Joy and humanity in communication: A design-based research approach to developing and understanding the impact of a novel education programme on hospital staff, co-designed and facilitated by clown doctors.

Aim: Clown doctors have a unique skill set and role, particularly in paediatric settings. Yet, there is limited research on whether clown doctors themselves could play a role in sharing these skills with health professionals. Acknowledging uncertainty in what our intervention should be, we used a design-based research (DBR) approach with the aim of (i) shaping the educational design and content of communication skills-based workshops for clinicians and (ii) understanding the educational impact on participants.

Comparison of multidirectional upper limb strength for non-disabled individuals and individuals with C4-C7 spinal cord injury in a seated position.

This study investigates the multidirectional upper limb strength of individuals with a C4-C7 spinal cord injury (SCI) and non-disabled individuals in a seated position by measuring multidirectional force at the hand. Current literature lacks quantitative strength data to evaluate strength requirements for people who have reduced upper limb function due to a cervical SCI. Seated multidirectional force measurements were recorded for eleven non-disabled and ten males with a C4-C7 SCI.

Quantitative functional assessment of multidirectional upper limb strength for individuals in a seated position.

Understanding the limitations that are imposed by a disability is critical to ensure engineers develop designs that can be used by people with reduced function. Current literature lacks detail on this information for people with cervical spinal cord injuries. The purpose of this study was to investigate the reliability of a novel testing methodology to quantitatively assess the multi-directional upper limb strength of individuals in a seated position.

Multiscale Analogue Modelling of Clinching Process to Investigate Thickness Tolerance and Tool Misalignment.

NEED-The effect of dimensional variability of sheet thickness (tolerance) and tool misalignment is poorly understood for the clinching process. Finite element analysis (FEA) is valuable but requires a lot of and is difficult to verify in this situation due to the asymmetrical geometry and nonlinear plasticity. OBJECTIVE-The objective of this work was to determine the effect of thickness tolerance, tool misalignment and sheet placement (top vs.

The Effects of Cooling and Shrinkage on the Life of Polymer 3D Printed Injection Moulds.

3D Printed Injection Moulds (3DIM), commonly used for low volume production and prototyping purposes, are known to fail abruptly and have a comparatively shorter life than conventional moulds. Investigating the underlying critical factors affecting failure may help in reducing the risk of abrupt failures and possibly prolong the 3DIM tool life. A hypothesis that the cooling time of the Injection Moulding (IM) process is a critical factor for 3DIM tool failure has been proposed.

Importance of Shared Treatment Goal Discussions in Rheumatoid Arthritis-A Cross-Sectional Survey: Patients Report Providers Seldom Discuss Treatment Goals and Outcomes Improve When Goals Are Discussed.

Objective: Treat-to-target (T2T) and shared decision-making are valued features of current guidelines for rheumatoid arthritis (RA) management. Although T2T has demonstrated value for improving RA outcomes, implementation remains inconsistent and lacks standardization and procedures for including patient input. We sought to better understand the impact of shared decisions on T2T and how treatment goal discussions between patients and providers impact RA treatment improvement and satisfaction.

Analysis of Raised Feature Failures on 3D Printed Injection Moulds.

Background: Polymer-based 3D Printed Injection Mould (3DIM) inserts are used as a cost-effective method for low volume injection moulding (50-500 parts). However, abrupt failure leading to a short tool life is a common shortcoming of 3DIM. Need: The underlying causes of raised feature failures on 3DIM are not well known.

Computational modelling and experimental validation of drug entrainment in a dry powder inhaler.

In a passive dry powder inhaler (DPI) a patient inhales to entrain drug powder. The goal of this study is to demonstrate experimentally that an Eulerian-Eulerian (EE CFD) computational fluid dynamics (CFD) method can accurately predict the entrainment of the dry powder formulation in DPIs. A CFD method that makes accurate predictions of the entrainment process can be applied in DPI design and optimization processes.

A personalized medicine approach to the design of dry powder inhalers: Selecting the optimal amount of bypass.

In dry powder inhalers (DPIs) the patient's inhalation manoeuvre strongly influences the release of drug. Drug release from a DPI may also be influenced by the size of any air bypass incorporated in the device. If the amount of bypass is high less air flows through the entrainment geometry and the release rate is lower.

Optimizing the Entrainment Geometry of a Dry Powder Inhaler: Methodology and Preliminary Results.

Purpose: For passive dry powder inhalers (DPIs) entrainment and emission of the aerosolized drug dose depends strongly on device geometry and the patient's inhalation manoeuvre. We propose a computational method for optimizing the entrainment part of a DPI. The approach assumes that the pulmonary delivery location of aerosol can be determined by the timing of dose emission into the tidal airstream.

Speech intelligibility assessment of protective facemasks and air-purifying respirators.

Speech Intelligibility (SI) is the perceived quality of sound transmission. In healthcare settings, the ability to communicate clearly with coworkers, patients, etc., is crucial to quality patient care and safety.

"My pet has passed": Relations of adult attachment styles and current feelings of grief and trauma after the event.

