Help! – you need your hands: Contribution of arm movements on balance performance in healthy individuals: A systematic review with meta-analysis

Background: Emerging evidence highlights that arm movements exert a substantial and functionally relevant contribution on postural control in healthy individuals. However, performance differences between free versus restricted arm movement for different balance categories with varying levels of task difficulty have not been systematically investigated yet. Objective: The objective of this systematic review and meta-analysis was to characterise, aggregate, and quantify performance discrepancies between free and restricted arm movement conditions for diverging balance categories with varying levels of task difficulty in healthy individuals. Methods: A systematic search of the literature according to the PRISMA guidelines was performed on the electronic databases PubMed, Web of Science, and SPORTDiscus from their inception date till 1st September 2024. To be applicable for analysis, studies had to report at least one measure of balance performance in healthy individuals. The included studies were coded according to the following criteria: age, sex, status, arm movement conditions, balance test, and test modality. Methodological study quality was assessed using the Appraisal tool for Cross-Sectional Studies. Weighted standardized mean differences (SMD) were calculated and classified according to their magnitude. Results: The literature search identified a total of N = 941 records, 25 of which met the inclusion criteria and were analysed in this review. A total of 725 participants (n = 331 females) participated in the studies. The free use of arm movement resulted in moderate (static: SMD = 0.51, dynamic: SMD = 0.66, proactive: SMD = 0.52, reactive: SMD = 0.50) improvements of balance performance. In addition, the performance enhancements were more pronounced for balance tasks with a high (static: SMD = 0.89, dynamic: SMD = 1.04) compared to a low (static: SMD = 0.20, dynamic: SMD = 0.76) difficulty level. Due to a lack of studies, no analysis for measures of proactive and reactive balance was performed. Conclusions: The findings revealed that the free use of arm movement positively affects several measures of balance performance, and this is effect is more pronounced for balance tasks with a high difficulty level

Understanding the relationship between the sustainability of the Professional Nurse Advocate Role, Organisational Culture and Quality Improvement Strategies in Healthcare: An Integrative Review

Aim: To understand the relationship between organisational culture and quality improvement strategies (QI) in healthcare and how this applies to the sustainability of the Professional Nurse Advocate (PNA) role.Background: In response to nurse burn-out experienced throughout and following the coronavirus pandemic, NHS England launched the PNA role to support nurses through the Advocating and Educating for Quality ImProvement (A-EQUIP) model (NHS England, 2021). Uptake of the role has been disparate, and organisational culture may be one factor contributing to this. However, as the PNA role is relatively new, there is limited research in this field. Therefore, organisational culture was explored in relation to QI strategies more widely to understand if there are findings transferable to the PNA role and its sustainability.Method: Following ethical approval, The Toronto (2020) six-phase integrative review method was followed. CINAHL, Medline, Embase, Emcare, HMIC and grey literature databases were systematically searched. 799 articles were retrieved and screened, with 20 articles being included in the review, displayed via Preferred Reporting Items for Systematic reviews and Meta Analysis (PRISMA) and critically appraised. Qualitative literature was analysed using thematic analysis, whilst mixed method and quantitative literature were synthesised narratively.Findings: 6 key themes were identified relating to organisational culture and implementation of QI strategies: 3 facilitators (Leadership, collective action and shared ideology) and 3 barriers (Leadership, disconnection and external influences). An association between collective action and the uptake of QI was identified that could link to PNA implementation and sustainability. However, discussion of sustainability in relation to implementation was lacking and warrants further research.Implications for practice: There is a clear link between cultures that allow collective action and successful implementation efforts. However, this review highlights the need for further research on the relationship between collective action and sustainability of initiatives such as the PNA role

Vertical shear instabilities in rotating stellar radiation zones:effects of the full Coriolis acceleration and thermal diffusion

