Acoustic test of a model rotor and tail rotor: Results for the isolated rotors and combined configuration

Acoustic data from a model scale main rotor and tail rotor experiment in the NASA Langley 14 by 22 Foot Subsonic Tunnel are presented for the main rotor and trail rotor in isolation and for the two rotors operating together. Results for the isolated main rotor show the importance of the rotor flapping conditions on mid-frequency noise content. High levels of main rotor retreating side blade-vortex interaction noise are shown to radiate downstream of the model. The isolated tail rotor noise results show the dominance of harmonic noise in the thrusting direction. The occurrence of tail rotor broadband noise is seen by the broadening of the tail rotor harmonics and is attributed to fuselage wake turbulence. The combined main and tail rotor data are presented to show the dominance of each rotor's different noise sources at different directivity locations

Advancing-side directivity and retreating-side interactions of model rotor blade-vortex interaction noise

Acoustic data are presented from a 40 percent scale model of the four-bladed BO-105 helicopter main rotor, tested in a large aerodynamic wind tunnel. Rotor blade-vortex interaction (BVI) noise data in the low-speed flight range were acquired using a traversing in-flow microphone array. Acoustic results presented are used to assess the acoustic far field of BVI noise, to map the directivity and temporal characteristics of BVI impulsive noise, and to show the existence of retreating-side BVI signals. The characterics of the acoustic radiation patterns, which can often be strongly focused, are found to be very dependent on rotor operating condition. The acoustic signals exhibit multiple blade-vortex interactions per blade with broad impulsive content at lower speeds, while at higher speeds, they exhibit fewer interactions per blade, with much sharper, higher amplitude acoustic signals. Moderate-amplitude BVI acoustic signals measured under the aft retreating quadrant of the rotor are shown to originate from the retreating side of the rotor

Acoustic measurements from a rotor blade-vortex interaction noise experiment in the German-Dutch Wind Tunnel (DNW)

Acoustic data are presented from a 40 percent scale model of the 4-bladed BO-105 helicopter main rotor, measured in the large European aeroacoustic wind tunnel, the DNW. Rotor blade-vortex interaction (BVI) noise data in the low speed flight range were acquired using a traversing in-flow microphone array. The experimental apparatus, testing procedures, calibration results, and experimental objectives are fully described. A large representative set of averaged acoustic signals is presented

Poly-substance use and sexual risk behaviours: a cross-sectional comparison of adolescents in mainstream and alternative education settings

Background: Surveys of young people under-represent those in alternative education settings (AES), potentially disguising health inequalities. We present the first quantitative UK evidence of health inequalities between AES and mainstream education school (MES) pupils, assessing whether observed inequalities are attributable to socioeconomic, familial, educational and peer factors. Methods: Cross-sectional, self-reported data on individual- and poly-substance use (PSU: combined tobacco, alcohol and cannabis use) and sexual risk-taking from 219 pupils in AES (mean age 15.9 years) were compared with data from 4024 pupils in MES (mean age 15.5 years). Data were collected from 2008 to 2009 as part of the quasi-experimental evaluation of Healthy Respect 2 (HR2). Results: AES pupils reported higher levels of substance use, including tobacco use, weekly drunkenness, using cannabis at least once a week and engaging in PSU at least once a week. AES pupils also reported higher levels of sexual health risk behaviours than their MES counterparts, including: earlier sexual activity; less protection against sexually transmitted infections (STIs); and having 3+ lifetime sexual partners. In multivariate analyses, inequalities in sexual risk-taking were fully explained after adjusting for higher deprivation, lower parental monitoring, lower parent-child connectedness, school disengagement and heightened intentions towards early parenthood among AES vs MES pupils. However, an increased risk (OR = 1.73, 95% CI 1.15, 2.60) of weekly PSU was found for AES vs MES pupils after adjusting for these factors and the influence of peer behaviours. Conclusion: AES pupils are more likely to engage in health risk behaviours, including PSU and sexual risk-taking, compared with MES pupils. AES pupils are a vulnerable group who may not be easily targeted by conventional population-level public health programmes. Health promotion interventions need to be tailored and contextualised for AES pupils, in particular for sexual health and PSU. These could be included within interventions designed to promote broader outcomes such as mental wellbeing, educational engagement, raise future aspirations and promote resilience

The Attitudes about Complex Therapy Scale (ACTS) in Type 2 Diabetes and Cardiovascular Disease: Development, Validity and Reliability

