̽��ֱ�� of Cambridge - John Clarkson

Talking about a revolution: 25 years of BT and Cambridge

skbf2 — Fri, 14 Oct 2022 09:24:46 +0000

Cambridge and BT have been working together for more than 25 years developing new technologies, exploring human behaviour and considering how those two things come together to shape our world.

Proper fit of face masks is more important than material, study suggests

sc604 — Thu, 11 Feb 2021 11:23:02 +0000

̽��ֱ��researchers, from the ̽��ֱ�� of Cambridge, carried out a series of different fit tests, and found that when a high-performance mask – such as an N95, KN95 or FFP2 mask – is not properly fitted, it performs no better than a cloth mask. Minor differences in facial features, such as the amount of fat under the skin, make significant differences in how well a mask fits.

̽��ֱ��results, published in the journal PLoS ONE, also suggest that the fit-check routine used in many healthcare settings has high failure rates, as minor leaks may be difficult or impossible to detect by the wearer. While the sample size was small, the researchers hope their findings will help develop new fit tests that are quick and reliable, in the case of future public health emergencies. ̽��ֱ��current study only evaluated the impact of fit on the wearer of the mask – the team will evaluate how fit impacts the protection of others in future research.

̽��ֱ��COVID-19 pandemic has made well-fitting face masks a vital piece of protective equipment for healthcare workers and civilians. While the importance of wearing face masks in slowing the spread of the virus has been demonstrated, there remains a lack of understanding about the role that good fit plays in ensuring their effectiveness.

“We know that unless there is a good seal between the mask and the wearer’s face, many aerosols and droplets will leak through the top and sides of the mask, as many people who wear glasses will be well aware of,” said Eugenia O’Kelly from Cambridge’s Department of Engineering, the paper’s first author. “We wanted to quantitatively evaluate the level of fit offered by various types of masks, and most importantly, assess the accuracy of implementing fit-checks by comparing fit-check results to quantitative fit testing results.”

For the study, seven participants first evaluated N95 and KN95 masks by performing a fit check, according to NHS guidelines. Participants then underwent quantitative fit testing – which uses a particle counter to measure the concentration of particles inside and outside the mask – while wearing N95 and KN95 masks, surgical masks, and fabric masks. ̽��ֱ��results assessed the protection to the mask wearer, which is important in clinical settings.

N95 masks – which are a similar standard to the FFP3 masks available in the UK and the rest of Europe – offered higher degrees of protection than the other categories of masks tested; however, most N95 masks failed to fit the participants adequately.

In their study, the researchers found that when fitted properly, N95 masks filtered more than 95% of airborne particles, offering superior protection. However, in some cases, poorly-fitted N95 masks were only comparable with surgical or cloth masks.

“It’s not enough to assume that any single N95 model will fit the majority of a population,” said O’Kelly. “ ̽��ֱ��most widely-fitting mask we looked at, the 8511 N95, fit only three out of the seven participants in our study.”

One observation the researchers made during their study was the width of the flange of the mask - the area of the material which comes in contact with the skin – may be a critical feature to fit. Masks which fit the greatest number of participants tended to have wider, more flexible flanges around the border.

In addition, small facial differences were observed to have a significant impact on quantitative fit. “Fitting the face perfectly is a difficult technical challenge and, as our research showed, small differences such as a centimetre wider nose or slightly fuller cheeks can make or break the fit of a mask,” said O’Kelly.

Self-performed fit-checks are attractive because they save on time and resources, and are often the only method of fit testing available. However, this study, and studies of fit-check systems in other countries, indicate that such fit-check systems are not reliable.

̽��ֱ��researchers hope that their results will be of use for those who are working on new technologies and programmes to assess fit, so that healthcare and other frontline workers are adequately protected in the case of any future pandemics. Additionally, they hope these results will bring attention to the importance of fit in clinical-grade masks, especially if such masks are to be widely used by the public. This study did not evaluate the impact of fit on protecting others, which is a future area of research.