Rotation deeply impacts the structure and the evolution of stars. To build coherent 1D or multi-D stellar structure and evolution models, we must systematically evaluate the turbulent transport of momentum and matter induced by hydrodynamical instabilities of radial and latitudinal differential rotation in stably stratified thermally diffusive stellar radiation zones. In this work, we investigate vertical (radial) shear instabilities in these regions. The full Coriolis acceleration with the complete rotation vector at a general latitude is taken into account. We formulate the problem by considering a canonical shear flow with a hyperbolic-tangent profile. We perform linear stability analysis on this base flow using both numerical and asymptotic Wentzel–Kramers–Brillouin–Jeffreys (WKBJ) methods. Two types of instabilities are identified and explored: inflectional instability, which occurs in the presence of an inflection point in shear flow, and inertial instability due to an imbalance between the centrifugal acceleration and pressure gradient. Both instabilities are promoted as thermal diffusion becomes stronger or stratification becomes weaker. Effects of the full Coriolis acceleration are found to be more complex in our parametric investigations in wide ranges of colatitudes and rotation-to-shear and rotation-to-stratification ratios. Also, new prescriptions for the vertical eddy viscosity are derived to model the turbulent transport triggered by each instability. We foresee that the inflectional instability will be responsible for turbulent transport in the equatorial region of strongly stratified radiative zones in slowly rotating stars while the inertial instability triggers turbulence in the polar regions of weakly stratified radiative zones in fast-rotating stars

Graffiti as Method:Spatio-temporal Analysis of Political Perception and Community Relations in Belfast

This article explores the methodological possibilities that a graffiti dataset offers to a spatio-temporal analysis of peace and conflict. Leveraging our original visual dataset of Belfast’s changing muralscape, the analysis unpacks how messages painted on walls offer a lens into evolving local sentiments, politics, unity, and divisions. We suggest that tracking changes in graffiti across time offers methodological innovation in understanding contested spaces, and, when used as a foundational method, a dataset enhances researcher understanding of violence, avoidance, memorialisation and publicly debated social issues, paving the way for further research on graffiti as a lens for understanding complex societal phenomena

Aerosolisation of new generation perfluoroalkyl ether carboxylic and sulfonic acids from aeration of contaminated aqueous solutions

There has been an industrial shift towards replacing legacy per- and polyfluoroalkyl substances (PFAS) with perfluoroalkyl ether carboxylic and sulfonic acids (PFECA and PFESA) including hexafluoropropylene oxide dimer acid (HFPO-DA), also known as GenX. These compounds have been detected in the atmosphere but their potential sources remain poorly understood.In this study, aerosolisation of six PFECA and PFESA from PFAS-contaminated water at concentrations and pHs representative of industrial sewage was investigated. All studied PFECA and PFESA were observed in the aerosols from the aeration of PFAS-fortified water at pH 6, 7 and 8. The aerosolisation behaviour of PFECA and PFESA increased with the analyte's carbon chain length and was influenced by the PFAS functional groups and pH of the aerated solution. PFESA with sulfonic acid groups aerosolised more from the solutions than PFECA with carboxylic acid groups. The ability of new generation PFAS to transfer from contaminated waters and become airborne (aerosolise up to a mass fraction 30.4 ± 2.7 %) raises concerns due to their potential health and environmental impacts. Our findings indicate that industrial and water management processes involving aeration of water contaminated with PFECA and PFESA could serve as potential sources of new-generation atmospheric PFAS

Preliminary findings of storytelling in schools as a pre-heatwave intervention to enhance children's behaviour to improve thermal comfort

Younger schoolchildren in particular are at risk of overheating in school due to two key factors. Firstly, children have a preference for lower temperatures than adults, and yet schools are designed and operated using adult thermal preference guidance. Secondly, younger schoolchildren often lack the confidence to change their behaviour in a school setting (remove a jumper, more away from direct sunlight, drink more water etc.) without prompting from the teacher. This paper reports a pilot study of a storytelling approach to enable schoolchildren to enhance their behaviour to improve their thermal comfort. A control: intervention study was undertaken across eight classes, in two schools in Hampshire, UK, with KS1 (national curriculum Key Stage 1, age 6–7) and KS2 (Key Stage 2 age 7–9) children. A new story, “The Hottest Day at School” was developed, where actions to improve thermal comfort were introduced, read by the teacher to children of intervention classes prior to a heatwave. The thermally influenced actions and feelings of schoolchildren were assessed during the heatwave event via a sticker log activity which each child completed. Fisher's exact and Pearson's chi-squared tests indicate statistically significant differences in the actions of KS1 children in particular. Whilst acknowledging the preliminary nature of the findings, the paper suggests that the storytelling approach does enable children to adapt their behaviour to enhance thermal comfort

