Rippon et al, 2008). This article provides
a summary of the published literature relating to foam dressings, investigating their
impact on healing rates, pain on dressing removal, fluid-handling capacity and their costeffectiveness.
It focuses on the independent assessment of the fluid-handling capacity of
eight commonly-prescribed foam dressings: four bordered (Cutimed® Siltec B, Mepilex®
Border, Allevyn® Life and Tegaderm™ foam adhesive) and four non-bordered (Cutimed®
Siltec/Cutimed® SiltecPLUS, Mepilex®, Allevyn® Non-Adhesive, and Tegaderm™ foam)
Coastal bathing water health risks: Developing means of assessing the adequacy of proposals to amend the 1976 EC Directive
No full textA randomised controlled feasibility study investigating the use of eccentric and concentric strengthening exercises in the treatment of rotator cuff tendinopathy
No full textObjectives: To conduct a feasibility study to compare concentric and eccentric rotator cuff strengthening exercises for rotator cuff tendinopathy. Methods: A total of 11 patients with rotator cuff tendinopathy who were on the waiting list for arthroscopic subacromial decompression surgery were randomised to perform eccentric rotator cuff strengthening exercises, concentric strengthening exercises or no exercises. Patients were evaluated in terms of levels of pain and function using the Oxford Shoulder Score and a Visual Analogue Scale initially, at 4 weeks and at 8 weeks. Results: The study design was found to be acceptable to patients and achieved a high level of 86% compliance. The drop-out rate was 0%. Two patients performing eccentric strengthening exercises improved sufficiently to cancel their planned surgery. Conclusion: Further research in this area is recommended. The study design was feasible and power calculations have been conducted to aid future research planning
Rapid manufacturing as a tool for agile manufacturing: applications and implementation perspectives
No full textManufacturing engineers and technologists around the globe are already well familiar with manufacturing methodologies and systems developments in the last part of the twentieth century. Many are probably also familiar with the current state of Rapid Prototyping (RP) technologies, especially in the areas of concept model making and prototype development. They may not however, be so familiar with the more recent developments of these technologies towards Rapid Manufacturing (RM) and the directions which the applications of RM technologies are taking for agile manufacturing purposes in particular. This paper critically reviews the various technologies currently available, outlines development trends in RM, discusses the approach, application and implementation perspectives by which these RM technologies are applied for increasing agility and responsiveness in manufacturing. Furthermore, the paper describes two case study examples to further illustrate the application scenarios in agile manufacturing before concluding remarks
Refining pathological evaluation of neoadjuvant therapy for adenocarcinoma of the esophagus
No full textAIM: To assess tumour regression grade (TRG) and lymph node downstaging to help define patients who benefit from neoadjuvant chemotherapy.METHODS: Two hundred and eighteen consecutive patients with adenocarcinoma of the esophagus or gastro-esophageal junction treated with surgery alone or neoadjuvant chemotherapy and surgery between 2005 and 2011 at a single institution were reviewed. Triplet neoadjuvant chemotherapy consisting of platinum, fluoropyrimidine and anthracycline was considered for operable patients (World Health Organization performance status ? 2) with clinical stage T2-4 N0-1. Response to neoadjuvant chemotherapy (NAC) was assessed using TRG, as described by Mandard et al. In addition lymph node downstaging was also assessed. Lymph node downstaging was defined by cN1 at diagnosis: assessed radiologically (computed tomography, positron emission tomography, endoscopic ultrasonography), then pathologically recorded as N0 after surgery; ypN0 if NAC given prior to surgery, or pN0 if surgery alone. Patients were followed up for 5 years post surgery. Recurrence was defined radiologically, with or without pathological confirmation. An association was examined between t TRG and lymph node downstaging with disease free survival (DFS) and a comprehensive range of clinicopathological characteristics.RESULTS: Two hundred and eighteen patients underwent esophageal resection during the study interval with a mean follow up of 3 years (median follow up: 2.552, 95%CI: 2.022-3.081). There was a 1.8% (n = 4) inpatient mortality rate. One hundred and thirty-six (62.4%) patients received NAC, with 74.3% (n = 101) of patients demonstrating some signs of pathological tumour regression (TRG 1-4) and 5.9% (n = 8) having a complete pathological response. Forty four point one percent (n = 60) had downstaging of their nodal disease (cN1 to ypN0), compared to only 15.9% (n = 13) that underwent surgery alone (pre-operatively overstaged: cN1 to pN0), (P < 0.0001). Response to NAC was associated with significantly increased DFS (mean DFS; TRG 1-2: 5.1 years, 95%CI: 4.6-5.6 vs TRG 3-5: 2.8 years, 95%CI: 2.2-3.3, P < 0.0001). Nodal down-staging conferred a significant DFS advantage for those patients with a poor primary tumour response to NAC (median DFS; TRG 3-5 and nodal down-staging: 5.533 years, 95%CI: 3.558-7.531 vs TRG 3-5 and no nodal down-staging: 1.114 years, 95%CI: 0.961-1.267, P < 0.0001).CONCLUSION: Response to NAC in the primary tumour and in the lymph nodes are both independently associated with improved DFS
