Steady pressure measurements in the strap-on booster interference Region of 1/20 scale aslv configuration

Wind tunnel studies were carried out to obtain pressure distribution in the strap-on booster interference region of 1/20th scale Augmented Satellite Launch Vehicle model configuration. Tests were done in the 1 .2m tunnel at NAL in the Mach number range of 0 .5 to 2.5 for the clean configuration as well as with spring housing attachments on the strap-on boosters. Both the model configurations with the boosters strapped on to the core vehicle in the horizontal plane (pitch) and in the vertical plane (yaw) were tested for incidences at 0, 4 and -4 deg. In addition pressure measurements were also done on the core vehicle alone at Mach numbers 2.1, 2.5 and 3.0 for 0, +4 degree incidences. The test Reynolds number was varied from 0.7 to 1.3 millions based on the maximum diameter of the model. The pressure distribution showed significant interference effects of boosters on the core vehicle. It is observed that the positive pressure peak associated with flow compression at the flare junction increases with increase in Mach number. In the pitch plane the normal force distribution remains positive along the core vehicle whereas in the yaw plane it is of less magnitude

An exploration of stakeholders’ perceptions of the barriers to clinical use of Assistive Technologies in services for upper-limb stroke rehabilitation

Introduction Half of all patients commencing stroke rehabilitation have marked impairment of the hemiplegic arm, with only 14% regaining useful function. Assistive technologies (ATs) have been developed and evaluated yet currently reach only a fraction of patients. The NIHR funded a five year research programme to generate understanding necessary to develop cost-effective stroke services in upper-limb rehabilitation. This stage aims to understand the potential advantages and disadvantages to the clinical use of ATs, and the needs and priorities of stakeholders. Method Participants include people with a stroke (n=40), their carers (n=20), health care professionals (n= 40), budget holders (n=15) and service commissioners (n=15). An interactive exhibition was held at the University of Southampton in October 2009 where stakeholders tested a range of ATs. Focus groups with each stakeholder group will be conducted within three months of the exhibition to discuss personal involvement in AT use, and positive and negative views on the AT presented. Results Results will be categorised in terms of barriers and facilitators to the use of upper-limb technologies addressing issues such as user comfort and acceptability, cost-benefit, evidence of effect and funding provision. Conclusion Getting research implemented in practice is challenging. This novel approach explores the barriers to using new technologies from the perspective of all key stakeholders. These findings will be combined with those of a national survey, and systematic review to inform a clinical trial resulting in a recommended care pathway for upper-limb rehabilitation

Blunt Renal Trauma in a Pre-Existing Renal Lesion

A 70-year-old male presented with direct trauma to his loin with gross hematuria, as an isolated case of blunt renal trauma (BRT) due to a traffic accident. A pre-existing renal lesion (PERL) was strongly suspected by his past history of gross macroscopic hematuria and monotrauma to the kidney without other associated injuries. Spiral CT scan with contrast and a retrograde pyelogram (RGP) confirmed an occult complex renal cyst. The gold standard of CT diagnosis in this situation is stressed. Computed tomography is particularly useful in evaluating traumatic injuries to kidneys with pre-existing abnormalities. The decision on the initial course of conservative management, ureteral retrograde stenting to drain extravasation, and its final outcome are discussed. Radical nephroureterectomy was carried out by a transperitoneal approach with an early vascular control of the renal pedicle. A brief review of recent literature has been undertaken

A pilot study of a single intermittent arm cycling exercise programme on people affected by Facioscapulohumeral dystrophy (FSHD)

