Vibration and shock in vehicles: new challenges, new methods, new solutions

There are many components that contribute to the overall feeling of comfort in a vehicle. One of the important components in the exposure to vibration. Vibration can cause an acute increase in discomfort. Furthermore, the presence of vibration accelerates the onset of discomfort for long duration exposures. It is therefore important that vibration remains a key consideration in the development of vehicle seats. There are currently two opportunities for vibration research in vehicles. The development of autonomous cars means that the assumptions relating to driving task and posture are no longer valid and therefore new seats will need to be developed that allow for the variety of tasks that an autonomous occupant will need to complete. Small fast boats can expose their occupants to significant vibration and shock affecting the comfort, performance and health of the crew. There are a multitude of potential control measures that can be implemented as part of a control strategy including design of boat and seat, and operational design

The health and sport engagement (HASE) intervention and evaluation project: protocol for the design, outcome, process and economic evaluation of a complex community sport intervention to increase levels of physical activity.

INTRODUCTION: Sport is being promoted to raise population levels of physical activity for health. National sport participation policy focuses on complex community provision tailored to diverse local users. Few quality research studies exist that examine the role of community sport interventions in raising physical activity levels and no research to date has examined the costs and cost-effectiveness of such provision. This study is a protocol for the design, outcome, process and economic evaluation of a complex community sport intervention to increase levels of physical activity, the Health and Sport Engagement (HASE) project part of the national Get Healthy Get Active programme led by Sport England. METHODS AND ANALYSIS: The HASE study is a collaborative partnership between local community sport deliverers and sport and public health researchers. It involves designing, delivering and evaluating community sport interventions. The aim is to engage previously inactive people in sustained sporting activity for 1×30 min a week and to examine associated health and well-being outcomes. The study uses mixed methods. Outcomes (physical activity, health, well-being costs to individuals) will be measured by a series of self-report questionnaires and attendance data and evaluated using interrupted time series analysis controlling for a range of sociodemographic factors. Resource use will be identified and measured using diaries, interviews and records and presented alongside effectiveness data as incremental cost-effectiveness ratios and cost-effectiveness acceptability curves. A longitudinal process evaluation (focus groups, structured observations, in-depth interview methods) will examine the efficacy of the project for achieving its aim using the principles of thematic analysis. ETHICS AND DISSEMINATION: The results of this study will be disseminated through peer-reviewed publications, academic conference presentations, Sport England and national public health organisation policy conferences, and practice-based case studies. Ethical approval was obtained through Brunel University London's research ethics committee (reference number RE33-12)

Factors associated with physical activity participation in adults with chronic cervical spine pain: a systematic review

Objective: To determine the factors associated with physical activity participation in adults with chronic cervical spine pain. Methods: A systematic review was conducted including searches of PubMed (MEDLINE), EMBASE and CINAHL from inception to June 12th, 2016. Grey literature and reference checking was also undertaken. Quantitative studies including factors related to physical activity participation in adults with chronic cervical spine pain were included. Two independent authors conducted the searches, extracted data and completed methodological quality assessment. Results: A total of seven studies met the selection criteria, however, four papers were finally included in the final review. A modified Downs and Black criteria was used to assess methodological quality, each study included was classed as moderate quality. A total of six factors were assessed against physical activity participation for people with chronic neck pain. These included: pain, fear of movement, smoking habits, socioeconomic status, gender, leisure and work time habits. A significant relationship was demonstrated between pain, leisure and work time habits and physical activity. Subjects were less likely to participate in physical activity if they were in pain. Subjects with neck pain were less likely to participate in physical activity in their leisure and work time. Conclusion: This review, based on a small number of heterogeneous studies demonstrated key factors that are likely to affect physical activity in people with chronic neck pain, most notably, pain levels, leisure and work habits. This review suggests that more in-depth, high quality studies are required to fully understand the impact of chronic pain on physical activity

Management of hyperlipidaemia

Copyright © 2005 Royal Australian College of General Practitioners Copyright to Australian Family Physician. Reproduced with permission. Permission to reproduce must be sought from the publisher, The Royal Australian College of General Practitioners.BACKGROUND: Hyperlipidaemia is a general term for elevated concentrations of any or all lipids in the plasma. An elevated cholesterol is one of several risk factors for coronary heart disease (CHD). In Australia, the use of cholesterol lowering drugs, mainly statins, consumes over $880 million or 16% of the Pharmaceutical Benefits Scheme drug budget and is growing. OBJECTIVE: This article focusses on primary hypercholesterolaemia, its relationship with CHD, and its management in the community setting. DISCUSSION There is strong evidence that treating middle aged men with statins who have established CHD will reduce overall mortality, CHD morbidity, or mortality and stroke. There is weaker but reasonable evidence for treating men aged over 65 years and women of any age who have CHD, or people without CHD but at high risk. There may be some benefits for patients with stroke and peripheral vascular disease who are at risk of CHD. While discontinuation rates are high, the occurrence of serious adverse reactions are infrequent.Nigel Stocks, James Allan and Peter R. Mansfiel

