A comparison of thermographic characteristics of the hands and wrists of rheumatoid arthritis patients and healthy controls

Thermal imaging has been applied to detect possible temperature variations in various rheumatic disorders. This study sought to determine whether rheumatoid arthritis (RA) patients without active synovitis in their hands exhibit different baseline thermographic patterns of the fingers and palms when compared to healthy individuals. Data from 31 RA patients were compared to that of 51 healthy controls. The RA patients were recruited upon confirmed absence of synovitis by clinical examination and musculoskeletal ultrasound. Participants underwent medical infrared imaging of the regions of interest (ROIs). Significant differences were found between the mean temperatures of the palm regions (29.37 °C (SD2.2); n = 306) and fingers (27.16 °C (SD3.2); n = 510) of the healthy participants when compared to the palm regions (31.4(SD1.84)°C; n = 186) and fingers (30.22 °C (SD2.4); n = 299) of their RA counterparts (p = 0.001), with the latter group exhibiting higher temperatures in all ROIs. Logistic regression models confirm that both palm and finger temperature increase significantly in RA without active inflammation. These innovative findings provide evidence that baseline thermal data in RA differs significantly from healthy individuals. Thermal imaging may have the potential to become an adjunct assessment method of disease activity in patients with RA.peer-reviewe

A Population-Based Study of Eating Disorders in Young Persons in Malta: Prevalence in Males Nearly Equals that in Females

Objective: The objective of this study was to examine the prevalence of eating disorders and attitudes to food and eating for youths between 10 and 16 years of age, in order to aid in the diagnosis and treatment of eating disorders in young people through empirical research in a previously unexamined area. Methods: The tool selected for this population-based study was the ChEAT, i.e. the Children’s Eating Attitudes Test. A representative cohort of 400, randomly sampled, young people aged 10-16, were asked all 26 questions of the ChEAT via telephone, while their parents/guardians were asked socio-demographic questions, Results: 5.5% (2.25% M, 3.25% F) of the cohort scored at or above the cut-off of 20, indicating the presence of an eating disorder. No significant associations were found between disordered eating and socio-demographic data. Conclusions: Findings indicate that males are catching up to females in eating disorder diagnoses. A male slightly higher mean ChEAT ≥20 could denote that disordered eating could be more acute for young men who are between 10 to 16 years old than it is for young women aged 10 to 16. The lack of significant association between the disordered eating and socio-demographic data could be a factor of the ages under examination in this study, and possibly these associations could arise at later ages

A comparative assessment of the financial costs and carbon benefits of REDD+ strategies in Southeast Asia

REDD+ holds potential for mitigating emissions from tropical forest loss by providing financial incentives for carbon stored in forests, but its economic viability is under scrutiny. The primary narrative raised in the literature is that REDD+ will be of limited utility for reducing forest carbon loss in Southeast Asia, while the level of finance committed falls short of profits from alternative land-use activities in the region, including large-scale timber and oil palm operations. Here we assess the financial costs and carbon benefits of various REDD+ strategies deployed in the region. We find the cost of reducing emissions ranges from $9 to$75 per tonne of avoided carbon emissions. The strategies focused on reducing forest degradation and promoting forest regrowth are the most cost-effective ways of reducing emissions and used in over 60% of REDD+ projects. By comparing the financial costs and carbon benefits of a broader range of strategies than previously assessed, we highlight the variation between different strategies and draw attention to opportunities where REDD+ can achieve maximum carbon benefits cost-effectively. These findings have broad policy implications for Southeast Asia. Until carbon finance escalates, emissions reductions can be maximized from reforestation, reduced-impact logging and investing in improved management of protected areas. Targeting cost-efficient opportunities for REDD+ is important to improve the efficiency of national REDD+ policy, which in-turn fosters greater financial and political support for the scheme

Evaluation of the impact of a pharmaceutical care service offered to rheumatoid arthritis patients within an ambulatory setting

