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Special section examining risk discussions across clinical specialties using conversation analysis: From information transfer to an interactional perspective.
Get PDFRisk and uncertainty are pervasive in clinical settings, from diagnosis to treatment decision-making and disease management. Accordingly, risk communication has attracted a sustained interest, and is predominantly characterised by information transfer, with a focus on how messages are framed and received. Conversation analysis (CA) provides a different approach to analysing communication, examining the complexities of how risk is broached, is calibrated to individual contexts, and is sensitively negotiated across clinical encounters. This special section showcases original research that significantly advances our insights into risk communication, offering novel and rigorous insights from a spectrum of actual clinical encounters. Seven original papers present analyses of authentic recordings of clinical encounters in the U.K., USA, and Sweden across a range of clinical specialties (primary care, obstetrics, nephrology, paediatrics, and neurology). The nature of the risks varies from immediate and high-stakes situations (such as during labour and delivery), to more distal severe risks (seizure-related unexpected death or fatal anaphylaxis). Other studies examine the likelihood of illness development. Collectively, these studies illustrate the projectability of risk, the collaborative construction of (and resistance to) risk-oriented lifestyle behaviours, and the ways in which patient/carer concerns or worries are invoked. They highlight practices for gathering risk-related information, and the pivotal ways in which risk discussions can facilitate shared decision-making. Studies also show practical ways clinicians sensitively address severe outcomes or morally charged matters of risk-relevant lifestyle behaviours, carefully progressing from establishing a patient's current understanding to providing recommendations. The final paper explores how these types of studies can be translated into training. A guest commentary provides a broad reflection on how CA investigations advance the field of risk communication. Overall, this special section highlights the promise of interactional studies in clinical risk communication, provides recommendations for future research, and calls for the systematic integration of this knowledge into clinical practice. [Abstract copyright: Copyright © 2025 The Authors. Published by Elsevier B.V. All rights reserved.
The SSB - a practice outcomes framework for services and organisations supporting and responding to sibling sexual behaviour and abuse (briefing paper)
Get PDFThis is a briefing paper based on UWE-funded research on the development of KPIs in sibling sexual abuse research
Decarbonising last-mile deliveries: When the national strategy fails to meet local needs and expectations
Get PDFThis paper explores views and perceptions of 35 local authorities towards potential solutions to decarbonise last-mile deliveries in England and presents their perspectives towards potential challenges and drivers to their implementation. The methodological approach is based on co-design and participatory methods to enable local authorities with different knowledge and expertise to produce, through back-casting, a series of specific actions that can support the implementation of effective measures to decarbonise last-mile deliveries. Results were presented to and stress-tested with 25 councillors, to understand to what extent sustainable transport policies for last-mile deliveries meet political will. Findings show that behaviour change, and collaborative schemes have the potential to have a stronger impact than new and clean technologies in reducing carbon emissions from last-mile deliveries, even though their implementation would be more difficult and less politically appealing. The paper also considers how different levels of governance can contribute to enable the decarbonisation pathway and reveals that lack of power, capacity and capabilities on local freight would be a major challenge for local governments. The paper recommends prioritise stakeholder collaboration, clarifying governance roles, integrating freight into political agendas, adopting systems thinking for planning, and fostering end-consumer behaviour change to accelerate the transition to net-zero last-mile deliveries
Adaptive secure control for uncertain cyber–physical systems with Markov switching against both sensor and actuator attacks
Get PDFIn this article, adaptive secure controller synthesis for uncertain cyber–physical systems with Markov switching (CPSMSs), both sensor and actuator stealthy attacks as well as generally unknown transition rates (GUTRs), is under consideration via neural sliding mode control (SMC) technique. In order to resist unknown attack signals from both sensor and actuator channels, a novel neural network (NN)-based SMC design is performed, which could not only guarantee the boundedness of relevant adaptive data but also force the actual state trajectories to arrive at the proposed sliding mode surface (SMS) with limited moments almost surely. Then, a fresh stochastically stable criterion for the resultant plant is provided in spite of hidden cyber attacks, GUTRs, and structural uncertainty, relying on the arrival of the SMS and stochastic stability theory. Finally, an F-404 aircraft engine model with performance comparisons is offered to confirm the feasibleness of the theoretical result
Integrating large language models for intuitive robot navigation
Get PDFHome assistance robots face challenges in natural language interaction, object detection, and navigation, mainly when operating in resource-constrained home environments, which limits their practical deployment. In this study, we propose an AI agent framework based on Large Language Models (LLMs), which includes EnvNet, RoutePlanner, and AIBrain, to explore solutions for these issues. Utilizing quantized LLMs allows the system to operate on resource-limited devices while maintaining robust interaction capabilities. Our proposed method shows promising results in improving natural language understanding and navigation accuracy in home environments, also providing a valuable exploration for deploying home assistance robots
