A System in the Wild: Deploying a Two Player Arm Rehabilitation System for Children With Cerebral Palsy in a School Environment

This paper outlines a system for arm rehabilitation for children with upper-limb hemiplegia resulting from cerebral palsy. Our research team designed a two-player, interactive (competitive or collaborative) computer play therapy system that provided powered assistance to children while they played specially designed games that promoted arm exercises. We designed the system for a school environment. To assess the feasibility of deploying the system in a school environment, the research team enlisted the help of teachers and staff in nine schools. Once the system was set up, it was used to deliver therapy without supervision from the research team. Ultimately, the system was found to be suitable for use in schools. However, the overriding need for schools to focus on academic activities meant that children could not use the system enough to achieve the amount of use desired for therapeutic benefit. In this paper, we identify the key challenges encountered during this study. For example, there was a marked reluctance to report system issues (which could have been fixed) that prevented children from using the system. We also discuss future implications of deploying similar studies with this type of system

The Production of Hospitable Space: Commercial Propositions and Consumer Co-Creation in a Bar Operation

This paper examines the processes through which a commercial bar is transformed into a hospitable space. Drawing on a study of a venue patronized by lesbian, gay, bisexual and transsexual/transgender consumers, it considers how social and commercial forms of hospitality are mobilized. The paper argues that hospitable space has an ideological, normative and situational dimension. More specifically, it suggests the bar’s operation is tied to a set of ideological conceptions, which become the potential basis of association and disassociation among consumers. It examines the forces and processes that shape who participates in the production and consumption of hospitality and how. Finally, it considers the situational, emergent nature of hospitality and the discontinuous production of hospitable space. Rather than focusing exclusively on host-guest or provider-customer relations, which dominates existing work on hospitality, the paper examines how consumers’ perceptions, actions and interactions shape the production of hospitality. By doing so the paper offers an alternative approach to understanding queer spaces, bar operation as well as hospitality

Immune profiling in human breast cancer using high-sensitivity detection and analysis techniques

Published September 24, 2015OBJECTIVES: Evaluation of immune profiles in human breast cancer using high-sensitivity detection and analysis methods. DESIGN: Cohort comparative analysis studies of breast tissue. SETTING: Human hospital and laboratory healthcare facilities. PARTICIPANTS: Women over 18 years. MAIN OUTCOME MEASURES: Evaluation of the comparative immunophenotype of human breast carcinoma and normal breast tissues. RESULTS: Leukocyte density and specific subgroups of lymphocytes and macrophages were generally higher in breast cancers compared to normal breast tissues. CD3, CD4, CD45RO, CD45RA(2H4), CD45 and HLA Class II (on TIL) were significantly expressed on breast tumour tissues compared with normal tissues (p < .01). Some 30% of T-cells were γδ-TCR positive, but the majority were αβ-TCR in type. CD19 (B-cell), CD14 (FMC32 and 33) and HLA Class I levels (epithelial and TIL) showed no significant differences. IL-2α receptor expression was low or absent on most TIL. CONCLUSIONS: High-sensitivity and image analysis techniques permitted accurate characterisation of the TIL infiltrate for immune profiling. Breast carcinoma showed predominance of CD4 T-cells of mainly memory phenotype. Normal breast tissues showed low leukocyte infiltration. Further correlation of these findings with clinical outcome, including survival, is proceeding with encouraging results.Brendon J Coventry, Michael J Weightman, John Bradley and John M Skinne

Strategies to Increase Early Discharges to Reduce Avoidable Patient Days and Improve Patient Flow

CREATING ALGORITHMS TO INCREASE THE NUMBERS OF HOSPITAL MORNING DISCHARGES RESULTING IN IMPROVED PATIENT FLOW Discharging a percentage of patients early in the day helps to improve patient flow. This results in a reduction of Emergency Department congestion as well as peaks in patient numbers in the early to late afternoon on patient care units. A cardiac unit in an academic tertiary medical center created a goal to increase the number of their discharges by 11 AM and to streamline key discharge planning activities. A root cause analysis was initiated and after identifying several barriers, two KPIs were developed using improvement measures of operational excellence. Post KPI inception, metric goals were exceeded within the established timeline. Next steps include reviewing DRG specific readmission rates to make sure there are no negative impacts as a result of the established countermeasures. In addition, the unit will provide coaches for other care units interested in adopting these strategies

Reflectance anisotropy spectroscopy assessment of the MOVPE nucleation of GaInP on Germanium (100)

This work summarizes the observations made on the variation and time evolution of the reflectanceanisotropy signal during the MOVPE growth of GaInPnucleation layers on Germanium substrates. This in situ monitoring tool is used to assess the impact of different nucleation routines and reactor conditions on the quality of the layers grown. This comparison is carried out by establishing a correlation between reflectanceanisotropy signature at 2.1 eV and the morphology of the epilayers evaluated by atomic force microscopy (AFM). This paper outlines the potential of reflectanceanisotropy to predict, explore, and therefore optimize, the best growth conditions that lead to a high quality III–V epilayer on a Ge substrat

Feasibility of school-based computer-assisted robotic gaming technology for upper limb rehabilitation of children with cerebral palsy

We investigated the feasibility of using computer-assisted arm rehabilitation (CAAR) computer games in schools. Outcomes were children's preference for single player or dual player mode, and changes in arm activity and kinematics. Method: Nine boys and two girls with cerebral palsy (6-12 years, mean 9 years) played assistive technology computer games in single-user mode or with school friends in an AB-BA design. Preference was determined by recording the time spent playing each mode and by qualitative feedback. We used the ABILHAND-kids and Canadian Occupational Performance Measure to evaluate activity limitation, and a portable laptop-based device to capture arm kinematics. Results: No difference was recorded between single-user and dual-user modes (median daily use 9.27 versus 11.2 min, p = 0.214). Children reported dual-user mode was preferable. There were no changes in activity limitation (ABILHAND-kids, p = 0.424; COPM, p = 0.484) but we found significant improvements in hand speed (p = 0.028), smoothness (p = 0.005) and accuracy (p = 0.007). Conclusion: School timetables prohibit extensive use of rehabilitation technology but there is potential for its short-term use to supplement a rehabilitation program. The restricted access to the rehabilitation games was sufficient to improve arm kinematics but not arm activity

Microwave and terahertz dielectric properties of MgTiO3–CaTiO3 ceramics

The THz dielectric properties of MgTiO3–CaTiO3 ceramics are reported. The ceramics were prepared via a solid-state reaction route and the sintering conditions were optimized to obtain ceramics with high permittivity and low loss in the terahertz frequency domain. The amount of impurities (MgTi2O5) and grain size increased with increasing sintering temperature. The dielectric properties improved with increasing density, and the best terahertz dielectric performance was obtained at 1260 °C, with a permittivity of 17.73 and loss of 3.07×10−3. Ceramics sintered above 1260 °C showed a sharp increase in loss, which is ascribed to an increase in the impurity content

Development and Preliminary Reliability of a Multitasking Assessment for Executive Functioning After Concussion

OBJECTIVES. Executive functioning deficits may result from concussion. The Charge of Quarters (CQ) Duty Task is a multitask assessment designed to assess executive functioning in servicemembers after concussion. In this article, we discuss the rationale and process used in the development of the CQ Duty Task and present pilot data from the preliminary evaluation of interrater reliability (IRR)