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Effective healthcare communication with children and young people:a systematic review of barriers and facilitators
No full textObjective: To identify children and young people's preferences for effective healthcare communication.Design: A systematic review of qualitative studies was conducted to identify evidence from children and young people on effective healthcare communication. Electronic databases and reference lists of relevant articles were searched to July 2020.Results: A total of 13 studies were included. Five major themes were identified: medical information (timing, amount, coordination and futures), person not patient (creating relationships, time, nurse involvement, sensitivity), type of communication (creative and interactive, behavioural, talking and listening, written communication), consultations (first impressions, with and without parents, actively promoting involvement, open and honest, age appropriate) and communication with parents (using parental knowledge, support).Conclusions: Research in this area remains sparse and consistent implementation is debateable. Children and young people articulate a preference for two-way healthcare communication. General principles for effective communication are identified as well as the need to avoid making assumptions and to tailor approaches to individuals. Establishing and maintaining relationships is essential and requires time and resources. Parents and carers have a positive role in healthcare communication which needs to be balanced with the needs and rights of children. All these factors also apply to children with communication difficulties or from marginalised groups, but additional extra support may be required.PROSPERO registration number: CRD42019145539.</p
A Pedagogy of Convivência Exploring the Potência of Individual and Collective Subjectivity in Brazilian Peripheries
No full textThis chapter brings together a set of concepts that have been elaborated over more than two decades as part of a process of political-intellectual engagement with peripheral territories and people in Brazil. These reflections take place, mostly, from the Metropolitan Region of Rio de Janeiro, where several studies and actions took place since the creation of the NGOs Observatório de Favelas, in 2001, and, later, UNIPeriferias (also known as Institute Maria and João Aleixo), in 2017. Both organizations, in which the authors of this chapter have influential roles, propose alternative projects to address social justice and human dignity based on the perspective of favelas and other peripheral territories. Such a vision was underpinned by the recognition and valorization of social, aesthetic, cultural, and epistemological references elaborated from peripheries. This involved a strong emphasis on the creation of mechanisms to promote the intellectual production and influence of peripheral groups in public arenas and policymaking. In the making of this intellectual and political process, three core concepts emerged: peripheries, potência, and convivência. The chapter will articulate these concepts to provide our interpretation of subjectivities at the margins. We acknowledge the need to contextualize these concepts and provide some cultural translations for an international audience. We also acknowledge the relevance for such concepts to be resignified beyond the context in which they were produced, by promoting an international dialogue with scholars interested in the peripheries and the margins of urban sociocultural and political landscapes
Managing masculinity when growing up with a violent father:A qualitative study of boys’ experiences
Get PDFA limited qualitative literature explores children's lived experiences of violence; boys’ relationships with perpetrator fathers remain largely unexplored. Drawing on interviews with 31 boys, this paper explores the accounts of their relationships with their perpetrator fathers, focusing particularly on the implications of boys’ understanding of these relationships for their sense of burgeoning masculinity. Three themes are considered: in (a) relational ambiguity; (b) performing masculinities, managing violence; and (c) envisioning alternative futures and re-visioning the past. Our findings highlight the importance of interventions for boys that facilitate the expression of their often complex and ambivalent feelings and fears about their father's violence, and what it means for them and their future.</p
Assessment of the Enhanced Paper Grip Test for Quantifying Balance Deficits in People with Multiple Sclerosis:A Reliability and Applicability Study
No full textThis study assessed the reliability and applicability of the Enhanced Paper Grip Test (EPGT) for quantifying balance deficits in people with multiple sclerosis (MS). Thirty individuals with MS (mean age: 41.9 ± 9.66 years, mean Expanded Disability Status Scale (EDSS) score: 2.13 ± 0.94; mean disease duration: 8.3 ± 6.0 years) were recruited. The EPGT demonstrated excellent intra-visit reliability, with intraclass correlation coefficients (ICC) of 0.96 (95 % CI: 0.93–0.98) for the weaker side and 0.94 (95 % CI: 0.89–0.97) for the stronger side. Inter-visit reliability, assessed in 15 participants, also showed excellent ICCs (0.97–0.99), with coefficients of variation ranging from 4.23 % to 5.50 %. Additionally, high and statistically significant correlations were observed between EPGT performance and balance, as assessed by the modified Mini-BESTest (r = 0.81–0.87, p < 0.001). Small but statistically significant correlations were found between EPGT results and EDSS scores (r = −0.36 to −0.38, p < 0.05). These findings suggest that the EPGT can reliably assess foot/ankle strength and identify balance deficits in people with MS, with potential clinical application for monitoring disease progression and guiding rehabilitation interventions.</p
Embedding Learning as a Practice of Value:Learning from the Experiences of Early Career Social Workers in Scotland
