Training needs and development of online AT training for healthcare professionals in UK and France

Background: Assistive Technologies (AT) in healthcare can increase independence and quality of life for users. Concurrently, new AT devices offer opportunities for individualised care solutions. Nonetheless, AT remains under-utilised and is poorly integrated in practice by healthcare professionals (HCPs). Although occupational therapists (OTs), physiotherapists and speech and language therapists (SLTs) consider that AT solutions can offer problem-solving approaches to personalised care, they have a lesser understanding of application of AT in their practice. In this paper, we report findings of a survey on AT knowledge and experiences of HCPs in UK and France. Training needs also explored in the survey are presented in a separate paper on development of online training for the ADAPT project. Method: A survey of 37 closed/open questions was developed in English and French by a team of healthcare researchers. Content was informed by published surveys and studies. Email invitations were circulated to contacts in Health Trusts in UK and France ADAPT regions and the survey was hosted on an online platform. Knowledge questions addressed AT understanding and views of impact on user’s lives. Experience questions focussed on current practices, prescription, follow-up, abandonment and practice standards. 429 HCPs completed the survey (UK=167; FR=262) between June and November 2018. Key results: Participants were mainly female (UK 89.2%; FR 82.8%) and qualified 10+ years (UK 66.5%; FR 62.2%). A key group in both countries were OTs (UK 34.1%; FR 46.6%), with more physiotherapists and SLTs in UK (16.8%, 16.8%; Vs. FR 6.5%, 2.3%), and more nurses in France (22.1% Vs. UK 10.8%). More HCPs were qualified to degree level in France (75.2%; UK 48.5%, p<0.001). In terms of knowledge, all HCPs agreed that AT helps people complete otherwise difficult or impossible tasks (UK 86.2%; FR 94.3%) and that successful AT adoption always depends on support from carers, family and professionals (UK 52.7%; FR 66.2%). There were some notable differences between countries that require further exploration. For example, more French HCPs thought that AT is provided by trial and error (84.7%, UK 45.5%, p<0.001), while more UK HCPs believed that AT promotes autonomous living (93.4%; FR 42.8%, p<0.001). Also, more French HCPs considered that AT refers exclusively to technologically-advanced electronic devices (71.8%, UK 28.8%, p<0.001). In both countries, top AT prescribers were OTs, physiotherapists and SLTs. Respondents had little/no knowledge in comparing/choosing AT (UK 86.8%; FR 76.7%) and stated they would benefit from interdisciplinary clinical standards (UK 80.8%; FR 77.1%). A third of HCPs did not know if AT users had access to adequate resources/support (UK 34.1%; FR 27.5%) and rated themselves as capable to monitor continued effective use of AT (UK 38.9%; FR 34.8%). Conclusion: Knowledge and application of AT was varied between the two countries due to differences in health care provision and support mechanisms. Survey findings suggest that HCPs recognised the value of AT for users’ improved care, but had low confidence in their ability to choose appropriate AT solutions and monitor continued use, and would welcome AT interdisciplinary clinical standards

A survey of assistive technology (AT) knowledge and experiences of healthcare professionals in the UK and France: challenges and opportunities for workforce development

Background: Assistive Technologies (AT) in healthcare can increase independence and quality of life for users. Concurrently, new AT devices offer opportunities for individualised care solutions. Nonetheless, AT remains under-utilised and is poorly integrated in practice by healthcare professionals (HCPs). Although occupational therapists (OTs), physiotherapists and speech and language therapists (SLTs) consider that AT solutions can offer problem-solving approaches to personalised care, they have a lesser understanding of application of AT in their practice. In this paper, we report findings of a survey on AT knowledge and experiences of HCPs in UK and France. Training needs also explored in the survey are presented in a separate paper on development of online training for the ADAPT project. Method: A survey of 37 closed/open questions was developed in English and French by a team of healthcare researchers. Content was informed by published surveys and studies. Email invitations were circulated to contacts in Health Trusts in UK and France ADAPT regions and the survey was hosted on an online platform. Knowledge questions addressed AT understanding and views of impact on user’s lives. Experience questions focussed on current practices, prescription, follow-up, abandonment and practice standards. 429 HCPs completed the survey (UK=167; FR=262) between June and November 2018. Key results: Participants were mainly female (UK 89.2%; FR 82.8%) and qualified 10+ years (UK 66.5%; FR 62.2%). A key group in both countries were OTs (UK 34.1%; FR 46.6%), with more physiotherapists and SLTs in UK (16.8%, 16.8%; Vs. FR 6.5%, 2.3%), and more nurses in France (22.1% Vs. UK 10.8%). More HCPs were qualified to degree level in France (75.2%; UK 48.5%, p<0.001). In terms of knowledge, all HCPs agreed that AT helps people complete otherwise difficult or impossible tasks (UK 86.2%; FR 94.3%) and that successful AT adoption always depends on support from carers, family and professionals (UK 52.7%; FR 66.2%). There were some notable differences between countries that require further exploration. For example, more French HCPs thought that AT is provided by trial and error (84.7%, UK 45.5%, p<0.001), while more UK HCPs believed that AT promotes autonomous living (93.4%; FR 42.8%, p<0.001). Also, more French HCPs considered that AT refers exclusively to technologically-advanced electronic devices (71.8%, UK 28.8%, p<0.001). In both countries, top AT prescribers were OTs, physiotherapists and SLTs. Respondents had little/no knowledge in comparing/choosing AT (UK 86.8%; FR 76.7%) and stated they would benefit from interdisciplinary clinical standards (UK 80.8%; FR 77.1%). A third of HCPs did not know if AT users had access to adequate resources/support (UK 34.1%; FR 27.5%) and rated themselves as capable to monitor continued effective use of AT (UK 38.9%; FR 34.8%). Conclusion: Knowledge and application of AT was varied between the two countries due to differences in health care provision and support mechanisms. Survey findings suggest that HCPs recognised the value of AT for users’ improved care, but had low confidence in their ability to choose appropriate AT solutions and monitor continued use, and would welcome AT interdisciplinary clinical standards

