2,788 research outputs found
DYNAMIC BALANCE IN ALPINE SKIERS
There are more than 200 million alpine skiers worldwide (Hunter, 1999) but currently ski equipment does not protect the knee as it does the rest of the lower leg and there has been a dramatic rise in knee ligament and meniscus injuries associated with alpine skiing in recent years (Pecina, 2002). Pujol et al. (2007) stated that 45-60% of knee injuries during alpine skiing involve the ACL. Balance is an important component of performance in skiing (Laskowski, 1999) and Natri et al. (1999) found that many skiers sustaining an injury believed they were only temporarily off balance and capable of regaining control. The three most common mechanisms of injury to the knee in skiing are linked to a loss of dynamic balance (Rossi et al., 2003)
Natural attenuation of Fukushima-derived radiocesium in soils due to its vertical and lateral migration
Processes of vertical and lateral migration lead to gradual reduction in contamination of catchment soil, particularly its top layer. The reduction can be considered as natural attenuation. This, in turn, results in a gradual decrease of radiocesium activity concentrations in the surface runoff and river water, in both dissolved and particulate forms. The purpose of this research is to study the dynamics of Fukushima-derived radiocesium in undisturbed soils and floodplain deposits exposed to erosion and sedimentation during floods. Combined observations of radiocesium vertical distribution in soil and sediment deposition on artificial lawn-grass mats on the Niida River floodplain allowed us to estimate both annual mean sediment accumulation rates and maximum sedimentation rates corresponding to an extreme flood event during Tropical Storm Etau, 6-11 September 2015. Dose rates were reduced considerably for floodplain sections with high sedimentation because the top soil layer with high radionuclide contamination was eroded and/or buried under cleaner fresh sediments produced mostly due to bank erosion and sediments movements. Rate constants of natural attenuation on the sites of the Takase River and floodplain of Niida River was found to be in range 0.2-0.4 year-1. For the site in the lower reach of the Niida River, collimated shield dose readings from soil surfaces slightly increased during the period of observation from February to July 2016. Generally, due to more precipitation, steeper slopes, higher temperatures and increased biological activities in soils, self-purification of radioactive contamination in Fukushima associated with vertical and lateral radionuclide migration is faster than in Chernobyl. In many cases, monitored natural attenuation along with appropriate restrictions seems to be optimal option for water remediation in Fukushima contaminated areas
Investigating and learning lessons from early experiences of implementing ePrescribing systems into NHS hospitals:a questionnaire study
Background: ePrescribing systems have significant potential to improve the safety and efficiency of healthcare, but they need to be carefully selected and implemented to maximise benefits. Implementations in English hospitals are in the early stages and there is a lack of standards guiding the procurement, functional specifications, and expected benefits. We sought to provide an updated overview of the current picture in relation to implementation of ePrescribing systems, explore existing strategies, and identify early lessons learned.Methods: a descriptive questionnaire-based study, which included closed and free text questions and involved both quantitative and qualitative analysis of the data generated.Results: we obtained responses from 85 of 108 NHS staff (78.7% response rate). At least 6% (n = 10) of the 168 English NHS Trusts have already implemented ePrescribing systems, 2% (n = 4) have no plans of implementing, and 34% (n = 55) are planning to implement with intended rapid implementation timelines driven by high expectations surrounding improved safety and efficiency of care. The majority are unclear as to which system to choose, but integration with existing systems and sophisticated decision support functionality are important decisive factors. Participants highlighted the need for increased guidance in relation to implementation strategy, system choice and standards, as well as the need for top-level management support to adequately resource the project. Although some early benefits were reported by hospitals that had already implemented, the hoped for benefits relating to improved efficiency and cost-savings remain elusive due to a lack of system maturity.Conclusions: whilst few have begun implementation, there is considerable interest in ePrescribing systems with ambitious timelines amongst those hospitals that are planning implementations. In order to ensure maximum chances of realising benefits, there is a need for increased guidance in relation to implementation strategy, system choice and standards, as well as increased financial resources to fund local activitie
Evaluating remediation of radionuclide contaminated forest near Iwaki, Japan, using radiometric methods
