Mixed Feelings about the Diagnosis of Type 2 Diabetes Mellitus: A Consequence of Adjusting To Health Related Quality Of Life

This study aims to explore patients’ reactions to the diagnosis of type 2 diabetes mellitus (T2DM) and their health related quality of life. We adopted a qualitative exploratory study design using a thematic analysis. Twelve patients with T2DM for more than a 2-year duration were interviewed using a semi-structured interview guide. Both purposive and theoretical samplings were used for data collection. The in-depth interviews were audio-taped and transcribed verbatim, followed by line-by-line coding and constant comparison to identify the themes. Data management was facilitated using Nvivo 10. Patients shared their mixed feelings about the diagnosis of T2DM. Six domains of quality of life emerged from these interviews, namely physical and social functioning, work function and social obligations, dietary freedom and conforming to treatment standard. Diabetes management needs to take these themes and patients’ feelings associated with their quality of life into consideration

Prevalence and anatomical location of muscle tenderness in adults with nonspecific neck/shoulder pain

<p>Abstract</p> <p>Background</p> <p>Many adults experience bothersome neck/shoulder pain. While research and treatment strategies often focus on the upper trapezius, other neck/shoulder muscles may be affected as well. The aim of the present study is to evaluate the prevalence and anatomical location of muscle tenderness in adults with nonspecific neck/shoulder pain.</p> <p>Methods</p> <p>Clinical neck/shoulder examination at two large office workplaces in Copenhagen, Denmark. 174 women and 24 men (aged 25-65 years) with nonspecific neck/shoulder pain for a duration of at least 30 days during the previous year and a pain intensity of at least 2 on a modified VAS-scale of 0-10 participated. Exclusion criteria were traumatic injuries or other serious chronic disease. Using a standardized finger pressure of 2 kg, palpable tenderness were performed of eight anatomical neck/shoulder locations in the left and right side on a scale of 'no tenderness', 'some tenderness' and 'severe tenderness'.</p> <p>Results</p> <p>In women, the levator scapulae, neck extensors and infraspinatus showed the highest prevalence of severe tenderness (18-30%). In comparison, the prevalence of severe tenderness in the upper trapezius, occipital border and supraspinatus was 13-19%. Severe tenderness of the medial deltoid was least prevalent (0-1%). In men, the prevalence of severe tenderness in the levator scapulae was 13-21%, and ranged between 0-8% in the remainder of the examined anatomical locations.</p> <p>Conclusions</p> <p>A high prevalence of tenderness exists in several anatomical locations of the neck/shoulder complex among adults with nonspecific neck/shoulder pain. Future research should focus on several neck/shoulder muscles, including the levator scapulae, neck extensors and infraspinatus, and not only the upper trapezius.</p> <p>Trial Registration</p> <p><a href="http://www.controlled-trials.com/ISRCTN60264809">ISRCTN60264809</a></p

Semi AI-based protection element for MMC-MTDC using local-measurements

Data Access Statement: Data supporting this study cannot be made available due to the research data are confidential, because of the arrangement the research groups have made with the commercial partner supporting the research.Copyright © 2022 The Authors. The multi-terminal HVDC system based on the modular multilevel converter (MMC-MTDC) is a promising technique for flexible power transmissions to multiple regions. As such a system is quite sensitive to DC faults, there is an acute need to propose a protection element that can trip the local DC circuit breaker (CB) within several milliseconds once there is an internal DC line fault. However, the existing main protection scheme faces a dilemma balancing selectivity and sensitivity. To solve this problem, a novel semi artificial-intelligence (AI) based protection element is proposed, including a start-up criterion and a fault-identification criterion. The start up criterion is based on the propagation characteristics of the initial fault-induced surge. To enhance the real time performance of the protection element, it will not trip the fault-identification process unless the fault is identified as a forward one. The fault-identification criterion is based on artificial intelligence (AI), and further determines whether the forward fault is internal, which only works if the start-up criterion trips. Simulation results indicate that the proposed protection element has satisfactory speed, sensitivity, and selectivity against internal DC faults and is quite secure under external fault conditions. The impact of disturbances, such as the white noise, abnormal samplings, etc., on the security of the proposed protection element is also discussed.National Natural Science Foundation of China under Grant No. 51907069; Natural Science Foundation of Guangdong Province under Grant No. 2022A1515011079 and 2020A1515010766

