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Supporting parents, safeguarding infants: A qualitative evaluation of parental experiences with the ICON program to reduce abusive head injury in England
No full textBackground: Abusive head trauma (AHT) is a leading cause of head injuries in children under 12 months of age. ICON is an AHT prevention program delivered in the National Health Service (United Kingdom) that educates and provides strategies for new parents on infant crying: infant crying is normal, comforting strategies can help, its ok to walk away, never shake a baby. Little is known about parental perspectives on ICON and similar programs. Objective: This study evaluated ICON from the perspective of new parents, identifying factors that influence its reach and effectiveness in providing tools to cope with a baby who is crying. Participants/Setting: Twenty-eight new parents of infants aged between two and six months were recruited from six geographic areas across England, selected to reflect ethnic, socioeconomic and regional diversity.Methods: This qualitative evaluation study interviewed new parents to understand their experiences of ICON. Data collection and analysis were concurrent and iterative. Framework analysis and an ecological framework guided analysis to explore factors affecting ICON’s reach and effectiveness. A diverse parent advisory panel informed study design and analysis.Results: ICON messages normalized infant crying for parents, provided comforting strategies and gave them permission to put their baby down when overwhelmed, and reinforced the message to never shake a baby. Mothers were the primary recipient of education. Factors impacting ICON’s effectiveness included tailoring education to family needs, presence of family/friend support, and the parent’s emotional state. Contextual factors impacted parental receptivity of ICON.Conclusions: New parents reported the ICON program messages supported them in coping with their babies when they cried. They identified factors to enhance that support; by engaging fathers, by enhancing healthcare professionals’ fidelity to the programme whilst personalising the message, and by addressing wider social and contextual conditions that shape everyday caregiving
Using Bayesian network analysis in social sciences: A case study of domestic water and energy use
Get PDFUnderstanding the factors that shape household water and energy use is essential for designing targeted conservation interventions that promote both sustainability and well-being. While studies in this area often rely on traditional “frequentist” statistical methods, which can struggle to capture the complex interdependencies among demographic, behavioural, psychological, and material influences. This paper introduces Bayesian network (BN) analysis as a novel and adaptable method with useful applications in water and energy studies and a wide variety of other social sciences. The paper offers a primer on how to conduct BN analysis, including underlying logic and range of choice of software platforms, before presenting a brief worked example based on the authors’ current research into household water and energy consumption in a UK city. The paper shows how Bayesian networks can generate valuable insights from relatively small and complex datasets, capture non-linear relationships, and support scenario-based reasoning, making them well-suited for exploratory studies, “what if?” scenario-testing and policy effectiveness review. The findings contribute to a more nuanced understanding of domestic water and energy consumption and offer a practical framework that can inform the design of targeted, evidence-based interventions to encourage sustainable water and energy use in households. We argue that there is much to be gained by proliferation of this analytical approach throughout the social sciences
Learning from mistakes: How the 1825 crisis led to advances in Macroeconomics
No full textThis paper demonstrates that prior to the 1825 crisis the Bank of England directors had a limited understanding of the nature of the early 19th century bank-based money supply and of how their policies determining the circulation of Bank notes could affect the macroeconomy through the banking system. It shows that, just as modern crises transform our understanding of the financial system, there is substantial evidence that the 1825 crisis promoted advances in economic thought (i) by making clear the Bank’s effect on credit extension throughout the country and the associated macroeconomic fluctuations, (ii) by teaching the Bank the importance of stabilizing the money supply (iii) and by advancing the understanding of the role of the lender of last resort. This paper also makes clear the essential role of the development of a bank-based payments system, where bank liabilities comprise a significant portion of the circulating money supply, and bank lending therefore plays an important role in monetary dynamics, in our understanding of macroeconomics. In particular, the onset of the macroeconomic fluctuations known as the business cycle are closely associated with the fluctuations in bank liabilities that arise in a bank-based payments system
Commentary: Theory and practice in teaching landscape architecture
Get PDFLandscape architecture educators often continue teaching and introducing innovative ideas with limited opportunities for critical reflection, particularly regarding the disconnect between pedagogical frameworks and the realities of practice in landscape higher education. Drawing on over two decades of experience, including the development of new programs, the successful management of established curricula, and the transformation of underperforming ones, this reflective piece explores how teaching theories in landscape architecture can better align educational practices with students’ engagement in spatial, ecological, and cultural complexities. The reflection emphasises the importance of encouraging students to critically evaluate their design decisions within broader social, environmental, and ethical contexts. It also highlights how acknowledging diverse learning styles and cultural backgrounds contributes to a more inclusive and responsive learning environment. Respecting individual perspectives fosters a collaborative studio culture, where varied experiences enrich both the design process and its outcomes. Finally, the piece considers how the integration of digital tools in landscape architecture education can significantly enhance students’ abilities in visualisation, analysis, and communication. These skills are increasingly essential in contemporary design practice