Radiometric surveys have been conducted in support of a project investigating the potential of biofuel power generation coupled with remediation of forests contaminated with radionuclides following the Fukushima Daiichi accident. Surveys conducted in 2013 and 2014 were used to determine the distribution and time dependence of radionuclides in a cedar plantation and adjacent deciduous forestry subject to downslope radionuclide migration, and a test area where litter removal was conducted. The radiocaesium results confirmed enhanced deposition levels in the evergreen areas compared with adjacent areas of deciduous forestry, implying significant differences in depositional processes during the initial interception period in 2011. Surveys were conducted both with and without a collimator on both occasions, which modified the angular response of the detector to separate radiation signals from above and below the detector. The combined data have been used to define the influence of radionuclides in the forest canopy on dose rate at 1 m, indicating that, in evergreen areas, the activity retained within the canopy even by 2013 contributed less than 5% of ground level dose rate. The time dependent changes observed allow the effect of remediation by litter removal in reducing radionuclide inventories and dose rates to be appraised relative natural redistribution processes on adjacent control areas. A 15x45 m area of cedar forest was remediated in September 2013. The work involved five people in a total of 160 person hours. It incurred a total dose of 40-50 µSv, and generated 2.1 t of waste comprising forest litter and understory. Average dose rates were reduced from 0.31 µSv h-1 to 0.22 µSv h-1, with nuclide specific analyses indicating removal of 30 ± 3% of the local radiocaesium inventory. This compares with annual removal rates of 10-15% where radionuclide migration down-slope over ranges of 10-50 m could be observed within adjacent areas. Local increases were also observed in areas identified as sinks. The results confirm the utility of time-series, collimated, radiometric survey methods to account for the distribution and changes in radionuclide inventory within contaminated forests. The data on litter removal imply that significant activity transfer from canopy to soil had taken place, and provide benchmark results against which such remediation actions can be appraised
Inspiratory muscle training (IMT) for adults discharged from hospital with community acquired pneumonia (CAP) – a feasibility study
Patients report significant morbidity following community-acquired pneumonia (CAP); 70% report persistent symptoms and up to 50% impaired daily activity at 4 weeks post-discharge. Respiratory muscle weakness is one possible mechanism for delayed recovery. Inspiratory muscle training (IMT) increases strength and endurance of inspiratory muscles, with improvements in patient-reported outcomes in other conditions. To our knowledge IMT has not previously been investigated in CAP.
To assess the tolerability of IMT in adults discharged from hospital with community-acquired pneumonia.
Patients hospitalised with a diagnosis of CAP between February 2017 and March 2018 were eligible for inclusion and convenience sampling was used for participant selection. Participants received an IMT device (POWERbreath KHP2) following familiarisation. Training frequency (twice daily) and load (50% PImax) were fixed, however training volume was incremental during weeks 1–3 (10, 20, 30 breaths) and constant thereafter (30 breaths.) Participants were followed by combination of telephone and clinic visits for 9 weeks. Outcomes of interest were; utilisation of IMT device per protocol (defined as >94% training adherence), patient-reported IMT acceptability, and number of device-related side effects. Statistical analysis was conducted using Stata (version 15.1.)
Twenty-two participants were recruited; 16 were male (72.7%), mean age was 55.2 years (range 27.9–77.3.) Participants completed IMT per protocol in 72.7% cases. One unrelated, unexpected serious adverse event (death) occurred during follow-up and 3 participants active at this time were stopped from further IMT by research sponsor pending investigation. Two participants were lost to follow-up. Side effects during IMT were reported on 15 occasions across 22 participants over a total 1183 training days. Reported side effects included chest pain (x2), cough (x1), dyspnoea (x4), and dizziness (x8). All side-effects were rated grade 1 and did not prevent participants from continuing training. Participant-reported IMT acceptability, defined by participants rating training as both ‘useful’ and ‘helpful’ at each follow-up contact, was 99.4%.
Inspiratory muscle training appears to be safe, tolerable, and acceptable to patients following CAP. Distinguishing CAP related symptoms and device-related side effects is challenging in patients recovering following an acute infective illness. A clinical trial to determine efficacy is warranted.Nottingham University Hospitals Trus
‘It’s not what it looks like. I’m Santa’: connecting community through film
The lived experiences of young people are becoming increasingly marginalised within the narrowly defined curricula of neoliberal contexts. Many young people are also cast within the media according to deficit discourses of youth, which contributes to the fragmentation of communities and the limitation of interaction between generations. This article describes a film project in which young people living in an ex-mining community in the Midlands of England worked in and with their community to create a representation of where they live. As part of the process, the young filmmakers did more than connect to other people’s memories as repositories of information; both as process and as product, their film can be seen to connect shared narratives of people and place, across time and space. We argue that this project offers a timely opportunity to reflect upon the ways in which we understand learning in and out of English classrooms
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