1,338 research outputs found

    Sustainability of innovations in healthcare: A systematic review and conceptual framework for professional pharmacy services.

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    BACKGROUND: Implementation science emerged to address the challenges associated with the incorporation of evidence-based innovations into practice. Once the challenge is overcome, the ultimate goal is to achieve the sustainability of innovations to promote their continuity and long-term integration. Assessment tools and measures have been designed to assess the sustainability of innovations in research and practice environments. However, the variability of assessment tools available becomes a challenge for policy makers, researchers and practitioners, particularly when deciding how to evaluate the sustainability of innovations. OBJECTIVES: to identify conceptual approaches and assessment tools for the sustainability of healthcare innovations and to develop a specific discipline-based framework for the sustainability of professional pharmacy services. METHODS: A systematic literature review was conducted in January of 2019 using PubMed, Scopus, and Web of Science. General information regarding the conceptual approaches (based on Nilsen's classification), assessment tools and the factors affecting the sustainability of the healthcare innovations was retrieved. RESULTS: From 3123 articles screened, 132 articles were selected from which 106 conceptual approaches and 26 assessment tools were identified. Several key factors moderating the sustainability of the innovations in healthcare were identified (e.g. funding, adaptation). A framework for the sustainability of professional pharmacy services is proposed based on these factors. It presents three performance domains influencing the service sustainability (i.e. environment, social and economic). CONCLUSIONS: The identified approaches in different healthcare settings have allowed the adaptation and design of a specific framework for pharmacy. The core factors included in the proposed framework are moderators of the sustainability process and should be considered in sustainability studies and evaluations. This framework will guide pharmacy practice researchers and practitioners to measure and achieve the sustainability of professional pharmacy services. Furthermore, the adaptation of this framework will allow its application to other healthcare settings. (Registration number CRD42018092160)

    Photo-stability of peptide-bond aggregates: N-methylformamide dimers

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    E. S.-G acknowledges a Liebig-stipend from the Fonds der Chemischen Industrie. This work was supported by the Cluster of Excellence RESOLV (EXC 1069) funded by the Deutsche Forschungsgemeinschaf

    Mechanically driven alloying of immiscible elements (Comment)

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    In conclusion we have proven that the fact that both fcc FeCu and bcc Fe magnetization agree at 300 K is simply an accident and our data at low temperature show clearly that the Fe contribution after precipitation from the metastable phase has a deficiency in magnetization of at least 20% with respect to the Fe state in fcc FeCu metastable solid solution

    Designing for usability: development and evaluation of a portable minimally-actuated haptic hand and forearm trainer for unsupervised stroke rehabilitation

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    In stroke rehabilitation, simple robotic devices hold the potential to increase the training dosage in group therapies and to enable continued therapy at home after hospital discharge. However, we identified a lack of portable and cost-effective devices that not only focus on improving motor functions but also address sensory deficits. Thus, we designed a minimally-actuated hand training device that incorporates active grasping movements and passive pronosupination, complemented by a rehabilitative game with meaningful haptic feedback. Following a human-centered design approach, we conducted a usability study with 13 healthy participants, including three therapists. In a simulated unsupervised environment, the naive participants had to set up and use the device based on written instructions. Our mixed-methods approach included quantitative data from performance metrics, standardized questionnaires, and eye tracking, alongside qualitative feedback from semi-structured interviews. The study results highlighted the device's overall ease of setup and use, as well as its realistic haptic feedback. The eye-tracking analysis further suggested that participants felt safe during usage. Moreover, the study provided crucial insights for future improvements such as a more intuitive and comfortable wrist fixation, more natural pronosupination movements, and easier-to-follow instructions. Our research underscores the importance of continuous testing in the development process and offers significant contributions to the design of user-friendly, unsupervised neurorehabilitation technologies to improve sensorimotor stroke rehabilitation.</p

    Designing for usability: development and evaluation of a portable minimally-actuated haptic hand and forearm trainer for unsupervised stroke rehabilitation

    Get PDF
    In stroke rehabilitation, simple robotic devices hold the potential to increase the training dosage in group therapies and to enable continued therapy at home after hospital discharge. However, we identified a lack of portable and cost-effective devices that not only focus on improving motor functions but also address sensory deficits. Thus, we designed a minimally-actuated hand training device that incorporates active grasping movements and passive pronosupination, complemented by a rehabilitative game with meaningful haptic feedback. Following a human-centered design approach, we conducted a usability study with 13 healthy participants, including three therapists. In a simulated unsupervised environment, the naive participants had to set up and use the device based on written instructions. Our mixed-methods approach included quantitative data from performance metrics, standardized questionnaires, and eye tracking, alongside qualitative feedback from semi-structured interviews. The study results highlighted the device's overall ease of setup and use, as well as its realistic haptic feedback. The eye-tracking analysis further suggested that participants felt safe during usage. Moreover, the study provided crucial insights for future improvements such as a more intuitive and comfortable wrist fixation, more natural pronosupination movements, and easier-to-follow instructions. Our research underscores the importance of continuous testing in the development process and offers significant contributions to the design of user-friendly, unsupervised neurorehabilitation technologies to improve sensorimotor stroke rehabilitation.</p

    Coercivity and its thermal dependence in microsized magnetic particles: Influence of grain boundaries

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    Fe_(73.5)Si_(13.5)B_9Nb_3Cu_1 powder particles have been obtained by gas atomization. Magnetization curves and coercivity were studied for particles ranging in size up to 1000ÎĽ. The overall magnetic behavior of such material is consequence of compositional heterogeneity of the microstructure as a whole. Anomalous temperature variation of coercivity (H_c) (i.e., a decrease in H_c with decreasing temperature) together with a decrease of saturation magnetization has been observed for less than 25 ÎĽm size. The origin of this behavior has been ascribed to metastable FeCu and FeNbSi phases in combination with an Fe-rich one. Making magnetic powders with coercive fields of the order of mOe remains a challenge for researchers. Our experiment has allowed us, at low temperature, achieving a coercive field of 9 Oe, much lower than those observed so far in this type of materials. This behaviour has been related with a FeCu phase present on grain boundaries

    Extended x-ray-absorption fine-structure studies of heat-treated fcc-Fe_50Cu_50 powders processed via high-energy ball milling

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    The local structure and chemistry of a ferromagnetic fcc-Fe_50Cu_50 solid solution obtained through high-energy ball milling were measured before and after heat-treatment-induced decomposition using extended x-ray-absorption fine-structure measurements. The decomposition is first evident with the phase separation of a-Fe after a heat treatment at 523 K. Analysis of the residual fee component revealed that the Fe atoms were predominantly surrounded by other Fe atoms, suggesting that the Fe has coalesced within the fee structure. The Fe atoms within the fee phase likely exist in low-spin clusters which provide an explanation for the reduced values of low-temperature magnetization previously measured in annealed samples [P. Crespo et aZ., Phys. Rev. B 48, 7134 (1993)]
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