An IT approach to cardiovascular care based on primary care

We describe a unique telemedicine approach to cardiovascular care, based in primary care, which combines store and forward with real time video. Patients presenting to the family practitioner (GP) with chest pain or symptoms indicative of cardiac disease are assessed within the health centre by exercise test ECG. The report, together with other clinical information is forwarded as an electronic referral to the cardiologist. Suitable candidates for angiography have an initial teleconsultation by video-conferencing, in which not only may the patient, GP and cardiologist discuss the diagnosis and forthcoming procedures in hospital, but also can undertake management of the patient, such as review of medication and life style. Follow-up consultations may be conducted by further tele-clinics. We also show how re-engineering the process has the potential to eliminate 75 of outpatient appointment

Simulations of Nonthermal Electron Transport in Multidimensional Flows: Synthetic Observations of Radio Galaxies

We have applied an effective numerical scheme for cosmic-ray transport to 3D MHD simulations of jet flow in radio galaxies (see the companion paper by Jones et al. 1999). The marriage of relativistic particle and 3D magnetic field information allows us to construct a rich set of ``synthetic observations'' of our simulated objects. The information is sufficient to calculate the ``true'' synchrotron emissivity at a given frequency using explicit information about the relativistic electrons. This enables us to produce synchrotron surface-brightness maps, including polarization. Inverse-Compton X-ray surface-brightness maps may also be produced. First results intended to explore the connection between jet dynamics and electron transport in radio lobes are discussed. We infer lobe magnetic field values by comparison of synthetically observed X-ray and synchrotron fluxes, and find these ``inverse-Compton'' fields to be quite consistent with the actual RMS field averaged over the lobe. The simplest minimum energy calculation from the synthetic observations also seems to agree with the actual simulated source properties.Comment: 7 pages, 1 figure; to appear in Life Cycles of Radio Galaxies, ed. J. Biretta et al., New Astronomy Review

Towards an integrated and interoperable platform for telehealth and telecare

Copyright @ 2012 International Journal of Integrated Care (IJIC). This work is licensed under a (http://creativecommons.org/licenses/by/3.0) Creative Commons Attribution 3.0 Unported License.We present experience of implementing and evaluating a platform purpose designed to integrate interoperable telehealth and telecare. We chose the IEEE 11073 standards for all devices and used ZigBee wireless to support many devices concurrently and exploit its mesh networking to extend range around the entire house. We designed the home gateway to be unobtrusive; in project Hydra we used the smart meter and in other projects (Reaction, inCasa) we have developed a purpose designed plugtop ZigBee to GPRS gateway. All use common protocols and are interoperable. Technically the projects have been a success, and we have already implemented a wide range of devices on the common platform (BP, weight, SpO2, glucose, PIR, medication monitor, bed/chair sensor). Immediate feedback from participants has confirmed our goal of simplicity and convenience of use (and thus encourage adherence); and it is interesting that in discussion they then focus on the data rather than the technology. Our current goal is to exploit the potential for combination of physiological and environmental data to determine if change of habits can be detected and how this correlates with change in health. We are using this functionality to manage the frail elderly within project inCasa and we propose to present preliminary findings

Monitoring habits and physiological data in the frail elderly

There is a need for new models of care enabled by technology to support long-term and independent living of the elderly. Integrating telecare and telehealth technologies can be used to provide innovative support in an unobtrusive way. inCASA is a European Commission funded project that uses an integrated platform to monitor both health and habits data in the frail elderly and demonstrate the concept of integrated health and social services through pilot trials. This paper presents the joint analysis of habits and clinical data from the UK pilot. The aim of the analysis is to determine the correlation between change in habits behaviour, change in physiological data and deterioration in the condition of the patient

3D printing and high tibial osteotomy

High tibial osteotomy (HTO) is a relatively conservative surgical option in the management of medial knee pain. Thus far, the outcomes have been variable, and apparently worse than the arthroplasty alternatives when judged using conventional metrics, owing in large part to uncer - tainty around the extent of the correction planned and achieved. This review paper introduces the concept of detailed 3D planning of the procedure, and describes the 3D printing technology that enables the plan to be performed. The different ways that the osteotomy can be undertaken, and the varying guide designs that enable accurate regis - tration are discussed and described. The system accuracy is reported. In keeping with other assistive technologies, 3D printing enables the surgeon to achieve a preoperative plan with a degree of accuracy that is not possible using conventional instruments. With the advent of low dose CT, it has been possible to confirm that the procedure has been under - taken accurately too. HTO is the ‘ultimate’ personal intervention: the amount of correction needed for optimal offloading is not yet com - pletely understood. For the athletic person with early medial joint line over - load who still runs and enjoys life, HTO using 3D printing is an attractive option. The clinical effectiveness remains unproven

