Retiring to the good life? The short-term effects of retirement on health

We estimate the impact of retirement on three subjective and objective measures of health using a regression discontinuity design. The results indicate that retirement increases an individual's sense of well-being and their mental health but not necessarily their physical health. Specifications tests suggest that the results are robust.

The impact of health information technology on the quality of medical and health care : a systematic review

Objective: To systematically review the published evidence of the impact of health information technology (HIT) on the quality of medical and health care specifically clinicians’ adherence to evidence-based guidelines and the corresponding impact this had on patient clinical outcomes. In order to be as inclusive as possible the research examined literature discussing the use of health information technologies and systems in both medical care such as clinical and surgical, and other health care such as allied health and preventive services.----- Design: Systematic review----- Data Sources: Relevant literature was systematically searched on English language studies indexed in MEDLINE and CINAHL(1998 to 2008), Cochrane Library, PubMed, Database of Abstracts of Review of Effectiveness (DARE), Google scholar and other relevant electronic databases. A search for eligible studies (matching the inclusion criteria) was also performed by searching relevant conference proceedings available through internet and electronic databases, as well as using reference lists identified from cited papers.----- Selection criteria: Studies were included in the review if they examined the impact of Electronic Health Record (EHR), Computerised Provider Order-Entry (CPOE), or Decision Support System (DS); and if the primary outcomes of the studies were focused on the level of compliance with evidence-based guidelines among clinicians. Measures could be either changes in clinical processes resulting from a change of the providers’ behaviour or specific patient outcomes that demonstrated the effectiveness of a particular treatment given by providers. ----- Methods: Studies were reviewed and summarised in tabular and text form. Due to heterogeneity between studies, meta-analysis was not performed.----- Results: Out of 17 studies that assessed the impact of health information technology on health care practitioners’ performance, 14 studies revealed a positive improvement in relation to their compliance with evidence-based guidelines. The primary domain of improvement was evident from preventive care and drug ordering studies. Results from the studies that included an assessment for patient outcomes however, were insufficient to detect either clinically or statistically important improvements as only a small proportion of these studies found benefits. For instance, only 3 studies had shown positive improvement, while 5 studies revealed either no change or adverse outcomes.----- Conclusion: Although the number of included studies was relatively small for reaching a conclusive statement about the effectiveness of health information technologies and systems on clinical care, the results demonstrated consistency with other systematic reviews previously undertaken. Widescale use of HIT has been shown to increase clinician’s adherence to guidelines in this review. Therefore, it presents ongoing opportunities to maximise the uptake of research evidence into practice for health care organisations, policy makers and stakeholders.

Microassembly fabrication of tissue engineering scaffolds with customized design

Browse > Journals> Automation Science and Enginee ...> Volume: 5 Issue: 3 Microassembly Fabrication of Tissue Engineering Scaffolds With Customized Design 4468741 abstract Han Zhang; Burdet, E.; Poo, A.N.; Hutmacher, D.W.; GE Global Res. Center Ltd., Shanghai This paper appears in: Automation Science and Engineering, IEEE Transactions on Issue Date: July 2008 Volume: 5 Issue:3 On page(s): 446 - 456 ISSN: 1545-5955 Digital Object Identifier: 10.1109/TASE.2008.917011 Date of Current Version: 02 July 2008 Sponsored by: IEEE Robotics and Automation Society Abstract This paper presents a novel technique to fabricate scaffold/cell constructs for tissue engineering by robotic assembly of microscopic building blocks (of volume 0.5$,times,$0.5$,times,$0.2 ${hbox{mm}}^{3}$ and 60 $mu {hbox{m}}$ thickness). In this way, it becomes possible to build scaffolds with freedom in the design of architecture, surface morphology, and chemistry. Biocompatible microparts with complex 3-D shapes were first designed and mass produced using MEMS techniques. Semi-automatic assembly was then realized using a robotic workstation with four degrees of freedom integrating a dedicated microgripper and two optical microscopes. Coarse movement of the gripper is determined by pattern matching in the microscopes images, while the operator controls fine positioning and accurate insertion of the microparts. Successful microassembly was demonstrated using SU-8 and acrylic resin microparts. Taking advantage of parts distortion and adhesion forces, which dominate at micro-level, the parts cleave together after assembly. In contrast to many current scaffold fabrication techniques, no heat, pressure, electrical effect, or toxic chemical reaction is involved, a critical condition for creating scaffolds with biological agents.