Reference:
Eugenia O’Kelly et al. ‘Comparing the fit of N95, KN95, surgical, and cloth face masks and assessing the accuracy of fit checking.’ PLoS ONE (2021). DOI: 10.1371/journal.pone.0245688

A team of researchers studying the effectiveness of different types of face masks has found that in order to provide the best protection against COVID-19, the fit of a mask is as important, or more important, than the material it is made of.

Fitting the face perfectly is a difficult technical challenge and small differences, such as a centimetre wider nose or slightly fuller cheeks, can make or break the fit of a mask

Eugenia O'Kelly

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Doctor in the Fight Against Ebola in Sierra Leone

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Beyond the pandemic: re-design our public health system

ta385 — Wed, 09 Dec 2020 09:25:18 +0000

COVID-19 has highlighted debilitating flaws in England’s public health systems decades in the making. Carol Brayne and John Clarkson from Cambridge Public Health, a new interdisciplinary centre, argue that a radical rethink is long overdue. They recommend bringing a ‘systems approach’ to the challenges, to help make our public health system fit for the future – for everyone.

Keeping patients safe in hospital

cjb250 — Tue, 15 Nov 2016 09:39:09 +0000

In November 2004, Mary McClinton was admitted to Virginia Mason Medical Center in Seattle, USA, to receive treatment for a brain aneurysm, a potentially serious swelling in a blood vessel. What followed was a tragedy, made worse by the fact that it was entirely preventable.

McClinton was mistakenly injected with the antiseptic chlorhexidine. It happened, the hospital says, because of “confusion over the three identical stainless steel bowls in the procedure room containing clear liquids — chlorhexidine, contrast dye and saline solution”. Doctors tried amputating one of her legs to save her life, but the damage to her organs was too great: McClinton died 19 days later.

Nine years on, an almost identical accident occurred at Doncaster Royal Infirmary in the UK. Here, the patient, ‘Gina’, survived, but only after having her leg amputated.

Professor Mary Dixon-Woods is one of Cambridge’s newest recruits, and she is on a mission: to improve patient safety in the National Health Service and in healthcare worldwide. She has recently taken up the role as RAND Professor of Health Services Research, having moved here from the ̽��ֱ�� of Leicester.

It is, she admits, going to be a challenge. Many different policies and approaches have been tried to date, but few with widespread success, and often with unintended consequences.

Financial incentives are widely used in the NHS and in the USA, but recent evidence suggests that they have little effect. “There’s a danger that they tend to encourage effort substitution – what people often refer to as ‘teaching to the test’,” explains Dixon-Woods. In other words, people focus on the areas that are being incentivised, but neglect other areas. “It’s not even necessarily conscious neglect. People have only a limited amount of time, so it’s inevitable they focus on areas that are measured and rewarded: it’s an economy of attention as much as anything else.”

In 2013, Dixon-Woods and colleagues published a study, funded by the Wellcome Trust, evaluating the use of surgical checklists introduced in hospitals to reduce complications and deaths during surgery. ̽��ֱ��checklists have become the most widely used patient safety intervention in the world and are recommended by the World Health Organization. Yet, the evidence shows that checklists may have little impact, and her research found that in some situations – particularly in low-income countries – they might even make things worse.

“ ̽��ֱ��checklists sometimes introduced new risks. Nurses would use the lists as a box-ticking exercise rather than as a true reflection of events – they would tick the box to say the patient had had their antibiotics when there were no antibiotics in the hospital, for example.” They also reinforced the hierarchies – nurses had to try to get surgeons to do certain tasks, but the surgeons used it as an opportunity to display their power and refuse.

Problems are compounded by a lack of standardisation. Dixon-Woods and her team spend time in hospitals to try to understand which systems are in place and how they are used. Not only does she find differences in approaches between hospitals, but also between units and even between shifts. “Standardisation and harmonisation are two of the most urgent issues we have to tackle. Imagine if you have to learn each new system wherever you go or even whenever a new senior doctor is on the ward. This introduces massive risk.”

