School of Health Sciences

Introduction Popliteal artery aneurysms are the most common peripheral arterial aneurysms, and are frequently bilateral. Acute limb ischemia, rupture and compression phenomena can complicate these aneurysms when the diameter exceeds 2 cm. Case Presentation We report an 82-year-old male patient with two giant femoropopliteal aneurysms, 10.5 and 8.5 cm diameters, managed in our institution. Both aneurysms were resected and a polytetrafluoroethylene (PTFE) femoropopliteal interposition graft was placed successfully. Management and literature review are discussed. Conclusion We believe this is the first report in the medical literature of bilateral giant femoropopliteal aneurysms.

To present performance data on the use of the Aorfix stent-graft in patients with hostile infrarenal abdominal aortic aneurysm (AAA) anatomy. Methods: A study protocol was designed to examine the safety and efficacy of the Aorfix endovascular stent-graft in AAA patients who had a proximal neck diameter between 18 and 30 mm, neck angulation between 60u and 90u, and/or severe iliac artery angulation/ tortuosity. Between September 2005 and April 2009, 20 men (mean age 72.467.7 years, range 55-89) were enrolled in the study. The mean AAA diameter was 61.8614.9 mm (range 45.5-102). The mean angulation of the proximal neck was 61.9u616.5u (range 30u-90u); in the iliac arteries, the angulation was 59.9u616.3u (range 30u-85u) for the left and 60.9u617.6u (range 28u-90u) on the right. Fourteen (70%) patients had .60u proximal neck angulation. Outcome measures were analyzed using life-table analysis. Results: The graft was successfully implanted in all but 1 patient (technical success 95%); failure to cannulate the contralateral iliac limb resulted in conversion to aortomonoiliac stentgraft placement. In 1 patient, bilateral renal artery stent rescue was performed due to severe procedure-related stenosis. Occlusion of an internal iliac artery was noted in 2 patients. Mean follow-up was 26.9 months (range 4.5-43.5). No aneurysm-related rupture or death occurred. Two endoleaks were observed: 1 type I without migration at 3 years and 1 type II at 13 months. Freedom from any type of endoleak was 91.6% at 1 year and 75.9% at 2 years. Freedom from any early or late intervention was 88.8% at 1 year and 76.0% at 2 years. Aneurysm sac shrinkage (.5 mm) was evident in 79% (11/14) of the cases reaching 12-month follow-up. Conclusion: The Aorfix device seems to be safe and reliable in purely complex infrarenal AAA anatomy, demonstrating good short and midterm clinical outcomes. Further larger or multicenter studies are needed to confirm the suitability of the Aorfix stent-graft in hostile infrarenal AAA anatomy.

If you read the news either as hard copy or online I am sure that you notice reports about the presence and use of robots more frequently; and often these have a positive message related to the benefits and advantages of the use of robots. My most recent encounter with similar news was last week's reading about a robot in the US, called VGo, which helped to 'Diagnose concussion on the football field' of an American football player (Erikson 2016). Not to mention other titles such as "Robots are coming to grandma's nursing home" (Schiller 2016)!

Security constraints that enforce security requirements characterize healthcare systems. These constraints have a substantial impact on the resiliency of the final system. Security requirements modelling approaches allow the prevention of cyber incidents; however, the focus to date has been on prevention rather than resiliency. Resiliency extends into the detection, mitigation and recovery after security violations. In this paper, we propose an enhanced at a conceptual level that attempts to align cybersecurity with resiliency. It does so by extending the Secure Tropos cybersecurity modelling language to include resiliency. The proposed conceptual model examines resiliency from three viewpoints, namely the security requirements, the healthcare context and its implementational capability. We present an overview of our conceptual model of a cyber resiliency language and discuss a case study to attest the healthcare context in our approach.

The purpose of this study was to explore personal accounts of acute non-specific low back pain experiences to gain insights and extend knowledge for physiotherapy practice and research. At present, knowledge of acute low back pain and understandings of the transition from acute to chronic low back problems largely derives from experimental research and population-generated findings developed from self-report questionnaires. Despite extensive research, there remains a limited ability to prevent the transition from acute low back pain problems to chronic pain and long term disability in many individuals.

A move towards self-management is central to health strategy around chronic low back pain, but its concept and meaning for those involved are poorly understood. In the reported study, four distinct and shared viewpoints on self-management were identified among people with pain and healthcare providers using Q methodology. Each construes self-management in a distinctive manner and articulates a different vision of change. Identification of similarities and differences among the viewpoints holds potential for enhancing communication between patients and healthcare providers and for better understanding the complexities of self-management in practice.

