Product Integration of Established Crash Sensors for Safety Applications in Lightweight Vehicles.

The functionality of products increases when more sensors are used. This trend also affects future automobiles and becomes even more relevant in connected and autonomous applications. Concerning automotive lightweight design, carbon fibre-reinforced polymers (CFRP) are suitable materials. However, their drawbacks include the relatively high manufacturing costs of CFRP components in addition to the difficulty of recycling. To compensate for the increased expenditure, the integration of automotive sensors in CFRP vehicle structures provides added value. As a new approach, established sensors are integrated into fibre-reinforced polymer (FRP) structures. The sensors are usually mounted to the vehicle. The integration of sensors into the structure saves weight and space. Many other approaches specifically develop new sensors for integration into FRP structures. With the new approach, there is no need for elaborate development of new sensors since established sensors are used. The present research also showed that the range of applications of the sensors can be extended by the integration. The present paper outlines the functional behaviour of the integrated sensor utilized for crashing sensing. First of all, the integration quality of the sensor is relevant. Different requirements apply to the usual mounting of the sensor. The self-sensing structure must fulfil those requirements. Moreover, unfamiliar characteristics of the new surrounding structure might affect the sensing behaviour. Thus, the sensing behaviour of the self-sensing composite was analyzed in detail. The overarching objective is the general integration of sensors in products with reasonable effort.

Cross-sectional survey of rehabilitation service availability for stroke and hip fracture in Australian public hospitals.

OBJECTIVE: To describe the rehabilitation services available for people with stroke and hip fracture across New South Wales/Australian Capital Territory metropolitan and rural/regional public hospitals in Australia. DESIGN: A cross-sectional study design was used. SETTING: New South Wales/Australian Capital Territory public hospital providing rehabilitation services for stroke and hip fracture. PARTICIPANTS: Delegates from 59 eligible hospitals. INTERVENTION: Information about the type, number and availability of inpatient and outpatient rehabilitation services at each hospital was collected via survey. MAIN OUTCOME MEASURES: Counts, percentages, mean (SD), median (IQR) were used to quantify the number and type of inpatient and outpatient services available. RESULTS: Across inpatient rehabilitation units, reduced availability was noted in the number of clinical disciplines available, availability of neuropsychology and social work in rural units. Across outpatient rehabilitation services, reduced availability was noted in the number of disciplines available, availability of occupational therapy, psychology, rehabilitation physicians, specialist nursing, geriatricians, and podiatry in rural services. Five rural hospitals had no access to outpatient rehabilitation. CONCLUSION: There was reduced availability of rehabilitation services and health disciplines in rural/regional settings. A follow-up study is underway investigating relationships between reduced outpatient service availability and inpatient length of stay in rural/regional versus metropolitan hospitals.

A general practice workplace-based assessment instrument: Content and construct validity.

Introduction: Relatively few general practice (GP) workplace-based assessment instruments have been psychometrically evaluated. This study aims to establish the content validity and internal consistency of the General Practice Registrar Competency Assessment Grid (GPR-CAG).Methods: The GPR-CAG was constructed as a formative assessment instrument for Australian GP registrars (trainees). GPR-CAG items were determined by an iterative literature review, expert opinion and pilot-testing process. Validation data were collected, between 2014 and 2016, during routine clinical teaching visits within registrars' first two general practice training terms (GPT1 and GPT2) for registrars across New South Wales and the Australian Capital Territory. Factor analysis and expert consensus were used to refine items and establish GPR-CAG's internal structure. GPT1 and GPT2 competencies were analysed separately.Results: Data of 555 registrars undertaking GPT1 and 537 registrars undertaking GPT2 were included in analyses. A four-factor, 16-item solution was identified for GPT1 competencies (Cronbach's alpha range: 0.71-0.83) and a seven-factor 27-item solution for GPT2 competencies (Cronbach's alpha: 0.63-0.84). The emergent factor structures were clinically characterisable and resonant with existing medical education competency frameworks.Discussion: This study establishes initial evidence for the content validity and internal consistency of GPR-CAG. GPR-CAG appears to have utility as a formative GP training WBA instrument.

