scholarly journals A Co-creation Centre for Accessible Rehabilitation Technology

2022 ◽  
Vol 2 ◽  
Author(s):  
Andy Kerr ◽  
Madeleine Ann Grealy ◽  
Anja Kuschmann ◽  
Rosie Rutherford ◽  
Philip Rowe

Background: The prevalence of disabling conditions is increasing globally. Rehabilitation improves function and quality of life across many conditions, particularly when applied intensively. The limited workforce, however, cannot deliver evidence-based intensive rehabilitation. By providing individuals with the tools for self- rehabilitation, technology helps bridge the gap between evidence and practise. Few people, however, can access rehabilitation technology. Barriers such as cost, training, education, portability and poor design stand in the way of equitable access. Our group of engineers and researchers have established a centre dedicated to developing accessible technology through close, frequent engagement with users and industry.Methods: The centre employs a co-creation model, coupling engineering and science with user experience and industrial partnerships to develop accessible technology and associated processes. Due to the complexity and size of the challenge the initial focus is stroke. Recruited through a medical charity, participants, with a wide range of disabilities, use prototype and commercial technology during an 8-week rehabilitation programme with supervision from health professionals. The centre includes de-weighting systems, neurostimulation, virtual reality, treadmills, bespoke rehab games, communication apps, powered exercise equipment and gamified resistance equipment. Standard outcome measures (International Classification of Functioning, Disability and Health) are recorded before, during, immediately after, and 3 months after the intervention and used in combination with an interview to design the initial rehabilitation programme, which is reviewed fortnightly. Qualitative methods (surveys and interviews) are used to capture personal experiences of the programme and individual technology and an advisory group of stroke survivors help interpret outcomes to feed into the technology design process. Ethical approval has been granted for a pilot cohort study with stroke survivors, which is currently underway (01/09/2021–31/12/2021) investigating acceptability and feasibility, due to report findings in 2022.Discussion: Through partnerships, research collaborations and a co-creation model a new centre dedicated to the development of accessible rehabilitation technology has been launched and currently undergoing acceptability and feasibility testing with stroke survivors. The centre, through its close engagement with users and industry, has the potential to transform the way rehabilitation technology is developed and help revolutionise the way rehabilitation is delivered.

2019 ◽  
Vol 6 ◽  
pp. 205566831986355 ◽  
Author(s):  
William E Clark ◽  
Manoj Sivan ◽  
Rory J O’Connor

This review evaluates the effectiveness of robotic and virtual reality technologies used for neurological rehabilitation in stroke survivors. It examines each rehabilitation technology in turn before considering combinations of these technologies and the complexities of rehabilitation outcome assessment. There is high-quality evidence that upper-limb robotic rehabilitation technologies improve movement, strength and activities of daily living, whilst the evidence for robotic lower-limb rehabilitation is currently not as convincing. Virtual reality technologies also improve activities of daily living. Whilst the benefit of these technologies over dose-controlled conventional rehabilitation is likely to be small, there is a role for both technologies as part of a broader rehabilitation programme, where they may help to increase the intensity and amount of therapy delivered. Combining robotic and virtual reality technologies in a rehabilitation programme may further improve rehabilitation outcomes and we would advocate randomised controlled trials of these technologies in combination.


Author(s):  
Francisco González ◽  
Pierangelo Masarati ◽  
Javier Cuadrado ◽  
Miguel A. Naya

Formulating the dynamics equations of a mechanical system following a multibody dynamics approach often leads to a set of highly nonlinear differential-algebraic equations (DAEs). While this form of the equations of motion is suitable for a wide range of practical applications, in some cases it is necessary to have access to the linearized system dynamics. This is the case when stability and modal analyses are to be carried out; the definition of plant and system models for certain control algorithms and state estimators also requires a linear expression of the dynamics. A number of methods for the linearization of multibody dynamics can be found in the literature. They differ in both the approach that they follow to handle the equations of motion and the way in which they deliver their results, which in turn are determined by the selection of the generalized coordinates used to describe the mechanical system. This selection is closely related to the way in which the kinematic constraints of the system are treated. Three major approaches can be distinguished and used to categorize most of the linearization methods published so far. In this work, we demonstrate the properties of each approach in the linearization of systems in static equilibrium, illustrating them with the study of two representative examples.


BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e024188
Author(s):  
Maureen Seguin ◽  
Laura Hall ◽  
Helen Atherton ◽  
Rebecca Barnes ◽  
Geraldine Leydon ◽  
...  