Extending the product portfolio with ‘devolved manufacturing’: Methodology and case studies
No full textCurrent research by the developers of rapid prototyping systems is generally focused on improvements in cost, speed and materials to create truly economic and practical economic rapid manufacturing machines. In addition to being potentially smarter/faster/cheaper replacements for existing manufacturing technologies, the next generation of these machines will provide opportunities not only for the design and fabrication of products without traditional constraints, but also for organizing manufacturing activities in new, innovative and previously undreamt of ways. This paper outlines a novel devolved manufacturing (DM) ‘factory-less’ approach to e-manufacturing, which integrates Mass Customization (MC) concepts, Rapid Manufacturing (RM) technologies and the communication opportunities of the Internet/WWW, describes two case studies of different DM implementations and discusses the limitations and appropriateness of each, and finally, draws some conclusions about the technical, manufacturing and business challenges involved
Reformulating the rj-McMC Algorithm for 3D Inversion of Passive Seismic Data for Near-Surface Characterization
No full textGeophysical subsurface characterization techniques could, due to their non-invasive nature, play a crucial role in the design and subsequent construction of infrastructure in urban & industrial environ- ments. Geo-data specialist company Fugro sees potential in upgrading their current ambient-seismic- noise-tomography workflow, to make use of state-of-the-art inversion schemes with the main goal of increasing the quality and accuracy of the initial-site characterization delivered to clients. In this thesis I explore the feasibility of utilizing the reverse-jump Markov chain Monte Carlo (rj-McMC) algorithm for the inversion of ambient seismic noise for characterization in urban & industrial environments. Specif- ically, testing the potential of scaling down this inversion algorithm to fit in a small scale, near-surface framework. To achieve this, I first carried out analyses to evaluate the appropriate Rayleigh wave frequency range, after which realistic noise hyperparameters, suited for this reduced scale problem, were obtained. Because of the potential exploitation of in-situ borehole measurements, I reformulated the Bayesian prior within the rj-McMC algorithm to implement these constraining shear wave velocity values appropriately. I conducted extensive synthetic experiments to gain insight into the behavior of this adapted algorithm, from which it was concluded that the inherent dynamic discretization partially prevents these constraints from being implemented to their full extent. Nevertheless, promising results lead me to conclude that the use of the rj-McMC algorithm for application in near-surface urban & industrial environments is feasible.Applied Geophysics | IDEA Leagu
Risk factors for prolonged ventilation in patients with chronic obstructive pulmonary disease presenting with acute respiratory failure
No full textIncludes abstract.Includes bibliographical references (leaves 35-37).Patients with COPD presenting to the Emergency Unit with acute hypercapnic respiratory failure often require invasive mechanical ventilation and subsequent admission to the intensive care unit (ICU). These patients are at an increased risk of prolonged and complicated ventilation and often experience weaning difficulties. In addition, the impact of a previous episode of pulmonary tuberculosis that might have resulted in structural lung disease on the duration of mechanical ventilation in such patients has not previously been evaluated. Methods: All patients with COPD admitted to the Respiratory ICU at Tygerberg academic hospital from the 01st January 2004 until 31st December 2007 requiring intubation and invasive mechanical ventilation for acute hypercapnic respiratory failure were included in the study
Clowns, Fools, and Killers: An Exploration of Horror, Comedy, and Madness Through the Roles of Murderer 2 and Sir Richard Ratcliffe in William Shakespeare\u27s Richard III
No full textThis document is a thesis submitted in partial fulfillment of the Master of Fine Arts degree in Theatre Arts with a Concentration in Musical Theatre. It is a detailed account of author RJ Magee’s artistic and scholarly process in creating the roles of Murderer 2 and Sir Richard Ratcliffe in William Shakespeare’s Richard III. The production was performed as part of Minnesota State University, Mankato’s mainstage season in October of 2022. In five chapters, this thesis chronicles the actor’s process: a preproduction analysis, a historical and critical perspective, a rehearsal and performance journal, a post-production analysis, and a process development analysis. Appendices and works cited are included
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