Advancing imaging technologies for patients with spinal pain : with a focus on whiplash injury

Background: Radiological observations of soft-tissue changes that may relate to clinical symptoms in patients with traumatic and non-traumatic spinal disorders are highly controversial. Studies are often of poor quality and findings are inconsistent. A plethora of evidence suggests some pathoanatomical findings from traditional imaging applications are common in asymptomatic participants across the life span, which further questions the diagnostic, prognostic, and theranostic value of traditional imaging. Although we do not dispute the limited evidence for the clinical importance of most imaging findings, we contend that the disparate findings across studies may in part be due to limitations in the approaches used in assessment and analysis of imaging findings. Purpose: This clinical commentary aimed to (1) briefly detail available imaging guidelines, (2) detail research-based evidence around the clinical use of findings from advanced, but available, imaging applications (eg, fat and water magnetic resonance imaging and magnetization transfer imaging), and (3) introduce how evolving imaging technologies may improve our mechanistic understanding of pain and disability, leading to improved treatments and outcomes. Study Design/Setting: A non-systematic review of the literature is carried out. Methods: A narrative summary (including studies from the authors' own work in whiplash injuries) of the available literature is provided. Results: An emerging body of evidence suggests that the combination of existing imaging sequences or the use of developing imaging technologies in tandem with a good clinical assessment of modifiable risk factors may provide important diagnostic information toward the exploration and development of more informed and effective treatment options for some patients with traumatic neck pain. Conclusions: Advancing imaging technologies may help to explain the seemingly disconnected spectrum of biopsychosocial signs and symptoms of traumatic neck pain

Sustainable decision making for emerging educational technologies in libraries

Purpose: The purpose of this article is to discuss approaches to sustainable decision-making for integrating emerging educational technologies in library instruction while supporting evidence-based practice (EBP) Design/methodology/approach: This article highlights recent trends in emerging educational technologies and EBP and details a model for supporting evidence informed decision-making. This viewpoint article draws on an analysis of recent literature, as well as experience from professional practice. Findings: Authors discuss the need for sustainable decision-making that addresses a perceived lack of evidence surrounding emerging technologies, a dilemma that many library educators and practitioner-researchers will have faced in their own library instruction. To support the evidence-informed selection and integration of emerging educational technologies, a two-pronged model is presented, beginning with an articulation of pedagogical aims, alignment of technological affordances to these aims and support of this alignment via hard evidence available in the research literature, as well as soft evidence found in the environmental scan. Originality/value: This article provides an outline and synthesis of key issues of relevance to library practitioners working within a challenging and ever-changing landscape of technologies available for learning and instruction. The proposed approach aims to create a sustainable model for addressing problems of evidence and will benefit academic librarians considering emerging educational technologies in their own pedagogy, as well as those who support the pedagogy of others

IMPLEMENTATION OF AN EVIDENCE-BASED BUNDLE TO REDUCE HOSPITAL ACQUIRED PRESSURE INJURY HARM RATES IN THE INTENSIVE CARE UNIT: A QUALITY IMPROVEMENT PROJECT

A pressure injury (PI) is a condition in which prolonged pressure or shear causes localized damage to the soft tissue and skin and is usually over a bony prominence (National Pressure Ulcer Advisory Panel (NPUAP), 2016). PIs can increase morbidity and mortality, increase length of stay, increase infection rates, increase healthcare costs and decrease quality of life (Agency for Healthcare Research and Quality (AHRQ), n.d.; Coyer et al., 2017). PIs are largely preventable yet continue to occur, despite the growing number of high-quality research articles that focus on this problem. Quality improvement initiatives are an effective way to translate evidence-based research into daily bedside practice. The purpose of this research was to utilize two evidence-based interventions to reduce hospital acquired PI HARM rates in the intensive care unit at a rural hospital in a Midwestern setting. Additionally, nursing self-reported compliance was assessed with the use of a survey to measure compliance over time. A retrospective pre-post design was utilized to compare ICU PI HARM rates prior to and after implementation of the interventions. Overall, PI rates increased from a mean of 0.53 in the ten months prior to implementation to a mean of 0.68 in the fourteen months after implementation. Nursing compliance was measured using a Likert-style questionnaire and was determined that the little variability over time suggested no changes in nursing compliance

