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  • The association between social vulnerability and frailty in community dwelling older people: a systematic review

    Ayeni, Ayodele; Sharples, Adrienne; Hewson, David; ; University of Bedfordshire; Hertfordshire Partnership University National Health Service (NHS) Foundation Trust (MDPI, 2022-09-26)
    The aim of this systematic literature review was to determine whether social vulnerability is associated with frailty in older people. Databases were searched for literature from January 2001 to March 2022. Hand searches of reference lists of the selected articles were also used to identify other relevant studies. Studies that met the inclusion criteria were selected. Two independent reviewers assessed the methodological quality using an established tool. Eleven eligible studies from Canada, Europe, USA, Tanzania, Mexico, and China were selected. The level of social vulnerability measured by the Social Vulnerability Index (SVI) from a meta-analysis was 0.300 (95% CI: 0.242, 0.358), with the highest SVI in Tanzania (0.49), while the lowest level of SVI was reported in China (0.15). The highest frailty level of 0.32 was observed in both Tanzania and Europe, with the lowest frailty reported in a USA study from Hawaii (0.15). In all studies, social vulnerability was a significant predictor of mortality for both sexes at subsequent data collection points. The association between SVI and frailty was high in Tanzania (r = 0.81), with other studies reporting stronger correlations for females compared to males, but at small to moderate levels. In one study, an increase of 1SD in SVI was linked to a 20% increase in frailty score at a subsequent evaluation. Additional study is warranted to determine a potential causality between social vulnerability and frailty.
  • Evaluating Palin Stammering Therapy for School Children (Palin STSC 8-14): protocol for a feasibility randomised controlled trial comparing Palin STSC(8-14) with usual treatment

    Millard, S.K.; Murphy, Suzanne; Barton, G.; Leathersich, M.; Mills, G.; Rixon, L.; Shepstone, L.; Sims, E.; Joffe, Victoria; Michael Palin Centre for Stammering, Whittington Hospital NHS Trust; et al. (Springer Nature, 2022-09-16)
    Having a stammer can have a significant effect on a child's social, emotional and educational development. With approximately 66,000 children in the UK having a stammer, there is a need to establish an adequate evidence base to inform clinical practice. We describe a feasibility trial to explore the effectiveness of a new therapy programme for children aged 8-14: Palin Stammering Therapy for School Children (Palin STSC(8-14)). Preliminary data from the Michael Palin Centre, where the programme was developed, indicate that Palin STSC(8-14) is effective in reducing stammering frequency and impact for children, with beneficial effects for parents too. We will investigate the feasibility of the methods required for a definitive randomised controlled trial to investigate the application of this therapy by NHS speech and language therapists (SLTs), compared with 'treatment as usual' (TAU), beyond the specialist context in which it was developed. This is a two-arm feasibility cluster-randomised controlled trial of Palin STSC(8-14) with TAU control arm, and randomisation at the level of the SLT. Quantitative and qualitative data will be collected to examine the following: the recruitment and retention of therapists and families, the acceptability of the research processes and the therapeutic intervention and the appropriateness of the therapy outcome measures. Assessments will be completed by children and parents at baseline and 6 months later, including measures of stammering severity; the impact of child's stammering on both children and parents; child temperament, behaviour and peer relations, anxiety; quality of life; and economic outcomes. There will also be a qualitative process evaluation, including interviews with parents, children, SLTs and SLT managers to explore the acceptability of both the research and therapy methods. Treatment fidelity will be examined through analysis of therapy session records and recordings. The findings of this feasibility trial will inform the decision as to whether to progress to a full-scale randomised controlled trial to explore the effectiveness of Palin STSC(8-14) when compared to Treatment as Usual in NHS SLT services. There is a strong need for an evidence-based intervention for school age children who stammer. ISRCTN. ISRCTN17058884 . Registered on 18 December 2019.
  • Support for difficulties in learning, behaviour and disability in New Zealand's schools

    Wearmouth, Janice; Berryman, Mere (Taylor and Francis, 2022-09-27)
  • Edge intelligence case study on medical Internet of Things security

    Feng, Xiaohua (Elsevier, 2023-02-01)
    MIoT (Medical Internet of Things) systems produced many of sensing data in the world. Consequently, there is a demand of scientific research in this field. Edge intelligence fit in this trends, as one of the developing cutting-edge technology. A systematic approach had been applied on the health informatics edge intelligence devices’ investigation. The observing and recording action that occurs in the process of this research to date had been satisfed. This work had been reported here. The analyzing of the case study data was carried out. Eventually, some results have been summarized based on the investigation. Furthermore, a solution is proposed for the kind of medical edge intelligence device data cyber security problem-solving. Edge intelligence was defined as “the devices available at the edge layer have some limited amount of computing resource which can be utilized and incorporated with machine learning or AI (Artificial intelligence) algorithms to perform RT (real time) data analytics”. Studying more in the category of edge intelligence would influence MIoT system. This survey on edge intelligence had been carried out on investigated recent MIoT, Robot, Raspberry Pi and AV (autonomous vehicle) and so on as edge terminal - edge intelligence devices and the challenges they had encounter. In particular, AI application in edge intelligence device handle medical data security threat. AI face more challenges in edge intelligence computing. In this survey, through some case studies, some advantages and disadvantages had been studied. MIoT edge intelligence device challenges on big data security issues had been discussed.
  • Disparities in the timing of antenatal care initiation and associated factors in an ethnically dense maternal cohort with high levels of area deprivation

    Puthussery, Shuby; Tseng, Pei-Ching; Sharma, Esther; Harden, Angela; Griffiths, Malcolm; Bamfo, Jacqueline; Li, Leah; ; University of Bedfordshire; Luton and Dunstable University Hospital NHS Foundation Trust; et al. (MDPI, 2022-09-19)
    Late access to antenatal care is a contributor to excess mortality and morbidity among ethnic minority mothers compared to White British in the UK. While individual ethnicity and socioeconomic disadvantage are linked to late antenatal care initiation, studies have seldom explored patterns of late initiation and associated factors in ethnically dense socially disadvantaged settings. This study investigated disparities in the timing of antenatal care initiation, and associated factors in an ethnically dense socially disadvantaged maternal cohort.

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