The public health ethics and economics of prioritising prevention and equity
No full textInternationally there are significant challenges to improving and protecting population health through effective prevention. In this novel analysis, we integrate public health evidence, ethics, and economics to argue that current health resourcing strategies neglect prevention, underestimate the social determinants of health, and fail to engage with the ethical dimensions of economic decision-making. We highlight the risk that overreliance on economic evidence may marginalise underserved populations, where data are limited, thereby deepening health inequalities. We conclude that improving population health and reducing disparities requires reframing prevention through both ethical and economic lenses. Investing in community-based, equity-oriented interventions can deliver sustained health and economic gains and support a more inclusive and resilient health system
Participatory budgeting, health promotion and theatre production: A qualitative case study in North London
Get PDFPurposeThis paper explores the role that participatory budgeting (PB) plays in enhancing emotional and social well-being through the commissioning, design, delivery of and participation in a drama and theatre intervention in a deprived community in North London.Design/methodology/approachA qualitative case study methodology employing constructivist grounded theory was used to explore how PB promoted health and well-being among residents of a deprived North London neighbourhood. FindingsEngaging in PB enabled residents to influence the commissioning, design and implementation of community-based interventions that responded directly to their perceived needs through culturally aspirational projects. The resulting theatre production promoted self-esteem, love and a positive sense of agency in residents. Analysis revealed themes of self-expression, praxis, self-realisation, sense of belonging and building of positive relationships between participants, characterised by trust and reciprocity.Originality/valueThe study points to the power of using PB to enable residents in very deprived neighbourhoods to decide on funding and influence the design and delivery of interventions to directly meet their needs. It also demonstrates the significance of culturally aspirational arts-based approaches in engaging deprived community members around health issues in promoting emotional and social well-being and a positive sense of individual and community belonging. The research also demonstrates the usefulness of PB as a co-production tool to enable residents to take control of and transform their lives as part of a wider community development approach in deprived urban communities
Why models underestimate historic building performance
No full textThere are 6.5m buildings in England, Scotland and Wales that date from before 1919 – around 20–30% of Britain's building stock – and reducing their carbon emissions is critical.This article outlines the findings of work between the University of Salford and the National Trust. The research conducted in-situ measurements to assess the building performance of 9 buildings of traditional construction, and compared the performance with modelled assumptions
Understanding stakeholder perspectives on integrating and sustaining a vertical HIV prevention program into routine health services in Zimbabwe: a qualitative study
No full textIntroduction The transition of Voluntary Medical Male Circumcision (VMMC), an HIV prevention service, in Zimbabwe from a donor-funded to a government-owned program involves the collective efforts and alignment of national and subnational government leaders, managers, health care providers, village health workers, community members, donors, and implementing partners. We sought to understand stakeholders’ perspectives on barriers, facilitators, and recommendations as a vertical HIV prevention program transitioned to an integrated, government-led model. Methods We conducted 54 semi-structured stakeholder interviews at the national and subnational levels. Interviews were audio-recorded, transcribed, and thematically analyzed . Results Participants highlighted a range of psychological and structural barriers and facilitators to integrating and sustaining the VMMC program. Respondents mentioned financing and staffing barriers to integration, particularly a lack of domestic resources, the transition from a fee-for-service to a facility-based performance model, and staff attrition. Notably, resistance to changing the VMMC program's operations was a significant barrier that may be tied to individual psychological barriers such as loss of power and job security. Donors and partners continued to control the funding for VMMC. Ideally, the Ministry of Health and Child Care (MoHCC) should have more autonomy over these decisions. At the subnational level there is an opportunity for increased responsibility and a greater sense of ownership through the decentralization of governance. Conclusion To ensure successful integration and local ownership of the VMMC as an HIV prevention program, stakeholders must address both psychological and structural barriers while aligning their perspectives on the transition. Individual providers have valid concerns about their financial security and the burden of additional responsibilities without adequate compensation. It is crucial for donors and partners to reduce their involvement and oversight. Additionally, resolving the financial barriers that prevent the government from having complete control of the program will require empowering local government stakeholders to fully take ownership. What is already known on this topic●Program sustainability and integration represent critical global health challenges, particularly in light of the increasing funding gap in development assistance for health following recent withdrawal of support from foreign governments. Achieving the Sustainable Development Goals and delivering basic health services are both at risk.