The objectives of the study were to evaluate the impact of a newly developed pharmaceutical care services directed to rheumatoid arthritis patients attending an out-patient setting. A total of 88 patients participated in the study and were randomly divided into two equal groups, Group A and Group B. The study was carried out over three phases. In phase 1 (time 0), Group A patients were assessed and offered a pharmaceutical care session. Group B patients were assessed but no pharmaceutical care session was delivered. At phase 2 (4-6 months), group A patients were re-assessed (first assessment post pharmaceutical care plan). Group B patients were re-assessed a second time (second baseline assessment) and a pharmaceutical care session was offered to Group B patients. At phase 3 (time 10-11 months) both groups were re-assessed a third time. The Health Assessment Questionnaire and the Short Form-36 were used as outcome measures during each assessment. There were statistically significant differences (p<0.05) in all the 8 domains of the SF-36 between Phase 1 and 3 for both groups. For the Health Assessment Questionnaire, a statistical improvement in the daily activities was identified after the pharmaceutical care intervention for both groups (Phase 2 for Group A and phase 3 for Group B). The newly developed individualised pharmaceutical care service provided by the pharmacist led to an improved quality of life as measured by the health related quality of life questionnaires.peer-reviewe

Designer empathy in virtual reality : transforming the designer experience closer to the user

Empathy is a key driver for designers to unlock their user’s perspective. However, its multi-dimensional nature can be detrimental to the design process; therefore, a structured approach is vital. The current emergence and capabilities of Virtual Reality (VR) technology have inspired this research to explore how designers can achieve the optimal level of empathy required to produce innovative design solutions. A qualitative study involving semi-structured interviews with design engineers working with industry was performed to analyse current challenges in empathic design and identify how VR can address such challenges. The study highlighted that communication and resource factors were the main barriers to designer empathy. In response to this finding, this research bridges the gap between the designer and the user through the digital transformation of the designer’s profession that provides enhanced value to human-centricity, social and ecological interactions. The outcome of this study entails the creation of a specification for a novel fully immersive virtual environment: Designer Empathy in VR that augments designers’ empathic skills and empowers the designer to achieve cognitive and affective empathy towards their user from multiple perspectives. This research is a platform for a future empirical study addressing the impact of digital empathy on creating user-centred and innovative design solutions

Eating disorders amongst young persons in Malta : a nationally representative study of the prevalence and effect of eating disorders among young persons in Malta

