Walking in hospital is associated with a shorter length of stay in older medical inpatients

Evidence suggests that inactivity during a hospital stay is associated with poor health outcomes in older medical inpatients. We aimed to estimate the associations of average daily step-count (walking) in hospital with physical performance and length of stay in this population. Medical in-patients aged ⩾65 years, premorbidly mobile, with an anticipated length of stay ⩾3 d, were recruited. Measurements included average daily step-count, continuously recorded until discharge, or for a maximum of 7 d (Stepwatch Activity Monitor); co-morbidity (CIRS-G); frailty (SHARE F-I); and baseline and end-of-study physical performance (short physical performance battery). Linear regression models were used to estimate associations between step-count and end-of-study physical performance or length of stay. Length of stay was log transformed in the first model, and step-count was log transformed in both models. Similar models were used to adjust for potential confounders. Data from 154 patients (mean 77 years, SD 7.4) were analysed. The unadjusted models estimated for each unit increase in the natural log of stepcount, the natural log of length of stay decreased by 0.18 (95% CI −0.27 to −0.09). After adjustment of potential confounders, while the strength of the inverse association was attenuated, it remained significant (βlog(steps) = −0.15, 95%CI −0.26 to −0.03). The back-transformed result suggested that a 50% increase in step-count was associated with a 6% shorter length of stay. There was no apparent association between step-count and end-of-study physical performance once baseline physical performance was adjusted for. The results indicate that step-count is independently associated with hospital length of stay, and merits further investigation.

Energy harvesting for monitoring bridges over their operational life

The use of energy harvesting materials for large infrastructure is a promising and growing field. In this regard, the use of such harvesters for the purpose of structural health monitoring of bridges has been proposed in recent times as one of the feasible options since the deployment of them can remove the necessity of an external power source. This paper addresses the performance issue of such monitors over the life-cycle of a bridge as it deteriorates and the live load on the structure increases. In this regard, a Lead Zirconate Titanate (PZT) material is considered as the energy harvesting material and a comparison is carried out over the operational life of a reinforced concrete bridge. The evolution of annual average daily traffic (AADT) is taken into consideration, as is the degradation of the structure over time, due to the effects of corrosion. Evolution of such harvested energy is estimated over the life-cycle of the bridge and the sensitivity of harvested energy is investigated for varying rates of degradation and changes in AADT. The study allows for designing and understanding the potential of energy harvesters as a health monitor for bridges. This paper also illustrates how the natural growth of traffic on a bridge over time can accentuate the identification of damage, which is desirable for an ageing structure. The paper also assesses the impact and effects of deployment of harvesters in a bridge as a part of its design process, considering performance over the entire life-cycle versus a deployment at a certain age of the structure.