●For VMMC, a vertical health program funded by external donors, countries need to plan for integration and sustainability of the program to maintain epidemiological benefits, such as reduced HIV transmission, after donor support has been withdrawn.●Few studies describe national and subnational level stakeholder perspectives on the barriers, facilitators, and recommendations that contribute to the successful transfer of ownership and integration of a large-scale, donor-funded vertical health program into government services. What this study adds●Sustainability of the HIV prevention program is hindered by insufficient domestic financing and fragmented budget management. Transitioning to government ownership and financing is a long-term goal complicated by economic instability, competing health priorities and limited domestic resources.●High staff attrition, driven by low wages and poor working conditions, disrupts service delivery and erodes institutional knowledge. Addressing these issues with better remuneration, non-financial incentives, and training could improve retention and motivation.●Decentralizing VMMC to primary health care facilities faces challenges such as limited space, staff shortages, and confidentiality concerns. Overcoming these barriers could improve accessibility, trust, and timeliness of services, making the program more patient-centered.●Power asymmetry between donors and government limits local ownership and integration of the HIV prevention program. Enhanced subnational engagement and empowerment can build ownership, improve program alignment with local needs, and foster sustainable, community-driven implementation.How this study might affect research, practice or policy ●Governments and policymakers need to prioritize domestic resource mobilization and increase allocations for HIV prevention funding into national health budgets to reduce reliance on donor funding and ensure sustainability.●Research on the effects of staff motivation and retention initiatives, including both financial and non-financial incentives, would provide valuable insights for workforce management in health systems.●Systematic involvement of subnational stakeholders in program planning and governance/decision-making is essential for fostering ownership, aligning programs with local needs and achieving program integration and sustainability
Machine learning- and deep learning-based myoelectric control system for upper limb rehabilitation utilizing EEG and EMG signals: A systematic review
Get PDFUpper limb disabilities, often caused by conditions such as stroke or neurological disorders, severely limit an individual’s ability to perform essential daily tasks, leading to a significant reduction in quality of life. The development of effective rehabilitation technologies is crucial to restoring motor function and improving patient outcomes. This systematic review examines the application of machine learning and deep learning techniques in myoelectric-controlled systems for upper limb rehabilitation, focusing on the use of electroencephalography and electromyography signals. By integrating non-invasive signal acquisition methods with advanced computational models, the review highlights how these technologies can enhance the accuracy and efficiency of rehabilitation devices. A comprehensive search of literature published between January 2015 and July 2024 led to the selection of fourteen studies that met the inclusion criteria. These studies showcase various approaches in decoding motor intentions and controlling assistive devices, with models such as Long Short-Term Memory Networks, Support Vector Machines, and Convolutional Neural Networks showing notable improvements in control precision. However, challenges remain in terms of model robustness, computational complexity, and real-time applicability. This systematic review aims to provide researchers with a deeper understanding of the current advancements and challenges in this field, guiding future research efforts to overcome these barriers and facilitate the transition of these technologies from experimental settings to practical, real-world applications
In silico and in vitro comparative analysis of 79 Acinetobacter baumannii clinical isolates
Get PDFAcinetobacter baumannii is a significant nosocomial bacterial pathogen that poses a substantial infection risk due to its high resistance to antibiotics and ability to survive in hospital environments. In this study, we performed comprehensive in silico and in vitro analyses on 79 A. baumannii clinical isolates from different geographical locations to uncover their genomic and epidemiological characteristics as well as their antibiotic and phage susceptibilities. Our findings revealed considerable genomic diversity among the isolates, as shown by average nucleotide identity (ANI) heat maps, multilocus sequence typing (MLST), and core genome MLST (cgMLST). We identified several international clones known for their high antibiotic resistance and global prevalence. Surprisingly, we also observed that the number of antimicrobial resistance genes (ARGs) was higher in isolates containing CRISPR-Cas systems. Plaque assays with 13 phages indicated that Acinetobacter phages have a narrow host range, with capsule loci (KL) serving as a good indicator of phage-bacteria interactions. The presence of CRISPR-Cas systems and other antiviral defense mechanisms in A. baumannii genomes also appears to play a key role in providing phage resistance, regardless of the phage receptors. We also found that spacers associated with subtypes I-F1 and I-F2 CRISPR-Cas systems predominantly target prophages, suggesting a role in maintaining genomic stability and contributing to phage-bacteria co-evolution. Overall, this study provides a set of highly characterized A. baumannii clinical isolates for future studies on antibiotic-phage-bacteria interactions