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Quantifying Morphological Changes in Middle Trapezius With Ultrasonography and Histogram Matching for Participants With and Without Facioscapulohumeral DystrophyObjective: Echogenicity is a biomarker in facioscapulohumeral muscular dystrophy (FSHD). Currently, it is not possible to compare echogenicity values, derived using quantified muscle sonography capture, based on different equipment instrumentation settings. Image normalization, using histogram matching, could address this limitation. The aim of this study was to investigate the sensitivity of histogram matching, with trapezius muscle echogenicity values, in participants with and without FSHD. Materials and Methods: Sensitivity analysis of a single measurement timepoint case control study of participants with FSHD, using age- and gender-matched controls. Correlations between trapezius muscle echogenicity, muscle thickness, and shoulder range of movements were also completed. Results: Data were collected for 14 participants, seven with FSHD and seven controls. The cohort had a mean age of 41.6 years. The FSHD group echogenicity values (118.2) were higher than controls (42.3), respectively, as well as statistically significant ( p = .002). An overall variance of 6.2 (range = −2.9 to 15.4) was identified between the reference images. Echogenicity explained 81% of the variance in muscle thickness and 74% of the variance in range of movement muscle thickness was explained by 61% of the variance for range of movement. Conclusion: Histogram matching for comparison of echogenicity was required. Different reference images affect echogenicity values, but the variability was less than between group differences. Further longitudinal evaluation based on a larger sample of participants is needed.
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Immersive Haptic Simulation for Training Nurses in Emergency Medical ProceduresThe use of haptic simulation for emergency procedures in nursing training presents a viable, versatile and affordable alternative to traditional mannequin environments. In this paper, an evaluation is performed in a virtual environment with a head-mounted display and haptic devices, and also with a mannequin. We focus on a chest decompression, a life-saving invasive procedure used for trauma-associated cardiopulmonary resuscitation (and other causes) that every emergency physician and/or nurse needs to master. Participants’ heart rate and blood pressure were monitored to measure their stress level. In addition, the NASA Task Load Index questionnaire was used. The results show the approved usability of the VR environment and that it provides a higher level of immersion compared to the mannequin, with no statistically significant difference in terms of cognitive load, although the use of VR is perceived as a more difficult task. We can conclude that the use of haptic-enabled virtual reality simulators has the potential to provide an experience as stressful as the real one while training in a safe and controlled environment.
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The Supporters of the Macclesfield Society for Acquiring Useful KnowledgeThe Macclesfield Society for Acquiring Useful Knowledge was founded in 1835 and became one of the East Cheshire silk town's most successful educational institutions by the mid nineteenth century. The Macclesfield version was part of the second wave of mechanics' institutes and lasted for fifty-seven years. The Society originated from two mutual improvement groups who enlisted the help of a leading silk manufacturer. As a result, the Society was founded to provide useful knowledge to the town's inhabitants without any political or religious bias. The Society's supporters tended to be businessmen, professionals and representatives from prominent families in the area, in common with those of many other mechanics' institutes. The extant reports contain information on the institution, together with speeches given by its prominent patrons which cover a broad range of topics, from local and regional issues to national legislation. This source material gives an insight into the beliefs of the Society's supporters and how they changed in response to different influences, such as the introduction of the 1870 Education Act, the effects of trade depression on Macclesfield and the loss of protective tariffs for the English silk industry. © The University of Leeds, 2011.
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How Can We Do This? Power Constraints & Barriers to InnovationThe author explores how power constraints and other barriers may factor into the innovative progress of careers services and professionalism of the career development sector - in this study funded by the Jisc careers research grant. In the rapidly evolving landscape of higher education institutions, career development practitioners stand at a critical juncture. At the heart of their role lies a critical challenge: navigating the intricate power dynamics that define and often constrain their ability to innovate. Practitioner voices on the process of innovation in their work have not been examined extensively in the sector's research literature before. This study examines the factors influencing their decision making about innovative practices.
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From Power Gaps to ProgressThis article discusses the power gaps faced by career development practitioners when applying innovative practices in higher education. Innovative practices have the potential to meet the demands of the evolving future of work, and power gaps can undermine our professionalism.