Transient extraction transform based fault location method with enhanced accuracy

The fast determination of internal or external fault for the VSC-MTDC is essential for its safety and continuous operation. As very limited time is permitted in an internal fault, transient-based protection elements are widely applied to locate the fault in a very small-time window. However, with such a short time window, location methods based on the wavelet transform or the mathematical morphology show limited performance balancing the resolution in the time and frequency domains. In recent years, there has been a novel time-frequency domain analysis method, naming the transient extraction transform (TET), with high accuracy in both domains. In this paper, a TET-based fast fault-location method is proposed with enhanced accuracy. Comparison studies are made to highlight the performance of such a method against internal faults for the VSC-MTDC.This work is supported by the National Natural Science Foundation of China under Grant No. 51907069 and the Natural Science Foundation of Guangdong Province under Grant No. 2021A151501239

Does implementation matter if comprehension is lacking? A qualitative investigation into perceptions of advance care planning in people with cancer

Purpose: While advance care planning holds promise, uptake is variable and it is unclear how well people engage with or comprehend advance care planning. The objective of this study was to explore how people with cancer comprehended Advance Care Plans and examine how accurately advance care planning documentation represented patient wishes. Methods: This study used a qualitative descriptive design. Data collection comprised interviews and an examination of participants’ existing advance care planning documentation. Participants included those who had any diagnosis of cancer with an advance care plan recorded: Refusal of Treatment Certificate; Statement of Choices; and/or Enduring Power of Attorney (Medical Treatment) at one cancer treatment centre. Results: Fourteen participants were involved in the study. Twelve participants were female (86%). The mean age was 77 (range: 61-91) and participants had completed their advance care planning documentation between 8 and 72 weeks prior to the interview (mean 33 weeks). Three themes were evident from the data: Incomplete advance care planning understanding and confidence; Limited congruence for attitude and documentation; Advance care planning can enable peace of mind. Complete advance care planning understanding was unusual; most participants demonstrated partial comprehension of their own advance care plan, and some indicated very limited understanding. Participants’ attitudes and their written document congruence was limited, but advance care planning was seen as helpful. Conclusions: This study highlighted advance care planning was not a completely accurate representation of patient wishes. There is opportunity to improve how patients comprehend their own advance care planning documentation

Augmented Power Dispatch for Resilient Operation through Controllable Series Compensation and N-1-1 Contingency Assessment

Copyright: © 2021 by the authors. Research on enhancing power system resilience against extreme events is attracting significant attention and becoming a top global agenda. In this paper, a preventive augmented power dispatch model is proposed to provide a resilient operation. In the proposed model, a new N-1-1 security criterion is proposed to select disruptive N-1-1 contingency cases that might trigger cascading blackouts, and an iterative contingency assessment process based on the line outage distribution factor is proposed to deal with security constraints. In terms of optimization objectives, two objectives related to power flow on the transmission line are considered to reduce the possibility of overload outages. Controllable series compensation devices are also considered in the model to improve the power flow distribution. Case studies conducted on the modified IEEE 30-bus, 118-bus and Polish 2382-bus systems show that the power flow solution of the proposed power dispatch model can avoid some branches from undertaking excessively heavy loads, especially lines forecasted to be affected by extreme events. The results of blackout simulations through a hidden failure cascading outage simulation model show that the average power losses of the proposed model are reduced by around 40% in some cases as compared to the classical economic dispatch model.Education Department of Guangdong Province: New and Integrated Energy System Theory and Technology Research Group; National Natural Science Foundation of China; Brunel University London BRIEF Funding

