Dexterous helical magnetic robot for improved endovascular access

Treating vascular diseases in the brain requires access to the affected region inside the body. This is usually accomplished through a minimally invasive technique that involves the use of long, thin devices, such as wires and tubes, that are manually maneuvered by a clinician within the bloodstream. By pushing, pulling, and twisting, these devices are navigated through the tortuous pathways of the blood vessels. The outcome of the procedure heavily relies on the clinician's skill and the device's ability to navigate to the affected target region in the bloodstream, which is often inhibited by tortuous blood vessels. Sharp turns require high flexibility, but this flexibility inhibits translation of proximal insertion to distal tip advancement. We present a highly dexterous, magnetically steered continuum robot that overcomes pushability limitations through rotation. A helical protrusion on the device's surface engages with the vessel wall and translates rotation to forward motion at every point of contact. An articulating magnetic tip allows for active steerability, enabling navigation from the aortic arch to millimeter-sized arteries of the brain. The effectiveness of the magnetic continuum robot has been demonstrated through successful navigation in models of the human vasculature and in blood vessels of a live pig.

'They only smoke in the house when I'm not in': understanding the limited effectiveness of a smoke-free homes intervention

Background

Children’s second-hand smoke (SHS) exposure in the home is highest in socio-economically disadvantaged areas. Personalized household air-quality measurements can promote changes in smoking that reduce SHS exposure. The ‘First Steps 2 Smoke-free’ (FS2SF) intervention is the first to trial this approach delivered as part of health professionals’ routine work. This paper reports the findings of qualitative interviews with participants that explored their experiences of the intervention and why outcomes varied.

Methods

120 women were recruited from the NHS First Steps Programme, which supports disadvantaged mothers. They received either personalized feedback on their home air quality and advice on reducing SHS or standard SHS advice. Qualitative interviews with 15 mothers were analyzed thematically using the Capability, Opportunity, Motivation, Behaviour (COM-B) model.

Results

The intervention increased women’s capability to change home-smoking behaviour, through increasing awareness and salience of SHS risks to their children, and motivation to act. However, taking effective action was constrained by their limited social and environmental opportunities, including others’ smoking in the home.

Conclusions

The FS2SF intervention was ineffective as it was unable to fully address the precarious, complex life circumstances that make creating a smoke-free home particularly difficult for women experiencing intersecting dimensions of disadvantage.

Mother and teacher reports of behaviour and perceived self-competence of children with hydrocephalus

The present study was designed to explore the social and behavioural functioning of children with hydrocephalus. The sample comprised 14 children with hydrocephalus (without spina bifida) and 14 controls with no history of neurological impairment matched for age and gender. Children were asked to report on their self-perceptions of academic and physical competence and on peer and maternal acceptance. In addition, mothers and teachers provided reports of the behavioural adjustment of both groups and mothers completed a questionnaire measuring locus of control orientation. Mothers of children with hydrocephalus also responded to a series of open-ended questions, their thoughts and feelings about the experience of having a child with hydrocephalus. Analyses of the data revealed that there was no difference in the self-perceptions of the two groups of children, although there was a trend for children with hydrocephalus to rate themselves as being lower in physical competence. There was a clear association between the presence of hydrocephalus and behaviour problems, with evidence of internalising and externalising problems being evident in the reports of both mothers and teachers, although the extent of agreement between the two informants was low. Maternal locus of control was related to behaviour problems in children with hydrocephalus, with a more external orientation being related to more behaviour problems. It is suggested that future researchers need to 1) focus on children's behaviour in context, 2) solicit data from a range of informants and 3) consider the complex transactions between biological and psychological factors to gain a fuller understanding of how hydrocephalus shapes children's development.