Background: Type 2 diabetes is associated with cardiovascular disease, and patients with both conditions are prescribed complex medication regimens. Aim: The aim was to develop a reliable and valid measure of attitudes associated with the prescription and management of multiple medicines in patients with Type 2 diabetes and cardiovascular disease. Methods: Principal component analysis (PCA) and Cronbach alpha assessed the reliability of the Attitudes about Complex Therapy Scale (ACTS). Examinations of relationships with related measures inform concurrent validity. Questionnaires were sent to a cross-sectional sample of 480 people prescribed multiple medicines for co-morbid Type 2 diabetes. Results: Cronbach alpha was 0.76, indicating the scale had good internal reliability. PCA rotated a four factor model accounting for 37% of the variance. Four subscales identified; 1. Concerns about multiple medicines and increasing numbers of medicines; 2.Anxiety over missed medicines; 3. Desires to substitute medicines and reduce the number of medicines prescribed and; 4. Perceptions related to organising and managing complex therapy. The ACTS showed significant relationships with measures of anxiety, depression, general beliefs about medicines and self-efficacy. Also, the ACTS significantly correlated with adherence to medicines, showing good predictive validity. Conclusion: The ACTS was designed to assess negative attitudes towards complex therapy and multiple medication management. This tool could aid prescribing decisions and may identify people who are intentionally non-adherent to all or some of their medicines

Aortopexy for the treatment of tracheomalacia in children: review of the literature

ABSTRACT: Severe tracheomalacia presents a significant challenge for Paediatricians, Intensivists, Respiratory Physicians, Otolaryngologists and Paediatric Surgeons. The treatment of tracheomacia remains controversial, but aortopexy is considered by most to be one of the best options. We conducted a review of the English literature relating to aortopexy. Among 125 papers, 40 have been included in this review. Among 758 patients (62% males) affected with tracheomalacia, 581 underwent aortopexy. Associated co-morbidities were reported in 659 patients. The most frequent association was with oesophageal atresia (44%), vascular ring or large vessel anomalies (18%) and innominate artery compression (16%); in 9% tracheomalacia was idiopathic. The symptoms reported were various, but the most important indication for aortopexy was an acute life-threatening event (ALTE), observed in 43% of patients. The main preoperative investigation was bronchoscopy. Surgical approach was through a left anterior thoracotomy in 72% of patients, while median approach was chosen in 14% and in 1.3% a thoracoscopic aortopexy was performed. At follow-up (median 47 months) more than 80% of the patients improved significantly, but 8% showed no improvement, 4% had a worsening of their symptoms and 6% died. Complications were observed in 15% of patients, in 1% a redo aortopexy was deemed necessary. In our review, we found a lack of general consensus about symptom description and evaluation, indications for surgery, though ALTE and bronchoscopy were considered by all an absolute indication to aortopexy and the gold standard for the diagnosis of tracheomalacia, respectively. Differences were reported also in surgical approaches and technical details, so that the same term “aortopexy” was used to describe different types of procedures. Whatever approach or technique was used, the efficacy of aortopexy was reported as high in the majority of cases (more than 80%). A subgroup of patients particularly delicate is represented by those with associated gastro-esophageal reflux, in whom a fundoplication should be performed. Other treatments of tracheomalacia, particularly tracheal stenting, were associated with a higher rate of failure, severe morbidity and mortality. NON ENGLISH ABSTRACT: La tracheomalacia severa rappresenta una sfida per Pediatri, Intensivisti, Pneumologi, Otorinolaringoiatri, Chirurghi Pediatri. Il trattamento della tracheomalacia è tuttora controverso. L’aortopessi è considerata da molti la migliore opzione terapeutica. Abbiamo condotto una revisione della letteratura di lingua inglese su tale argomento. Di 125 lavori, 40 sono stati inclusi nella revisione. Tra 758 pazienti (62% maschi) affetti da tracheomalacia, 581 sono stati sottoposti ad aortopessi tra il 1968 e il 2008. In 659 pazienti alcune comorbidità erano presenti. L’associazione più frequente era con l’atresia esofagea (44%), l’anello vascolare o un’anomalia dei grossi vasi (18%), la compressione da parte dell’arteria innominata (16%); nel 9% la tracheomalacia era idiopatica. I sintomi riportati sono stati variabili, ma l’indicazione più importante all’aortopessi sono stati eventi di ALTE, osservati nel 43% dei pazienti. Lo studio diagnostico preoperatorio principale è stato la broncoscopia. L’approccio chirurgico è avvenuto attraverso una toracotomia anteriore sinistra nel 72% dei pazienti, mentre un approccio mediano è stato scelto nel 14% e nell’1.3% dei casi è stato eseguito un approccio toracoscopico. Al follow-up (mediana di 47 mesi) la maggioranza dei pazienti sono migliorati significativamente, ma l’8% di essi non è migliorato, il 4% è peggiorato e il 6% è morto. Complicazioni sono state riportate nel 15% dei pazienti, nell’1% un nuovo intervento di aortopessi è stato necessario. In questa revisione abbiamo trovato che non c’è un consenso generale sulla valutazione e sulla descrizione dei sintomi, sulle indicazioni chirurgiche ed esami preoperatori, anche se le ALTE e la broncoscopia venivano considerate rispettivamente un’indicazione assoluta all’aortopessi e il “gold standard” diagnostico per la tracheomalacia. Venivano riportate differenze negli approcci chirurgici e nei dettagli tecnici, e lo stesso termine di aortopessi veniva usato per indicare diverse procedure chirurgiche. In ogni caso, indipendentemente dall’approccio o tecnica utilizzati, l’efficacia dell’aortopessi veniva riportata come elevata nella maggioranza dei casi (più dell’80%). Un sottogruppo di pazienti particolarmente delicato è rappresentato da quelli con reflusso gastroesofageo associato, nei quali sarebbe indicata una fundoplicatio. Altri trattamenti della tracheomalacia, quali stent tracheale, sembrano gravati da una maggiore percentuale di insuccessi, morbidità severa e mortalità

