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Development and validation of a prognostic model to predict relapse in adults with remitted depression in primary care: secondary analysis of pooled individual participant data from multiple studies
No full textBackground Relapse of depression is common and contributes to the overall associated morbidity and burden. We lack evidence-based tools to estimate an individual’s risk of relapse after treatment in primary care, which may help us more effectively target relapse prevention.
Objective The objective was to develop and validate a prognostic model to predict risk of relapse of depression in primary care.
Methods Multilevel logistic regression models were developed, using individual participant data from seven primary care-based studies (n=1244), to predict relapse of depression. The model was internally validated using bootstrapping, and generalisability was explored using internal–external cross-validation.
Findings Residual depressive symptoms (OR: 1.13 (95% CI: 1.07 to 1.20), p<0.001) and baseline depression severity (OR: 1.07 (1.04 to 1.11), p<0.001) were associated with relapse. The validated model had low discrimination (C-statistic 0.60 (0.55–0.65)) and miscalibration concerns (calibration slope 0.81 (0.31–1.31)). On secondary analysis, being in a relationship was associated with reduced risk of relapse (OR: 0.43 (0.28–0.67), p<0.001); this remained statistically significant after correction for multiple significance testing.
Conclusions We could not predict risk of depression relapse with sufficient accuracy in primary care data, using routinely recorded measures. Relationship status warrants further research to explore its role as a prognostic factor for relapse.
Clinical implications Until we can accurately stratify patients according to risk of relapse, a universal approach to relapse prevention may be most beneficial, either during acute-phase treatment or post remission. Where possible, this could be guided by the presence or absence of known prognostic factors (eg, residual depressive symptoms) and targeted towards these.publishedVersio
Kvifor blir det som det blir? Ei utstilling med utgangspunkt i det å teikne med tråd
No full textI januar og februar 2024 hadde eg ei utstilling i biblioteket ved Høgskulen på Vestlandet - Campus Sogndal. Utstillinga bar tittelen Kvifor blir det som det blir? Dette er ein del av forskingsspørsmålet som eg har arbeidd med dei tre siste år i samband med det å teikne med tråd: Kvifor gjer eg som eg gjer? Kvifor blir det som det blir? Under prosessen med arbeida har eg reflektert mykje over kvifor eg gjer som eg gjer, og i utstillinga kjendest det naturleg å stå att med siste delen av forskingsspørsmålet: Kvifor blir det som det blir? Framleis er eg i ein prosess, men utstillinga og refleksjon kring den er ein måte å samle trådane på. Eg ser på det som eit vegkryss der eg prøver å få oversikt før vegen går vidare.KFF 202
«Det handlar om å lære seg å bruke det» - Om djupnelæring i grunnskulefaget kunst og handverk
No full textDjupnelæring har fått ei sentral rolle i nyare norske skulepolitiske dokument. Denne artikkelen ser på djupnelæringsomgrepet i Læreplanverket Kunnskapsløftet 2020 (LK20) i grunnskulefaget kunst og handverk (KH) og kjerneelementet handverksferdigheiter. Undersøkinga bygger på eitt kasus frå 5. trinn og rettar eit særskilt søkelys mot korleis lærarar forstår djupnelæring i KH, og kva dei legg vekt på i undervisinga i faget. Data for analysen er intervju med tre lærarar, i tillegg til deltakande observasjon av 14 doble undervisingsøkter. Resultat av konvensjonell innhaldsanalyse viser at lærarane signaliserer usikkerheit når dei snakkar om å kunne måla djupnelæring hjå eleven. Ein stor grad av skjønn vert nytta for å fylle eit uavklart djupnelæringsomgrep i læreplanen generelt og KH spesielt. Lærarane rapporterer ikkje i særleg grad endra praksis som resultat av det retningsgjevande djupnelæringsomgrepet i LK20. I staden knyter dei tolkinga av djupnelæring direkte til læringa som allereie ligg i praktisk, skapande arbeid i verkstad. Det er behov for ein vidare diskusjon i fagmiljøet og meir empirisk forsking om djupnelæring i KH.publishedVersio
The effects of the perception of corruption on public trust in government in Africa: a comparative analysis
No full textThis study examines the effects of corruption on public trust in government in Africa atvarious levels and explores variations across stable and fragile states. This study usesAfrobarometer data collected from households in 2019 to understand whether this linkexists. Using ordered logit analysis and marginal effects, the study reveals that corruptionsignificantly diminishes trust in government. High levels of corruption in the presidency,parliament, and local government are all associated with declining levels of trust. Thiscorruption extends to judges, magistrate courts, religious, and traditional leaderssuspected of corruption, who are expected to uphold ethical standards. Corruption in theoffice of the president reduces trust in the president, parliament, and local governments,while corruption in parliament decreases trust in parliament and local governments. Localgovernment corruption impacts trust at the local level. Despite a high level of corruptionin stable states, corruption in the local government is not responsive to public trust. Thesensitivity of corruption to trust in the government is more pronounced in fragile statesthan in stable states. This study illustrates the pressing need to combat corruption andrebuild trust in governments. The findings highlight the need for context-specific anti-corruption strategies and policy interventionspublishedVersio
The long and icy journey of Mesozoic marine reptile vertebrae from northern Germany, their provenance and internal structures
No full textMesozoic vertebrate fossils within glacially transported deposits of Pleistocene age are rare. Here, we examine five isolated, strongly eroded vertebrae of Mesozoic marine reptiles, most probably plesiosaurs, from glacigenic sediments of northern Germany. In addition, three consecutive plesiosaur vertebrae, having already been described in previous publications, are briefly reconsidered. For one heavily eroded specimen, litho- and biostratigraphical analyses of associated sediment, including thin sectioning and calcareous nannofossil investigations, confirm a mid-Cretaceous age. The internal morphology of the five isolated vertebrae in focus, investigated with the help of microCT, reveals the presence of (neuro)vascular cavities within the respective centra. Unexpectedly, we found diverse internal cavity patterns which have only one feature in common: a medial pair of foramina on the floor of the neural canal that is connected to deep-reaching canals.publishedVersio