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How can we do this? An investigation of power constraints and other barriers to career development practitioners’ innovation in higher educationThis article investigates the factors influencing career development practitioners’ decisions in relation to innovation in a Higher Education context. Drawing on a dissertation research project, it presents an early substantive grounded theory of practitioners ‘Constructing Empowerment’ to overcome power constraints and other barriers to innovation. The article provides an argument that the sector is at a ‘critical juncture’ in which radical ideas can rapidly be implemented, and that a decision-making model to discern good, from bad or ambiguous ideas may be beneficial for maintaining quality standards and healthy professional boundaries.</jats:p>
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Presenting a theory of how career development practitioners innovateThe presentation shares an introduction to a theory of how careers practitioners innovate in higher education. It explores the output from a grounded theory study in a cathedrals group university, where practitioner voices about innovation are explored. Previously their voices have only been based on conjecture, not grounded in their own words.
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A theory of how career development practitioners innovateAn exploration of the power constraints and other barriers to innovation by career development practitioners in HE. Based upon a grounded theory study of a Cathedral's Group University.
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Community, Cholera, Chapel and Children: The History of Chester Royal Infirmary’s Surviving Stained-glass WindowsThe installation of two sets of stained-glass windows at Chester Royal Infirmary in the early twentieth century represent one of the ways in which Florence Nightingale’s suggested improvements to the lives of patients could be achieved through attractive and colourful objects in the hospital environment. Generations of patients were thus able to benefit from these artefacts until the closure of the hospital in 1994 and the removal of the windows from the original building. Four of these windows were installed at the University of Chester’s Wheeler Building (formerly County Hall) as a community project in 2023. Background research was undertaken to piece together the stories behind these windows and the many people involved, who themselves contributed to the hospital, city and beyond in many different ways. Therefore, this article explores the history behind the windows and their time as popular features of this key medical institution, which provided care for Chester’s patients for over 230 years.
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Back into the light: The unveiling of Chester Royal Infirmary’s stained-glass windows at the University of ChesterOn 7 June 2023, the University of Chester’s Faculty of Health, Medicine and Society (FHMS) Historical Society hosted an event at the University’s Wheeler Building, when four stained glass windows from the former Chester Royal Infirmary were unveiled in their new home
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Macclesfield Baths and Washhouses and its patrons in the nineteenth centuryThe East Cheshire market town of Macclesfield had grown to become the leading centre of the English silk industry by the mid nineteenth century and this resulted in severe pressure on the town’s inadequate services. One element of the national campaign to improve sanitary conditions in urban areas was the public baths and washhouses movement from the 1840s, which resulted in the Public Baths and Wash-houses Acts in 1846 and 1847. Macclesfield’s Baths and Washhouses opened in January 1850 and it was one of the first provincial towns after Liverpool to provide such facilities. This article will therefore explore the national baths and washhouses movement, the impact of industrialisation on living conditions in Macclesfield, the history of the town’s Baths and Washhouses in the nineteenth century, the people active in its development and the range of motives which may have encouraged their support for this early addition to the public services for inhabitants.
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The Fall of the House of Wynnstay: The 1885 Election in East DenbighshireThis article discusses the 1885 election in East Denbighshire when the Williams-Wynn family of Wynnstay lost the parliamentary seat that the family had represented for over 170 years. The election took place amidst the backdrop of legislative changes to corrupt practices, the electorate, and changing constituency boundaries. Conservative and Liberal party organisation in East Denbighshire is discussed.
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The role of the local newspaper during World War One: An important link between the home front and the battle frontThis article discusses the role of the local newspapers during World War One and argues that it provided a link between the home front and the battle front, in particular as a reminder of the home front, keeping up morale and encouraging recruitment, providing war news and descriptions of wartime experiences, helping to send gifts to soldiers, alleviating boredom, and creating a community of soldiers.
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Trabant: Go with the legend"The car is that mediation between state and society. If you look at when they finally opened the borders for people to go West, the Trabis also went with them." Modern Languages undergraduate Austen Lowe was invited to Drystone Radio's Backseat Driver show to discuss his research on the Trabant with Mark Stone. This radio broadcast outlines the misunderstandings surrounding GDR mobility. The conversation focusses on how the wooden and plastic car personifies the state in which it was made. The broadcast aims to draw parallels between production techniques in the GDR and the FRG, relating these methods to cars produced more recently in Zwickau. What did quality actually mean in the GDR and is the Trabant really a motoring legend?