One place that has managed to break this pattern is Northern Ireland, which has overcome the problem of poor labelling of lines such as intravenous lines and urinary catheters

Even when an institution manages to make genuine improvements in patient safety, too often these interventions cannot be replicated elsewhere or scaled up, leading to the curse of “worked once”, as she describes it.

One place that has managed to break this pattern is Northern Ireland, which has overcome the problem of poor labelling of lines such as intravenous lines and urinary catheters. A sick patient may have several different lines attached to them; these were not labelled in any consistent way – if at all – so a nurse might use the wrong line or leave a line in place too long, risking infection. Over 18 months, the health service in Northern Ireland came up with a solution. Soon, whether you are in a hospital, a nursing home or a hospice, every line will be labelled the same way.

“I’m interested in how they managed to achieve that and what we can learn that can be used in the next place that wants to standardise their lines.”

Dixon-Woods compares the issue of patient safety to that of climate change, in the sense that it is a “problem of many hands”, with many actors, each making a contribution towards the outcome, and where it is difficult to identify who has responsibility for solving the problem. “Many patient safety issues arise at the level of the system as a whole, but policies treat patient safety as an issue for each individual organisation.”

Nowhere is this more apparent than the issue of ‘alarm fatigue’. Each bed in an intensive care unit typically generates 160 alarms per day, caused by machinery that is not integrated. “You have to assemble all the kit around an intensive care bed manually,” she explains. “It doesn’t come built as one like an aircraft cockpit. This is not a problem a hospital can solve alone. It needs to be solved at the sector level.”

Dixon-Woods has turned to Professor John Clarkson in Cambridge’s Engineering Design Centre to help. Clarkson has been interested in patient safety for over a decade; in 2004, his team published a report for the Chief Medical Officer entitled ‘Design for patient safety – a system-wide design-led approach to tackling patient safety in the NHS’.

We need to look through the eyes of the healthcare providers to see the challenges and to understand where tools and techniques we use in engineering may be of value
John Clarkson

“Fundamentally, my work is about asking how can we make it better and what could possibly go wrong,” explains Clarkson. It is not, he says, just about technology, but about the system and the people within the system. When he trains healthcare professionals, he avoids using words like ‘risk’, which mean different things in medicine and engineering, and instead asks questions to get them thinking about the system.

“We need to look through the eyes of the healthcare providers to see the challenges and to understand where tools and techniques we use in engineering may be of value. I have no doubt that if you were to put a hundred engineers into Addenbrooke’s [Hospital], you could help transform its care.”

There is a difficulty, he concedes: “There’s no formal language of design in healthcare. Do we understand what the need is? Do we understand what the requirements are? Can we think of a range of concepts we might use and then design a solution and test it before we put it in place? We seldom see this in healthcare, and that’s partly driven by culture and lack of training, but partly by lack of time.”

Dixon-Woods agrees that healthcare can learn much from how engineers approach problems. “Medical science tends to prioritise trials and particular types of evidence, whereas engineering does rapid tests. Randomised controlled trials do have a vital role, but on their own they’re not the whole solution. There has to be a way of getting our two sides talking.”

Only then, she says, will we be able to prevent further tragedies such as the death of Mary McClinton.

Healthcare is a complex beast and too often problems arise that can put patients’ health – and in some cases, lives – at risk. A collaboration between the Cambridge Centre for Health Services Research and the Department of Engineering hopes to get to the bottom of what’s going wrong – and to offer new ways of solving the problems.

Standardisation and harmonisation are two of the most urgent issues we have to tackle. Imagine if you have to learn each new system wherever you go or even whenever a new senior doctor is on the ward. This introduces massive risk

Mary Dixon-Woods

Toshiyuki Imai

Intravenous drip

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Winners announced in the inaugural Vice-Chancellor’s Impact Awards and Public Engagement with Research Awards

jeh98 — Tue, 21 Jun 2016 09:58:54 +0000

On Monday 20 June, the Vice-Chancellor and Pro Vice-Chancellor for Research presented two sets of inaugural awards; the Impact Awards run by the Research Strategy Office, and the Public Engagement with Research Awards run by the Public Engagement team in the Office of External Affairs and Communications.