Background: Students in higher education may adopt different approaches to studying, depending upon their perceptions of the academic quality of their courses and programmes, and both are likely to depend upon the nature of the curricula to which they are exposed. Aims: Perceptions of quality and approaches to studying were investigated in students taking pre-registration programmes in a school of health professions. Two of the programmes were 3-year undergraduate programmes with subject-based curricula, and two were 2-year entry-level masters programmes with problem-based curricula. Method: The Course Experience Questionnaire (CEQ) and the Revised Approaches to Studying Inventory (RASI) were administered to the students within a single survey. Their teachers were also surveyed with regard to their beliefs and intentions about teaching. Results: The teachers on the two kinds of programme exhibited similar beliefs and intentions about teaching. However, the students on the masters programmes produced higher ratings than did the students on the undergraduate programmes with regard to the appropriateness of their assessment, the acquisition of generic skills and the emphasis on student independence. The students on the masters programmes were also more likely to show a deep approach to studying and less likely to show a surface approach to studying than were the students on the undergraduate programmes. Conclusions: The CEQ and the RASI provide complementary evidence for use in research, in quality assurance and in quality enhancement. In comparison with subject-based curricula, problem-based curricula seem to enhance students' perceptions of their programmes and the quality of their learning.

To understand experiences and perspectives of job retention project users in relation to challenges faced and support received; to develop explanatory insight into effective interventions. 14 employed users of a United Kingdom job retention project, with a range of mental health problems. Semi-structured individual interviews which were collaboratively designed with service users. Data analysis involved deductive & inductive thematic analysis, constant comparative analysis, and service user collaboration. Participants' feelings of guilt and self blame were a major obstacle to job retention. The project helped them address these by supporting a reappraisal of their situation. This assisted identification of job accommodations and adjustments and confidence in self advocacy. Thus an important basis for improved dialogue with their employer was established. A peer support group provided an important adjunct to individual project worker interventions. 10 participants retained employ...

Older people with severe visual impairments usually experience difficulty in their mobility and independence. In the Netherlands the number of seriously visual impaired people is estimated between 160,000 and 300,000 people. This is 1.1% to 2% of the total Dutch population. In this study, we have examined the mobility experiences of visually impaired people in detail. Ten participants were interviewed twice. The data was collected using in-depth interviews which were audiotaped, verbatim transcribed and analysed by the empirical phenomenology according to Giorgi. The findings showed that participants experienced a severely limited range of mobility. This limitation influenced their occupational space and their independence. The impact of their mobility problems also showed an evident shift in Activities of Daily Living (ADL). They attended less social activities and became more dependent on assistance. The findings showed that the consequences of visual impairments were often misunderstood by others; the tension of being dependent, and the inability of facial recognition as a barrier to social life were common experiences. These experiences can provide occupational therapists with an improved understanding of the difficulties that the visually impaired elderly experience.

Role-emerging placements, which take place in settings where there are no on-site occupational therapy educators, are increasingly being used within occupational therapy curricula internationally. Although literature on such placements is increasing, little has explored the early stages and demands of such placements. Interpretative phenomenological analysis was used to gain an understanding of how five MSc pre-registration occupational therapy students experienced and ascribed meaning to their role-emerging placements. Interviews were carried out with the students within one month of their role-emerging placement. This article explores one of the themes that emerged from the study, 'Thrown in', that reflected the challenges students faced in the early days of their placement. Key findings revealed that students found the early stages of placement cognitively, emotionally and ontologically demanding. They felt temporarily lost, anxious and overwhelmed by their experience, which impacted on their sense of self. Recommendation is made that consideration is given to students' ontological discomfort, or 'sense of being' on placement and pre-placement preparation.

Interprofessional education (IPE) is perceived to be one strategy to reduce professional compartmentalisation and improve collaborative practices. The unequal power relationsexisting between the various professions who need to collaborate for IPE remains largely unexamined and it is only in recent years that sociological theories have been employed within the interprofessional field. This paper uses selected findings from an exploratory case study into IPE conducted at the University of Malta and then examines these findings from a Bourdieusian perspective. The first part of this paper introduces the breath of theoretical perspectives employed for IPE and then goes on to provide an overview of Bourdieu's theories of social practices. The second part outlines the context of this case study and presents selected findings. The third section discusses how these findings were examined using Bourdieu's concepts helping us demystify the various ways in which health care professions worked and interacted, and how this all made sense within a wider societal context. It also highlights the relevance of taking into account Bourdieu's concepts during the development of IPE.

Changes in health and social care present exciting opportunities for occupational therapists in the United Kingdom to expand their practice into innovative settings. To prepare graduates for these opportunities, placement experiences must reflect current trends in practice. Role-emerging placements are increasingly being used within occupational therapy to help students develop the skills, knowledge and attributes needed to become the therapists of tomorrow. This paper provides an overview of the literature on the use of role-emerging placements within the profession by considering the current context of placements, the rationale for the development of role-emerging placements and their potential strengths and limitations. The paper aims to increase awareness in the UK of role-emerging placements and their potential value within health and social care education.