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The impact of severe haemophilia and the presence of target joints on health-related quality-of-lifeBackground: Joint damage remains a major complication associated with haemophilia and is widely accepted as one of the most debilitating symptoms for persons with severe haemophilia. The aim of this study is to describe how complications of haemophilia such as target joints influence health-related quality of life (HRQOL). Methods: Data on hemophilia patients without inhibitors were drawn from the ‘Cost of Haemophilia across Europe – a Socioeconomic Survey’ (CHESS) study, a cost-of-illness assessment in severe haemophilia A and B across five European countries (France, Germany, Italy, Spain, and the UK). Physicians provided clinical and sociodemographic information for 1285 adult patients, 551 of whom completed corresponding questionnaires, including EQ-5D. A generalised linear model was developed to investigate the relationship between EQ-5D index score and target joint status (defined in the CHESS study as areas of chronic synovitis), adjusted for patient covariates including socio-demographic characteristics and comorbidities. Results: Five hundred and fifteen patients (42% of the sample) provided an EQ-5D response; a total of 692 target joints were recorded across the sample. Mean EQ-5D index score for patients with no target joints was 0.875 (standard deviation [SD] 0.179); for patients with one or more target joints, mean index score was 0.731 (SD 0.285). Compared to having no target joints, having one or more target joints was associated with lower index scores (average marginal effect (AME) -0.120; SD 0.0262; p < 0.000). Conclusions: This study found that the presence of chronic synovitis has a significant negative impact on HRQOL for adults with severe haemophilia. Prevention, early diagnosis and treatment of target joints should be an important consideration for clinicians and patients when managing haemophilia.
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The relationship between target joints and direct resource use in severe haemophiliaObjectives Target joints are a common complication of severe haemophilia. While factor replacement therapy constitutes the majority of costs in haemophilia, the relationship between target joints and non drug-related direct costs (NDDCs) has not been studied. Methods Data on haemophilia patients without inhibitors was drawn from the ‘Cost of Haemophilia across Europe – a Socioeconomic Survey’ (CHESS) study, a cost assessment in severe haemophilia A and B across five European countries (France, Germany, Italy, Spain, and the United Kingdom) in which 139 haemophilia specialists provided demographic and clinical information for 1285 adult patients. NDDCs were calculated using publicly available cost data, including 12-month ambulatory and secondary care activity: haematologist and other specialist consultant consultations, medical tests and examinations, bleed-related hospital admissions, and payments to professional care providers. A generalized linear model was developed to investigate the relationship between NDDCs and target joints (areas of chronic synovitis), adjusted for patient covariates. Results Five hundred and thirteen patients (42% of the sample) had no diagnosed target joints; a total of 1376 target joints (range 1–10) were recorded in the remaining 714 patients. Mean adjusted NDDCs for persons with no target joints were EUR 3134 (standard error (SE) EUR 158); for persons with one or more target joints, mean adjusted NDDCs were EUR 3913 (SE EUR 157; average mean effect EUR 779; p < 0.001). Conclusions Our analysis suggests that the presence of one or more target joints has a significant impact on NDDCs for patients with severe haemophilia, ceteris paribus. Prevention and management of target joints should be an important consideration of managing haemophilia patients.
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Modelling low velocity impact induced damage in composite laminatesThe paper presents recent progress on modelling low velocity impact induced damage in fibre reinforced composite laminates. It is important to understand the mechanisms of barely visible impact damage (BVID) and how it affects structural performance. To reduce labour intensive testing, the development of finite element (FE) techniques for simulating impact damage becomes essential and recent effort by the composites research community is reviewed in this work. The FE predicted damage initiation and propagation can be validated by Non Destructive Techniques (NDT) that gives confidence to the developed numerical damage models. A reliable damage simulation can assist the design process to optimise laminate configurations, reduce weight and improve performance of components and structures used in aircraft construction.