A Novel Power Market Mechanism Based on Blockchain for Electric Vehicle Charging Stations

© 2021 by the authors. This work presents a novel blockchain-based energy trading mechanism for electric vehicles consisting of day-ahead and real-time markets. In the day-ahead market, electric vehicle users submit their bidding price to participate in the double auction mechanism. Subsequently, the smart match mechanism will be conducted by the charging system operator, to meet both personal interests and social benefits. After clearing the trading result, the charging system operator uploads the trading contract made in the day-ahead market to the blockchain. In the real-time market, the charging system operator checks the trading status and submits the updated trading results to the blockchain. This mechanism encourages participants in the double auction to pursue higher interests, in addition to rationally utilize the energy unmatched in the auction and to achieve the improvement of social welfare. Case studies are used to demonstrate the effectiveness of the proposed model. For buyers and sellers who successfully participate in the day-ahead market, the total profit increase for buyer and seller are 22.79% and 53.54%, respectively, as compared to without energy trading. With consideration of social welfare in the smart match mechanism, the peak load reduces from 182 to 146.5 kW, which is a 19.5% improvement.Department of Finance and Education of Guangdong Prov- ince 2016 [202]: Key Discipline Construction Program, China; the Education Department of Guang- dong Province: New and Integrated Energy System Theory and Technology Research Group [Pro- ject Number 2016KCXTD022]; Brunel University London BRIEF Funding; National Natural Science Foundation of China (51907031)

A Novel Data-Driven Method for Behind-the-Meter Solar Generation Disaggregation with Cross-Iteration Refinement

10.13039/501100007914-Brunel University London (Grant Number: BRIEF Funding); 10.13039/501100001809-National Natural Science Foundation of China (Grant Number: 51907031); Education Department of Guangdong Province (Grant Number: 2016KCXTD022); Department of Finance and Education of Guangdong Province (Grant Number: Key Discipline Construction Program, China)

Study protocol: developing a decision system for inclusive housing: applying a systematic, mixed-method quasi-experimental design

Background Identifying the housing preferences of people with complex disabilities is a much needed, but under-developed area of practice and scholarship. Despite the recognition that housing is a social determinant of health and quality of life, there is an absence of empirical methodologies that can practically and systematically involve consumers in this complex service delivery and housing design market. A rigorous process for making effective and consistent development decisions is needed to ensure resources are used effectively and the needs of consumers with complex disability are properly met. Methods/Design This 3-year project aims to identify how the public and private housing market in Australia can better respond to the needs of people with complex disabilities whilst simultaneously achieving key corporate objectives. First, using the Customer Relationship Management framework, qualitative (Nominal Group Technique) and quantitative (Discrete Choice Experiment) methods will be used to quantify the housing preferences of consumers and their carers. A systematic mixed-method, quasi-experimental design will then be used to quantify the development priorities of other key stakeholders (e.g., architects, developers, Government housing services etc.) in relation to inclusive housing for people with complex disabilities. Stakeholders randomly assigned to Group 1 (experimental group) will participate in a series of focus groups employing Analytical Hierarchical Process (AHP) methodology. Stakeholders randomly assigned to Group 2 (control group) will participate in focus groups employing existing decision making processes to inclusive housing development (e.g., Risk, Opportunity, Cost, Benefit considerations). Using comparative stakeholder analysis, this research design will enable the AHP methodology (a proposed tool to guide inclusive housing development decisions) to be tested. Discussion It is anticipated that the findings of this study will enable stakeholders to incorporate consumer housing preferences into commercial decisions. Housing designers and developers will benefit from the creation of a parsimonious set of consumer-led housing preferences by which to make informed investments in future housing and contribute to future housing policy. The research design has not been applied in the Australian research context or elsewhere, and will provide a much needed blueprint for market investment to develop viable, consumer directed inclusive housing options for people with complex disability