79347 research outputs found
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Assessing Antimicrobial Susceptibility Testing Guideline Adherence by Laboratories Providing Bacteriology Services in Ghana: A Pilot Study.
No full textObjectives: To assess the adherence of Ghanaian healthcare laboratories to AST standards and to assess discrepancies between breakpoint-defining dosages and recommended doses in Ghanaian National Standard Treatment Guidelines (NSTGs). Methods: Nineteen laboratories were issued electronic questionnaires regarding AST methods and guidance. NSTG doses and breakpoint-defining dosages were compared to determine the applicability of AST standards. Results: Eleven of the 19 laboratories responded. Traditional biochemical species identification was the most common method among surveyed laboratories, with disc diffusion being the main AST method. All laboratories reported using CLSI standards. Major quality assurance issues identified regarding AST testing included the use of outdated standards, failure to consistently determine inoculum density, irregular use of quality control strains, and agent limitations on antibiotic disc panels. Discrepancies in definitions for multidrug resistance and the testing of such isolates were also identified. When comparing recommended NSTG doses to breakpoint-defining dosages, the EUCAST standard had a higher number of doses available for review (30/30, 100% versus 14/30, 47%) and a higher percentage of full agreement (19/30, 63% versus 6/30, 20%) compared with CLSI. Discrepancies between breakpoint-defining and recommended dosages were found for meropenem, ceftriaxone, and amoxicillin-clavulanic acid oral/iv, leading to potential underdosing. Conclusions: This study highlights the need for rigorous adherence to AST standards and outlines considerations for the adoption of AST standards in a low-middle-income country
Strategies to support safe wandering in care homes for older adults – what works, for whom, and in which circumstances?: A realist synthesis
Full text linkObjectives: Wandering is a common behaviour among people with dementia living in care homes, driven by various factors such as enjoyment, a sense of purpose, lifelong habits, and social interaction. These elements can bring both physical and mental benefits, highlighting the need for strategies that enable safe wandering while respecting individual autonomy. This realist synthesis aimed to explore these strategies and the conditions under which they lead to successful outcomes. Methods: This realist synthesis involved scoping the literature to develop initial theoretical explanations for how different strategies could support safe wandering. From this literature, we developed context-mechanism-outcome configurations, which we combined into initial programme theories. Systematic searches were then used to test and refine these programme theories. Studies were prioritised for inclusion based on criteria of relevance and richness. We extracted data pertinent to the initial programme theories and documented relevance, richness, and rigour. We synthesised data into five refined programme theories. At each stage of the process, we collaborated with stakeholders to develop and validate the strategies. Results: The review included 79 evidence sources, leading to five refined programme theories. 1) Personalised Care: Emphasising the importance of staff practicing person-centred care by understanding residents, their reasons for wandering, and their life histories. 2) Monitoring: Effective monitoring requires good visual access or technological solutions that enable staff to observe residents, and detect when residents need support to walk while also enabling resident freedom and independence. 3) Navigation: Navigation is facilitated by dementia-friendly design features and environmental cues, which help minimise the challenges residents face due to diminished orientation and wayfinding abilities. 4) Managing access: Involving balancing residents’ safety and autonomy. Strategies may include restricting access to unsafe areas by locking doors or using technology and camouflage, while ensuring access to safe spaces. 5) Hydration and nutrition: Hydration and nutrition (e.g., suitable snacks) is provided to prevent weight loss for residents who wander and may not stay seated during meals. These theories provide insight into supporting safe wandering, leading to improved wellbeing for both residents and staff, enhanced safety and autonomy for residents, and reduced staff anxiety. Discussion: Strategies that create a supportive environment, provide physical assistance, and support hydration and nutrition enabled residents to wander safely. Identified strategies improved wellbeing for both residents and staff. However, the same strategies also led to ethical concerns around digital monitoring, deception, and access restrictions
Impact of increased educational screen exposure on adolescent overweight and the mediating role of physical activity and sleep quality: a natural experiment study from China