Sensor Systems for FRP Lightweight Structures: Automotive Features Based on Serial Sensor Products.

To achieve resource efficiency and an increased performance, as well as a higher safety and more features for vehicles, lightweight composites are a central sphere of activity for automotive innovations. This becomes particularly striking if the focus is not only a reduced vehicle weight but also an efficient overall concept. In addition to compatible material technologies and component design, new electronic solutions are of interest. A research contribution at the Robert Bosch Company deals with the direct integration of a current automotive acceleration sensor in fiber-reinforced polymer (FRP) parts. The sensor is part of the passive vehicle safety. Primarily, the principal application of the currently mounted sensor as an integrated part of the vehicle structure was proven. Sensor-integrated parts were evaluated on their sensing functionality as well as their structural performance. The present research is done to use the integrated sensor for a secondary feature. The study shows that the sensor can also be an indicator for the condition of its surrounding FRP structure. Hence, the sensor integration makes it possible to derive a secondary feature for automobiles by using the current sensor for future functionalized lightweight structures.

Early rehabilitation after hospital admission for road trauma using an in-reach multidisciplinary team: a randomised controlled trial.

OBJECTIVE: To investigate the impact of an in-reach rehabilitation team for patients admitted after road trauma. DESIGN: Randomised control trial of usual care versus early involvement of in-reach rehabilitation team. Telephone follow-up was conducted by a blind assessor at three months for those with minor/moderate injuries and six months for serious/severe injuries. SETTING: Four participating trauma services in New South Wales, Australia. SUBJECTS: A total of 214 patients admitted during 2012-2015 with a length of stay of at least five days. INTERVENTION: Provision of rehabilitation services in parallel with ward based therapy using an in-reach team for the intervention group. The control group could still access the ward based therapy (usual care). MAIN MEASURES: The primary outcome was acute length of stay. Secondary outcomes included percentage requiring inpatient rehabilitation, function (Functional Independence Measure and Timed Up and Go Test), psychological status (Depression Anxiety and Stress Score 21), pain (Orebro Musculoskeletal Pain Questionnaire) and quality of life (Short Form-12 v2). RESULTS: Median length of stay in acute care was 13 days (IQR 8-21). The intervention group, compared to the control group, received more physiotherapy and occupational therapy sessions (median number of sessions 16.0 versus 11.5, P=0.003). However, acute length of stay did not differ between the intervention and control groups (median 15 vs 12 days, P=0.37). There were no significant differences observed in the secondary outcomes at hospital discharge and follow-up. CONCLUSION: No additional benefit was found from the routine use of acute rehabilitation teams for trauma patients over and above usual care.

Palliative care and spiritual well-being in lung cancer patients and family caregivers.

BACKGROUND: Spiritual well-being is an important dimension of quality of life (QOL) and is a core component of quality oncology and palliative care. In this analysis, we aimed to describe spiritual well-being outcomes in a National Cancer Institute (NCI)-supported Program Project that tested the effectiveness of an interdisciplinary palliative care intervention in lung cancer patients and their family caregivers (FCGs). METHODS: Patients undergoing treatments for NSCLC and their FCGs were enrolled in a prospective, quasi-experimental study. Patients and FCGs in the intervention group were presented at interdisciplinary care meetings and received four educational sessions that included one session focused on spiritual well-being. Spiritual well-being for patients was measured using the FACIT-Sp-12, and FCG spiritual well-being was measured using the COH-QOL-FCG spiritual well-being subscale. Multivariate analysis of covariance was undertaken for subscale and item scores at 12 weeks, controlling for baseline, by religious affiliations (yes or no) and group assignment. RESULTS: Religiously affiliated patients reported better scores in the Faith subscale and items on finding strength and comfort in faith and spiritual beliefs compared to non-affiliated patients. Non-affiliated patients had better scores for feeling a sense of harmony within oneself. By group, patients who received the intervention had significantly better scores for the Meaning/Peace subscale. CONCLUSIONS: Our findings support the multidimensionality of spiritual well-being that includes constructs such as meaning and faith for lung cancer patients and FCGs with or without religious affiliations. Palliative care interventions should include content that targets the spiritual needs of both patients and FCGs. Copyright © 2015 John Wiley & Sons, Ltd.

