Month: July 2015

Week 3 at the Royal Hospital for Neuro-disability

Scientists from all walks of life will likely be familiar with the concept of known unknowns and unknown unknowns. I believe these two phrases can be considered synonyms for research. I started this week with a set of known unknowns; research avenues to pursue given where I thought I could gain information to aid the development of the wheelchair seat prescription device I mentioned in my last post. By the end of this week, after travelling through link after link online and receiving a ton of leads from discussions with hospital staff, this project has gained more facets than it started with. It turns out there are far more unknown unknowns than known unknowns in this project!

It started with a simple question: ‘This hospital has developed a system for creating wheelchair seats. Surely other institutions have developed their own systems?’ Yes they have. In fact, research around the problem of pressure sores in wheelchair-bound patients I mentioned in my last post has been going on since at least the early 1970s. Even more interestingly, the processes still in use by the Royal Hospital for Neuro-disability (RHN) were first outlined over 30 years ago in several of these research papers. While carving the seat from a foam block remains a widely used technique, more radical solutions have been offered in the last few decades. One example builds the seat from a matrix of linked ball-and-socket joints that are infinitely configurable and can be easily adjusted as the patient’s condition and posture develops. Another example creates the seat by pouring a liquid into a bag on which the patient is then seated, that dries and expands into a foam. These newer solutions all have their benefits and flaws. While being infinitely configurable, the ball-and-socket joints in the first example can loosen with time, disrupting the initial shape that perfectly suited the patient. While the second example possibly creates a more accurate mould, it is a labour-intensive process which can easily go wrong.

matrixseating
A complete configurable seat made from a matrix of ball-and-socket joints. Image courtesy of MatrixSeating
SunMate FIPS
How to make a complete seat using the Liquid SunMate Foam In-Place Seating product, where the foam starts as a liquid which is poured into bag taking the patient’s shape. Image courtesy of Dynamic Systems Inc.

The question of how to create the seat quickly and efficiently is only half the problem. As was the topic of my last post, a seat for a typical RHN patient serves two main purposes; to maintain their posture and distribute their body weight correctly over the seat to prevent pressure sores. The solutions mentioned above all aim to address these requirements. However my discussions with hospital staff have revealed that the way wheelchairs are typically used in rehabilitation hospitals presents a fresh set of design considerations which the designers may never have foreseen – the unknown unknowns if you will. This includes how the seats will respond to slings being left between the patient and the seat, and the effect of adult nappies on the pressure distribution. At the same time, my forays into research papers on the topic of pressure distribution have suggested that there is more to the topic than meets the eye, and certainly more than the aforementioned seat solutions seem to account for. I can’t say I’ve yet come to any strong conclusions on the matter myself!

My research into these considerations using predominantly academic papers will continue into the fourth week in order to create as well-rounded a design solution as possible, whether it be for a permanent seat or a seat prescription device.

Halfway with Asha

It’s now been two weeks and they’ve flown past! While by no means an expert, I can safely say I understand the issue of youth unemployment in much more depth now. Over the past week, I have been working on my mini-project which has now been confirmed.

Before comparing projects, it is important to finalise the criteria that will be used; they vary widely and can often be hard to measure. Prior to my involvement in the project, the team had created an Excel spreadsheet which brought the criteria together from different research papers. For my mini-project, I am going through these papers again and contextualising the criteria; this involves summarising the paper, focusing on the challenges faced by India in particular, and creating a model which can be used to compare projects. Here is an example:

Analysis Framework

 

Taken from one of the papers I have been reading, it gives the flowchart of a typical intervention that aims to deal with youth unemployment. This particular one focuses on TVETs – Technical Vocational Education and Training programs. A suitable criteria could be based on inputs (time invested, financial cost etc.) or outputs (skills gained by beneficiary, their salary etc.). The difference between outputs (which are individual to the beneficiary) and outcomes (which are large-scale changes, such as productivity of the company or rate of unemployment) is important when choosing criteria for success. I am currently working on a framework which outlines what my project report will cover. I will then start writing the report, aiming to finish it next week so I can get feedback and improve it before a final submission in week four.

Finally, to finish off, I just wanted to emphasise the importance of context in the papers I have been reading. This statistic highlights it particularly well:

  • “ITCs spend 61.2% of their expenditure on staff“.
  • “ITIs spend 92.1% of their expenditure on staff”.

