3 research outputs found
Adaptive Passivity-Based Pose Tracking Control of Cable-Driven Parallel Robots for Multiple Attitude Parameterizations
The proposed control method uses an adaptive feedforward-based controller to
establish a passive input-output mapping for the CDPR that is used alongside a
linear time-invariant strictly positive real feedback controller to guarantee
robust closed-loop input-output stability and asymptotic pose trajectory
tracking via the passivity theorem. A novelty of the proposed controller is its
formulation for use with a range of payload attitude parameterizations,
including any unconstrained attitude parameterization, the quaternion, or the
direction cosine matrix (DCM). The performance and robustness of the proposed
controller is demonstrated through numerical simulations of a CDPR with rigid
and flexible cables. The results demonstrate the importance of carefully
defining the CDPR's pose error, which is performed in multiplicative fashion
when using the quaternion and DCM, and in a specific additive fashion when
using unconstrained attitude parameters (e.g., an Euler-angle sequence)
What works for whom in the management of diabetes in people living with dementia: a realist review
Background
Dementia and diabetes mellitus are common long-term conditions and co-exist in a large number of older people. People living with dementia (PLWD) may be less able to manage their diabetes, putting them at increased risk of complications such as hypoglycaemia. The aim of this review was to identify key mechanisms within different interventions that are likely to improve diabetes outcomes in PLWD.
Methods
This is a realist review involving scoping of the literature and stakeholder interviews to develop theoretical explanations of how interventions might work, systematic searches of the evidence to test and develop the theories and their validation with a purposive sample of stakeholders. Twenty-six stakeholders — user/patient representatives, dementia care providers, clinicians specialising in diabetes or dementia and researchers — took part in interviews, and 24 participated in a consensus conference.
Results
We included 89 papers. Ten focused on PLWD and diabetes, and the remainder related to people with either dementia, diabetes or other long-term conditions. We identified six context-mechanism-outcome configurations which provide an explanatory account of how interventions might work to improve the management of diabetes in PLWD. This includes embedding positive attitudes towards PLWD, person-centred approaches to care planning, developing skills to provide tailored and flexible care, regular contact, family engagement and usability of assistive devices. An overarching contingency emerged concerning the synergy between an intervention strategy, the dementia trajectory and social and environmental factors, especially family involvement.
Conclusions
Evidence highlighted the need for personalised care, continuity and family-centred approaches, although there was limited evidence that this happens routinely. This review suggests there is a need for a flexible service model that prioritises quality of life, independence and patient and carer priorities. Future research on the management of diabetes in older people with complex health needs, including those with dementia, needs to look at how organisational structures and workforce development can be better aligned to their needs.
Trial registration
PROSPERO, CRD42015020625. Registered on 18 May 2015