Novel smart glove technology as a biomechanical monitoring tool

Developments in Virtual Reality (VR) technology and its overall market have been occurring since the 1960s when Ivan Sutherland created the world’s first tracked head-mounted display (HMD) – a goggle type head gear. In society today, consumers are expecting a more immersive experience and associated tools to bridge the cyber-physical divide. This paper presents the development of a next generation smart glove microsystem to facilitate Human Computer Interaction through the integration of sensors, processors and wireless technology. The objective of the glove is to measure the range of hand joint movements, in real time and empirically in a quantitative manner. This includes accurate measurement of flexion, extension, adduction and abduction of the metacarpophalangeal (MCP), Proximal interphalangeal (PIP) and Distal interphalangeal (DIP) joints of the fingers and thumb in degrees, together with thumb-index web space movement. This system enables full real-time monitoring of complex hand movements. Commercially available gloves are not fitted with sufficient sensors for full data capture, and require calibration for each glove wearer. Unlike these current state-of-the-art data gloves, the UU / Tyndall Inertial Measurement Unit (IMU) glove uses a combination of novel stretchable substrate material and 9 degree of freedom (DOF) inertial sensors in conjunction with complex data analytics to detect joint movement. Our novel IMU data glove requires minimal calibration and is therefore particularly suited to multiple application domains such as Human Computer interfacing, Virtual reality, the healthcare environment

Trends in day-case bladder outflow obstruction surgery: a study using Hospital Episode Statistics

This is the final version. Available from Wiley via the DOI in this record. Data Availability Statement. This report does not contain patient identifiable data. Data in this report are anonymized. The underlying HES data cannot be made available directly by the authors as the data were obtained under licence/data-sharing agreement from NHS Digital. HES data are available from NHS Digital upon application.OBJECTIVES: To describe the contemporary evolution of day-case bladder outflow obstruction (BOO) surgery in England and to profile day-case BOO surgery practices across England in terms of the types of operation performed and their safety profiles. MATERIALS AND METHODS: This was a retrospective observational analysis of Hospital Episode Statistics and UK Office for National Statistics data. All 111 043 recorded operations across 117 hospital trusts over 66 months, from 1 January 2017 to 30 June 2022, were obtained. Operations were identified as one of: transurethral resection of prostate (TURP); laser ablation or enucleation; vapour therapy; prostatic urethral lift (PUL); or bladder neck incision. Monthly day-case rate trends were plotted across the study period. Descriptive data, day-case rates and 30-day hospital readmissions were analysed for each operation type. Multilevel regression modelling with mixed effects was performed to determine whether day-case surgery was associated with higher 30-day hospital readmissions. RESULTS: Day-case patients were younger, with fewer comorbidities. Time series analysis showed a linear day-case rate increase from 8.3% (January 2017) to 21.0% (June 2022). Day-case rates improved for 92/117 trusts in 2021/2022 compared with 2017. Three of the six trusts with the highest day-case rates performed predominantly day-case TURP, and the other three laser surgery. Nationally, PUL and vapour surgery had the highest day-case rates (80.9% and 38.1%). Most inpatient operations were TURP. Multilevel regression modelling found reduced odds of 30-day readmission after day-case BOO surgery (all operations pooled), no difference for day-case vs inpatient TURP, and reduced odds following day-case LASER operations. CONCLUSIONS: The day-case rates for BOO surgery have linearly increased. Minimally invasive surgical technologies are commonly performed as day cases, whereas high day-case rates for TURP and for laser ablation operations are seen in a minority of hospitals. Day-case pathways to treat BOO can be safely developed irrespective of operative modality

The Getting It right First Time (GIRFT) programme in urology; rationale and methodology

This is the final version. Available on open access from Wiley via the DOI in this recordThe Getting It Right First Time (GIRFT) programme is a quality improvement initiative covering the National Health Service in England. The programme aims to standardise clinical practices and improve patient and system level outcomes by utilising data-driven insights and clinically-led recommendations. There are GIRFT workstreams for every medical and surgical specialty, including urology. Defining features of the GIRFT methodology are that it is clinically led by experienced clinicians, data-driven, and specialty specific. Each specialty workstream conducts deep-dive visits to every hospital, analysing performance data and engaging with clinicians and management to identify and share improvement priorities. For urology, GIRFT has completed deep-dive visits and published reports outlining priority areas for development. Reports include recommendations pertaining to streamlining care pathways, reducing the acuity of care environments, enhancing emergency services, optimising utilisation of outpatient services, and workforce training and utilisation. The GIRFT academy provides guides for implementing best practices specific to priority areas of care. These include important disease pathways, and GIRFT-advocated innovations such as urology investigation units and urology area networks. GIRFT offers clinical transformation, cost reduction, equity in access to care, and leaner models of care that are often more environmentally sustainable. Evaluation efforts of the programme have focussed on assessing the adoption of GIRFT recommendations, understanding barriers to change, and modelling the climate impact of advocated practices

Optimized consumer-centric demand response

Demand side management has focused more on centralized control and heavily depends on continuous consumer interaction, often overlooking consumer thermal and visual comfort. Distribution grid management will necessitate the active involvement of new market actors (i.e. prosumers, aggregators, distribution system operators, retailers, etc.), so a holistic approach becomes critical to transform demand into an active element of electricity system management. This paper presents a consumer centric demand flexibility framework, which facilitates the automated, human-centric demand response, minimizes consumer interactions and accommodates various power system ancillary services

Initial experience of the BREAST-Q breast-conserving therapy module.