IntroductionMany patients now turn to the internet as a resource for healthcare information and advice. However, patients’ use of the internet to manage their health has been positioned as a potential source of strain on the doctor–patient relationship in primary care. The current evidence about what happens when internet-derived health information is introduced during consultations has relied on qualitative data derived from interview or questionnaire studies. The ‘Harnessing resources from the internet to maximise outcomes from GP consultations (HaRI)’ study combines questionnaire, interview and video-recorded consultation data to address this issue more fully.Methods and analysisThree data collection methods are employed: preconsultation patient questionnaires, video-recorded consultations between general practitioners (GP) and patients, and semistructured interviews with GPs and patients. We seek to recruit 10 GPs practising in Southeast England. We aim to collect up to 30 patient questionnaires and video-recorded consultations per GP, yielding up to 300. Up to 30 patients (approximately three per participating GP) will be selected for interviews sampled for a wide range of sociodemographic characteristics, and a variety of ways the use of, or information from, the internet was present or absent during their consultation. We will interview all 10 participating GPs about their views of online health information, reflecting on their own usage of online information during consultations and their patients’ references to online health information. Descriptive, conversation and thematic analysis will be used respectively for the patient questionnaires, video-recorded consultations and interviews.Ethics and disseminationEthical approval has been granted by the London–Camden & Kings Cross Research Ethics Committee. Alongside journal publications, dissemination activities include the creation of a toolkit to be shared with patients and doctors, to guide discussions of material from the internet in consultations.


1993 ◽  
Vol 1 (1) ◽  
pp. 3-9
Author(s):  
Heinz Riesenhuber

Thea purpose of science funding policy is to pave the way into new territory without knowing the final outcome to be expected. This needs the input of a wide range of scientific advice in response to well defined questions. There must be a serious intention to listen and if possible act on such advice.


1966 ◽  
Vol 112 (486) ◽  
pp. 471-484 ◽  
Author(s):  
Saul H. Rosenthal ◽  
Gerald L. Klerman

As currently used, the diagnosis of depression includes a wide range of clinical phenomena. This has not always been the case. Near the end of the 19th century, when the term depression began to evolve the meanings that it has today it was applied primarily to psychotics. The formulations of Freud in Mourning and Melancholia (1917), and of Kraepelin in Manic Depressive Insanity (1921) were based upon observations of patients who were both depressed and psychotic. In their work the contrast was between psychotic depression (or “melancholia”) on one hand, and normal sadness on the other. In the succeeding half-century, however, as psychiatry has extended its boundaries, increasing attention has been focused on non-psychotic depressions, often called “neurotic” or “reactive.” As these “neurotic” or “reactive” depressions reached public attention, a debate began over the way in which the depressive population should be described and the extent to which it should be subdivided. Critical and often sarcastic written battles were fought between the separatists and the unifiers during the 1920's and 1930's. These debates have been informatively chronicled by Partridge (1949). We have found it useful to divide these theorists into unifiers, dualists, and pluralists.


2017 ◽  
Vol 3 (3) ◽  
pp. 137-143 ◽  
Author(s):  
Colin Hamilton ◽  
Anna Maw ◽  
Andrew Gill ◽  
Mita Brahmbhatt ◽  
Robert Phaal ◽  
...  

IntroductionAcquired brain injury (ABI) is a major cause of morbidity and mortality in childhood. Specialist rehabilitation services are often situated far from families and local services may be non-standardised and fragmented. A strategic level of understanding is needed to improve patient care and outcomes. Roadmapping techniques are commonly used in industry settings to discover and present a systematic understanding of structures; however, they are rarely used in the healthcare setting. With continuing pressures on healthcare systems worldwide, they provide an effective method for examining services.MethodsThe Institute for Manufacturing (IfM) strategic roadmapping method was used to identify areas of difficulty and opportunities in paediatric neurorehabilitation. Participants included stakeholders from a wide range of professions and sectors who have input with children after ABI.ResultsDelegates identified a range of ‘layers’ covering trends, drivers, current experience and unmet needs. From these layers, four priorities were identified and further expanded.These included: ‘access to medical and therapy expertise close(r) to home’, ‘shared understanding across family, school and health’, ‘family and professional awareness of resources and support’ and ‘establishing a centre for rehabilitation technology evaluation, advice and co-ordination of services and research’.ConclusionThe IfM strategic roadmapping method identified and developed key areas for development in the field of paediatric neurological rehabilitation. Healthcare professionals looking at strategic level difficulties should strongly consider the use of such systematic tools when evaluating areas of practice.


Author(s):  
E. V. Mikhailovskaia ◽  
O. V. Sapunova

The article outlines the way the English system of punctuation marks is presented in contemporary ELT research and practice. The following types of sources are considered and analyzed in the article: grammar books for teaching English as the first, second or foreign language; reference books and web-sites aimed at preparing students for IELTS and TOEFL; books belonging to the genre known as popular science; purely scientific works on punctuation in general and the semicolon in particular. The main goals of the research are to reveal the central tendencies in teaching English punctuation on the example of the so-called weighty stops of vertical segmentation, namely the semicolon, and to see whether they manage to present a certain norm of using the stop. Thus, the present paper focuses on the semicolon one of the most controversial stops in the system, which has been proved to function both at the syntactic and stylistic levels. It is shown that a formal / grammatical approach is the most common way to treat punctuation in ELT literature; however, it does not take into account stylistic and prosodic peculiarities of the stops and thus fails to show the whole spectrum of its usage, as well as its phonetic and stylistic potential. Consequently, such an approach should not be applied to English one of the languages exhibiting a semantic-stylistic type of punctuation. It is proposed that the approach to be used in teaching English punctuation most effectively is pragmalinguistics, since it exploits a wide range of methods and means of analyzing a text, and also considers and highlights all the aspects of using the stops (their syntactic function, stylistic capacities and prosodic characteristics). Moreover, the article poses the question that the current methodology of the approach has to be further developed.