Hungry 24/7? HCI design for sustainable food culture workshop

This workshop proposes to explore new approaches to cultivate and support sustainable food culture in urban environments via human computer interaction design and ubiquitous technologies. Food is a challenging issue in urban contexts: while food consumption decisions are made many times a day, most food interaction for urbanites occurs based on convenience and habitual practices. This situation is contrasting to the fact that food is at the centre of global environment, health, and social issues that are becoming increasingly immanent and imminent. As such, it is timely and crucial to ask: what are feasible, effective, and innovative ways to improve human-food-interaction through human-computer-interaction in order to contribute to environmental, health, and social sustainability in urban environments? This workshop brings together insights across disciplines to discuss this question, and plan and promote individual, local, and global change for sustainable food culture.

An adolescent injury intervention : selecting targeted behaviours with implications for program design and evaluation

Objectives: This paper sought to identify the behaviour change targets for an injury prevention program; Skills for Preventing Injury in Youth, SPIY. The aim was to explore how such behaviours could subsequently be implemented and evaluated in the program. Methods and Design: The quantitative procedure involved a survey with 267 Year 8 and 9 students (mean age 13.23 years) regarding their engagement in risk-taking behaviours that may lead to injury. The qualitative study involved 30 students aged 14 to 17 years reporting their experiences of injury and risk-taking. Results: Injury risk behaviours co-occurred among three-quarters of those who reported engaging in any alcohol use or transport or violence related injury risk behaviour. Students described in detail some of these experiences. Conclusions: The selection process of identifying target behaviours for change for an injury prevention program is described. Adolescents’ description of such risk behaviours can inform the process of operationalising and contextualising program content and deciding on evaluation methodology. The design of an effective injury prevention program involves considerable preparatory work and this paper was able to describe the process of identifying the behavioural targets for change that can be operationalised and evaluated in the injury prevention program, SPIY.

Computational fluid dynamics for improved bioreactor design and 3D culture

The complex relationship between the hydrodynamic environment and surrounding tissues directly impacts on the design and production of clinically useful grafts and implants. Tissue engineers have generally seen bioreactors as 'black boxes' within which tissue engineering constructs (TECs) are cultured. It is accepted that a more detailed description of fluid mechanics and nutrient transport within process equipment can be achieved by using computational fluid dynamics (CFD) technology. This review discusses applications of CFD for tissue engineering-related bioreactors -- fluid flow processes have direct implications on cellular responses such as attachment, migration and proliferation. We conclude that CFD should be seen as an invaluable tool for analyzing and visualizing the impact of fluidic forces and stresses on cells and TECs.

Stroke education : promising effects on the health beliefs of those at risk

Background: The effect of patient education on reducing stroke has had mixed effects, raising questions about how to achieve optimal benefit. Because past evaluations have typically lacked an appropriate theoretical base, the design of past research may have missed important effects. --------- Method: This study used a social cognitive framework to identify variables that might change in response to education. A mixed design was used to evaluate two approaches to an intervention, both of which included education. Fifty seniors completed a measure of stroke knowledge and beliefs twice: before and after an intervention that was either standard (educational brochure plus activities that were not about stroke) or enhanced (educational brochure plus activities designed to enhance beliefs about stroke). Outcome measures were health beliefs, intention to exercise to reduce stroke, and stroke knowledge. --------- Results: Selected beliefs changed significantly over time but not differentially across conditions. Beliefs that changed were (a) perceived susceptibility to stroke and (b) perceived benefit of exercise to reduce risk. Benefit beliefs, in particular, were strongly and positively associated with intention to exercise. -------- Conclusion: Findings suggest that basic approaches to patient education may influence health beliefs. More effective stroke prevention programs may result from continued consideration of the role of health beliefs in such programs.