Choice and information in the public sector: a Higher Education case study

Successive governments have encouraged the view of users of public services as consumers, choosing between different providers on the basis of information about the quality of service. As part of this approach, prospective students are expected to make their decisions about which universities to apply to with reference to the consumer evaluations provided by the National Student Survey. However, a case study of a post-1992 university showed that not all students made genuine choices and those who did tended to be in stronger social and economic positions. Where choices were made, they were infrequently based on external evaluations of quality

Simulations of Nonthermal Electron Transport in Multidimensional Flows: Application to Radio Galaxies

We have developed an economical, effective numerical scheme for cosmic-ray transport suitable for treatment of electrons up to a few hundreds of GeV in multidimensional simulations of radio galaxies. The method follows the electron population in sufficient detail to allow computation of synthetic radio and X-ray observations of the simulated sources, including spectral properties (see the companion paper by Tregillis et al. 1999). The cosmic-ray particle simulations can follow the effects of shock acceleration, second-order Fermi acceleration as well as radiative and adiabatic energy losses. We have applied this scheme to 2-D and 3-D MHD simulations of jet-driven flows and have begun to explore links between dynamics and the properties of high energy electron populations in radio lobes. The key initial discovery is the great importance to the high energy particle population of the very unsteady and inhomogeneous flows, especially near the end of the jet. Because of this, in particular, our simulations show that a large fraction of the particle population flowing from the jet into the cocoon never passes through strong shocks. The shock strengths encountered are not simply predicted by 1-D models, and are quite varied. Consequently, the emergent electron spectra are highly heterogeneous. Rates of synchrotron aging in "hot-spots" seem similarly to be very uneven, enhancing complexity in the spectral properties of electrons as they emerge into the lobes and making more difficult the task of comparing dynamical and radiative ages.Comment: 7 pages, 1 figure; to appear in Life Cycles of Radio Galaxies, ed. J. Biretta et al., New Astronomy Review

Sustainable production of organic wheat

The aim of the project is to use an ecological approach to analyse the interactions of a range of key agronomic variables in organic wheat production (wheat genotype, spatial arrangement of seed, seed density and wheat/white clover bi-cropping) to determine an optimal approach to improved and stabilised production. The fi rst set of data revealed that seedling competition was infl uenced by seed rate and drilling arrangement. Furthermore, the variety Hereward had increased emergence and establishment to Aristos. An interaction exists between wheat variety, seed rate and drilling arrangement on the level of canopy cover at different developmental stages – these factors are important for the suppression of weeds. The input of farmers in the selection of trial variables ensures results have a direct application to the industry. The results of yield and quality at harvest will provide further insights into the interaction of agronomic variables

Evolutionary breeding of healthy wheat: from plot to farm

Genetically diverse Composite Cross Populations (CCPs) may be useful in environmentally variable low-input systems as an alternative to pure line varieties. They are formed by hybridising lines with diverse evolutionary origins, bulking the F1 progeny, and allowing natural selection of the progeny in successive crop environments. CCPs derived from 10 high yielding parents (YCCPs), 12 high quality parents (QCCPs), or all 22 parents (YQCCPs), were grown at four sites (2 organic, 2 conventional) in the UK; they are currently (2006) in F5. The YCCPs out yielded the QCCPs, which had better quality characteristics. Although the CCPs performed within the range of the parents, the values obtained were often better than the mean of the parents. Some population samples are now being grown on farms and other sites in England, France, Germany and Hungary

The identification and production of varieties that increase the value of oats as a profitable component of organic production

Two experiments, one comprising husked, and the other naked, oats were established at Wakelyns Agroforestry, Suffolk in October 2004 to determine traits and varieties of oats suited to organic systems, and whether growing variety mixtures conferred any advantage. Unselected F2 breeding lines were also included for selection. Husked varieties had relatively higher yields; this may have been partly the result of poor establishment in the naked varieties. Variety height was found to be an important characteristic; tall oat varieties out-yielded the dwarfs. Two of the three variety mixtures containing the naked oat variety Expression yielded 8 and 9 % higher than the average of the component varieties. The data will be verified in the second year of replicated trials (2005/06), which will include the best performing husked and naked varieties, and a mixture of superior IGER-bred F2 breeding lines