No full textAcross the Global North, professional learning for social workers has become a matter of concern. Efforts to ‘fix’ the problem have focused narrowly on formal methods of learning and show limited connect with recent research. In this article, we report on findings from a mixed-method longitudinal cohort study, which examined early career social workers experiences of learning over the first five years of professional practice. Drawing on a repeat-measure annual online survey, our findings provide an inside-view of how early career social workers in Scotland experience work-based learning over time and how professional learning for social workers can be enhanced. Quantitative and qualitative data were analysed using descriptive statistical analysis and reflexive thematic analysis respectively and integrated using a convergence coding matrix to identify meta-themes. Our findings support an integrative, developmental and ecological approach to professional learning, embedded in a value-led understanding of social work as practice. We invite the profession to embrace and embed learning as a ‘practice of value’, both as an antidote to managerial approaches to practice and learning and as a way of valuing the extraordinary work that social workers do
Complex dynamics in a delayed diffusive cell population model of hepatitis b with capsids, mitotic transmission, and non-cytopathic antiviral mechanisms
Get PDFHepatitis B virus (HBV) infection remains one of the most serious global health challenges of our time. It causes liver diseases such as hepatocellular carcinoma, cirrhosis, and liver failure. Understanding the host-virus interactions involved in the pathogenesis of HBV is crucial for designing more effective preventive and therapeutic strategies. In this paper, we investigate the viral dynamics of an HBV mathematical model governed by partial differential equations (PDEs), incorporating mitotic transmission, the cure of infected hepatocytes, a saturated infection functional response rate, HBV DNA-containing capsids, and three distinct delays representing intracellular delay, intracellular capsid production delay, and virus replication delay. We establish the existence, uniqueness, positivity, and uniform boundedness of solutions. By conducting a qualitative analysis and employing Lyapunov functionals, we study the global asymptotic stability of both the infection-free equilibrium and the unique endemic equilibrium under suitable conditions and threshold parameters. Furthermore, we perform numerical simulations, utilizing biologically relevant parameter values, to illustrate the analytical results and to demonstrate the model's capability to provide deeper insights into HBV infection dynamics. Our findings reveal rich and complex patterns, including both regular and irregular periodic oscillations. Notably, irregular oscillations may indicate disruptions in hepatocyte regulation and subsequent deterioration of functional activity. A comparison with existing models in the literature highlights that our model avoids the overestimations present in models that neglect certain compartments and delays
Complex dynamics in a delayed diffusive cell population model of hepatitis b with capsids, mitotic transmission, and non-cytopathic antiviral mechanisms
Get PDFHepatitis B virus (HBV) infection remains one of the most serious global health challenges of our time. It causes liver diseases such as hepatocellular carcinoma, cirrhosis, and liver failure. Understanding the host-virus interactions involved in the pathogenesis of HBV is crucial for designing more effective preventive and therapeutic strategies. In this paper, we investigate the viral dynamics of an HBV mathematical model governed by partial differential equations (PDEs), incorporating mitotic transmission, the cure of infected hepatocytes, a saturated infection functional response rate, HBV DNA-containing capsids, and three distinct delays representing intracellular delay, intracellular capsid production delay, and virus replication delay. We establish the existence, uniqueness, positivity, and uniform boundedness of solutions. By conducting a qualitative analysis and employing Lyapunov functionals, we study the global asymptotic stability of both the infection-free equilibrium and the unique endemic equilibrium under suitable conditions and threshold parameters. Furthermore, we perform numerical simulations, utilizing biologically relevant parameter values, to illustrate the analytical results and to demonstrate the model's capability to provide deeper insights into HBV infection dynamics. Our findings reveal rich and complex patterns, including both regular and irregular periodic oscillations. Notably, irregular oscillations may indicate disruptions in hepatocyte regulation and subsequent deterioration of functional activity. A comparison with existing models in the literature highlights that our model avoids the overestimations present in models that neglect certain compartments and delays
MLAR-UNet:LDCT image denoising based on U-Net with multiple lightweight attention-based modules and residual reinforcement
No full textObjective. Computed tomography (CT) is a crucial medical imaging technique which uses x-ray radiation to identify cancer tissues. Since radiation poses a significant health risk, low dose acquisition procedures need to be adopted. However, low-dose CT (LDCT) can cause higher noise and artifacts which massively degrade the diagnosis. Approach. To denoise LDCT images more effectively, this paper proposes a deep learning method based on U-Net with multiple lightweight attention-based modules and residual reinforcement (MLAR-UNet). We integrate a U-Net architecture with several advanced modules, including Convolutional Block Attention Module (CBAM), Cross Residual Module (CR), Attention Cross Reinforcement Module (ACRM), and Convolution and Transformer Cross Attention Module (CTCAM). Among these modules, CBAM applies channel and spatial attention mechanisms to enhance local feature representation. However, serious detail loss caused by incorrect embedding of CBAM for LDCT denoising is verified in this study. To relieve this, we introduce CR to reduce information loss in deeper layers, preserving features more effectively. To address the excessive local attention of CBAM, we design ACRM, which incorporates Transformer to adjust the attention weights. Furthermore, we design CTCAM, which leverages a complex combination of Transformer and convolution to capture multi-scale information and compute more accurate attention weights. Results. Experiments verify the embedding rationality and validity of each module and show that the proposed MLAR-UNet denoises LDCT images more effectively and preserves more details than many state-of-the-art methods on clinical chest and abdominal CT datasets. Significance. The proposed MLAR-UNet not only demonstrates superior LDCT image denoising capability but also highlights the strong detail comprehension and negligible overheads of our designed ACRM and CTCAM. These findings provide a novel approach to integrating Transformer more efficiently in image processing.</p
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