The power of a single prototype : sustainable fashion textile design and the prevention of carcinogenic melanoma

Is there a role for prototyping (sketching, pattern making and sampling) in addressing real world problems of sustainability (People, Profit, and Planet), in this case social/healthcare issues, through fashion and textiles research? Skin cancer and related illnesses are a major cause of disfigurement and death in New Zealand and Australia where the rates of Melanoma, a serious form of skin cancer, are four times higher than in the Northern Hemisphere regions of USA, UK and Canada (IARC, 1992). In 2007, AUT University (Auckland University of Technology) Fashion Department and the Health Promotion Department of Cancer Society - Auckland Division (CSA) developed a prototype hat aimed at exploring a barrier type solution to prevent facial and neck skin damage. This is a paradigm shift from the usual medical research model. This paper provides an overview of the project and examines how a fashion prototype has been used to communicate emergent social, environmental, personal, physiological and technological concerns to the trans-disciplinary research team. The authors consider how the design of a product can enhance and support sustainable design practice while contributing a potential solution to an ongoing health issue. Analysis of this case study provides an insight into prototyping in fashion and textiles design, user engagement and the importance of requirements analysis in relation to sustainable development. The analysis and a successful outcome of the final prototype have provided a gateway to future collaborative research and product development.

Design and evaluation of an MRI compatible axial compression device for 3D assessment of spinal deformity and flexibility

Magnetic Resonance Imaging (MRI) offers a valuable research tool for the assessment of 3D spinal deformity in AIS, however the horizontal patient position imposed by conventional scanners removes the axial compressive loading on the spine which is an important determinant of deformity shape and magnitude in standing scoliosis patients. The objective of this study was to design, construct and test an MRI compatible compression device for research into the effect of axial loading on spinal deformity using supine MRI scans. The compression device was designed and constructed, consisting of a vest worn by the patient, which was attached via straps to a pneumatically actuated footplate. An applied load of 0.5 x bodyweight was remotely controlled by a unit in the scanner operator’s console. The entire device was constructed using non-metallic components for MRI compatibility. The device was evaluated by performing unloaded and loaded supine MRI scans on a series of 10 AIS patients. The study concluded that an MRI compatible compression device had been successfully designed and constructed, providing a research tool for studies into the effect of axial loading on 3D spinal deformity in scoliosis. The 3D axially loaded MR imaging capability developed in this study will allow future research investigations of the effect of axial loading on spinal rotation, and for imaging the response of scoliotic spinal tissues to axial loading.

Building research capacity in the nursing workforce : the design and evaluation of the nurse researcher role

Objectives: The Nurse Researcher Project (NRP) was initiated to support development of a nursing research and evidence based practice culture in Cancer Care Services (CCS) in a large tertiary hospital in Australia. The position was established and evaluated to inform future directions in the organisation.---------- Background: The demand for quality cancer care has been expanding over the past decades. Nurses are well placed to make an impact on improving health outcomes of people affected by cancer. At the same time, there is a robust body of literature documenting the barriers to undertaking and utilising research by and for nurses and nursing. A number of strategies have been implemented to address these barriers including a range of staff researcher positions but there is scant attention to evaluating the outcomes of these strategies. The role of nurse researcher has been documented in the literature with the aim to provide support to nurses in the clinical setting. There is, to date, little information in relation to the design, implementation and evaluation of this role.---------- Design: The Donabedian’s model of program evaluation was used to implement and evaluate this initiative.---------- Methods: The ‘NRP’ outlined the steps needed to implement the nurse researcher role in a clinical setting. The steps involved the design of the role, planning for the support system for the role, and evaluation of outcomes of the role over two years.---------- Discussion: This paper proposes an innovative and feasible model to support clinical nursing research which would be relevant to a range of service areas.---------- Conclusion: Nurse researchers are able to play a crucial role in advancing nursing knowledge and facilitating evidence based practice, especially when placed to support a specialised team of nurses at a service level. This role can be implemented through appropriate planning of the position, building a support system and incorporating an evaluation plan.

