26207 research outputs found
Sort by
Learning from young people’s experiences of climate change education
No full textThis article centres on young people’s experiences of climate change education (CCE). There is much written on CCE (e.g. what it is, what it should be, how it should be taught, where it should be taught), but there is little exploring young people’s views on learning about climate and the climate crisis. This Spotlight On article considers data collected as part of 21 focus groups, which engaged more than 100 young people in Bristol (UK), Galway (Ireland), Genoa (Italy) and Tampere (Finland). The article outlines key themes that transect young people’s experiences of CCE. The authors then consider how prominent themes inform the guiding principles for future CCE according to the young people participating in the CCC-CATAPULT European project
An idea-packed guide for scientists teaching communication skills
No full textTeaching Science Students to Communicate: A Practical Guide is aimed at scientists who want to teach science students transferrable communication skills. It starts with a rallying cry and is filled with creative ideas for teaching sessions with top tips on how to run them effectively. Above all, this book should help scientists instil a disposition in their students that should underpin any act of communication — empathy
Factors associated with repeat emergency department visits for mental health care in adolescents: A scoping review
Get PDF1.1ObjectivesThe aim of this review was to identify factors associated with multiple visits to emergency department (ED) services for mental health care in adolescents.1.2MethodsElectronic databases (MEDLINE, PsycINFO, Embase, CINAHL, Web of Science and ProQuest Dissertations & Thesis Global) were searched for evidence that presented an association between risk factors or correlates of multiple visits to the emergency departmental for mental health care by 10-24 year olds. High impact use was defined as at least one return ED visit for mental health care. Primary studies of any quantitative design were included, with no exclusions based on language or country and all possible risk factors were considered. Data were extracted and synthesised using quantitative methods; frequencies of positive, negative and null associations were summarised for categories of potential risk factors.1.3ResultsSixty-five studies were included in the review. Most studies were from North America and reported a wide range of measures of high impact ED use, the most common being a binary indicator of multiple ED visits. Sex/gender and age were the most frequently reported risk factors. Measure of previous or concurrent access to mental health care was consistently positively associated with high impact use. Having private health insurance, compared with public or no insurance, was generally negatively associated with high impact use. Proxy measures of socioeconomic position (SEP) showed associations between lower SEP and more high impact use in a small number of studies. No other factors were consistently or uniformly associated with high impact use.1.4ConclusionsThe review identified a substantial evidence base but due to the variability in study design and measurement of both risk factors and outcomes, no consistent risk factors emerged. More research is needed, particularly outside North America, using robust methods and high quality routinely collected data. Key words: emergency department; high impact ED use; repeat ED visits; adolescent; mental healt
P071 Exploring experiences and preferences of people with rheumatoid arthritis for digital interventions to promote physical activity (PA)
Get PDFBackground/Aims Physical activity (PA) is effective for managing symptoms of rheumatoid arthritis (RA) but people with RA are less active than their healthy counterparts. A digital intervention (DI) to promote PA, is a potential solution. There is a paucity of literature available exploring the requirements of people with RA for a digital intervention. It is important to explore experiences and preferences before developing such an intervention. Aims: 1. Identify digital technology currently used by people with RA to support PA. 2. Understand the preferences and acceptability of people with RA for potential DI delivery. Methods A survey was developed to address these aims. A patient research partner (CS) and ‘think aloud’ pilots contributed to development. The survey was circulated once to members of the National Rheumatoid Arthritis Society in November 2022. This study was approved by the National Health Service Research Ethics Committee (reference 22/NE/0158). Results 1178 people consented to take part (86% female, 64% aged 55-74). The majority used digital technology every day (97%). 84% anticipated using a potential DI to support PA, most preferably every day (48%) or 2-3 times a week (14%). 16% never anticipated using DI to support PA. 34% reported currently using technology to support PA; mostly an app without healthcare professional (HCP) interaction (42%) or internet videos (40%). A further 27% had tried technology to support PA but discontinued, and 39% had never tried. An app was the most preferable delivery platform (56%), followed by a website (43%) or internet videos (28%). 