CFD and PIV analysis of a novel, low shear stress intra-aortic ventricular assist device

Stroke has emerged as the primary contributor to morbidity and mortality in patients undergoing treatment with Left Ventricular Assist Devices (LVADs), possibly arising from the turbulent flow and elevated wall shear stresses generated in these devices. A minimally invasive LVAD (LifeheART) has been proposed to address these issues, employing an intra-aortic location and a shaftless impeller design. The current study uses Particle Image Velocimetry (PIV) flow visualization, carried out in a Cardiovascular Mock Circulation Loop (CMCL), to identify the velocity distribution at the pump outlet in order to validate the developed CFD model. Subsequently, the model evaluates the blood shear stress distribution and blood damage index. The results showed that the calculated viscous shear stress (VSS) and the blood damage index of the LifeheART prototype is significantly lower than the published data for current clinically available devices, confirming the potential utility of the new design to improve patient outcomes

First true blood pressure measurement with micropulse detection of arterial opening achieved

There is a well-accepted need for a new more accurate solution to automatic blood pressure measurement, in spite of clinical convenience continuing to encourage the adoption of oscillometric devices with their known poor accuracy throughout healthcare. Our solution avoids estimates, mathematical modelling, oscillometric algorithms, and inadequate calibration against numerous private clinical data sets. Here we show that our new technique detects, from an arm cuff, micropulses associated with arterial opening between systolic and diastolic pressures; hence detecting systole at the first micropulse and diastole at the last, during cuff deflation. Our technique has equivalent accuracy to the gold standard auscultatory method, and is significantly better than the requirements of the current international standard for blood pressure devices. Our results provide scientific evidence for the effectiveness of our technique, and demonstrate significant clinically important improvements. We anticipate that our technique can be automated easily and economically. We acknowledge that this early study is an initial manual evaluation, but expect this new technique to be an automated universal solution for true blood pressure measurement, and a vital step change in an important clinical measurement in healthcare of the worldwide population

The intersections of race and gendered stereotypes within the constructions of digital women footballers in video games

This article employs Bogost’s (2007) ‘procedural rhetoric’ frame to explore the ways in which the numerical values which constitute FIFA 22’s ‘Top 100’ Black and White digital women footballers reflect or challenge the exclusionary discourses that have, thus far, shaped the experiences of White and Black female sporting athletes in the social world. In doing so, this research is the first to empirically demonstrate considerable differences between the construction, sporting competencies and artificial emotional and sporting intelligence assigned to Black and White digital players within football video games. Findings also demonstrate the ways in which the numerical foundations of racialised digital women footballers are informed by, and reflect, processes of both sporting misogynoir and Whiteness, which intersect and underpin the markedly anti-Black and anti-feminine framings and sporting competencies of digital Black female footballers within this digital sports world

Hydrological vs. mechanical impacts of soil water repellency on erosion

Soil erosion is a major concern for both agricultural and natural resources. Soil water repellency (SWR) is known to hinder wetting of soils, decreasing infiltration of water and thus increasing overland flow—the driving force for erosion. These hydrological impacts of SWR on erosion, are quite well established. In contrast, the mechanical impacts of SWR, namely on the resistance to erosion, are poorly understood. Here, we provide a critical review of the current understanding of both the hydrological and mechanical impacts of SWR on erosion. Analysis of compiled experimental data provides contradictory evidence: an increase in erosion with increasing SWR in some cases, versus a decrease in others, with a strong dependency on the mechanism (weather, fire, or pollution-induced SWR). We offer a plausible explanation for this contradiction—that the net erosional impacts of SWR depend on the balance between its hydrological and mechanical effects on erosion, and exemplify this in a simple 1D slope model. Our simulations illustrate the dual nature of SWR's influence on soil erosion, and explain the diversity of published data. Finally, we identify research gaps and suggest ways to address them