Perceptions and Experiences of Adult Children of Parents and Carers with Alcohol-Related Problems in Botswana: The Coexistence of Resilience and Resemblance
No full textThis study explores the resilience and resemblance among children of parents with alcohol-related problems in Botswana. Alcohol misuse affects both users and their families, particularly children. Although children raised in an alcoholic environment often face long-term adversities, some become resilient adults while others present behaviours resembling those of their parents. This study used socio-ecological resilience theory to explore the perceptions and experiences of adult children of parents and carers with alcohol-related problems, as well as the pathways they use to navigate risks. We collected data from seven adult children in a village in Botswana using in-depth, unstructured interviews. The study revealed two global themes: familial practices and protective factors. The vulnerability, resemblance, and resilience experienced by adult children of parents with alcohol-related problems are discussed. This study helps us to understand the adult children of parents and carers with alcohol-related problems in a rural cultural context. Their lived experiences demonstrate that resilience and resemblance coexist and are not mutually exclusive.publishedVersio
A qualitative exploration of the coping strategies of UK ethnic minority healthcare workers during the COVID-19 pandemic
No full textPurpose
There is a dearth of empirical evidence on the coping strategies of UK ethnic minority (UKEM) healthcare workers during the coronavirus disease 2019 (COVID-19) pandemic despite evidence of their increased risk of infection and less protection, disproportionate redeployment, and gross work-life imbalance. The present study explored UKEM healthcare workers’ coping strategies during the COVID-19 pandemic.
Methods
A qualitative design comprising individual and joint interviews, and a focus group was used. Participants were 15 UKEM healthcare workers (11 females; age range: 26–58 [43.3 ± 9.4] years). Data were analyzed using thematic analysis.
Results
Participants navigated the pandemic using three key coping strategies: problem-focused coping (active and restraint coping), emotion-focused coping (positive reframing, reflective acceptance, and religiosity/spiritual bypass), and social coping and support-seeking. They particularly underscored the importance of religiosity/spiritual bypass as a coping strategy.
Conclusion
The pandemic challenged our sample of UKEM healthcare workers to deploy a variety of coping strategies. Religiosity/spiritual bypass was particularly important in navigating the challenges of the pandemic. Coping strategy enhancement interventions among UKEM healthcare workers and the UKEM community during and post hyper-precarious conditions such as pandemics may benefit from targeting the identified coping strategies.publishedVersio
Perceptions and Use of AI Chatbots among Students in Higher Education: A Scoping Review of Empirical Studies
No full textWith the recent arrival of publicly available AI chatbots like ChatGPT, Copilot, Gemini, and Claude follows a need for knowledge about how students in higher education perceive and use these tools, and what this might mean for their learning processes. This scoping review analyzes 24 empirical articles published between 1 January 2022 and 5 September 2023 on students’ perceptions and use of AI chatbots in higher education. The articles were reviewed using a five-stage scoping review methodology. The findings underscore a global research interest in how students engage with AI chatbots, which is especially pronounced in Asia. The studies span diverse disciplines, with a predominance in science, technology, engineering, and mathematics disciplines. The empirical findings reveal that students perceive AI chatbots as highly useful and motivating as personal task assistants and for getting immediate feedback and help with writing, coding, and academic tasks. However, students are concerned about the accuracy and reliability of the responses from the chatbots, as well as potential negative impacts on their learning processes, critical thinking, discipline, and creativity. The purpose-driven use of AI chatbots among students and their potentially positive influence on motivation and learning processes offer insights for educators and policymakers. Our research concludes that while positive attitudes, perceptions, and critical use prevail, addressing students’ concerns is crucial for responsible AI integration in higher education.publishedVersio
Cross-sectional exploratory survey among health researchers in Europe on the awareness of and barriers affecting the use of an evidence-based research approach
No full textObjectives This exploratory study was conducted to find out how well the concept of evidence-based research (EBR) is known among European health researchers with substantial clinical research experience, and which barriers affect the use of an EBR approach. The concept of EBR implies that researchers use evidence synthesis to justify new studies and to inform their design. Design A cross-sectional exploratory survey study. Setting and participants The survey was conducted among European health researchers. Respondents included 205 health researchers (physicians, nurses, dentists, allied health researchers and members of other professions involved in health research) with a doctoral degree or at least 5 years of research experience. Primary and secondary outcome measures The primary outcome measures were the level of awareness of the concept of EBR and the presence of barriers affecting the use of an EBR approach. Secondary outcome measures include correlations between sociodemographic characteristics (eg, profession) and awareness of EBR. Results We discovered that 84.4% of the respondents initially indicated their awareness of the concept of EBR. Nevertheless, 22.5% of them concluded that, on reading the definition, they either do not know or do not fully comprehend the concept of EBR. The main barriers affecting the use of an EBR approach were related to organisational issues, such as not being attributed resources (30.5% of the respondents), time (24.8%) or access to implement it (14.9%). Conclusions Despite the limitations, this study clearly shows that ongoing initiatives are necessary to raise awareness about the importance of implementing the EBR approach in health research. This paper contributes to a discussion of the issues that obstruct the implementation of the EBR approach and potential solutions to overcome these issues, such as improving the knowledge and skills necessary to practice the EBR approach.publishedVersio