Measuring Political Commitment in Statistical Models for Evidence-based Agenda Setting in Nonmotorized Traffic

When investigating national and international transport policies of the last decade, an ever increasing emphasis on promoting non-motorized transport modes such as walking or cycling can be identified, aiming at reaching multiple political targets (eg. reducing pollution, increasing health or lowering land consumption). However, despite substantial financial efforts being put into infrastructural or awarenessraising activities, achieving the desired modal shift towards active mobility remains a challenge. This is frequently due to unclear cause and effect patterns between active mode shares and their determinants, which in turn leads to uncoordinated or highly fragmented initiatives that impede target-oriented planning. An internationally adopted approach to overcome this problem is applying aggregated statistical models that explain modal choice involving multiple regression techniques and hypothetical covariates. Still, general critique against these models points out that important intangible soft factors such as attitudinal characteristics of the local population or mind-sets and political commitment of decision makers are not duly reflected. Also, for Austria there is currently no systematic holistic approach to explain spatial variance in active travel shares on the scale of municipalities. Hence the main objective of our research is to design a comprehensive macroscopic model-based approach for the quantitative explanation of modal split shares in active travel modes in Austria. In our approach we attach great importance to the inclusion of soft factors in order to contribute novel findings on the dynamics behind active travel. The research outcomes will aid decision makers and planners in their question where and more specifically, how to effectively invest into active mobility by revealing key soft factors and intangible determinants of active travel mode shares alongside a broad range of more known, traditional factors. Based on this evidence-based decision support approach it is possible to simulate impacts of actions when aiming at locally promoting active travel modes

Morphing architecture with responsive material systems

My research focuses design issues in architecture that can change its shape and other properties in response to changing external stimuli. Previous research has considered whether architecture can morph using ‘hard’ mechanical hinges, components, and systems for actuation and kinetic transformation. Few have explored the ‘soft’ alternatives. In my research I explore whether there is an opportunity for using a ‘soft’ system approach that exploits the performance of responsive materials when applied to lightweight, flexible and adaptive architectural designs that respond to environmental and lighting stimuli. I investigate unexplored approaches using responsive and ‘soft’ form-changing materials. This investigation presents opportunities for designing responsive morphing architecture with ‘hingeless’ actuation and transformation. My research aim is to investigate novel design strategies for responsive kinetic architecture through the exploration of alternative material systems and design tools with sensing and responsive capacities. This aim is investigated and evaluated through a ‘Design Tetralogy’, of four experimental design investigations in the form of architectural skins and envelopes as project works, namely Tent, Curtain, Blind and Blanket. Each focuses on an individual research area: elasticity, Tensegrity, kinetic materiality and sensitivity. The investigations were conducted using a rigorous method called responsive kinetic material system (RKMS), based on the concept of soft kinetics. This concept served as the ‘guiding principle’ for using he interchange of elasticity and memory in the properties of form-changing materials to affect physical transformation and kinesis in architecture. All four design investigations involved a series of conceptual prototypes as ‘reciprocal interventions’ to retrofit existing buildings. These prototypes serve as novel hybrid material systems, and as evidence to demonstrate the potential for practical applications of responsive morphing architecture with minimal, mechanical and discrete components that sense real-time data, manipulate daylight effects and perform active illumination. The outcomes and findings of my project-based design investigations contribute to early-stage design strategies for architects and designers to model morphing architecture through parametric design processes with responsive material explorations and accessible technologies. I conclude from my research that through the exploitation of alternative form-changing material systems with responsive capacities and novel tools, an alternative design paradigm for responsive morphing architecture can be conceived. This paradigm is based on anticipation of a new material culture in which physical computation is synthesised with dynamic material properties. This synthesis produces an atypical model as an alternative to mainstream architectural design research and practice for responsive kinetic architecture

Family- and school-based correlates of energy balance-related behaviours in 10-12-year-old children: a systematic review within the ENERGY (EuropeaN Energy balance Research to prevent excessive weight Gain among Youth) project