Gap, a mycobacterial specific integral membrane protein, is required for glycolipid transport to the cell surface

The cell envelope of mycobacteria is a complex multilaminar structure that protects the cell from stresses encountered in the environment, and plays an important role against the bactericidal activity of immune system cells. The outermost layer of the mycobacterial envelope typically contains species-specific glycolipids. Depending on the mycobacterial species, the major glycolipid localized at the surface can be either a phenolglycolipid or a peptidoglycolipid (GPL). Currently, the mechanism of how these glycolipids are addressed to the cell surface is not understood. In this study, by using a transposon library of Mycobacterium smegmatis and a simple dye assay, six genes involved in GPLs synthesis have been characterized. All of these genes are clustered in a single genomic region of approximately 60 kb. We show by biochemical analyses that two non-ribosomal peptide synthetases, a polyketide synthase, a methyltransferase and a member of the MmpL family are required for the biosynthesis of the GPLs backbone. Furthermore, we demonstrate that a small integral membrane protein of 272 amino acids named Gap (gap: GPL addressing protein) is specifically required for the transport of the GPLs to the cell surface. This protein is predicted to contain six transmembrane segments and possesses homologues across the mycobacterial genus, thus delineating a new protein family. This Gap family represents a new paradigm for the transport of small molecules across the mycobacterial envelope, a critical determinant of mycobacterial virulence

Effects of a 75-km mountain ultra-marathon on heart rate variability in amateur runners

BACKGROUND: This study examined the effects of a mountain ultra-marathon (MUM) on the activity of the autonomous nervous system through heart rate variability (HRV) monitoring and determined whether this variable related to final performance. METHODS: Heart rate and HRV were measured in eight male amateur runners (aged 37-60 years). Measurements were recorded before and after the event, in resting conditions, as well as continuously throughout the whole MUM. In addition, percentage (%) of heart rate reserve (HRres) and partial and total times during the race were analyzed. RESULTS: Average heart rate (HRavg) measured at rest was increased after the event (+37%). Standard deviation of successive differences (SDSD) and the square root of the mean squared differences of successive NN intervals (RMSSD) were reduced after the MUM (-56% and -59%, respectively). There was a positive relationship between the frequency-domain index normalized low frequency power (PLFn) measured at rest before the event and race time (0.79) while there was a negative relationship between race time and the difference in HRavg before and after the event. In the last half of the event, there was a high correlation (Spearman coefficient of correlation >0.9) between race time and the standard deviation of the NN intervals (SDNN) registered during the race. CONCLUSIONS: Autonomous cardiac regulation can be related to the performance in a mountain ultra-marathon. HRV monitoring could represent a practical tool for the evaluation of the relationship between the autonomous nervous system activity and performance in a mountain ultra-marathon

Characterization of microbulk detectors in argon- and neon-based mixtures

A recent Micromegas manufacturing technique, so called Microbulk, has been developed, improving the uniformity and stability of this kind of detectors. Excellent energy resolutions have been obtained, reaching values as low as 11% FWHM at 5.9 keV in Ar+5%iC4H10. This detector has other advantages like its flexible structure, low material budget and high radio-purity. Two microbulk detectors with gaps of 50 and 25 um have been characterized in argon- and neon-based mixtures with ethane, isobutane and cyclohexane. The results will be presented and discussed. The gain curves have been fitted to the Rose-Korff gain model and dependences of the electron mean free path and the threshold energy for ionization have been obtained. The possible relation between these two parameters and the energy resolution will be also discussed.Comment: Submitted to the Journal of Instrumentatio

