A GaAs MMIC chip-set for 10 to 15GHz radio-links applications

This paper describes the development of a GaAs MMIC chip-set for Ku-band radio-links transmitter. This chip-set includes two circuits, a times-two multiplier 5-7.5GHz to 10-15GHz, and a single side band up-converter. The development and the results of these circuits are analysed. The times-two multiplier is based on a specific balanced configuration leading to a very high level of input frequency suppression at the output (typically 50dBc) on a 2.7mm² chip. The mixer circuit is a broadband build-in single side band mixer of 10mm², with typically 30dBc image suppression

Analysing the sustainability of the physical rehabilitation sector in seven fragile countries through multi-stakeholder involvement using a participatory consensus tool

Background: Sustainability is identified by nearly all organisations working in global health as one of the key indicators for project evaluation. Though typically recognised as an essential component for good project management to ensure positive impact, it is rarely applied effectively in practical terms and there are very few practical methods or tools to support implementation and monitoring of sustainable interventions. Further, despite efforts of stakeholders at all levels, the rehabilitation sector is not usually at the top of policy-makers’ agendas, which often results in limited to no funding and makes the task of building sustainability even more challenging at field level

Self care programs and multiple sclerosis: Physical therapeutics treatment - literature review

AbstractObjectiveTo clarify the therapeutic education program impact with multiple sclerosis patients, literature review. Highlight contents and efficacy.MethodA non-systematic review on Medline, PubMed and Cochrane library databases from 1966 to 2010 using the following keywords: “multiple sclerosis”, “self-care”, “self-management” and specific symptoms keywords. Clinical trials and randomized clinical trials, as well as literature reviews published in English, French and German will be analyzed.ResultsCounseling is a part of the non-pharmacological management of chronic illnesses such as multiple sclerosis. Symptoms’ diversity and the different clinical forms limit standardized programs of self-care management, applicable to patients. In the literature review, counseling programs have often low metrology. A behavior change with patients and medical staff could exist. To empower the patient, to reduce symptoms’ impact and to improve treatment access are the aims of educational therapy.ConclusionTherapeutic education program for multiple sclerosis patients could progress with their standardization and assessment, for each sign. To promote the educational therapy of multiple sclerosis patients, a specific training for medical staff, as specific financing are necessary

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 literature review of the challenges encountered in the adoption of assistive technology (AT) and training of healthcare professionals

Background: Long-term disabilities often result in loss of autonomy and social interaction. Accordingly, there is a demand for Assistive Technology (AT) devices to enable individuals to live independently for as long as possible. However, many people experience difficulties in obtaining and using AT. This paper presents findings from a narrative literature review undertaken as part of the development of AT training for healthcare professionals, one of the work areas of the ADAPT project (Assistive Devices for Empowering Disabled People through Robotic Technologies), funded by EU INTERREG France (Channel) England. The results of the review informed the design of a survey of healthcare professionals regarding their views and experiences of AT and the development of AT training. Method: The review sought to understand challenges encountered in the adoption and use of AT as well as how training of healthcare professionals in AT takes place. A narrative approach was adopted as the most appropriate way to synthesise published literature on this topic and describe its current state-of-art. Narrative reviews are considered an important educational tool in continuing professional development. An initial search was conducted via databases in the UK and France, including CINAHL, Academic Search Index, Social Sciences Citation Index, BDSP (Base de données en Santé Publique), Documentation EHESP/MSSH (Ecole des Hautes Etudes en Santé Publique/Maison des Sciences Sociales et Handicap), Cairn, Google Scholar and Pubmed. Inclusion criteria for the review included: covering issues relating to AT provision and training, English or French language, and published from 1990 onwards. Application of these criteria elicited 79 sources, including journal papers (48), reports (11), online sources (11), books (6) and conference papers (3). Sources were thematically analysed to draw out key themes. Key results: The majority of papers were from USA and Canada (27), then UK (20) and France (19). Others were from Europe (7), Australia (3), country unknown (2), and one joint UK/France publication. The main source of literature was journal papers (48), of which the most common types were practice reports (18), evaluation surveys (10) and qualitative studies (9). The review uncovered a number of key challenges related to the adoption of devices, including: difficulty defining AT across disciplines, lack of knowledge of healthcare professionals and users, obtrusiveness and stigmatisation AT users can experience when using devices, and shortfalls in communication amongst professional groups and between professionals and users. These issues can lead to abandonment of AT devices. Furthermore, substantial barriers to healthcare professionals exist, including inconsistent provision and quality of training, lack of evaluation of training, lack of resources and funding, shortage of qualified professionals to teach, and the increasingly rapid development of the technologies. Conclusion: Support, training and education for prescribers, distributors, users, and their carers is vital in the adoption and use of AT. Evidence indicates a need for comprehensive education in the AT field, as well as ongoing assessment, updates and evaluation which is embedded in programmes

Micro-crystalline inclusions analysis by PIXE and RBS

A characteristic feature of the nuclear microprobe using a 3 MeV proton beam is the long range of particles (around 70 \mu m in light matrices). The PIXE method, with EDS analysis and using the multilayer approach for treating the X-ray spectrum allows the chemistry of an intra-crystalline inclusion to be measured, provided the inclusion roof and thickness at the impact point of the beam (Z and e, respectively) are known (the depth of the inclusion floor is Z + e). The parameter Z of an inclusion in a mineral can be measured with a precision of around 1 \mu m using a motorized microscope. However, this value may significantly depart from Z if the analyzed inclusion has a complex shape. The parameter e can hardly be measured optically. By using combined RBS and PIXE measurements, it is possible to obtain the geometrical information needed for quantitative elemental analysis. This paper will present measurements on synthetic samples to investigate the advantages of the technique, and also on natural solid and fluid inclusions in quartz. The influence of the geometrical parameters will be discussed with regard to the concentration determination by PIXE. In particular, accuracy of monazite micro-inclusion dating by coupled PIXE-RBS will be presented

Chronic wounds consultation by telemedicine between a rehabilitation healthcare center and nursing home or home

Saint-Hélier Rehabilitation Center (pôle MPR Saint-Hélier), located in Rennes, has been selected for a regional telemedicine project in 2014 about chronic wounds.AimTo make care access easier for heavy disabilities patients in nursing homes or at home with chronic wounds.MethodThe members of TLM Pl@ies chronic team are specialist doctors and nurses for wounds. On request, the occupational therapist or dietician involve in the consultation (multidisciplinary approach). A secure videoconference (web) is used.ResultsSince July 2014, over 100 teleconsultations have been done. Targeted population is constituted by patients:– whose access to care is decreased due to moving difficulties;– of which the health care team is crossing difficulties in the care process (wound care but also disability, nutrition..).Seventy percent of requests come from the nursing home, 30% from homes (pressure ulcers stages 3 and 4, arterial ulcers, venous or mixed). Middle age: 78 years (20–101 years). Only 3 patients refused. Time to organize the teleconsultation is on average 13 days. Consultations last on average 25 minutes. In 30% of cases the teleconsultation is extended by a real live training time for the nurse at home guided by the TLM Pl@ies chroniques team. We evaluate professional satisfaction and technical satisfaction. Without teleconsultation, in 77% of cases transportation request for consultation would be made, in 5% hospitalization. In 18% no request would be done.Discussion/conclusionThese first results, encouraging, confirms the interest of specialized consultations in medico-social settings, and telemedicine can be an effective solution