Peter Cudd

Interventions employing mobile technology for overweight and obesity: an early systematic review of randomized controlled trials

Obesity is a global epidemic with major healthcare implications and costs. Mobile technologies are potential interventions to promote weight loss. An early systematic review of this rapidly growing area of research was conducted. Electronic databases were searched for articles published between January 1998 and October 2011. Data sources included Medline, Embase and the Cochrane Central Register of Controlled Trials. Ongoing research was searched for using clinical trials databases and registers. Out of 174 articles retrieved, 21 met the inclusion criteria of randomized controlled trials (RCTs) on mobile technology interventions facilitating weight loss in overweight and obese adults with any other comparator. A narrative synthesis was undertaken. Seven articles were included and appraised using the Cochrane risk of bias tool: four presented a low risk of bias and three presented a high risk of bias. There is consistent strong evidence across the included multiple high‐quality RCTs that weight loss occurs in the short‐term because of mobile technology interventions, with moderate evidence for the medium‐term. Recommendations for improving the reporting and quality of future trials are made including reporting weight loss in percent to meet clinical standards, and including features such as long‐term follow‐up, cost‐effectiveness and patient acceptability.

Communicating by telephone : Views of a group of people with stuttering impairment

Abstract A study of the use of and attitudes towards the telephone by persons with stuttering impairment is presented. Data was collected by survey (postal questionnaire). Results indicate that making calls may be more problematic than answering them. Avoidance-like behaviours were more prevalent amongst younger adult stutterers than their older counterparts. Severe stutterers use the telephone least. Many stutterers surveyed see telephoning as being more problematic than ‘face-to-face’ communication and give a range of reasons for this. Telephoning difficulties can have wide ranging effects. Some implications of these findings are discussed.

Wheelchair-mounted integrated control systems for multiply handicapped people

Integrated control systems allow disabled people access to multiple functions from a single input device (for example a set of switches). Multiply handicapped users are thereby able to switch efficiently between wheelchair control, communication, computer access and control of their environment, without third-party help. Integrated systems have been developed for multiply handicapped children and adults in the Barnsley area. The design philosophy has concentrated upon utilizing, wherever possible, commercially available assistance devices and remotely controlling these via logic-based integrated control systems tailored to the needs and abilities of the individual client. This approach presents few problems as the inputs to commercially available devices are often based on simple switch control. The systems already supplied have proved, after an initial training period, to be easy to operate and have led to a considerable improvement in quality of life for the users. Computer-based, wheelchair-mounted integrated systems are now being developed. A prototype system currently emulates the logic-based controllers described above, employing the screen to display information on the current status of the system. Future development will move toward a more flexible system which will be able to read a variety of input signals and control a large number of outputs. The system will also have the facility to utilize software-based communications, keyboard emulation and environmental control packages as well as business and education software. Such a system could be easily set up, via software, for use by any disabled person.

Phased-Array Design Considerations for Deep Hyperthermia through Layered Tissue

Results are presented which demonstrate localized heating at depth, by a phased array in a homogeneous thorax phantom and the problems caused by a more realistic case of a layered tissue equivalent phantom. A phased array of contacting radiators is proposed for overcoming the difficulty of selective heating within the body cavity caused primarily by the muscle layer. The field from one aperture radiator in contact with layered tissue is predicted by a planar spectral diffraction algorithm incorporating transmission and reflection operations on the plane wave spectrum. This prediction process is validated by experimental results. The algorithm enables the prediction of a minimum number of phased contacting radiators required for selective heating within lung tissue through fat and muscle layers at 2.45 GHz, and provides a guide for the design requirements of a multiapplicator system.

Implementation of a PC-based integrated control system for children

Children with severe physical disabilities often require a range of technological devices to aid them with the fundamental tasks carried out in everyday life. These tasks areas may include mobility, communication, environment control and computer access for education. The most efficient, and often the most cost-effective, way of providing for these requirements is by the provision of a single, integrated system tailored to the individuals needs and abilities. BASIS, the Barnsley And Sheffield Integrated System, is an integrated control system based on a wheelchair-mounted personal computer (PC) and currently implements the following modules: wheelchair control; a spoken communication package; control of home equipment via infra-red; and a facility to run third-party software. The system presents a consistent and uniform environment to the user for selection and activation of these modules and can be controlled by one to four switches (scanning or directed access), a touch screen, a head pointer or a mouse. Safety considerations have played a central part in the design of the system. BASIS can be tailored to the users requirements by editing a text file in software and by connecting the appropriate hardware modules to the serial and parallel ports. The graphical user interface has been designed for use by children and employs pictorial representation (icons) of available functions on a colour screen. These icons can be chosen from clip-art or drawn on computer drawing package. It is also possible to scan in and utilize drawings or photographs.(ABSTRACT TRUNCATED AT 250 WORDS)

The influence of tissue layering on microwave thermographic measurements

Non-invasive thermal imaging and temperature measurement by microwave radiometry has been investigated for medical diagnostic applications and monitoring hyperthermia treatment of cancer, in the context of heterogeneous body structure. The temperature measured by a radiometer is a function of the emission and propagation of microwaves in tissue and the receiving characteristics of the radiometric probe. Propagation of microwaves in lossy media was analysed by a spectral diffraction approach. Extension of this technique via a cascade transmission line model provides an efficient algorithm for predicting the field patterns of aperture antennas contacting multi-layered tissue. A coherent radiative transfer analysis was used to relate the field pattern of a radiating antenna to its receiving characteristics when used as a radiometer probe, leading to a method for simulating radiometric data. Measurements and simulations were used to assess the effect of overlying fat layers upon radiometer response to temperature hot spots in muscle-type media. Results suggest that dielectric layering in tissue greatly influences measured temperatures and should be accounted for in the interpretation of radiometric data.

Inexpensive PC-based integrated control systems for severely physically disabled people

The development of a low cost integrated assistance system based around small/portable IBM compatible personal computers is presented. The system design and issues that affect the current system and those of future systems are discussed.

The CORES project

Discussion paper of a proposed project that is the initial phase of a far reaching research programme. The CORES project aims to investigate the development of a speech-only-input based Human Computer Interface (HCI) which will lead to suitably skilled disabled users being able to operate any commonly available commercial personal computer or workstation. The long term aim is to generalise this to a portable device with an adaptable HCI (both in hardware and software terms) suitable for disabled and able-bodied people alike.

Human-computer interfacing for the severely physically disabled

Human computer interfacing issues and the need for design standards for switch operated integrated rehabilitation systems are discussed. Input methods and compatibility problems are summarised. Formulae for access times to menu structures for a number of single switch selection methods are given. Quantitative comparisons are given for example selection processes. It is concluded that row column scanning is fastest for small selection sets. Advantages and disadvantages of the use of multiple switches for input are indicated.

Weaving a clinical academic career: Illuminating the method and pattern to follow:

The benefits of developing occupational therapists as clinical academics are well recognised. They include improved healthcare outcomes and experiences for service users, efficiencies for organisations and increased prominence of occupational therapy within healthcare. Yet occupational therapists describe uncertainty about how best to navigate clinical academic career pathways. We suggest that occupational therapists can increase their research aspirations, confidence and capacity by following a four-step method, weaving together clinical, academic and personal development. We outline our view of clinical academic development as a process with flexibility to incorporate occupational therapists’ diversity of interests and circumstances. By demystifying and illuminating the process of clinical academic development, we believe that occupational therapists may be able to weave more clinical academic development opportunities into their careers and increase the profession’s research capacity.