Purpose The most recently developed module of the BREAST-Q, a validated patient outcome measure, is for patients who have undergone breast-conserving therapy (BCT) for cancer. This aim of this study was to assess patient satisfaction and quality of life after BCT using BREAST-Q, investigate clinical risk factors for lower satisfaction and explore the relationship between patient satisfaction with the appearance of their breasts and the other domains of the BREAST-Q.Methods Women who had undergone unilateral BCT in the preceding 1-6 years were invited to participate at the time of their annual surveillance mammogram. Clinicopathological data were collected from an electronic database. Linear regression was used to evaluate risk factors for lower satisfaction. Spearman's rho correlation coefficients were calculated to evaluate the relationship between domains.Results 200 women completed the questionnaire. Mean age was 60 years (SD 11.1). Time from surgery was 35.5 months (SD 17.8). Median score for 'Satisfaction with breasts' was 68 (interquartile range 55-80). Lowest scores were for 'sexual wellbeing' (57, IQR 45-66). On multivariate analysis, BMI at the time of surgery (p = 0.002), delayed wound healing (p = 0.001) and axillary surgery (p = 0.003) were independent risk factors for lower satisfaction. There was significant correlation between 'Satisfaction with breasts' and all other BREAST-Q domains.Conclusion High BMI, delayed wound healing and axillary surgery are risk factors for lower patient satisfaction. This first publication reporting the whole dataset for the BREAST-Q BCT will serve as a benchmark for future studies of patient satisfaction following BCT

Developing the Warwick Patient Experiences Framework (WaPEF): Utilising patient-based evidence to shape clinical guidelines International Journal of Quality in Healthcare

Objective This paper presents the development of the Warwick Patient Experiences Framework (WaPEF) and describes how it informed the development of the NICE Guidance and Quality Standard, ‘Patient experience in adult NHS services: improving the experience of care for people using adult NHS services’. Design The WaPEF was developed using a thematic qualitative overview that utilized a systematic review approach. Search strategies were developed, inclusion and exclusion criteria developed and data extracted from papers. Results The WaPEF identifies seven key generic themes that are important to a high-quality patient experience: patient as active participant, responsiveness of services, an individualized approach, lived experience, continuity of care and relationships, communication, information and support. Conclusions The WaPEF is the first patient experiences framework with an explicit link to an underpinning patient evidence base, linking themes and sub-themes with specific references. The WaPEF informed the structure and content of the NICE Patient Experiences Guidance. The guidance, published in February 2012, will form a key part of the NHS Outcomes Framework in the UK for the future evaluation of health and social care. The proposed framework could be adapted to other country contexts and settings

Inside out: Fusing 3D imaging modalities for the internal and external investigation of multi-material museum objects

3D imaging methods are increasingly employed in cultural heritage research to analyse and document objects in museum collections. In this work, we provide an interactive visualisation plugin for the open-source software Blender, to combine and inspect two complementary 3D imaging modalities: CT images, which capture the interior; and surface scans, which capture the exterior. 3D CT scan data can be visualised, both as volumetric representation and as orthogonal slices, and a 3D surface scan can be registered onto the CT data. It allows users to simultaneously and interactively inspect these modalities and to virtually cut through an object. It also provides tools for generating output images and videos for research and public outreach purposes. The plugin workflow was applied to four case studies from the collections of the Rijksmuseum, Amsterdam, and the British Museum, London. The plugin is published open-source together with detailed guidelines and a practice dataset

Patient attitudes towards medical students at Damascus University teaching hospitals

Background: The cooperation of patients and their consent to involve medical students in their care is vital to clinical education, but large numbers of students and lack of experience as well as loss of privacy may evoke negative attitudes of patients, which may sometimes adversely affect the clinical teaching environment. This study aimed to explore the attitudes of patients towards medical students at Damascus University hospitals, and to explore the determinants of those attitudes thus discussing possible implications applicable to clinical teaching. Methods: This cross-sectional study was conducted at three teaching hospitals affiliated to the Faculty of Medicine at Damascus University. Four hundred patients were interviewed between March and April 2011 by a trained sociologist using a structured questionnaire. Results: Of the patients interviewed, 67.8 % approved the presence of medical students during the medical consultation and 58.2 % of them felt comfortable with the presence of students, especially among patients with better socio-economic characteristics. 81.5 % of the patients agreed to be examined by students in the presence of the supervisor, while 40.2 % gave agreement even in the absence of the supervisor. Privacy was the most important factor in the patients ’ reticence towards examination by the students, whilst the relative safety and comfort if a supervisor was available determined patients ’ agreement