For patients affected by Facioscapulohumeral dystrophy (FSHD), alternate methods for increasing physical activity engagement that may benefit shoulder function and wider health are needed. Arm cycling has been proposed as a potential method for achieving this although dosage parameters and evidence is limited. The aim of this study was to conduct a pilot study evaluating the effect of a single intermittent arm cycling exercise programme on people affected by FSHD. People with confirmed genetic diagnosis of FSHD between the ages 18–60 years were recruited to attend a single session for the exercise intervention (5 exercise efforts lasting 2 minutes each with 30 seconds of rest between each effort). Prior to exercise, measures of shoulder function (Oxford shoulder score), strength and range of movement were recorded. During the exercise participants were video recorded to quantify range of movement and extract movement profile features. Participants comments were recorded and followed up four days later to check for adverse events. Fifteen participants, (6F:9M) were recruited with median (IQR) Oxford Shoulder Scores of 25 (18 to 39). All participants successfully completed the exercise intervention with only transient symptoms consistent with exercise being reported and achieving a median (IQR) rate of perceived exertion scores of 13 (12 to 13). Movement profile data was available for 12 out of 15 participants and suggests that exercise intensity did not compromise movement. An association between strength and shoulder function (R2 = 0.5147), Rate of perceived exertion (RPE) of the final effort against shoulder function and strength (R2 = 0.2344 and 0.1743 respectively) was identified. Participant comments were positive regarding the exercise intervention. Our study demonstrates that an intermittent arm cycling programme is feasible for people affected by FSHD. Further work is needed to evaluate physiological responses to exercise across variations in programme variables and equipment set up in a larger sample of people affected by FSHD.Funder: The Orthopaedic Institute Limited; Grant(s): RPG16

Assessment of fracture risk tools in care home residents: a multi-centre observational pilot study.

BACKGROUND: Fragility fractures are common in care home residents but established tools have not been tested in this population. AIM: To identify the most practicable tool for use. METHODS: DESIGN: Multicentre prospective observational cohort pilot study. SETTING: 18 care homes in Boston, UK. ASSESSMENTS: fragility risk score at baseline with FRAX, QFractureScore, Garvan nomogram, body mass index and TUGT for each participant. OUTCOMES: falls, fractures, combined falls & fractures. Follow-up; 12 months. RESULTS: 217/618 (35%) residents in the 18 care homes were enrolled. 147 (68%) had mental capacity,70 (32%) did not. There were 325 falls and 10 fractures in participants during the study. At the same time there were 1671 falls and 103 fractures in residents not participating in the study. Multiple regression analyses showed that only age had a statistically significant association with falls (χ2(1) = 5.7775, p = 0.0162), fractures (χ2(1) = 4.7269, p = 0.0297) and combined falls & fractures (χ2(1) = 4.7269, p = 0.0297). C-statistics were: falls; FRAX 0.544, BMI 0.610, QFractureScore 0.554, Garvan nomogram 0.579, TUGT 0.656, fractures; FRAX 0.655, BMI 0.708, QFractureScore 0.736, Garvan nomogram 0.712, TUGT 0.590, combined falls and fractures, c-statistics were same as for fractures. Fifty-four participants (25%) died during follow-up. Charlson comorbidity index predicted mortality, R2 = 0.021 (p = 0.034). CONCLUSIONS: QFractureScore, BMI and Garvan nomogram were good predictors of fractures and combined falls and fractures Only age had statistically significant association with the outcomes. No tool was good predictor of falls

A Scoping Literature Review of Studies Assessing Effectiveness and Cost-Effectiveness of Prosthetic and Orthotic Interventions

Purpose: Approximately 1.5% of the world’s population (~100 million people) need a prosthesis/orthosis. The objective of the study was to establish an overview of the literature that has examined prosthetic and orthotic interventions with a view to inform policy development. Methods: Fourteen databases were searched from 1995-2015. Studies reporting primary research on the effectiveness or cost-effectiveness of prosthetic and orthotic interventions were examined. Metadata and information on study characteristics were extracted from the included studies. Results: The searches resulted in a total of 28,958 articles, a focus on studies with the words “randomised” OR “randomized” OR “cost” OR “economic” in their citation reduced this total to 2,644. Research has predominantly been conducted in Australia, Canada, Germany, Netherlands, UK and USA. 346 randomised controlled trials were identified, with only four randomised controlled trials examining prosthetic interventions. The majority of research examined lower limb orthoses in the adult population and used a wide range of outcome measures. Conclusions: While various international organisations have highlighted the value of providing prosthetic and orthotic services, both to the user and society as a whole, the availability of scientific research to inform policy is limited. Future structured evaluation of prosthetic and orthotic interventions/services is warranted to inform future policy developments