Building a Health System Institutional Repository: Setting Yourself Up for Success from the Start

Background: While more common in university settings, institutional repositories (IR) have a place within hospitals and healthcare systems too, though the challenges in creating them may be different. This paper looks at the development of a Digital Commons institutional repository at Providence St. Joseph Health. The authors present the necessary steps for a successful initiative beginning with the planning process and building from there. Highlighted are some of the different challenges faced in non-academic settings; considerations when selecting a platform and designing and structure; and recommendations for doing outreach and promotion to unique user groups. Description: Library staff proactively followed trends in IRs and prepared for future state. Identifying technology requirements and platform options, exploring other health system IRs, and building a search algorithm to capture the affiliations within a newly merged enterprise meant that when approached by senior leadership about publication tracking the library was well positioned for success. Library staff selected a platform, determined the repository’s scope, and identified key stakeholders. An implementation plan included securing funding and executive support, hiring a librarian, and developing a framework for year 1 of the project. A complex organization presented unique challenges when designing a metadata and taxonomy structure. Getting buy-in from clinicians required a strong elevator pitch, and a direct tie to the organization’s strategic goals. Anticipating organizational needs meant a platform able to accommodate datasets, visual collections, Magnet documentation, and locally-published peer-reviewed journals Conclusion: Digital Commons launched in July 2018, and within 3 months was populated with 700+ publications and included profiles from several world-renowned researchers. A successful Year 1 is on track and will be measured by hitting a publication target of 1000 and successfully importing all 2018 affiliated publications from PubMed. Library staff is now focused on marketing and outreach, with the intention to rapidly grow the Expert Gallery to include individuals from a diverse representation of disciplines and health system markets, increase submission of non-periodical scholarly activity, and to form collaborative partnerships for growth into new areas like datasets, and video.https://digitalcommons.psjhealth.org/other_pubs/1059/thumbnail.jp

Living with the user: Design drama for dementia care through responsive scripted experiences in the home

Participation in forms of drama and narrative can provoke empathy and creativity in user-centred design processes. In this paper, we expand upon existing methods to explore the potential for responsive scripted experiences that are delivered through the combination of sensors and output devices placed in a home. The approach is being developed in the context of Dementia care, where the capacity for rich user participation in design activities is limited. In this case, a system can act as a proxy for a person with Dementia, allowing designers to gain experiences and insight as to what it is like to provide care for, and live with, this person. We describe the rationale behind the approach, a prototype system architecture, and our current work to explore the creation of scripted experiences for design, played out though UbiComp technologies.This research is funded by the Arts and Humanities Research Council UK, (AH/K00266X/1) and Horizon Digital Economy Research (RCUK grant EP/G065802/1)

Using cultural probes to inform the design of assistive technologies

This paper discusses the practical implications of applying cultural probes to drive the design of assistive technologies. Specifically we describe a study in which a probe was deployed with home-based carers of people with dementia in order to capture critical data and gain insights of integrating the technologies into this sensitive and socially complex design space. To represent and utilise the insights gained from the cultural probes, we created narratives based on the probe data to enhance the design of assistive technologies.This work was supported by the Arts and Humanities Research Council (AH/K00266X/1) and RCUK through the Horizon Digital Economy Research grant (EP/G065802/1)