User factors affecting the use of digital services in five European regions and countries.

Digitalisation has great potential to reduce costs, improve access and enhance user experience. However, it could also increase inequality, with some people struggling to access and use digital services. It is important to understand who is likely to be excluded in this way and why. This can help to identify groups at particular risk of digital exclusion, inform efforts to overcome the barriers, and develop more inclusive digital services. This paper introduces a set of five linked datasets examining a range of user factors affecting the use of digital services. The datasets focus on the use of digital mobility services, but the data is useful in understanding the use of other digital services as well. The user factors considered include technology access, use and competence and attitudes towards digital technology. The datasets were the results of surveys in five European regions and countries (Germany, Italy, Barcelona Metropolitan Area, Flanders and the Netherlands). Samples were taken of the adult (age 16+) population with a total of 3,454 participants.

Understanding flow properties of mannitol powder at a range of temperature and humidity.

Inadequate flowability of powders in industries during handling can cause many problems. For example, lack of flow from hoppers, poor tablet weight consistency, and low production rate in tableting. Many factors are known to commonly affect flow properties of powders, such as temperature, humidity and conditioning duration. In this paper, flow properties of a mannitol powder, which was conditioned between 24 and 72 h at various high relative humidities and temperature, were measured using a shear tester. A statistical model was developed to investigate the relative importance of these variables on the mannitol flow properties. The developed model showed all independent variables are significant in estimating bulk cohesion. Two separate approaches were used to evaluate inter-particle forces in the bulk, and how these changed with environmental conditions. First, inter-particle forces were inferred from the measured bulk properties using the Rumpf model approach. Secondly, inter-particle forces were predicted based on a model of moisture present on the particle surface using a combination of Kelvin model with the Laplace-Young (KLY) equation. The second approach also involved a new method to measure surface energy of mannitol powder based on measurements using Finite Dilution Inverse Gas Chromatography (FD-IGC). The surface energies of the mannitol powder were measured at high temperature (35 °C) and at different range of relative humidities. In spite of the fundamentally different approaches to the two ways of inferring inter-particles forces, these forces came out within less than 1.5:1 in magnitude. The Rumpf approach from bulk behaviour data obviously reflected the measured change in behaviour with humidity in particular, but this was not predicted from the KLY approach, however the likely reasons for this are postulated and recommendations for improvement are made.

Breaking the cycle of frustration: Applying Neisser's Perceptual Cycle Model to drivers of semi-autonomous vehicles.

Semi-autonomous cars are already on the road and highly autonomous cars will soon be with us. Little is understood about how drivers will adapt to the changing relationship with their vehicle, but to ensure safety and consumer acceptance, this insight is vital. To this end, an on-road study in a semi-autonomous vehicle was undertaken with six UK drivers. The 'think aloud' technique was employed and video and audio footage of their interaction with the vehicle was captured. Neisser's (1976) Perceptual Cycle Model (PCM) was used to analyse the data and three case studies are presented to highlight how poor synergy between driver and semi-autonomous vehicles can occur from the lens of Schema, Action or World information. Seven key design considerations are proposed to ensure a more positive and safer interaction between driver and autonomous vehicle to guide focus by manufacturers. Further evidence for the existence of a 'counter cycle' (Plant and Stanton, 2015) within the PCM is found and how this relates to the challenges of using verbal protocals expressed during a fast moving dynamic task is discussed.

From Awareness to Action: The Community of Sarnia Mobilizes to Protect its Workers from Occupational Disease.

An exploratory qualitative case study investigated how different sectors of a highly industrialized community mobilized in the 1990s to help workers exposed to asbestos. For this study, thirty key informants including representatives from industry, workers, the community, and local politicians participated in semi-structured interviews and focus groups. The analysis was framed by a "Dimensions of Community Change" model. The informants highlighted the importance of raising awareness, and the need for leadership, social and organizational networks, acquiring skills and resources, individual and community power, holding shared values and beliefs, and perseverance. We found that improvements in occupational health and safety came from persistently communicating a clearly defined issue ("asbestos exposure causes cancer") and having an engaged community that collaborated with union leadership. Notable successes included stronger occupational health services, a support group for workers and widows, the fast-tracking of compensation for workers exposed to asbestos, and a reduction in hazardous emissions.

Osteochondroma of the clavicle causing Horner's syndrome.