ITIs and ITCs are institutions that are involved in running the TVET program, with the key difference being source of funding – ITIs are funded (at least partially) by the Government whereas ITCs are private institutions. As the author goes on to mention, this seems to imply that ITCs are more efficient with their allocated budget. However, the reality is that ITCs are often understaffed and employ teachers who lack training – naturally this leads to lower salaries and a lower spending on staff for ITCs. This simple difference can skew the comparison significantly, leading to a biased and unfair representation of the programs. This is a systematic error that needs to be dealt with before project comparison begins – and it is one which I am helping to solve!

Sponsorships

For the past week, my work has been based around obtaining sponsorship, big and small, for general operation and the annual dinner.

As London Tigers is a sports-based charity, I made a list of companies that were sports or fitness related and had some kind of donation request form on their websites or accepted sponsorship proposals. The sports based organisations included brands such as Umbro, Lucozade and Nike to name a few. For these companies, the application was relatively shorter with more simple online forms asking whether we were asking for cash or product, what it was going to be used for and how the company would benefit. These were good to start off with and practise proposals with as it gave me an idea of what I would need to include in a sponsorship proposal I would have to do from scratch.

Picture1

 

Using experience from form-filling out to 5 companies, I came across a major airline that dedicated a lot of online space for organisations after their sponsorship. Many of the websites I came across earlier stated that they did not accept unsolicited proposals so it took some time to find any that did. This airline application not only required a proposal in the form of a Powerpoint, an official letter to accompany it, up to 3 more attachments AND an extensive application form. It took some time to complete all of it and to decide what to apply for – the Sports Complex or the Annual Awards? Or both? Even though this application/proposal was time-consuming to compile, it was an excellent experience.

CDP- Introduction and first days

After a couple of weeks here at CDP I thought it was about time to give a summary of the work done by CDP and what I’ve been up to since the start of July.

CDP (previously known as the Carbon Disclosure Project) are a global environmental non-profit organisation, whose goal is to increase transparency of environmental effects of companies and change the behaviours of companies for the better in three key areas: Carbon emissions, Water usage and Deforestation. CDP do this by asking companies to perform self assessments and disclose emissions and usage data by responding to CDP’s annual questionnaires on Water, Climate Change and Deforestation. During my internship I am working in the Water team, a small core team of 4 permanent staff where the focus currently is the production of this years ‘Global Water Report’, which summarises the results of the water questionnaire companies have responded to. My role is to write case studies on companies responses to different questions, finding the companies that have demonstrated the ‘best practice’ in terms of their awareness and response to water related issues, as well as (try to) make cool graphs and think about interesting ways to represent the vast amount of data that has been collected over the last 5 years of the water program. The first iteration of the CDP Water website, illustrating the results from last year’s report can be found here: http://globalwaterresults.cdp.net/

microsite screenshot

 

Screenshot image of the CDP water results site (link above).

CDP is able to gain responses from the biggest companies in the world such as Coca-Cola, Unilever and Volkswagen because it has the backing of several hundred investors who hold trillions of dollars in assets. Money talks and the hope is that companies will change their ways a lot quicker when responding to the requests of investors. Personally, I wish that the impetus for change wasn’t the fear of economic losses but rather the social and environmental benefit to the world. However the truth is that a large proportion of companies are simply unaware of the environmental risks they face and the damages they can and do cause, and often responding to CDP, even if only because of a direct request from investors, is a first step along the journey towards sustainable development. This is a very different kind of environmental organisation to those I have been used to seeing on the news such as Greenpeace. The approach here is much more of a friendly coercion of companies when compared to the the more confrontational approach we see more often in the headlines. I believe both approaches have their own merits. There is a clear desire here to build momentum in the run up to the UN Climate Change Conference in Paris this December. With the 2015 Global Water report launching in October, CDP has the opportunity to show that progress as well as the intent to use water responsibly and sustainably exists in the corporate world and that CDP can guide those companies who may be lagging behind towards sustainability.

Something that is immediately clear here at CDP is that the people are genuinely passionate and believe in their work which is breeds a productive and spirited atmosphere. Other first impressions are that this is a very welcoming, friendly and collaborative workplace, with lots of small teams often working together, blurring the lines of segregation between departments which is pleasant to be a part of. The office is located next to St. Katharine Docks near Tower Bridge, which is a lovely place to work and not too bad to commute to from South East London, as it is 10 minute walk from Wapping on the Overground. There are also several Imperial alumni here, most of whom graduated through the Masters in Environmental Technology, which is good for networking if you’re into that kind of thing.

st k docks

(Image from  http://www.visitlondon.com/things-to-do/place/3876714-st-katharine-docks)

The CDP office is one of the tall buildings to the right of centre in the background.

Over the next few weeks I will continue to work on case studies and learn more about the structure of this years report as well as some of the other operations of the organisation. I’ll keep you updated in further posts as well as explaining a bit more about the importance of water (cue cool infographics).