No full textBackground: Globally, increasing numbers of adolescents use digital devices for learning, and this educational screen exposure may alter behavioral patterns and be associated with the rising prevalence of adolescent overweight. Limited research has examined the interrelationships among educational screen exposure, adolescent overweight, physical activity, and sleep quality. This study aims to assess the impact of educational screen exposure on adolescent overweight prevalence and to identify related mediating risk behaviors. Methods: Data on 41,157 adolescents from 16 cities in China were from the Database of Youth Health. Body mass and height were measured to estimate body mass index. Physical activity and sleep quality data were collected using a self-administered questionnaire. We drew data from two waves (2015 and 2017) of adolescent health surveys, which coincided with China’s online education policy since 2015. The implementation of this policy resulted in a substantial increase in adolescents’ educational screen exposure, with the intensity of the policy implementation influenced by local Internet infrastructure. We allocated adolescents into exposure and control groups based on the local Internet penetration rate. Leveraging this policy-driven natural experiment, a difference-in-differences approach was then applied to compare changes in overweight prevalence, physical activity, and sleep quality before and after the policy implementation between these two groups. Results: The increase in overweight prevalence of adolescents in the exposure group from 2015 to 2017 was 3.1% greater than those in the control group (Coef. 0.03, 95% CI: 0.01 to 0.05, p < 0.01). The exposure group showed significant reductions in physical activity frequency (Coef. -0.49, 95% CI: -0.52 to -0.45) and sleep quality (Coef. -0.06, 95% CI: -0.09 to -0.02). Mediation analyses suggested that reduced physical activity and sleep quality were plausible mediating variables linking educational screen exposure and overweight prevalence. Male adolescents experienced a greater increase in overweight associated with educational screen exposure compared to their peers (Coef. 0.026, 95% CI: 0.01 to 0.04). Conclusions: Educational screen exposure may contribute to increased overweight in adolescents by reducing physical exercise and impairing sleep quality. Educators, guardians, and policymakers should consider effective measures to minimize the adverse impacts of educational screen exposure by promoting physical activities among adolescents
Setting a Research Agenda for the Assessment and Treatment of Aphasia in Minority Languages
No full textThe aim of this position article is to establish the state of affairs in aphasia assessment and treatment in individuals who speak minority languages. This article reports on recommendations from a panel of experts working with individuals with aphasia in a variety of languages to develop a research agenda for aphasia assessment and treatment in minority languages. Members of Working Group 2 (Aphasia Assessment and Outcomes) of the Collaboration of Aphasia Trialists (CATs) were invited to respond to a short online agenda-setting questionnaire and to discuss issues regarding this topic. The panel of experts then refined the responses and recommendations into future research themes and objectives. Seven priority themes were identified: Definitions, Tools, Research Practices, Treatment, Speech and language pathology (SLP) Training, Societal Impact, and Norms. In the EU alone, about 60 minority/regional languages are spoken by around 40 million people. Considering increasing caseloads and a lack of clinical tools for speakers of minority languages, this research agenda has an important impact for future research and clinical advancements
AI for the underdogs: Navigating risk and growth in high-tech micro-firms through generative artificial intelligence
No full textGenerative Artificial Intelligence (Gen-AI) has gained significant traction in larger firms, yet its adoption among micro-firms remains underexplored particularly in contexts marked by resource scarcity and heightened operational risk. This study addresses this gap by investigating how hightech micro-firms adopt Gen-AI for risk management and growth. Drawing on semi-structured interviews with decision-makers from eight Finnish micro-firms, the research applies the Technology-Organization-Environment (TOE) framework to identify critical enablers and barriers. The findings highlight five key dimensions influencing adoption: technological readiness, leadership engagement, regulatory compliance, data-driven decision-making, and competitive pressures. While Gen-AI fosters operational resilience and strategic agility, its impact is constrained by limited data quality and high implementation costs. By offering a holistic and theoretically grounded perspective, this study advances understanding of Gen-AI adoption in microfirms and contributes to literature on digital transformation under resource constraints. The insights also inform policymakers and practitioners aiming to enhance AI accessibility and governance for micro-enterprises
Crop metabolic engineering towards enhanced resistance to pests and pathogens
Full text linkPlants produce a vast array of specialized metabolites that serve as essential defenses against herbivores and pathogens. However, the capacity to produce these compounds differs substantially among plant species and is frequently diminished during domestication. Advances in synthetic metabolic engineering enable efficient elucidation and engineering of plant specialized metabolic pathways active in crop pest and pathogen resistance. This review summarizes strategies and workflows for selecting defensive metabolic pathways, identifying candidate biosynthetic genes, and rewiring native or introducing heterologous pathways to enhance crop resistance to pests and pathogens. Strategies include weighted gene co-expression network construction, biosynthetic gene cluster scanning, and metabolite genome-wide association studies for pathway discovery, as well as transcriptional reprogramming, enzyme activity optimization, and transporter deployment for pathway engineering. We further discuss challenges in using synthetic metabolic engineering to enhance crop resistance and highlight the potential of artificial intelligence in addressing them
Juror Decision-Making and Diminished Responsibility: Diagnosis has little impact, but Stigma may matter (a partial replication of Baker et al (2022)).