A 17-year-old girl was admitted with a 1-year history of right-sided headaches and unilateral ptosis for 6 months. She was diagnosed with Horner's syndrome. Ultrasound and CT scan demonstrated an osteochondroma of the posterosuperior aspect of the medial clavicle compressing adjacent structures, including the right internal jugular vein and right common carotid artery. Cartilage sequence MRI showed an osteochondroma with a 5 mm cartilage cap. There were no suspicious features of malignancy. The patient was referred to a specialist centre for surgical resection. Osteochondroma of the clavicle presenting with Horner's syndrome is extremely rare, with only one previously reported case. In this case report, we discuss the anatomy of the oculosympathetic chain, which consists of a three neuron arc. The disruption of the neuronal arc, at any point, may result in Horner's syndrome. We also discuss the various causes of Horner's syndrome and its radiological investigation.

The role of sonoelastography in planning percutaneous biopsy of soft tissue tumours.

The aim of this study was to evaluate whether compression elastography has a useful role in the planning of percutaneous ultrasound-guided biopsies of soft tissue tumours. Consecutive patients were evaluated in the sarcoma clinic after their initial imaging work-up, involving ultrasound and MR. The multi-disciplinary team decided when percutaneous biopsy for histology was required, and this was performed in the multi-disciplinary clinic using ultrasound guidance. An experienced sarcoma radiologist performed the ultrasound with compression elastography in all cases. Grey scale imaging was used to predict the needle track for each biopsy and routinely, two passes were made into each lesion. In this study, the track for the second pass was predicted from the elastogram, aiming for a stiff (blue) area within the lesion. The samples were separately potted in formalin and sent to the sarcoma pathologist. Pathology reports for each sample were assessed to evaluate whether the elastographic blue targets yielded any specific diagnostic quality; 157 biopsies were performed in separate patients, including two passes per patient as per routine protocol; 107 (68.1%) were benign lesions and 50 (31.9%) were malignancies. In the benign group, 16 (14.9%) showed significant blue areas in the lesion. However, nine of these were thought to be artefactual, as they showed grey scale characteristics of complex cysts. Positive histology was recorded in all the blue areas, but in the benign lesions positivity was not seen solely in the blue areas; 14 (28%) in the malignant group showed blue areas in the lesion and five biopsies were positive in blue areas only. Overall, the blue target yielded the only positive tissue in 10% of the malignancies, equating to 3% of the whole study population. The p value was 0.008829 for positive histology for malignancy from blue areas only.

Making the case for inclusive design.

This paper describes the University of Cambridge, Engineering Design Centre's (EDC) case for inclusive design, based on 10 years of research, promotion and knowledge transfer. In summary, inclusive design applies an understanding of customer diversity to inform decisions throughout the development process, in order to better satisfy the needs of more people. Products that are more inclusive can reach a wider market, improve customer satisfaction and drive business success. The rapidly ageing population increases the importance of this approach. The case presented here has helped to convince BT, Nestlé and others to adopt an inclusive approach.

Empathic engineering: helping deliver dignity through design.

Dignity is a key value within healthcare. Technology is also recognized as being a fundamental part of healthcare delivery, but also a potential cause of dehumanization of the patient. Therefore, understanding how medical devices can be designed to help deliver dignity is important. This paper explores the role of empathy tools as a way of engendering empathy in engineers and designers to enable them to design for dignity. A framework is proposed that makes the link between empathy tools and outcomes of feelings of dignity. It represents a broad systems view that provides a structure for reviewing the evidence for the efficacy of empathy tools and also how dignity can be systematically understood for particular medical devices.

Development of two electronic bladder diaries: a patient and healthcare professionals pilot study.

AIMS: Assess patients' preferences in a pilot crossover study of two different electronic voiding diaries against a standard paper diary. Assess urological health professional (HP) opinions on the electronic bladder diary reporting system. METHODS: Two different electronic diaries were developed: (1) electronically read diary-a card with predefined slots read by a card reader and (2) e-diary-a handheld touch screen device. Data uploaded from either electronic diary produced an electronic report. We recruited 22 patients split into two cohorts for each electronic diary, 11 completed each type of electronic diary for 3 days either preceded or followed by a standard paper diary for 3 days. Both diaries were completed on the 7th day. Patients' perceptions of both diaries were recorded using a standardized questionnaire. A HP study recruited 22 urologists who were given the paper diary and the electronic reports. Time taken for analysis was recorded along with accuracy and HP preferences. RESULTS: The majority of patients (82%) preferred the e-diary and only 1/11 found it difficult to use. Patients had the same preference for the electronically read diary as the paper diary. The paper diary took 66% longer to analyze than the electronic report (P < 0.001) and was analyzed with an accuracy of 58% compared to 100%. Slightly more HP (9%) preferred the electronic report to the paper diary. CONCLUSIONS: This proposed e-diary with its intuitive interface has overcome previous deficiencies in electronic diaries with most patients finding the format user-friendly. Electronic reports make analysis and interpretation by HP quicker and more accurate.