At any point in time several million people across the globe are affected by eating disorders. Eating disorders such as Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder affect women more than men, with young female adolescents being the most at-risk group. However, there is growing awareness that this is not solely a young women’s issue, as men and older women are increasingly being diagnosed with eating disorders. These disorders devastate lives and have a high mortality rate. Their sociological and public health impacts make them major public health concerns. The duration and course of an eating disorder can be anywhere from a few years to around 15 years, with the detrimental effects on a sufferers’ life resulting in very real costs to person in terms of education, employment productivity and future security. The American Psychological Association (APA) defines eating disorders (EDs) as abnormal eating habits that can threaten health or even life. Eating disorders cause disruptions to normal perceptions and attitudes to food whereby, depending on the disorder, the sufferer exerts intense control, typical with anorexia nervosa, or loses control over their food intake, such as with binge eating disorder or bulimia. The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders, (DSM-5, 2013), lists six main specific eating disorders and two other categories - OSFED (other specified feeding and eating disorders) and UFED (unspecified feeding and eating disorders), which are also clinical diagnoses. The most commonly recognised and prevalent of these disorders are Anorexia Nervosa (AN), Bulimia Nervosa (BN) and Binge Eating Disorder (BED). Another eating disorder, that is becoming increasingly prevalent and disturbing, in that it affects even the very young, is Avoidant/Restrictive Food Intake Disorder (ARFID) - previously referred to as Selective Eating Disorder (SED). Anorexia Nervosa (AN), or simply, Anorexia, is characterised by an extreme fear of gaining weight, an abnormally low body weight and a distorted perception of weight. Persons suffering from anorexia have a strong wish to control their weight and shape and use extreme efforts, including starvation, to achieve this objective. The pursuit of the anorexic ideal has a significant effect on the life of sufferers, yet leaves them dissatisfied. No matter how much weight is lost, sufferers remain fearful of weight gain and experience a constant desire to lose more weight. This is because anorexia is not about weight or food. It is a dangerous and unhealth psychological way to exert control over emotional or psychological problems. Anorexia, Despite being the rarest of the eating disorders, anorexia is perhaps the most renowned and has the highest mortality risk of all the Eds, and the lowest recovery outcomes. Bulimia Nervosa (BN), or Bulimia as it is usually referred to, is characterised by frequent and uncontrollable episodes of overeating or binges, habitually consisting of the consumption of thousands of calories in a single sitting, accompanied by extreme efforts to avoid gaining weight. These behaviours set up a vicious cycle that wreaks havoc on body and mind, and tend to be accompanied by extreme secrecy and feelings of shame. Binge Eating Disorder (BED), is compulsive eating without purging behaviours. It is characterized by recurring episodes of excessive food consumption over a short period of time, often to the point of discomfort. As a result, sufferers are highly likely to be overweight or obese. This loss of control over food intake is accompanied by feelings of shame and guilt. Typically binge eaters are dissatisfied with their body shape, but this is not accompanied by body image distortion as with AN or BN. Avoidant/Restrictive Food Intake Disorder (ARFID), is a type of extreme picky eating or food phobia that is characterised by a restriction or avoidance of certain foods that sufferers find themselves unable to eat - to the extent that sufferers cannot meet their nutritional needs through food intake alone. Often whole food groups will be excluded, such as meat or green vegetables, which, besides causing clinical nutritional deficiencies to persons suffering from this condition, also interferes significantly with the sufferers’ life. Eating disorders arise for complex reasons and usually centre around a desire to control food intake, whereby, what starts as an attempt to lose weight or eat healthily, can spiral out of control. There is not usually one, single, cause for an eating disorder, and much less expert agreement as to what causes EDs. Rather there may be various causes at the root of a disorder. Aside from attempts to diet, family dynamics and genetic factors are shown to have significant influence on the predisposition to eating disorders. A family history of eating or mental health disorders, as well as exceedingly high family expectations, particularly in the case of female suffers, are indicated as possible causes. Psychological and emotional factors such as anxiety, depression, stress and low self-esteem, as well as abuse and childhood trauma, can also trigger an eating disorder. Other factors thought to be significant risk stimuli for eating disorders are self-esteem and body dissatisfaction issues linked to impossible ideals of female beauty - and nowadays even male ideals - on traditional and social media. The epidemiology of eating disorders provides information about trends in frequency and occurrence of eating disorders over time. Despite challenges in data collection, the epidemiological study of EDs remains extremely important in providing a general picture of how these disorders develop and progress. Epidemiological studies show that the most studied cohort is 15-19-year old females, and that eating disorders are on the increase in non- Western countries, as well as being on the rise among men and older women. Prevalence data shows that lifetime prevalence for a full threshold ED is 2.9% for females and 0.1% for males. For sub threshold EDs, lifetime prevalence figures are 2.2% for females and 0.7% for males (Nagl et al., 2016). Persons afflicted with eating disorders suffer a number of adverse medical and psychological problems. Eating disorders put the body under great strain and the medical impact of an eating disorder touches every organ system in the body (Jahraus, 2018). Eating disorders have various physical effects, such as fatigue, they disrupt natural growth, have detrimental effects on the circulation and nervous system, can cause cardiac and renal difficulties and chronic pain. Although some of these effects can be reversed once detrimental feeding behaviours are stopped, some health consequences can be lasting. The negative outcomes are even more severe for children and adolescents. As well as impacting health, eating disorders also cause significant disturbance to an individual’s social and psychological wellbeing. Eating disorders, particularly Anorexia and Bulimia, have the highest mortality rate of all the psychological illnesses. Suicide attempts are common among patients with EDs, particularly sufferers of Anorexia. Given the several adverse consequences of EDs on every area of a patients’ life, and the diminished quality of life that sufferers lead, identifying and treating EDs is crucial. The earlier the patient is diagnosed and treatment started, the better the outcome. Awareness of EDs by primary care professionals and specialists is extremely important. The consensus nowadays is that best treatment practice is a multidisciplinary and tailored approach that will treat the physical and medical aspects of the disorder, as well as psychological factors and other attributes.peer-reviewe

Empathic empowerment : an exploration and analysis of a situated interaction through empathic modelling and role-play