Nathan

Week 2 at the Royal Hospital for Neuro-disability

It is often the case with many a soap opera episode that the opening story leads on to a bigger issue that takes up the remaining time of the episode before reaching resolution at the end.

My Charity Insights project, much like many a research project, is beginning to resemble such an episode. The problems with current wheelchairs as identified at the outset have swiftly revealed a deeply related and possibly more fundamental issue with wheelchairs. The seat, the undeniably most important wheelchair component, is fundamentally flawed.

It’s a problem rehabilitation hospitals and companies alike have been trying to solve for decades. How do you design a seat that is applicable to the widest spectrum of users? Current wheelchair seats range from the very basic foldable fabric sling seat used predominantly by people unable to walk but able to use their upper body and arms, to the carer-propelled custom-moulded foam seat used almost everywhere at the Royal Hospital for Neuro-disability (RHN). Between those options there is a plethora of seat designs incorporating space age hydrophobic covers and countless repositionable cushion pads. Each has their pros and cons. The question is what factors are you trying to maximise and minimise for a particular patient?

'Chair 4 Life' electric wheelchair design, courtesy of Renfrew Group
One of the more high-tech designs: ‘Chair 4 Life’ electric wheelchair design for children. Image courtesy of Renfrew Group.

In the case of the patients cared for by the RHN, there are two important functions the seat must serve. The first is that the seat must maintain the patient’s correct posture as in most cases they do not have the ability to maintain that correct posture on their own. The second function is inseparable from the first and attempts to solve a problem able-bodied people will likely never have.

Consider a wooden park bench and a padded armchair. Which would you rather spend 3 hours sitting on non-stop? I would hope you would find the armchair more comfortable, and the reason is fairly obvious. It’s not simply that the armchair is softer. Instead, it deforms to spread your weight more evenly over your rear and back, while a flat hard bench doesn’t deform at all and creates pressure points over the bony areas of your rear. The result is that you will find yourself shifting around on the bench more often than on the armchair to move the maximum pressure point away from the part that is aching.

Seat Pressue Map
Pressure Mapping using a flexible sheet embedded with an array of electronic pressure sensors, placed between the patient and the seat, is a good way to assess the pressure distribution on a seat. The red areas signify the points of highest pressure while dark blue areas signify the lowest pressure points. Image courtesy of Herman Miller.

Now consider this. A wheelchair patient at the RHN remains seated for around 3 hours between rests, when they are hoisted out of their wheelchair and onto a bed perhaps. A flat hard wheelchair seat will be more than just unconformable after a while. Alongside excess moisture and friction, prolonged high pressure over a particular part of the body results in the development of a pressure sore over that area, which can take months to heal. For patients who are unable to shift themselves in their seat, the current solution is to spread the weight as evenly over their body as possible by moulding a seat that is unique to that patient’s body. Even this design has limitations as it is only effective when the patient remains perfectly still all the time. There will always be some movement, even if it is as simple as the patient sliding downwards a little. The majority of high-end wheelchairs feature a tilting mechanism that allow the entire seat to pivot, relieving the posterior from carrying the entirety of the patient’s weight, and instead placing some of it on the back.

Tilting wheelchair
The tilting mechanism on high-end wheelchairs redsitributes the patient’s weight more over their back. Image courtesy of MobilityBasics.ca

My main aim this week was to find out more about this seat problem, the current solutions and possible solutions for the future. This has involved a close examination of the current seat moulding method used at the hospital, and an investigation into alternative techniques. The aim is to develop a universally applicable device that can be used to prescribe a more effective seat design that better distributes the patient’s weight and is more versatile to changes in the patient’s body as their condition develops.

I have a lot of research paper digging to do!

An Introduction to Asha for Education

“Socio-economic equality through the education of underprivileged children” – This is the grand aim of Asha for Education, my host charity for the Insights scheme this summer. It has over 66 offices worldwide, running more than 300 projects in India to help improve the literacy levels of the poorest in society. The majority of the international ‘chapters’, as they are called, are responsible for fundraising. However as part of my internship, I am involved with the project analytics side of things.

With over 300 projects, some are bound to under-perform. On the other hand, there will be lots of projects that achieve their aims and make a difference in society. Part of my task is to analyse and compare different projects and come to a judgement about the reason for the outcome. The lessons that can be learned from one successful project can then be applied to other struggling ones. To narrow the field of projects, I spent the first week getting to know my target area well – youth unemployment projects.