This study examined attachment relationships and emotional distress after the passing of a pet. Participants were 73 university students 17-26 years of age who had lost a family pet within the past 5 years. They completed measures of attachment styles toward people and their pet, as well as complicated grief, depression, and trauma.

Potential of a cyclone prototype spacer to improve in vitro dry powder delivery.

Purpose: Low inspiratory force in patients with lung disease is associated with poor deagglomeration and high throat deposition when using dry powder inhalers (DPIs). The potential of two reverse flow cyclone prototypes as spacers for commercial carrier-based DPIs was investigated.

Methods: Cyclohaler®, Accuhaler® and Easyhaler® were tested with and without the spacers between 30 and 60 Lmin−1.

Development of an attachment-informed measure of sexual behavior in late adolescence.

There is considerable interest in relations between sexual behavior and romantic attachment styles in adolescence as attachment needs are increasingly met through intimate partners rather than parents. The objectives of this research were to organize a measure of sexual behavior within an attachment theory framework, and then show that this new measure uniquely predicted sexual approach styles and invasive sexual experiences. 190 18- and 19-year-old university students in late adolescence completed sexual behavior items that were provided ambivalent (anxious) and avoidant dimensions.

Representations of attachment relationships, the self, and significant others in middle childhood.

Introduction: This research examines the interrelations of attachment security, feelings towards the self, and attributions about others in middle childhood.

Methods: Five-to nine-year-old children (n=176) completed the Separation Anxiety Test, which provided a measure of attachment security and a puppet interview was used to assess feelings towards the self. A subset of 89 participants received vignettes of social situations with ambiguous outcomes to assess the emotional valence of children's attributions.

Attachment dimensions and young children's response to pain.

Background/objective: The present study examined the relationship between attachment dimensions and child pain behaviour following both an everyday pain incident (eg, bumps and scrapes) and acute pain incident (eg, immunization) in 66 five-year-old children.

Methods: Secure, avoidant, ambivalent and controlling attachment dimensions were assessed using aggregates of laboratory-based reunion behaviour, performance on representational measures of attachment and the measure of emotion regulation. Child pain behaviour, during immunization and everyday pain incidents, was rated in terms of reactivity, anger and calming time.

Eccentric strain at long muscle length evokes the repeated bout effect.

The repeated bout effect (RBE) is a phenomenon characterized by less delayed onset muscle soreness (DOMS) and torque deficit after the second of 2 separate eccentric exercise bouts. Previous investigators have reported that shifting of optimum angle after an initial bout of eccentric exercise mediates the RBE. We hypothesized that an RBE for elbow extensor exercise occurs after an initial bout performed at long (starting position of 50 degrees to an end position of 130 degrees) but not short (starting position of 0 degrees to an end position of 80 degrees) muscle length because strain at long length evokes a shifting of the optimum angle to a longer length.

Time perception: does it distinguish ADHD and RD children in a clinical sample?

This study used a double-dissociation design to evaluate whether children with ADHD demonstrated specific deficits relative to children with Reading Disorders. Recent theory suggests that ADHD children have deficits in time perception and working memory, whereas RD children have deficits in phonological decoding. The performance of 113 clinic-referred children aged 6-11 was examined using measures of working memory, phonological processing, and time perception.

Relations between young children's responses to the depiction of separation and pain experiences.

This study examined relations between young children's representations of separation and pain experiences in 60, 4- and 5-year-old children. Separation representations were assessed with the Separation Anxiety Test (SAT) and pain representations were assessed by examining responses to pictures of children about to experience pain in the presence of parent figures. Results showed that representations of separation and pain experience were systematically related and the patterns were not accounted for by the child's ability to differentiate emotional states, language ability, or reports of emotional regulation.

A measles outbreak in the Whitsundays, Queensland: the shape of things to come?

This report describes a small outbreak of measles that occurred in the Whitsunday region, north Queensland, in July to August 2002. With one exception, all the cases were deliberately unvaccinated because their parents were conscientious objectors to vaccination. It is suggested that this pattern of measles outbreaks, with most cases being not preventable because of conscientious objection, will become increasingly recognised in the future.

Ultrastructural characterization of the mesenchyme of the facial processes during development of the rat intermaxillary segment.

This study quantifies ultrastructural changes within the mesenchyme of the maxillary and medial/lateral nasal processes before and after formation of the intermaxillary segment. At both day 11 and day 13 of development, 4 fetal rat heads were fixed with 3% glutaraldehyde and processed for electron microscopy. Differences between cells within the facial processes were discerned at day 11 of gestation.

Does the Conners' Continuous Performance Test aid in ADHD diagnosis?

The performance of clinic-referred children aged 6-11 (N = 100) was examined using the Conners' Continuous Performance Test (CPT) and measures of auditory attention (Auditory Continuous Performance Test; ACPT), phonological awareness, visual processing speed, and visual-motor competence. The Conners' CPT overall index was unrelated to measures of visual processing speed or visual-motor competence. Although the Conners' CPT converged with the ACPT, the latter demonstrated age and order effects.