Design of a Web interface for anatomical images

Interactive documents for use with the World Wide Web have been developed for viewing multi-dimensional radiographic and visual images of human anatomy, derived from the Visible Human Project. Emphasis has been placed on user-controlled features and selections. The purpose was to develop an interface which was independent of host operating system and browser software which would allow viewing of information by multiple users. The interfaces were implemented using HyperText Markup Language (HTML) forms, C programming language and Perl scripting language. Images were pre-processed using ANALYZE and stored on a Web server in CompuServe GIF format. Viewing options were included in the document design, such as interactive thresholding and two-dimensional slice direction. The interface is an example of what may be achieved using the World Wide Web. Key applications envisaged for such software include education, research and accessing of information through internal databases and simultaneous sharing of images by remote computers by health personnel for diagnostic purposes.

Single case experimental design : an overview

Background: In health related research, it is critical not only to demonstrate the efficacy of intervention, but to show that this is not due to chance or confounding variables. Content: Single case experimental design is a useful quasi-experimental design and method used to achieve these goals when there are limited participants and funds for research. This type of design has various advantages compared to group experimental designs. One such advantage is the capacity to focus on individual performance outcomes compared to group performance outcomes. Conclusions: This comprehensive review demonstrates the benefits and limitations of using single case experimental design, its various design methods, and data collection and analysis for research purposes.

Design and evaluation of an MRI compatible axial compression device for 3D assessment of spinal deformity and flexibility in adolescent idiopathic scoliosis

Magnetic Resonance Imaging (MRI) offers a valuable research tool for the assessment of 3D spinal deformity in AIS, however the horizontal patient position imposed by conventional scanners removes the axial compressive loading on the spine. The objective of this study was to design, construct and test an MRI compatible compression device for research into the effect of axial loading on spinal deformity using supine MRI scans. The device was evaluated by performing unloaded and loaded supine MRI scans on a series of 10 AIS patients. The patient group had a mean initial (unloaded) major Cobb angle of 43±7º, which increased to 50±9º on application of the compressive load. The 7° increase in mean Cobb angle is consistent with that reported by a previous study comparing standing versus supine posture in scoliosis patients (Torell et al, 1985. Spine 10:425-7).

Novel car carrier design : prevention of falls from heights

This article reports the details of a research on novel design in the field of semitrailer sector and discuss design by hazard prevention techniques. The novel design made addresses occupational health and safety (OHS)concerns of fall from heights. The research includes a detailed survey of national data sources to examine the fatalities caused due to fall from heights in car carriers. The study investigates OHS recommendations in Australia for semitrailer sector. Often injuries are caused due to drivers working above the 1.5 meter height for loading, unloading of the cars, moving the decks up, down, strapping the cars, and slipperly. The new design is developed using latest computer aided design and engineeing (CAD, CAE), product data management (PDM), virtual design process (VDP). The new car carrier design excels in reducing the risks of injuries to drivers and new bench mark for OHS standards. The new design has all the decks operated with hydraulics and uses unique ratchet lock mechanism (fool proof design) and loading happens at a safe working height (below 1.5 meter). All the cars are strapped on the safe working height, and then car desks operated hydraulically to transfer them to the required position. This also includes the car on the prime mover, which shuttles across from one deck to other using hydraulic and rack-pinion mechanisms. The novel design car carrier solves the problem of falls from height: next step would be to transfer this technology across other similar effected sectors.