Objective: To identify family- and school-based correlates of specific energy balance-related behaviours (physical activity, sedentary behaviour, breakfast consumption, soft drink consumption) among 10-12-year-olds, using the EnRG framework (Environmental Research framework for weight Gain prevention). Design: A literature review to identify observational studies exploring at least one family- or school-based correlate of the specific behaviours, resulting in seventy-six articles. Setting: Eighteen studies were conducted in Europe, forty-one studies in North America and seventeen studies in Australasia. Subjects: Healthy children aged 10-12 years. Results: Parental and maternal physical activity, doing physical activities with parents and parental logistic support were identified as the most important, positive correlates of physical activity. Parental rules was the most important correlate of sedentary behaviour and was inversely related to it. School socioeconomic status was positively related to physical activity and inversely related to sedentary behaviour. The available studies suggested a positive relationship between soft drink availability at home and consumption. Soft drink availability and consumption at school were the most important school-based correlates of soft drink consumption. A permissive parenting style was related to more soft drink consumption and less breakfast consumption. Conclusions: An important role has been awarded to parents, suggesting parents should be involved in obesity prevention programmes. Despite the opportunities a school can offer, little research has been done to identify school-environmental correlates of energy balance-related behaviours in this age group. Obesity prevention programmes can focus on the most important correlates to maximize the effectiveness of the programme. Future research should aim at longitudinal studies

The influence of the food environment on overweight and obesity in young children : a systematic review

The increasing prevalence of childhood obesity has led to interest in its prevention, particularly through school-based and family-based interventions in the early years. Most evidence reviews, to date, have focused on individual behaviour change rather than the ‘obesogenic environment’. This paper reviews the evidence on the influence of the food environment on overweight and obesity in children up to 8 years. Electronic databases (including MEDLINE, EMBASE, Cochrane Controlled Trials Register (CCTR), DARE, CINAHL and Psycho-Info) and reference lists of original studies and reviews were searched for all papers published up to 31 August 2011. Study designs included were either population-based intervention studies or a longitudinal study. Studies were included if the majority of the children studied were under 9 years, if they related to diet and if they focused on prevention rather than treatment in clinical settings. Data included in the tables were characteristics of participants, aim, and key outcome results. Quality assessment of the selected studies was carried out to identify potential bias and an evidence ranking exercise carried out to prioritise areas for future public health interventions. Thirty-five studies (twenty-five intervention studies and ten longitudinal studies) were selected for the review. There was moderately strong evidence to support interventions on food promotion, large portion sizes and sugar-sweetened soft drinks. Reducing food promotion to young children, increasing the availability of smaller portions and providing alternatives to sugar-sweetened soft drinks should be considered in obesity prevention programmes aimed at younger children. These environment-level interventions would support individual and family-level behaviour change

INSPIRE sustainability internships: Promoting campus greening initiatives through student participation

Purpose - An exploration of the outputs of an internship programme, one of a number of campus-based sustainability activities that have been introduced at the University of Wales, Trinity Saint David, to encourage student-led campus-based greening initiatives. Design/methodology/approach - A Case Study approach was undertaken, allowing the researcher to investigate the programme in its real-life context. The researcher used multiple sources of evidence to gain as holistic a picture as possible. Findings - Interns report positive changes in their behaviours towards sustainability as well as encouraging feedback on their experiential learning, the development of their soft skills, and the creation of new knowledge. Moreover, students communicated perceived benefits for their future careers. The reported outcomes reflect mutually beneficial relationships for student and institution, for example raising the profile of campus greening activities; supporting the University’s aim to embed sustainability throughout its campus, community and culture. Research limitations/implications - The researcher recognises the limitations of the research, in particular the small sample size, which has resulted primarily in qualitative results being presented. Practical implications - Feedback from previous interns will be used to shape future internships. In particular, INSPIRE will look for opportunities to work more closely with University operations, departments, faculties and alongside University staff, both academic and support staff. Social implications - Following student feedback, INSPIRE will give students opportunities for wider involvement including an opportunity to propose their own projects in order to shape future internships that meet the needs of student body on campus. Originality/value - Despite being one case study from one institution, the research highlight the value of such programmes for other institutions