Wireless Accelerometers for Early Detection of Restenosis

AbstractThe goal of this paper is to use accelerometers as an early detection of restenosis. Restenosis (re-narrowing of the blood vessel) typically occurs within 3-6 months after the implantation of a stent. Finite element modelling of an occluded blood vessel showed that eddies along with an increase in velocity occur around the occlusion. In this paper a wireless accelerometer device was used to detect an occlusion. A human phantom model was used to mimic the wireless transmission capabilities of the system through human muscle ex-vivo. Fast Fourier transform results from the accelerometer showed that a non-occluded blood vessel had significant peaks >15Hz, whereas an occluded blood vessel had peaks <15Hz, which provides a signature template for detecting restenosis. The results of the FEM and human phantom experiments show that an accelerometer sensor is capable of detecting restenosis

Understanding leadership in a world of shared problems: advancing network governance in large landscape conservation

Conservation of large landscapes requires three interconnected types of leadership: collaborative leadership, in which network members share leadership functions at different points in time; distributive leadership, in which network processes provide local opportunities for members to act proactively for the benefit of the network; and architectural leadership, in which the structure of the network is intentionally designed to allow network processes to occur. In network governance, each leadership approach is necessary to achieve sustained, successful outcomes. We discuss each of these approaches to leadership and offer specific practices for leaders of networks, including: shaping the network's identity and vision, attracting members, instilling leadership skills in members, and advancing common interests. These practices are then illustrated in case studies

Means to an End: An Assessment of the Status-blind Approach to Protecting Undocumented Worker Rights

This article applies the tenets of bureaucratic incorporation theory to an investigation of bureaucratic decision making in labor standards enforcement agencies (LSEAs), as they relate to undocumented workers. Drawing on 25 semistructured interviews with high-level officials in San Jose and Houston, I find that bureaucrats in both cities routinely evade the issue of immigration status during the claims-making process, and directly challenge employers’ attempts to use the undocumented status of their workers to deflect liability. Respondents offer three institutionalized narratives for this approach: (1) to deter employer demand for undocumented labor, (2) the conviction that the protection of undocumented workers is essential to the agency’s ability to regulate industry standards for all workers, and (3) to clearly demarcate the agency’s jurisdictional boundaries to preserve institutional autonomy and scarce resources. Within this context, enforcing the rights of undocumented workers becomes simply an institutional means to an end

"Sometimes we can't fix things": A qualitative study of health care professionals' perceptions of end of life care for patients with heart failure

Background Although heart failure has a worse prognosis than some cancers, patients often have restricted access to well-developed end of life (EoL) models of care. Studies show that patients with advanced heart failure may have a poor understanding of their condition and its outcome and, therefore, miss opportunities to discuss their wishes for EoL care and preferred place of death. We aimed to explore the perceptions and experiences of health care professionals (HCPs) working with patients with heart failure around EoL care. Design A qualitative in-depth interview study nested in a wider ethnographic study of unplanned admissions in patients with heart failure (HoldFAST). We interviewed 24 HCPs across primary, secondary and community care in three locations in England, UK – the Midlands, South Central and South West. Results The study revealed three issues impacting on EoL care for heart failure patients. Firstly, HCPs discussed approaches to communicating with patients about death and highlighted the challenges involved. HCPs would like to have conversations with patients and families about death and dying but are aware that patient preferences are not easy to predict. Secondly, professionals acknowledged difficulties recognising when patients have reached the end of their life. Lack of communication between patients and professionals can result in situations where inappropriate treatment takes place at the end of patients’ lives. Thirdly, HCPs discussed the struggle to find alternatives to hospital admission for patients at the end of their life. Patients may be hospitalised because of a lack of planning which would enable them to die at home, if they so wished. Conclusions The HCPs regarded opportunities for patients with heart failure to have ongoing discussions about their EoL care with clinicians they know as essential. These key professionals can help co-ordinate care and support in the terminal phase of the condition. Links between heart failure teams and specialist palliative care services appear to benefit patients, and further sharing of expertise between teams is recommended. Further research is needed to develop prognostic models to indicate when a transition to palliation is required and to evaluate specialist palliative care services where heart failure patients are included

Nuovi scenari dell'agricoltura in provincia di Venezia

Background: Standardised patients are used in medical education to expose students to clinical contexts and facilitate transition to clinical practice, and this approach is gaining momentum in physiotherapy programs. Expense and availability of trained standardised patients are factors limiting widespread adoption, and accessing clinical visits with real patients can be challenging. This study addressed these issues by engaging senior students as standardised patients for junior students. It evaluated how this approach impacted self-reported constructs of both the junior and senior students