Educators' perceived mental health literacy and capacity to support students' mental health: associations with school-level characteristics and provision in England

Conceptual frameworks for school-based, preventive interventions recognise that educators' capacity is, in part, dependent on school-level characteristics. This study aimed to (i) examine the factor structure and internal consistency of the Mental Health Literacy and Capacity Survey for Educators (MHLCSE); (ii) assess responses in relation to supporting students' mental health; (iii) describe schools' mental health provision in terms of designated roles, training offered, and perceived barriers; (iv) investigate variance in MHLCSE outcomes explained by schools; and, (v) explore school-level predictors of educators' perceived MHL and capacity after controlling for individual-level characteristics. A multi-level, cross-sectional design involving 710 educators across 248 schools in England was used, and secondary analyses of baseline data collected as part of the Education for Wellbeing Programme were conducted. Mental health provision data was available for 206 schools, of which 95% offered training to some staff, and 71% had a designated mental health lead. Secondary schools offered significantly more training than primary schools. Significant barriers included lack of capacity in Child and Adolescent Mental Health Services (CAMHS) and within school, and communication challenges between agencies. The amount of training offered by schools significantly predicted educators' awareness and knowledge of mental health issues, treatments and services, legislation and processes for supporting students' mental health and comfort providing active support, with increased training predicting higher scores. However, little variance was explained by schools (1.7-12.1%) and school-level variables (0.7-1.2%). Results are discussed in relation to current mental health and education policy in England

Now is the time for a comfort congress

When buying a bed, a chair or a car, taking the train, holding a hand tool or flying across the ocean, comfort comes into play. Users interact with products and rate their experience. Therefore, designers and manufacturers of products such as seats, cars, beds, hand tools, and production lines strive for optimal comfort. If we look at some trends like “attention to health”, “ageing workforce (and population)”, “environmental awareness and sustainability” and “attention to well-being”, (dis)comfort is an important consideration (Vink & Hallbeck, 2012). This means that in our daily lives we are confronted with comfort

A phase I/II study of rovalpituzumab tesirine in delta-like 3-expressing advanced solid tumors

Delta-like protein 3 (DLL3) is highly expressed in solid tumors, including neuroendocrine carcinomas/neuroendocrine tumors (NEC/NET). Rovalpituzumab tesirine (Rova-T) is a DLL3-targeting antibody-drug conjugate. Patients with NECs and other advanced DLL3-expressing tumors were enrolled in this phase I/II study (NCT02709889). The primary endpoint was safety. Two hundred patients were enrolled: 101 with NEC/NET (large-cell NEC, gastroenteropancreatic NEC, neuroendocrine prostate cancer, and other NEC/NET) and 99 with other solid tumors (melanoma, medullary thyroid cancer [MTC], glioblastoma, and other). The recommended phase II dose (RP2D) was 0.3 mg/kg every 6 weeks (q6w) for two cycles. At the RP2D, grade 3/4 adverse events included anemia (17%), thrombocytopenia (15%), and elevated aspartate aminotransferase (8%). Responses were confirmed in 15/145 patients (10%) treated at 0.3 mg/kg, including 9/69 patients (13%) with NEC/NET. Rova-T at 0.3 mg/kg q6w had manageable toxicity, with antitumor activity observed in patients with NEC/NET, melanoma, MTC, and glioblastoma

Quantum entanglement between a nonlinear nanomechanical resonator and a microwave field

We consider a theoretical model for a nonlinear nanomechanical resonator coupled to a superconducting microwave resonator. The nanomechanical resonator is driven parametrically at twice its resonance frequency, while the superconducting microwave resonator is driven with two tones that differ in frequency by an amount equal to the parametric driving frequency. We show that the semi-classical approximation of this system has an interesting fixed point bifurcation structure. In the semi-classical dynamics a transition from stable fixed points to limit cycles is observed as one moves from positive to negative detuning. We show that signatures of this bifurcation structure are also present in the full dissipative quantum system and further show that it leads to mixed state entanglement between the nanomechanical resonator and the microwave cavity in the dissipative quantum system that is a maximum close to the semi-classical bifurcation. Quantum signatures of the semi-classical limit-cycles are presented.Comment: 36 pages, 18 figure