No full textLittle is known about the interaction between mental health information, juror stigma towards mental health conditions, and juror decision-making. The present study sought to partially replicate previous research (Baker et al, 2022) which had investigated how a personality disorder diagnosis may influence juror decision-making concerning the partial defence of Diminished Responsibility. The present study recruited an online general population sample where participants viewed a set of and experimentally manipulated video vignettes describing a homicide offence. These were identical except for the clinical description used (‘psychopathy’, ‘personality disorder’ or ‘complex mental health condition’). The results suggested that whilst the diagnostic manipulation made little difference to Diminished Responsibility decisions, stigmatic attitudes towards offenders with mental health conditions, as well as a greater tendency to see the defendant’s actions as more within their personal control, were associated with a lower likelihood of supporting the partial defence of Diminished Responsibility
Energising Participation? Responding to the UK Government’s Climate and Nature Public Participation Plan
No full textDissociation and Cooling Dynamics of 2-cyanoindene Monocations: Survival of Small PAHs in Harsh Interstellar Radiation Fields
No full textThe molecule, 2-cyanoindene, C10H7N (2CNI) is the only cyanosubstituted polycyclic aromatic hydrocarbon (PAH) detected in space, for which the hydrocarbon counterpart, indene, has also been observed in the same astrochemical environment—the molecular cloud TMC-1. In this study, based on experiments in two different laboratories, the collision and radiation-driven dissociation and cooling dynamics of the 2-cyanoindene monocations are investigated using one of the electrostatic ion-beam storage rings of the DESIREE facility, and the DESIRS beamline at the SOLEIL synchrotron radiation facility. The storage ring experiments quantify the balance between fragmentation and radiative cooling of the stored cations, while the synchrotron experiments characterize dissociation channels from the vacuum ultraviolet-induced dissociative photoionization of the neutrals. Recurrent fluorescence is shown to play an important role in the radiative stabilization of 2CNI+. The results from both sets of experiments are combined to obtain a self-consistent set of microcanonical rate coefficients for dissociation and radiative cooling that completely describe the near-dissociation threshold dynamics of 2CNI+ across the microseconds-seconds time range. This timescale is suitable for incorporation into astrochemical models of PAH growth and destruction lifecycles. This study extends its findings to different astrochemical environments by simulating the extent of fragmentation and the cascade emission spectra of 2CNI+ under varying interstellar radiation fields. These results indicate that radiative cooling enhances the resilience of 2-cyanoindene to harsh radiation conditions, suggesting that small cyano-PAHs may survive longer than previously assumed in a wider range of astrochemical environments, extending beyond cold, dark molecular clouds
Error-based learning in health professions education: AMEE Guide No. 191
No full textError-Based Learning (EBL) represents a paradigm shift in Health Professions Education (HPE), moving from punitive approaches to embracing errors as learning opportunities. This AMEE guide targets educators, curriculum designers, clinicians, and learners, bridging theory with practical strategies to optimize EBL in training and assessment. The guide contrasts Error Management Theory (EMT), which emphasizes learning from errors, with Error Avoidance Theory (EAT). Core EBL components including psychological safety, structured reflection, deliberate error exposure, and feedback are detailed alongside actionable implementation strategies, including simulation-based scenarios with debriefing, contrasting case-based rea- soning, structured error-logging through reflective portfolios and assessment for learning. Looking ahead, we discuss emerging innovations in EBL, including the potential reconceptu- alization of educational tools such as the ‘escape room’ as an ‘error room’ and AI. This guide challenges traditional paradigms and calls for a deliberate focus on error-embracing in HPE