A novel sensing technique for measurement of magnitude and polarity of electrostatic charge distribution across individual particles.

Electrostatic charge is generated during powder handling due to particle-particle and particle-wall collisions, rubbing, sliding, and rolling. In case of bipolar charge generation, the electrostatic forces may significantly change the inner forces and increase powder adhesion and cause a serious problem in material handling process. Therefore, the knowledge of distribution of charge across the individual particles is helpful to identify the role of triboelectrification and the effects of various relevant variables especially change in the contact materials, environmental conditions during processing, etc. A novel approach based on inductive sensor has been developed to detect the either polarity of charged particle and to characterise the bipolar charge distribution in the population of particulate material. To achieve this, an amplification unit configured as a pure integrator and signal processing techniques has been used to de-noise and correct the baseline of signal and MATLAB algorithm developed for peak detection. The polarity of charged particles obtained by this method is calibrated with Faraday pail method and the results are promising. Experimental study has been carried out by using two distinct populations of oppositely charged particles (glass beads-PVC, olivine sand, and silica sand). The obtained results indicate that the method is able to detect the distribution of polarities of charged particles.

Image-guided soft-tissue foreign body extraction - success and pitfalls.

AIM: To outline the pitfalls for image-guided percutaneous removal of foreign bodies (FBs). MATERIALS AND METHODS: Three hundred and fifty prospective patients were referred for ultrasound imaging for FB diagnosis and percutaneous removal during 2008-2010. Those patients with suitable FBs were offered guided percutaneous removal. The procedural methods and difficulties were recorded and all outcomes were noted, including surgical success and complications. RESULTS: Sixty-three patients had a negative ultrasound for FB and they were discharged with no subsequent attendances. Of the remaining 287 patients, 12 were deemed unsuitable for percutaneous removal, 15 attempted percutaneous removals failed, and eight were not attempted due to lack of symptoms. The remaining 252 patients underwent successful retrieval and there were no procedural complications. The procedural limitations were mainly related to the anatomical site, type of FB, instrumentation, bubbles, ultrasound beam width, and mobility of the FB. CONCLUSION: Ultrasound-guided percutaneous removal of FBs is a safe and viable approach to the management of FBs achieving at least 88% success overall and with attention to the pitfalls, the learning curve should improve the success rate.

Climate change and sustainable development: realizing the opportunity.

Manifold linkages exist between climate change and sustainable development. Although these are starting to receive attention in the climate exchange literature, the focus has typically been on examining sustainable development through a climate change lens, rather than vice versa. And there has been little systematic examination of how these linkages may be fostered in practice. This paper examines climate change through a sustainable development lens. To illustrate how this might change the approach to climate change issues, it reports on the findings of a panel of business, local government, and academic representatives in British Columbia, Canada, who were appointed to advise the provincial government on climate change policy. The panel found that sustainable development may offer a significantly more fruitful way to pursue climate policy goals than climate policy itself. The paper discusses subsequent climate change developments in the province and makes suggestions as how best to pursue such a sustainability approach in British Columbia and other jurisdictions.

The groin hernia - an ultrasound diagnosis?

AIMS: Ultrasound is a non-invasive, non-ionising radiation modality which is highly successful at soft tissue imaging. Groin pain from an occult hernia can be a difficult clinical diagnosis made easier by good imaging. The aim of this study was to demonstrate the accuracy of ultrasound in diagnosing and typing the groin hernia, which could lead to its justification of use in the imaging of the occult hernia. PATIENTS AND METHODS: A total of 118 patients with a clinical diagnosis of a groin hernia, prospectively underwent a blinded, ultrasound examination of the groin. All patients underwent surgery and these findings were compared with the ultrasound results. RESULTS: 120 symptomatic groins in 118 patients underwent surgery. Ultrasound diagnosed 118 hernias and there were two normal ultrasound examinations. Surgery confirmed the same two patients to be normal - ultrasound sensitivity for all hernias was 100% with 100% specificity. Two femoral hernias were seen in this study, both correctly identified at ultrasound. Of the inguinal hernias, ultrasound identified 36 of 42 direct hernias (sensitivity 86%, specificity 97%) and 72 of 74 indirect hernias (sensitivity 97%, specificity 87%) CONCLUSIONS: This study confirms that ultrasound can accurately diagnose groin hernias and this may justify its use in the assessment of the occult hernia.