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Transposing tirtha: Understanding religious reforms and locative piety in early modern HinduismThe paper deals with a historical and hitherto obscure case of de-commercialisation of sacred geography of India. Sahajanand Swami, an eighteenth century religious leader from Gujarat who became popular as Bhagwan Swaminarayan took an initiative to eliminate corruption in Dwarka, one of the most sacred destination in Hindu imagination. He also attempted to transpose the piety of Dwarka and recreate a parallel religious experience at Vadtal, an important site in Swaminarayan Hinduism. This process of making sacred sites more egalitarian is classified here as a 'religious reform'. The paper assesses this bivalent pursuit as an institutional reform within religion as well as a religious process in the context of piety, authority and orthodoxy. Through the example of Sahajanand Swami, it is argued to calibrate the colonial paradigm of reform that was largely contextual to social issues and western thought and failed to appreciate the religious reforms of that era. By constructing a nuanced typology of 'religious reform' distinct from 'social reforms', the paper eventually calls for a reassessment of religious figures who have significantly contributed in reforming the Hindu tradition in the medieval and modern era.
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Neuropsychiatric symptoms following metal-on-metal implant failure with cobalt and chromium toxicityBackground: There were at least 31,171 metal-on-metal (MoM) hip implants in the UK between 2003 and 2011. Some of these were subject to failure and widescale recalls and revisions followed. Method This is a presentation of ten cases (mean age 60 years) where we evaluated neuropsychiatric morbidity following metal-on-metal hip implant failure and revision. Implants were ASR total hip replacement (acetabular implant, taper sleeve adaptor and unipolar femoral implants) performed between 2005 and 2009. This case series describes, for the first time, neuropsychiatric complications after revision where there has been cobalt and chromium toxicity. Results Pre-revision surgery, nine patients had toxic levels of chromium and cobalt (mean level chromium 338 nmol/l, mean cobalt 669.4 nmol/l). Depression assessment showed 9 of 9 respondents fulfilled the BDI criteria for depression and 3 of these were being treated. 7 of 9 patients showing short term memory deficit with mean mini mental state examination score of 24.2. The normal population mean MMSE for this group would be expected to be 28 with <25 indicating possible dementia. Conclusions We found neurocognitive and depressive deficits after cobalt and chromium metallosis following MoM implant failure. Larger studies of neurocognitive effects are indicated in this group. There may be implications for public health.
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Development and feasibility of a Swallowing intervention Package (SiP) for patients receiving radiotherapy treatment for head and neck cancer—the SiP study protocolBackground Head and neck cancer (HNC) is the sixth most common cancer worldwide, and the functional, psychological and social consequences of HNC cancer and its treatment can be severe and chronic. Dysphagia (swallowing problems) affects up to two thirds of patients undergoing combined chemoradiotherapy. Recent reviews suggest that prophylactic swallowing exercises may improve a range of short- and long-term outcomes; however, the importance of psychological and behavioural factors on adherence to swallowing exercises has not been adequately studied. This study aims to develop and test the feasibility of a Swallowing intervention Package (SiP) designed in partnership with patients, speech and language therapists (SLTs) and other members of the head and neck multi-disciplinary team (MDT), for patients undergoing chemoradiotherapy (CRT) or radiotherapy (RT) for head and neck cancer. Methods/design This feasibility study uses quantitative and qualitative research methods, within a quasi-experimental design, to assess whether patients will tolerate and adhere to the SiP intervention, which aspects of the intervention can be implemented and which cannot, whether treatment fidelity can be achieved across different contexts, whether study processes and outcome measures will be feasible and acceptable and to what extent the intervention is likely to have an impact on swallowing dysfunction and quality of life. Patients are being recruited from five sites in Scotland and England (three interventions and two usual care). The SLT based in the relevant intervention centre teaches the exercise programme and provides supporting materials. A combination of patient-reported outcome measures (PROMs), adherence measures and clinical swallowing assessments are used prior to intervention (baseline), at the end of treatment, 3 and 6 months post-treatment. Discussion This collaborative study has taken a unique approach to the development of a patient-centred and evidence-based swallowing intervention. The introduction of an e-SiP app provides an exploration of the use of technology in delivering this intervention. The study provides an opportunity to examine the feasibility of delivering and participating in a supported swallowing intervention across several different NHS sites and will provide the evidence needed to refine intervention and study processes for a future trial. Trial registration NCRI portfolio, 18192 & 20259