An initial loading-dose vitamin D versus placebo after hip fracture surgery: randomized trial.

BACKGROUND: Improving vitamin D (25-OHD) status may be an important modifiable factor that could reduce disability severity, fall-rates and mortality associated after hip fracture surgery. Providing a loading-dose post-surgery may overcome limitations in adherence to daily supplementation. METHOD: In this randomized, double-blind, placebo-controlled trial, 218 adults, aged 65-years or older, requiring hip fracture surgery were assigned to receive a single loading-dose of cholecalciferol (250,000 IU vitamin-D3, the REVITAHIP - Replenishment of Vitamin D in Hip Fracture strategy) or placebo, both receiving daily vitamin-D(800 IU) and calcium (500 mg) for 26-weeks. Outcome measures were 2.4 m gait-velocity, falls, fractures, death (Week-4), 25-OHD levels, quality-of-life measure (EuroQoL) and mortality at weeks-2, 4 and 26. RESULTS: Mean age of 218 participants was 83.9(7.2) years and 77.1 % were women. Baseline mean 25-OHD was 52.7(23.5)nmol/L, with higher levels at Week-2 (73 vs 66 nmol/L; p = .019) and Week-4 (83 vs 75 nmol/L; p = .030) in the Active-group, but not at Week-26. At week-4, there were no differences in 2.4 m gait-velocity (0.42 m/s vs 0.39 m/s, p = .490), fractures (2.7 % vs 2.8 %, p = .964) but Active participants reported less falls (6.3 % vs 21.1 %, χ(2) = 4.327; p = 0.024), with no significant reduction in deaths at week-4 (1 vs 3, p = 0.295), higher percentage reporting 'no pain or discomfort' (96.4 % vs 88.8 %, p = 0.037), and trended for higher EuroQoL-scores (p = 0.092) at week-26. One case of hypercalcemia at week-2 normalised by week-4. CONCLUSION: Among older people after hip fracture surgery, the REVITAHIP strategy is a safe and low cost method of improving vitamin-D levels, reducing falls and pain levels. TRIAL REGISTRATION: The protocol for this study is registered with the Australian New Zealand Clinical Trials Registry ANZCTRN ACTRN12610000392066 (Date of registration: 14/05/2010).

Cancer rehabilitation: a barometer for survival?

PURPOSE: This pilot study was conducted to describe the clinical features and functional outcomes of patients attending inpatient rehabilitation for cancer-related deconditioning and neurological deficits and to explore factors associated with improved survival. METHODS: Using a retrospective audit, demographic characteristics, discharge outcomes, survival time, and functional status as measured by Functional Independence Measure (FIM) were recorded for 73 patients. Clinical status was estimated by Karnofsky Performance Status Scale (KPS). Cox regression was used to assess factors associated with improved survival following discharge from rehabilitation. RESULTS: Significant functional gains following rehabilitation were observed in total FIM (p = 0.02), motor FIM (p = 0.001), and KPS (p = 0.003). Length of survival ranged from 9.0 to 25.0 months, with 26 cases surviving to the end of study (censored). Patients scoring a total FIM of ≥80 survived significantly longer than patients scoring <80 (p = 0.002). At discharge, motor FIM scores (p = 0.004), FIM Efficiency (p = 0.001), KPS scores (p = 0.022), ambulation ability (p = 0.026), return to home (p = 0.009), and receipt of in-home services (p = 0.045) were significantly associated with improved survival. CONCLUSIONS: Functional improvement achieved through inpatient rehabilitation was associated with prolonged survival among cancer patients. Rehabilitation leading to improved independence among cancer patients may act as a marker of those with greater likelihood of better prognosis.

Effect of Skin-to-Skin Holding on Stress in Mothers of Late-Preterm Infants: A Randomized Controlled Trial.