Empathy is fundamental in obtaining a deep understanding of user needs (Battarbee et al. 2015; Bennett and Rosner 2019) and drives creative conceptualisation (Alzayed et al. 2020). It is also key to a humancentred design process, which has become fundamental in design teaching (Underwood and Powell 2023). Designers have gone to great lengths to get closer to the user experience particularly in situations foreign to the designer, for instance, due to varied physical or cognitive abilities (Raviselvam et al. 2022). One effective method is empathic modelling which simulates the perceptual and physical abilities of users (Nicolle and Maguire 2003). Patricia Moore pioneered empathic modelling by transforming herself into an elderly woman for a long period (1979 to 1982), to obtain a thorough understanding of such users (Moore 2012). This method was also adopted using a 'third age suit', developed by Ford, to replicate of experience of the elderly, which led to a successful and inclusive design. However, such simulations are never a complete replacement for real-life experiences (Raviselvam et al. 2022). This research explores a unique method involving the integration of role-play with empathic modelling, entitled Empathic Empowerment, to discover how empathic design theory is embodied in scenario structuring. Empathic Empowerment was explored through a qualitative study performed in the form of workshops conducted with design students. Participants were invited to role-play a situated interaction in pairs, involving a visually impaired client sitting alone at a restaurant and a server. Their main objectives were to order items from a menu and take the order respectively. Through Empathic Empowerment, this research aims to empower designers to experience the optimal level of designer empathy in a situated interaction drawn from habitual user experiences. In combination with the Empathic Empowerment method, the outcome of this paper is a novel evaluation system, entitled the Empathic Empowerment Scale, which is developed to support and analyse the elicited designer empathy

An extended AI-experience : Industry 5.0 in creative product innovation

Creativity plays a significant role in competitive product ideation. With the increasing emergence of Virtual Reality (VR) and Artificial Intelligence (AI) technologies, the link between such technologies and product ideation is explored in this research to assist and augment creative scenarios in the engineering field. A bibliographic analysis is performed to review relevant fields and their relationships. This is followed by a review of current challenges in group ideation and state-of-the-art technologies with the aim of addressing them in this study. This knowledge is applied to the transformation of current ideation scenarios into a virtual environment using AI. The aim is to augment designers’ creative experiences, a core value of Industry 5.0 that focuses on human-centricity, social and ecological benefits. For the first time, this research reclaims brainstorming as a challenging and inspiring activity where participants are fully engaged through a combination of AI and VR technologies. This activity is enhanced through three key areas: facilitation, stimulation, and immersion. These areas are integrated through intelligent team moderation, enhanced communication techniques, and access to multi-sensory stimuli during the collaborative creative process, therefore providing a platform for future research into Industry 5.0 and smart product development

Determining the presence of peripheral arterial disease in patients with rheumatoid arthritis

Objectives: The aim of the study was to determine the manifestations of PAD in a population of RA participants with no history of cardiovascular events.Methods: A prospective observational non-experimental study was conducted on 100 participants presenting with RA and no history of significant cardiovascular events. Vascular assessment including Doppler spectral waveform analysis and Ankle Brachial Pressure Index was conducted.Results: Triphasic waveforms was found in the Posterior Tibial Artery (PT) in 70% right foot, 66% left foot and Dorsalis Pedis Artery (DP) in both feet in the64% of the patients. Twenty-nine per cent of the participants had biphasic PT right foot and 33% had biphasic PT left foot. Thirty-six per cent had biphasic DP both feet whilst only one participant (1%) had a discontinuous monophasic PT of both feet. The ABPI readings were found to be normal in 96% of participants and mild PAD was found in only 4% of the study population.Conclusions: Results indicate that whilst the ABPI index was normal in the majority of participants, waveform analysis was suboptimal (biphasic) in approximately one-third of the study sample. These findings highlight that the assessment of peripheral arterial perfusion should utilize both modalities to identify patients with early PAD.peer-reviewe

A review of crimes against the administration of justice

The crimes which we will discuss fall into the wide class of offences against the public administration which more particularly impede or interfere with the proper administration of justice. These crimes are dealt with in our code in Sec 99 to 110; the salient offences being: 1. calumnious accusation; 2. simulation of an offence; 3. perjury; 4. retraction; 5. false swearing. In the course of the discussion we will refer to the writings of Italian jurists which have laid the foundations of these sections in our code.peer-reviewe