Research at the ̽��ֱ�� of Cambridge has had profound effects on society – it is a formal part of the ̽��ֱ��’s mission.

̽��ֱ��Vice-Chancellor’s Impact Awards have been established to recognise and reward those whose research has led to excellent impact beyond academia, whether on the economy, society, culture, public policy or services, health, the environment or quality of life.

In this, its inaugural year, there were 71 nominations across all Schools. Nominations were initially judged by School, with one overall best entry selected by external advisor Schlumberger. A prize of £1,000 was awarded to the best impact in each School, with the prize for the overall winner increased to £2,000.

̽��ֱ��winners were announced at an award ceremony on 20 June 2016, hosted by Professor Sir Leszek Borysiewicz. These winners, although very diverse, illustrate only a small part of the wide range of impact that Cambridge's research has had.

This year’s winners were:

Dr Mari Jones (Faculty of Modern and Medieval Languages)

Norman French has been spoken in Jersey for over 1,000 years. Today, however, this language (Jèrriais to its speakers) is obsolescent: spoken by some 1% of the population. ̽��ֱ��research of Mari Jones has sought to preserve Jèrriais and has helped raise the profile of the language within Jersey and beyond, with impacts on local and national media, language policy and education, and cultural identity and development.

Dr Gilly Carr (Department of Archaeology and Anthropology)

̽��ֱ��Channel Islands have long had great difficulty in coming to terms with the darker side of the German occupation. ̽��ֱ��aim of Gilly Carr’s research is to increase awareness of Channel Islander victims of Nazi persecution through creation of a plural ‘heritage landscape’ and via education. ̽��ֱ��creation of this heritage is a major achievement and will be of significant impact for the Channel Islands.

Professor Steve Jackson (Wellcome Trust/CRUK Gurdon Institute)

Olaparib is an innovative targeted therapy for cancer developed by Steve Jackson. In 2014 Olaparib was licensed for the treatment of advanced ovarian cancer by the US Food and Drug Administration and the European Medicines Agency. ̽��ֱ��following year, NICE made the drug available on the NHS in England for specific ovarian cancer patients. 2015 saw promising findings from a clinical trial in prostate cancer and Olaparib received Breakthrough Therapy Designation earlier this year. Olaparib is currently in clinical trials for a wide range of other cancer types.

Professor John Clarkson and Dr Nathan Crilly (Department of Engineering)

It is normal to be different. ̽��ֱ��demographics of the world are changing, with longer life expectancies and a reduced birth rate resulting in an increased proportion of older people. Yet with increasing age comes a general decline in capability, challenging the way people are able to interact with the ‘designed’ world around them. ̽��ֱ��Cambridge Engineering Design Centre has worked with the Royal College of Art to address this ‘design challenge’. They developed a design toolkit and realised what was by now obvious, that inclusive design was simply better design.

Dr Nita Forouhi and Dr Fumiaki Imamura (MRC Epidemiology Unit)

Identifying modifiable risk factors is an important step in helping reduce the health burden of poor diet. Forouhi and Imamura have advanced our understanding of the health impacts of sugars, fats and foods, through both scale and depth of investigation of self-reported information and nutritional biomarkers. They have engaged at an international level with policy and guidance bodies, and have used the media to improve public understanding with the potential for a direct impact on people’s health.

In 2015, the ̽��ֱ�� of Cambridge received a one-year £65k Catalyst Seed Fund grant from Research Councils UK to embed high quality public engagement with research and bring about culture change at an institutional level.

̽��ֱ��Public Engagement with Research Awards were set up to recognise and reward those who undertake quality engagement with research. 69 nominations were received from across all Schools.

This year’s winners were:

Dr Becky Inkster (Department of Psychiatry)

Dr Inkster’s work work explores the intersection of art and science through the prism of mental health research. Dr Inkster has successfully collaborated with ̽��ֱ��Scarabeus Theatre in a performance called Depths of My Mind and founded the website HipHopPsych, showcasing the latest psychiatry research through hip hop lyrics. Her approach has allowed her to engage with hard-to-reach teenage audiences, encouraging them to reflect on their own mental health. Beyond this work she has explored the use of social media to diagnose mental illness, and has gathered patient perspectives on ethics, privacy and data sharing in preparation for research publication.