51% would prefer to be offered or signposted to digital technology to support PA by an exercise professional with specific rheumatology training or a healthcare professional (22%). Potential DI delivery methods were rated on a Likert scale of 1-5 for general acceptability, a score of five indicating highest acceptability: automated response mean[SD] 3.6[0.9], ad-hoc HCP interaction 3.5[0.8] pre-arranged HCP interaction 3.4[1] and no interaction 3.1[1]. Conclusion People with RA are using digital technology regularly and many anticipated using a DI to support PA. Despite this, only a third are currently using digital technology to support PA. An app or website platform was the preferred delivery method suggesting that an internet delivered intervention is acceptable. Acceptability ratings of DI delivery methods were similar. Further sub-group analysis and exploration of free text responses is planned to inform tailoring of DI delivery. Disclosure C. Gerlis: None. A. Berry: None. S. Halls: None. M. Loizou: None. C. Swales: None. F. Cramp: None
The experiences of patients with musculoskeletal conditions accessing first contact physiotherapy practitioner appointments in general practice in the UK: A qualitative study
Get PDFBackground: First Contact Physiotherapy Practitioners (FCPPs) provide expert care for patients with musculoskeletal (MSK) conditions in General Practice. Access to FCPPs can facilitate timely care and efficient use of health services. However, there is little evidence about patient experiences of accessing FCPP appointments. Objective: To explore the experiences of patients with MSK conditions who have accessed an FCPP appointment in a General Practice setting in the UK. Design: Exploratory qualitative design. Methods: Patients with MSK conditions who had experience of accessing FCPP appointments were recruited via social media. Semi‐structured interviews were conducted and recorded via MS Teams. Data were analysed using thematic analysis. Results: Of 13 patients interviewed, there were 10 females and three males, with an age range between 20 and 80 years. The main themes identified were: (1) Awareness of FCPP, (2) Access routes, (3) Facilitators to access, (4) Barriers to access, (5) Likelihood of re‐accessing FCPP. Awareness of FCPP was generally low amongst participants. There were a variety of routes to access FCPP appointments; some were felt to be sub‐optimal by participants. Facilitators included quick/easy access to FCPP. Barriers included difficulty contacting General Practitioner (GP) surgeries and public perception of needing to see a GP initially. The likelihood of re‐consultation with a FCPP was low when participants had disappointing care experiences. Conclusion: This study provides new evidence about patient experiences of accessing FCPP. It explores positive and negative aspects of access from patients' perspectives. It also highlights areas for improvement in terms of GP staff/patient awareness and understanding of FCPP
Why reinforcement learning?
Get PDFThe term Artificial Intelligence (AI) has come to be one of the most frequently expressed keywords around the globe. Machine learning (ML) continues to gain popularity in the provision of solutions to both industrial and everyday problems, and advancements in infrastructure computing technologies have driven a surge of interest in AI, ML, and particularly large language models (LLMs). This involves huge data stocks and bulky data processing. However, many real-world problems lack the necessary existing data for modelling and model training. Furthermore, numerous dynamic problems do not retain data for later use due to constantly evolving circumstances, resulting in significant challenges in identifying or uncovering patterns (domain knowledge) within such dynamic structures and situations. These problems remain as significant and outstanding challenges
The UK NHS cervical screening information leaflet: Discourse, purpose and potential for change
Get PDFBackground Cervical cancer screening prevents unnecessary deaths, yet rates of attendance have been dropping in the United Kingdom. Leaflets communicate screening information in invites to everyone eligible to attend. However, these information leaflets are known to be hard to understand and inaccessible. Aim To understand how cervical screening is constructed in information leaflets and how this might impact engagement with screening programmes.Method Discourse analysis of the current UK information leaflet, and a version redesigned with a public and patient involvement group. Result The current leaflet uses discourses of neutrality and patient autonomy, with design akin to a scientific texts. The redesigned leaflet presents a simplified, step-by-step guide to screening that aims to motivate and persuade readers. Discussion The current information leaflet positions intended audiences as rational agents who have responsibility to make a choice to attend screening based on scientific information. The public’s redesign positions the state as responsible for simplifying and convincing people to attend screening. The disjuncture may be due to different underlying ideologies – neoliberalism versus ‘welfarism’. Conclusion Shifting the current discourse to simplified and clearer language which emphasises choice in the process could help people make an informed decision to engage in screening