2015 ◽  
Vol 3 (12) ◽  
pp. 1-186 ◽  
Author(s):  
Paul Roderick ◽  
Hugh Rayner ◽  
Sarah Tonkin-Crine ◽  
Ikumi Okamoto ◽  
Caroline Eyles ◽  
...  

BackgroundConservative kidney management (CKM) is recognised as an alternative to dialysis for a significant number of older adults with multimorbid stage 5 chronic kidney disease (CKD5). However, little is known about the way CKM is delivered or how it is perceived.AimTo determine the practice patterns for the CKM of older patients with CKD5, to inform service development and future research.Objectives(1) To describe the differences between renal units in the extent and nature of CKM, (2) to explore how decisions are made about treatment options for older patients with CKD5, (3) to explore clinicians’ willingness to randomise patients with CKD5 to CKM versus dialysis, (4) to describe the interface between renal units and primary care in managing CKD5 and (5) to identify the resources involved and potential costs of CKM.MethodsMixed-methods study. Interviews with 42 patients aged > 75 years with CKD5 and 60 renal unit staff in a purposive sample of nine UK renal units. Interviews informed the design of a survey to assess CKM practice, sent to all 71 UK units. Nineteen general practitioners (GPs) were interviewed concerning the referral of CKD patients to secondary care. We sought laboratory data on new CKD5 patients aged > 75 years to link with the nine renal units’ records to assess referral patterns.ResultsSixty-seven of 71 renal units completed the survey. Although terminology varied, there was general acceptance of the role of CKM. Only 52% of units were able to quantify the number of CKM patients. A wide range reflected varied interpretation of the designation ‘CKM’ by both staff and patients. It is used to characterise a future treatment option as well as non-dialysis care for end-stage kidney failure (i.e. a disease state equivalent to being on dialysis). The number of patients in the latter group on CKM was relatively small (median 8, interquartile range 4.5–22). Patients’ expectations of CKM and dialysis were strongly influenced by renal staff. In a minority of units, CKM was not discussed. When discussed, often only limited information about illness progression was provided. Staff wanted more research into the relative benefits of CKM versus dialysis. There was almost universal support for an observational methodology and a quarter would definitely be willing to participate in a randomised clinical trial, indicating that clinicians placed value on high-quality evidence to inform decision-making. Linked data indicated that most CKD5 patients were known to renal units. GPs expressed a need for guidance on when to refer older multimorbid patients with CKD5 to nephrology care. There was large variation in the scale and model of CKM delivery. In most, the CKM service was integrated within the service for all non-renal replacement therapy CKD5 patients. A few units provided dedicated CKM clinics and some had dedicated, modest funding for CKM.ConclusionsConservative kidney management is accepted across UK renal units but there is much variation in the way it is described and delivered. For best practice, and for CKM to be developed and systematised across all renal units in the UK, we recommend (1) a standard definition and terminology for CKM, (2) research to measure the relative benefits of CKM and dialysis and (3) development of evidence-based staff training and patient education interventions.FundingThe National Institute for Health Research Health Services and Delivery Research programme.


2013 ◽  
Vol 10 (2) ◽  
pp. 293-307
Author(s):  
Radojle Radetic ◽  
Marijana Pavlov-Kagadejev ◽  
Darko Brodic ◽  
Nikola Milivojevic

The paper presents the real instrument functional characteristics and describes the way of practical solutions of its performance improvement. It presents the design process of the instrument made for resistance measuring. In order to achieve desired objectives, a great number of experiments have been carried out during the development. Basically, the comparison method has been applied. At first, it was intended for the small resistor measuring as a single range unit. Later, the device has been improved and upgraded for a wide range resistance measuring. Finally, some of the difficulties have been detected and explained as well. The paper contains solutions developed and applied for their overcoming.


2021 ◽  
Vol 8 (4) ◽  
pp. 191-211
Author(s):  
Hero Abdulrahman Mustafa ◽  
Idrees Abdulla Mustafa

Style and stylistics are two critical terms, that they exceed Kurdish modern criticism in the spread of researching modern critical literature of people and modern Kurdish literature. Style is a wide range of using language, stylistics is a researchable science and it is the detail of the styles.           Modern linguistics that (Bale) invented, paves the way for the emergence of this modern science for studying style, how modern linguistics studies (speech) and likewise stylistics studies styles of speech. This research sheds light on these two terms.


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