Dr Paolo Bombelli (Department of Biochemistry)

Dr Bombelli’s research looks to utilise the photosynthetic chemistry of plants to create biophotovoltaic devices, a sustainable source of solar power. For over five years, he has been taking his research out of the lab to science festivals, schools and design fairs; tailoring his approach to a wider variety of audiences. Through his engagement, he has reached thousands of people, in multiple countries, and is currently developing an educational toolkit to further engage school students with advances in biophotovoltaic technology. Dr Bombelli’s public engagement work has also advanced his research, namely through a transition from using algae to moss in live demonstrations.

Dr Ruth Armstrong and Dr Amy Ludlow (Institute of Criminology and Faculty of Law)

Dr Armstrong and Dr Ludlow have collaborated on a research project addressing the delivery of education in the prison sector. Their project, Learning Together, pioneered a new approach to prison education where the end-users, the prisoners, are directly engaged with the design, delivery and evaluation of the research intervention. Adopting this shared dialogue approach has yielded positive results in terms of prisoners’ learning outcomes and has gathered praise from prison staff and government policy makers. Through continued engagement and partnership working, Armstrong and Ludlow have managed to expand their initiative across a broad range of sites and institutional contexts.

Dr Hazel Wilkinson (Department of English)

Dr Wilkinson is investigating the history of reading and writing habits in the eighteenth century. In collaboration with Dr Will Bowers at the ̽��ֱ�� of Oxford, she has developed an online public platform, journallists.org, which allows readers to engage with installments of periodicals, diaries, letters, and novels, on the anniversaries of the day on which they were originally published, written, or set. Her approach has allowed members of the public to actively participate in research. She has also inspired thousands of readers to engage with under-read eighteenth and nineteenth century texts, often for the very first time.

Dr Paul Coxon (Department of Materials Science and Metallurgy)

Over the last ten years Dr Coxon has endeavored to engage with audiences often overlooked by traditional public engagement channels. He has given talks in venues as varied as bingo halls, working men’s social clubs and steam fairs to showcase his passion for solar research, steering clear of the “flashes and bangs” approach often associated with Chemistry. He has also designed a Fruit Solar Cell Starter Kit, used in fifty low-income catchment schools across the UK.

Mr Ian Hosking and Mr Bill Nicholl (Department of Engineering and Faculty of Education)

Ian Hosking and Bill Nicholl are cofounders of Designing Our Tomorrow, a platform for transforming D&T education in schools. Their public engagement initiative began in 2009 and brought together research around inclusive design and creativity in education. Through production of their DOT box, Hosking and Nicholl have taken active research questions into the classroom and given students control of designing technological solutions. Engagement with teachers, students and policymakers is integral to the success of their initiative and has resulted in engineering design being included in the national curriculum and GCSE qualifications.

Researchers from across the ̽��ֱ�� have been recognised for the impact of their work on society, and engagement with research in the inaugural Vice-Chancellor’s Impact Awards and Public Engagement with Research Awards.

̽��ֱ�� of Cambridge

Dr Ruth Armstrong and Dr Amy Ludlow receive their award from the Vice-Chancellor, Professor Sir Leszek Borysiewicz

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Health costs of ageing will shoot up without technological innovation

sc604 — Tue, 14 Jul 2015 14:54:09 +0000

A new report co-authored by Cambridge researchers warns that without technological innovation over the next decade, healthcare costs in the UK could be significantly higher than currently projected by the Office of Budget Responsibility (OBR). Without productivity improvements, health spending in 2063-64 might need to be 5.0% of GDP higher than is currently projected.

̽��ֱ��report, Opportunity Knocks, has been published today by London-based think tank International Longevity Centre-UK (ILC-UK), in conjunction with the Institute of Engineering and Technology and the Engineering Design Centre at the ̽��ֱ�� of Cambridge.