Adaptive stiffness in lattice metastructures through tensile-buckling inspired topology morphing
Get PDFThis paper explores the use of simultaneous tensile buckling of unit cells to induce a transformation in lattice topology. Under tension, unit cells undergo passive transformation from a rectangle-like to a triangle-/pentagon-like topology, with an associated change in the effective stiffness properties. This behaviour is investigated through finite element analysis and experiments, with analytical results providing insights into the observed behaviour. The analysis identifies (i) that the initial unit cell topology (rectangular) is dominated by membrane effects, (ii) the transformation phase is associated with negative stiffness, and (iii) once formed, the new topology (triangular/pentagonal) exhibits increased stiffness in both compression and tension. Finite element analysis confirms that the unit cell behaviour is also preserved in lattices. Under tension, the lattice undergoes a seven-fold increase in stiffness as it transitions from its initial to the new topology, with a regime of negative stiffness during this transformation accounting for approximately 82% of its total elastic deformation. This new approach to elastically tailor the nonlinear response of (meta-)materials/structures has the potential to contribute to the development of novel tensile energy absorbers
Trajectory patterns of macronutrient intake and their associations with obesity, diabetes, and all-cause mortality: A longitudinal analysis over 25 years
Get PDFOver the past decades, China has been undergoing rapid economic growth, which may have significantly influenced the dietary patterns and health status of the Chinese population. Our study aimed to assess the associations of potential macronutrient trajectory patterns with chronic diseases and all-cause mortality using the latent class trajectory model (LCTM) and the longitudinal data of the China Health and Nutrition Survey obtained between 1991 and 2015. A 24-hour diet recall was used to assess the dietary intake. The Poisson regression model was employed to investigate the correlations between trajectory patterns and chronic diseases and all-cause mortality. A total of 8115 participants were included in the final analysis. We explored four and three trajectory patterns for male and female populations, respectively. We found that a decreasing very high-carbohydrate trajectory together with a U-shape protein trajectory was associated with a higher risk of diabetes in the male population (odds ratio (OR): 2.23; 95% confidence interval (CI): 1.31–3.77). A similar pattern for moderate protein intake was also associated with the risk of diabetes in the female population (OR: 1.82; 95% CI: 1.18–2.79). In addition, we show that a decreasing low-carbohydrate trajectory and an increasing high-fat trajectory were associated with a lower risk of all-cause mortality (OR: 0.76; 95% CI: 0.60–0.96) and a higher risk of obesity (OR: 1.24; 95% CI: 1.05–1.47) in males. Our results shed light on some salient nutritional problems in China, particularly the dual challenges of undernutrition and overnutrition
Life-course influences of poverty on violence and homicide: 30-year Brazilian birth cohort study
Get PDFBackground: Homicide is the leading cause of death among young people in Latin America, one of the world's most violent regions. Poverty is widely considered a key cause of violence, but theories suggest different effects of poverty, depending on when it is experienced in the life-course. Longitudinal studies of violence are scarce in Latin America, and very few prospective data are available worldwide to test different life-course influences on homicide.Methods: In a prospective birth cohort study following 5914 children born in southern Brazil, we examined the role of poverty at birth, in early childhood, and in early adulthood on violence and homicide perpetration, in criminal records up to age 30 years. A novel Structured Life Course Modelling Approach was used to test competing life-course hypotheses about ‘sensitive periods’, ‘accumulation of risk’, and ‘downward mobility’ regarding the influence of poverty on violence and homicide.Results: Cumulative poverty and poverty in early adulthood were the most important influences on violence and homicide perpetration. This supports the hypothesis that early adulthood is a sensitive period for the influence of poverty on lethal and non-lethal violence. Results were replicable using different definitions of poverty and an alternative outcome of self-reported fights.Conclusion: Cumulative poverty from childhood to adulthood was an important driver of violence and homicide in this population. However, poverty experienced in early adulthood was especially influential, suggesting the importance of proximal mechanisms for violence in this context, such as unemployment, organized crime, drug trafficking, and ineffective policing and justice systems