Effects of ergo-nutritional strategies on recovery in combat sports disciplines

In order to improve the recovery process in combat sports disciplines, ergo-nutritional strategies could be an effective option in training and competition. Some of these ergo-nutritional aids could improve performance but literature references are scarce, with controversial results regarding actual recovery effects. This systematic review aimed to examine which ergo-nutritional methods are most effective for assisting in the recovery process in combat sports, and to determine the appropriate training stimuli. This systematic review was carried out following the Preferred Reporting Items for Systematic Review (PRISMA) guidelines. A computerized search was performed in PubMed, Web of Science, the Cochrane Collaboration Database, Evidence Database, Evidence Based Medicine Search review, National Guidelines, EM-BASE, Scopus and Google Scholar system (from 1995 to April 30, 2021). The PICOS model was used to define inclusion and exclusion criteria. Out of 123 studies initially found, 18 met the eligibility criteria and were included in the review. Data from 367 athletes from different disciplines were examined. The evidence was grouped in 4 areas: oxidative stress, muscle and energy recovery, muscle repair, and metabolic acidosis. Evidence showed that vitamins, minerals, and some natural ergo-nutritional products are effective as antioxidants. Carbohydrates and protein determine the recovery effect. Sodium bicarbonate has a role as primary acidosis metabolic delayer. Accordingly, ergo-nutritional aids can help in the recovery process. Considering the effects outlined in the literature, more studies are needed to provide firm evidence. Para mejorar el proceso de recuperación en las disciplinas deportivas de combate, las estrategias ergo-nutricionales son una opción eficaz en el entrenamiento y la competición. Algunas de estas alternativas mejoran el rendimiento, pero actualmente existe una escasa bibliografía con resultados controvertidos relacionados con el efecto de recuperación. Esta revisión sistemática tuvo como objetivo determinar qué estrategias ergo-nutricionales son más efectivas en los procesos de recuperación. Se llevó a cabo siguiendo las pautas Preferred Reporting Items for Systematic Review (PRISMA). Se realizó una búsqueda computarizada en PubMed, Web of Science, Cochrane Collaboration Database, Evidence Database, Evidence Based Medicine Search review, National Guidelines, EM-BASE, Scopus y el sistema Google Scholar (desde 1995 hasta el 30 de abril de 2021). Se utilizó el modelo PICOS para definir los criterios de inclusión y exclusión. De los 123 estudios encontrados inicialmente, 18 cumplieron los criterios de elegibilidad y fueron incluidos. Se examinaron datos de 367 atletas de diferentes disciplinas. La evidencia se agrupó en 4 áreas: estrés oxidativo, recuperación muscular y energética, reparación muscular y acidosis metabólica. La evidencia mostró que las vitaminas, los minerales y algunos productos ergo-nutricionales naturales son eficaces como antioxidantes, los hidratos de carbono y las proteínas determinan su efecto recuperador y el bicarbonato de sodio es el principal retardador metabólico de la acidosis. Se destaca la importancia de aceptar un plan ergo-nutricional para mejorar el proceso de recuperación. A pesar de ello, y teniendo en cuenta los efectos descritos en la literatura, se necesitan más estudios para reforzar la evidencia actual

Long-time discrete particle effects versus kinetic theory in the self-consistent single-wave model

The influence of the finite number N of particles coupled to a monochromatic wave in a collisionless plasma is investigated. For growth as well as damping of the wave, discrete particle numerical simulations show an N-dependent long time behavior resulting from the dynamics of individual particles. This behavior differs from the one due to the numerical errors incurred by Vlasov approaches. Trapping oscillations are crucial to long time dynamics, as the wave oscillations are controlled by the particle distribution inhomogeneities and the pulsating separatrix crossings drive the relaxation towards thermal equilibrium.Comment: 11 pages incl. 13 figs. Phys. Rev. E, in pres

Quasilinear theory of the 2D Euler equation

We develop a quasilinear theory of the 2D Euler equation and derive an integro-differential equation for the evolution of the coarse-grained vorticity. This equation respects all the invariance properties of the Euler equation and conserves angular momentum in a circular domain and linear impulse in a channel. We show under which hypothesis we can derive a H-theorem for the Fermi-Dirac entropy and make the connection with statistical theories of 2D turbulence.Comment: 4 page