Demographics China and India

This is the problem I am helping to solve. The graph on the left shows the population demographics for China, with male in blue and female in orange; the graph on the right shows the same for India. China, over the last few decades, had a transition from right to left. This signifies an increase in the workforce (the population aged 15 to 59) and resulted in economic growth and improvement in standards of living for much of the population. To take advantage of this, policies need to be implemented to combat youth illiteracy and unemployment, something which India is yet to do. It is expected that India’s demographics will mirror those of China’s by 2040, giving the country about 25 years to take advantage of this demographic dividend. Asha has many projects which help with this, especially targeting disadvantaged and underprivileged youth.

In the first week, I have mainly been reading up on the background of the situation. This is key to understanding the impact that the projects are having in their rural communities. In addition, the analysis has already been going for about 6 months; I have the remainder of the week to look over the data that has been collected so far. This will prepare me well to start my own mini-project next week, finishing off with a report on my findings. I look forward to completing that by the end of the month!

Second Set of Stripes

Week 1-2

Pitch Side Banners

IMG_3891 spikes april 2014 1

In June 2014, London Tigers Sports Complex was opened – a £2.2m state of the art facility which offers training, sports, youth, intergenerational and community facilities. As the centre of all of London Tigers’ sporting activities, it is home to:

  • 2 tennis courts
  • 2 cricket pitches
  • 3 lane cricket nets
  • 11-a-side artificial grass football pitch
  • Athletics running track

The park sees over 600 people pass through the complex daily and during summer it sees up to 1000 people per day. One of the ways in which the organisation could make use of these facilities and generate an additional income, is by displaying banners on the pitch side which local businesses could advertise on.  The sports complex facilities are available for hire so this location is great for attracting not only pedestrians passing through to Southall Broadway, but visitors from across London.

Using my trusty aide Google, I compiled list of local businesses, franchises and banks to approach in relation to the pitch side banners. For each one, made a contact sheet with the relevant person’s details. I then wrote a specific proposal letter in relation to just the banners, which could be emailed as a follow-up to somebody after the initial phone call.

Annual Achievement Awards

This will be held in October 2015 and aims to recognise the achievements of the young people from the past year. For it to be able to take place, we need to secure both corporate and small businesses as sponsors. Whilst looking at local businesses for the pitch side banners, I made a separate list of potential sponsors for the Awards Dinner. This included local supermarkets.

I also put together a Sponsorship Package as a PDF that could be either emailed or printed so that businesses have the flexibility in how they choose to support us.

 

Week 1 at the Royal Hospital for Neuro-disability

If you’re reading this as a fellow engineer, I have a challenge for you. Strike up a debate with a doctor about which of your two professions is best, and I guarantee you that the doctor will rebut with the indisputable repost: ‘the human body is the ultimate engineering’. Try and counter that one!

This is exactly the realm I entered upon starting my first day at the Royal Hospital for Neuro-disability for my Charity Insights placement this summer. I received several slightly surprised looks as I introduced myself not as a medical student eager to delve into the world of neuroscience, but as a student of mechanical engineering with no inclination to becoming a doctor. A valid question arises; what am I doing in a hospital?

As the name implies, this is not your typical multi-purpose hospital. It was established over 160 years ago as a service ‘to give permanent relief to such persons as are hopelessly disqualified for the duties of life, by disease, accident or deformity’. Today its beautiful 18th century buildings remain and it cares for hundreds of patients suffering from a variety of severe neurological diseases. Its most important motive is ‘Finding Ability in Disability’, and that’s where I come in.

My task during the placement is to examine the current design and prescription of wheelchairs for hospital patients, and investigate new designs and processes that more effectively meet the patients’ needs.

My first day began with a tour of the hospital and its facilities by the Principal Medical Officer and the Associate Director of the Institute. They demonstrated how several currently used wheelchairs work and pointed out what they had gathered about their design flaws. Due to the unique requirements of many of the patients, some of the components of the standard wheelchairs had been replaced with parts custom designed and built at the hospital. Even these bespoke components needed improving in several ways. I was introduced to the biomedical engineering staff at the hospital and shown around the on-site workshop they use to manufacture parts.

A typical carer-propelled bespoke wheelchair including moulded foam seat and seat tilting mechanism
A typical carer-propelled bespoke wheelchair including moulded foam seat and seat tilting mechanism
A simpler wheelchair design with standard seat and manual self-propulsion using large wheels with grips
A simpler wheelchair design with standard seat and manual self-propulsion using large wheels with grips

Much of the remainder of the week involved getting up to speed with the latest developments in wheelchair design and outlining the improvements that can be made to existing designs as well as exploring fresh ideas. I look forward to seeing what path the research takes!