It points out that predictions for the growth in healthcare productivity are optimistic given historic trends, and that technological innovation will be vital to fill the gap. ̽��ֱ��authors argue that there is significant potential for responding to the challenges of ageing through new developments in wearable technologies, big data, 3D printing, cloud computing, the internet of things, and smart cities.

“Technological innovation is vital to help individuals and society as a whole adapt to ageing,” said Mike Bradley of Cambridge’s Engineering Design Centre, which pioneered the Inclusive Design approach: designing products to be useful to as many people as possible. “But there are still many barriers to be overcome.”

̽��ֱ��report suggests that a design response to ageing can also benefit the UK economy: Those over 65 spend around £2.2 billion per week and they could be spending over £6 billion per week (£312 billion per year) by 2037.

However, one in three 85-89 year olds has difficulty shopping for groceries and more than one in ten in this age group has difficulty managing money. More than half of those aged 90 and over have difficulty shopping for groceries and a quarter of this age group have difficulty managing money. Four in ten individuals over 75 and three quarters of individuals over 85 do not have internet access.

̽��ֱ��report highlights a range of ideas for new technology which emerged from a workshop organised by ILC-UK, IET and ̽��ֱ��Engineering Design Centre at ̽��ֱ�� ̽��ֱ�� of Cambridge. ̽��ֱ��ideas are designed not as ‘solutions to ageing’ but to highlight the potential for innovation in focusing on this consumer group.

A kettle which monitors blood pressure
TV ‘buddies’ to allow people to remotely share the experience of watching a programme
A ‘cuddle cushion’ which would allow relatives being able to send each other cuddles
A smart water bottle which would prompt people to drink more to prevent dehydration
Accessible and modern ‘Boris Scooters’ (or Segways) in towns and cities to help people with mild mobility impairments get around
̽��ֱ��development of national ‘trusted information’ systems for online and telephone transactions to reduce the risk of scams

“This report champions the positive impact that technology and design will play in helping us all to live longer, healthier, independent lives. However, we acknowledge that the potential of technology has not been fully realised. We also have to dispel the myth that this is simply a matter of niche solutions for an ageing society,” said Gordon Attenborough, the Institution of Engineering and Technology’s Head of Sectors.

“There’s so much more that we should achieve through the widespread application of existing and emerging technologies. It’s vital that we design and innovate with a broad range of users in mind, wholly inclusive and accessible to all. Achieve that and technology will mitigate the impending costs of an ageing society and deliver the promise it has failed to so far.

David Sinclair, Director of the International Longevity Centre – UK added: “Technology undoubtedly offers significant potential to help respond to the challenges of ageing. But the opportunity of technological innovation in this area has historically been over egged and under realised. For us to maximise the potential of new technologies however we need more evidence on what really works and whether it will save money. We need regulation which protects consumers while not preventing technological innovation. And we need industry to recognise the potential of the older consumer and design for all. Finally, we need a public debate on the challenges and opportunities of using big data to improve the lives of older people.”

Professor John Clarkson, Director of the Engineering Design Centre at Cambridge: “This report highlights that there is a huge commercial opportunity for companies to design inclusively, driving increased customer satisfaction and boosting their market share by delivering more competitive products and services.”

̽��ֱ��report also highlights some ideas to maximise the potential of the sharing economy to support our ageing society.

Cooking buddies

A barcode scanner in the home could be used to upload the contents of your fridge to an interface which would share the information with your neighbours. Taking a peek in to each other’s fridges, seeing what people had a surplus of or what was about to go out of date, could encourage neighbours to cook together making meal times more sociable.

Integrated leisure and transport

Leisure activities, such as a trip to the theatre or to a restaurant, could come with transport included. When you book a ticket there could be the option to also book transport. If a large number of people were also booking transport to an event a mini-bus could then be sent to collect them all at a much lower costs than them all booking taxis separately.

Adapted from a ILC-UK press release.

New report urges government and designers to work together to break down the barriers to innovation in order to adapt to an ageing population.

Technological innovation is vital to help individuals and society as a whole adapt to ageing

Mike Bradley

Emanuele Toscano

Generations

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