PURPOSE: To examine the effect of skin-to-skin care (SSC) on stress perception between mothers who provided SSC to their late-preterm born infants and mothers who provided blanket holding. DESIGN AND METHODS: This was a longitudinal 2-group randomized controlled trial of 40 infant-mother dyads recruited from a level 3 neonatal intensive care unit in the upper Midwest. OUTCOME MEASURE: Maternal stress was measured using the Parental Stressor: Neonatal Intensive Care Unit (PSS: NICU) scale pre- and post-SSC intervention. Demographic and other mother and infant covariates were extracted from medical records. Physiologic stability was measured by the Stability of the Cardiorespiratory System in Preterm Infants (SCRIP) score. Study personnel used daily logs to track frequency and duration of SSC and holding sessions. RESULTS: The intervention and the control groups had similar pre- (mean ± standard deviation, 2.34 ± 0.86 for SSC and 2.94 ± 0.87 for holding) and post-intervention (mean ± standard deviation, 2.55 ± 0.95 for SSC and 2.78 ± 0.90 for holding) overall stress scores. Hours of SSC holding positively correlated with the change in stress scores for the entire scale (r = 0.58; P = .001), and for infant appearance (r = 0.58; P = .001) and parent role alteration (r = 0.48; P = .02) subscales. This relationship remained significant after controlling for the infant's length of stay and SCRIP score. IMPLICATIONS FOR PRACTICE: Mothers who provide SSC may experience more stress related to a more facilitated progression in the mother and infant relationship. IMPLICATIONS FOR RESEARCH: The relationship between increased stress and the number of hours of SSC holding warrants further investigation.

An initial loading-dose vitamin D versus placebo after hip fracture surgery: baseline characteristics of a randomized controlled trial (REVITAHIP).

BACKGROUND: Hypovitaminosis D is particularly common among older people with a proximal femoral (hip) fracture. There are currently no agreed strategies for vitamin D replenishment after hip fracture surgery. The REVITAHIP Study is a multisite, double-blinded randomized-controlled trial investigating the effects of an oral vitamin D loading dose on gait velocity after hip fracture surgery. We describe the baseline characteristics of participants, aiming to document hypovitaminosis D and its associations after hip fracture. METHODS: Participants, over 65, recruited within 7 days following hip fracture surgery from 3 Australia hospitals, were randomly allocated to receive a loading dose of vitamin D3 (250,000IU) or placebo, followed by oral maintenance vitamin D3/calcium (800 IU/500 mg) and the usual hip fracture rehabilitation pathway. Demographic and clinical data were collected, including surgical procedure, pre-fracture functional status, Mini Mental State Examination (MMSE) score, serum 25-hydroxyvitamin D (25-OHD), Verbal Rating Scale (VRS) for pain, grip strength and gait velocity. The associations of baseline 25-OHD levels with demographic and clinical data were assessed using Pearson's correlation, ANOVA and regression analyses. RESULTS: Two-hundred-and-eighteen people with hip fracture participated in the study. Mean age was 83.9+/-7.2 years, 77% were women and 82% lived in private homes. Fifty-six percent had a subcapital fracture. Mean comorbidity count was 3.13+/-2.0. Mean MMSE was 26.1+/-3.9. Forty-seven percent of participants had hypovitaminosis D (<50 nmol/L). Multivariate regression models demonstrated higher baseline vitamin D levels were significantly associated with higher premorbid Barthel index scores, lower post-operative VRS pain levels and use of vitamin D. CONCLUSION: This study cohort shared similar demographic characteristics and comorbidities with other cohorts of people with hip fracture, with the probable exception of less cognitive impairment. Hypovitaminosis D was not as prevalent as previously documented. Patients taking vitamin D supplements and with higher premorbid Barthel index, reflecting greater independence and activity, tended to have higher 25-OHD levels at baseline. Further, lower VRS pain ratings following surgery were associated with higher vitamin D levels. Such associations will need further investigation to determine causation. (ANZCTR number, ACTRN12610000392066). TRIAL REGISTRATION: The protocol for this study is registered with the Australian New Zealand Clinical Trials Registry ANZCTRN ACTRN12610000392066.