Design Methodology for Rehabilitation Robots: Application in an Exoskeleton for Upper Limb Rehabilitation

This article presents a methodology for the design of rehabilitation devices that considers factors involved in a clinical environment. This methodology integrates different disciplines that work together. The methodology is composed by three phases and 13 stages with specific tasks, the first phase includes the clinical context considering the requirements of the patient and therapist during the rehabilitation, the second phase is focused in engineering based on the philosophy of digital twin, and in the third phase is evaluated the device. This article explains the characteristics of the methodology and how it was applied in the design of an exoskeleton for passive rehabilitation of upper limb

The importance of division of work and clinical focus in health human resources planning: a dynamic, multi-professional, needs-based simulation model

Background: Comprehensive health human resources (HHR) planning is essential for addressing population health needs and meeting other common health care system objectives. For reasons that remain unclear, conceptually invalid approaches to HHR planning remain commonplace in Canada and other countries. The overarching aim of this study is to assess the feasibility of using a dynamic, multi-professional, needs-based simulation model to inform HHR planning in Nova Scotia. Objectives: 1) Estimate the supply of and requirements for physicians, nurses, social workers, and psychologists to address anxiety and depression among school-aged children in Nova Scotia through 2032; and 2) Identify technical and political factors affecting the choice of HHR planning models in Nova Scotia. Methods: A dynamic, multi-professional, needs-based simulation model was used to achieve the first objective. A series of key informant interviews with HHR planners from different Nova Scotia stakeholder groups was conducted to address the second objective. Results: Simulation modeling suggests Nova Scotia currently lacks the number and mix of HHR required to address anxiety and depression among its school-aged children, and that this problem will worsen without intervention. Examples of policy interventions with the potential to address simulated HHR gaps are provided. The most important factor identified as affecting the choice of HHR planning model in Nova Scotia was the buy-in of key stakeholder groups. Other factors identified as particularly important in determining this choice were the model’s balance between comprehensiveness and complexity, the political and technical capacity of individuals and organizations responsible for HHR planning, and concerns regarding the availability of appropriate planning data to populate the model. Conclusion: Use of this model to inform HHR planning in Nova Scotia is feasible with appropriate engagement of key stakeholders. The structure and presentation of the model are viewed by HHR planners in the province as being suited to facilitating such engagement. Coordinated investments are needed to ensure adequate planning capacity among the individuals and organizations responsible for HHR planning in Nova Scotia, and the availability of adequate data to inform HHR and health system planning

Health human resources planning and the production of health: Development of an extended analytical framework for needs-based health human resources planning.

Traditional approaches to health human resources planning emphasize the role of demographic change on the needs for health human resources. Conceptual frameworks have been presented that recognize the limited role of demographic change and the broader determinants of health human resource requirements. Nevertheless, practical applications of health human resources planning continue to base plans on the size and demographic mix of the population applied to simple population-provider or population-utilization ratios. In this paper an analytical framework is developed based on the production of health care services and the multiple determinants of health human resource requirements. In this framework attention is focused on estimating the ‘flow’ of services required to meet the needs of the population that is then translated into the required ‘stock’ of providers to deliver this ‘flow’ of services. The requirements for human resources in the future is shown to depend on four elements: the size and demographic mix of the population (demography), the levels of risks to health and morbidity in the population (epidemiology), the services deemed appropriate to address the levels of risks to health and morbidity (standards of care), and the rate of service delivery by providers (productivity). Application of the framework is illustrated using hypothetical scenarios.health human resources planning, demography, epidemiology, standards of care, productivity

Mapping Platform Urbanism: Charting the Nuance of the Platform Pivot

Urban planners are increasingly working with ideas around datafied cities, such as platform urbanism, to understand urban life and changes with technology. This article seeks to assist urban planners in these efforts by analysing and mapping the qualities of platform urbanism. Drawing on a dataset of approximately 100 examples that detail urban data practices, we trace some of the current tendencies that are shaping the nature and dynamics of platform urbanism. While we identify no unifying narrative or overarching pattern to our data, we interpret this as supporting Barns’ (2019) notion of a pivot towards platforms. We argue this through exploring the interoperability between data sources and domains (vertical and horizontal integration), identifying elements of how platforms intermediate urban life through their growth in different sectors and the use of geolocation, and note the different artefacts that contribute to platform urbanism. We also note a concerning dynamic where city administration becomes ‘locked in’ to specific corporate products and interests, and thereby ‘locked out’ from alternatives. We discuss this in the context of social inclusion and what this means for urban planners, including the fragility of corporate platforms and what platforms urbanism means for social relationships in the city

‘Are they out to get us?’ Power and the ‘recognition’ of the subject through a ‘lean’ work regime

Critical studies of ‘lean’ work regimes have tended to focus on the factory shop floor or public and healthcare sectors, despite its recent revival and wider deployment in neoliberal service economies. This paper investigates the politics of the workplace in a United Kingdom automotive dealership group subject to an intervention inspired by lean methods. We develop Foucauldian studies of governmentality by addressing lean as a technology of power deployed to act on the conduct of workers, examining how they debunk, distance themselves from and enact its imperatives. Our findings support critiques of lean work regimes that raise concerns about work intensification and poor worker health. Discourses of professional autonomy allow workers to distance themselves from lean prescriptions, yet they are reaffirmed in their actions. More significantly, we illustrate the exercise of a more encompassing form of power, showing how lean harnesses the inherently exploitable desire for recognition among hitherto marginalised workers, and its role as a form of ‘human capital’. The paper contributes to critical studies of lean by illustrating its subtle, deleterious and persistent effects within the analytical frame of neoliberal governmentality. We also demonstrate how studies of governmentality can be advanced through the analysis of contested social relations on the ground, highlighting the ethico-political potential of Foucauldian work

Excess Cancer Mortality in Psychiatric Patients

Objectives: There are conflicting data oil cancer incidence and mortality in psychiatric patients, although most Studies suggest that while cancer mortality is higher, incidence is no different from that in the general population. Different methodologies and outcomes may account for some of the conflicting results. We investigated the association between mental illness and cancer incidence, first admission rates, and mortality in Nova Scotia using a standard methodology