Smith F.,Napier University
The Cochrane database of systematic reviews | Year: 2013
Surgical wounds that become infected are often debrided because clinicians believe that removal of this necrotic or infected tissue will expedite wound healing. There are numerous methods available but no consensus on which one is most effective for surgical wounds. To determine the effect of different methods of debridement on the rate of debridement and healing of surgical wounds. In March 2013, for this third update, we searched the Cochrane Wounds Group Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL. We included randomised controlled trials (RCTs) with outcomes including at least one of the following: time to complete debridement or time to complete healing. Two review authors independently reviewed the abstracts and titles obtained from the search, extracted data independently using a standardised extraction sheet and independently assessed methodological quality. One review author was involved in all stages of the data collection and extraction process, thus ensuring continuity. Five RCTs (159 participants) were eligible for inclusion; all compared treatments for infected surgical wounds and reported time required to achieve a clean wound bed (complete debridement). One trial compared an enzymatic agent (streptokinase/streptodornase) with saline-soaked dressings. Four trials compared the effectiveness of dextranomer beads or paste with other products (different comparator in each trial) to achieve complete debridement. Meta-analysis was not possible due to the unique comparisons within each trial. One trial reported that dextranomer achieved a clean wound bed significantly more quickly than Eusol, and one trial comparing enzymatic debridement with saline-soaked dressings reported that the enzyme-treated wounds were cleaned more quickly. However, methodological quality was poor in these two trials. There is a lack of large, high-quality published RCTs evaluating debridement per se, or comparing different methods of debridement for surgical wounds, to guide clinical decision-making.
Lombardi D.,Napier University |
Bhattacharya S.,University of Surrey
Earthquake Engineering and Structural Dynamics | Year: 2014
The purpose of this paper is to investigate the effects of liquefaction on modal parameters (frequency and damping) of pile-supported structures. Four physical models, consisting of two single piles and two 2×2 pile groups, were tested in a shaking table where the soil surrounding the pile liquefied because of seismic shaking. The experimental results showed that the natural frequency of pile-supported structures may decrease considerably owing to the loss of lateral support offered by the soil to the pile. On the other hand, the damping ratio of structure may increase to values in excess of 20%. These findings have important design consequences: (a) for low-period structures, substantial reduction of spectral acceleration is expected; (b) during and after liquefaction, the response of the system may be dictated by the interactions of multiple loadings, that is, horizontal, axial and overturning moment, which were negligible prior to liquefaction; and (c) with the onset of liquefaction due to increased flexibility of pile-supported structure, larger spectral displacement may be expected, which in turn may enhance P-delta effects and consequently amplification of overturning moment. Practical implications for pile design are discussed. © 2013 John Wiley & Sons, Ltd.
Psycharakis S.G.,Napier University
Journal of Strength and Conditioning Research | Year: 2011
The purpose of this study was to examine longitudinally the reliability and validity of ratings of perceived exertion (RPE) for monitoring exercise intensity in elite swimmers, with the percentage of maximum heart rate (%HR max) and the blood lactate concentration (La) being the criterion measures. Moreover, the purpose was to examine whether an adjustment of HRmax, as previously suggested for recreational/university swimmers, is required for subsequent calculations of %HRmax for elite swimmers. Seventeen swimmers competing at international level performed a 7 x 200 m incremental swim test at their specialty stroke 4 times during a period of 6 months. The RPE validity was examined with the use of correlation and with repeated measures analysis of variance (ANOVA) of the z-transformed values. The RPE reliability was examined with a factorial ANOVA, with %HRmax and La being the dependent variables and test (4 levels) and RPE stage (7 levels) the fixed factors. The RPE was found to be a valid method for monitoring exercise intensity, with the correlation coefficients with %HRmax and La being 0.85 and 0.82, respectively. There was a strong correspondence between RPE and %HRmax scores and a weaker correspondence between RPE and La scores, suggesting that that RPE reflects accurately the HR levels of elite swimmers. The longitudinal intertest reliability was high as no significant differences were found in the values of %HRmax or La between the 4 tests. The good validity and reliability of RPE suggest that it can be used in elite swimmers' training for the purpose of monitoring exercise intensity. Contrary to previous recommendations for recreational/university swimmers, when prescribing intensity for elite swimmers, the predicted HRmax value used for subsequent calculations should not be adjusted because such an adjustment would appear to underestimate HRmax. © 2011 National Strength and Conditioning Association.
Egdell V.,Napier University
Ageing and Society | Year: 2013
This paper explores the different ways in which informal carers for people with dementia negotiate their care-giving role across the changing organisational and spatial landscape of care. In-depth qualitative data are used to argue that the decisions of carers are socially situated and the result of negotiations involving individuals, families and wider cultural expectations. These decisions affect where care occurs. In addressing these issues this paper draws attention to the lack of choice some carers may have in taking on the care-giving role; how and why carers draw upon support; and the different expectations of the care-giver's capabilities across the different sites of care, specifically at home and in nursing homes. It concludes that research and policy attention should focus on how the expectations about the role and abilities of carers are affected by where, and how, care is delivered. In doing so this paper contributes to the emerging health geography literature on care-giving as well as developing the spatial perspective in the established gerontological literature. © 2012 Cambridge University Press.
Benyon D.,Napier University
Interacting with Computers | Year: 2012
Mixed reality technologies have been around for over 10 years but it is only with the proliferation of smart phones and tablet (computers) that mixed and augmented reality interaction is reaching the mass market. There are now enough examples of mixed reality interactions that we can begin to abstract principles of design and principles of user experience (UX) for these new spaces of interaction. In this paper I develop the notion of mixed reality as a blended space. Mixed reality is a blend of a physical space and a digital space. The term 'blend' here is borrowed from blending theory which is a theory of cognition that highlights the importance of cross domain mappings and conceptual integration to our thought process that are grounded in physically-based spatial schemas. The concept of a blended space is developed by recognizing that physical space and digital space can both be described in terms of the objects and agents who inhabit the space, the structure of the objects' relationships (the topology of the space) and the changes that take place in the space (the volatility, or dynamics of the space). The blended space will be more effective if the physical and digital spaces have some recognizable and understandable correspondences. The issue of presence in this blended space is then discussed and it is suggested that traditional definitions of presence are inadequate to describe the experiences that blended spaces offer. Presence is considered as interaction between the self and the content of the medium within which the self exists, and place is this medium. Blended spaces mean that people have an extended presence; from their physical location into digital worlds. © 2012 British Informatics Society Limited. All rights reserved.