Mapping use of high dose or long‐term Oral Glucocorticoids and Steroid‐Sparing strategies in adults with chronic conditions: A rapid scoping review of reviews
Get PDFPurpose: Oral glucocorticoids (OGCs) have a broad range of uses and are effective in treating numerous conditions. However, it is commonly acknowledged that OGCs at high doses or over long periods have a burden of toxicity. Despite the use of steroid‐sparing therapies, OGCs continue to be prescribed to treat a wide range of immune and inflammatory conditions. We aimed to address the following research questions: (1) what are the contemporary indications for high dose and/or long‐term OGCs? (2) what patterns of use are described in the literature for high dose and/or long‐term OGCs? (3) which evidence do we have for chronic conditions related to well‐established steroid‐sparing strategies and tapering regimes for OGCs? (4) what adverse effects have been reported with high dose and/or long‐term OGCs? Methods: A rapid scoping review was conducted using the Joanna Briggs Institute guidelines. The Protocol has been published on the Open Science Framework. A systematic search of MEDLINE (Sep 2014 to Sep 2024) identified systematic reviews and scoping reviews involving adults (≥ 18 years) treated with high doses and/or long‐term OGCs for chronic inflammatory conditions. Studies involving pregnant women were excluded. Results: In total, 137 reviews were included. OGCs were indicated in 47 different conditions in dermatology, respiratory, gastrointestinal, hematology, immunology, rheumatology, and other miscellaneous categories. Across all specialties, OGCs were used either at high doses (at least 20 mg prednisone equivalent per day) or for long durations (for at least 3 months). For types of adverse effects reported in the included reviews, 20 were labeled as endocrine, 13 as immunological, 21 as musculoskeletal, 30 as gastrointestinal, and 16 as cardiovascular. Sixty‐four reviews looked for/reported unspecified adverse events. One hundred and fifteen reviews had evidence of steroid‐sparing/tapering regimes, indicating the wide use of these strategies to mitigate the harmful effects of OGCs. Conclusion: OGCs are used for a broad range of inflammatory conditions across multiple specialties. There is evidence related to a broad range of potential adverse effects across multiple body systems regardless of the indication of use. Further research is needed using a combined cross‐condition approach to their measurement and reduction, alongside gaining more insight into the impact of OGCs on patients' quality of life
Roadmap for resilience: A UK food plan for 2050
No full textThe UK food system faces pressures that make transformation inevitable. The food system accounts for 38% of UK emissions, when imports are included, and will become our biggest source by the 2040s. Climate impacts are estimated to have added 1% annually to food price inflation in European countries. Poor diet costs the UK £268 billion annually in health impacts and lost productivity. Two-thirds of adults live with overweight or obesity, yet under 1% fully meet dietary guidelines. We import 50% of vegetables and 85% of fruit, while much of our cereals harvest goes to feed animals rather than people. More than 7.2 million people live in food-insecure households – an 80% increase in just three years. Things needn’t be this way. UK agriculture and land use have a key role to play in building a much better food system that works for everyone.Our food, farming and landscapes will change radically over the next half century, whether we like it or not. The question is whether we actively manage change for the public good, or respond haphazardly as changes are forced on us. We only have a brief window but if we grasp the opportunity, we can ensure everyone has access to healthy and sustainable food, nature flourishes, our emissions fall and our food system is fair and secure for future generations of farmers and citizens.This Roadmap, developed with input from over 150 experts through the AFN Network+ (UK Agri-Food for Net Zero Network+), offers practical pathways to transform our food system by 2050. National net zero commitments and material pressures mean changes within the broader food system are required, but the goal isn’t just to meet climate targets – it’s to future-proof the UK’s food system while boosting public health, protecting the environment, and strengthening our economy and national security. Our approach addresses what we grow, how we use land and what we eat – and will bring benefits for health, resilience and sustainability
Shielding against oil shocks: Contagion dynamics in Islamic versus conventional markets
Get PDFThis paper empirically examines the decoupling hypothesis by assessing the asymmetric transmissions and contagion effects of oil price shocks on Islamic and conventional stock indices in major oil-importing and -exporting countries. Using the Asymmetric Dynamic Conditional Correlation GARCH (ADCC-GARCH) model, we analysed the dynamic relationships between oil price shocks and stock indices during three critical periods: the Global Financial Crisis (GFC, 2007–2009), the European Sovereign Debt Crisis (ESDC, 2010–2012), and the Oil Price Plunge (OPP, 2014–2016). Our findings indicate that oil-importing and -exporting countries mostly demonstrate insignificant asymmetric responses, suggesting that Islamic and conventional indices are not excessively affected by negative oil shocks. The contagion analysis reveals that oil price shocks predominantly exhibited contagion effects in Islamic and conventional stock indices during the GFC. However, Islamic stock indices in countries such as Japan, Korea, Saudi Arabia, the UAE, Norway, Oman, and Brazil were less affected by these shocks compared with their conventional counterparts. Notably, Islamic indices in Korea, Italy, Saudi Arabia, and Qatar during the ESDC, as well as in the USA, India, Korea, and Germany during the OPP, demonstrated strong resilience to oil price shocks, lending support to the decoupling hypothesis. Portfolio analysis further shows that incorporating Islamic indices into conventional portfolios enhances risk-adjusted returns and hedging effectiveness, with performance improving as the allocation to Islamic indices increases. These findings hold significant implications for investors, portfolio managers, policymakers, and market participants
Heat treatment of 440C stainless steel: Mechanical and electrochemical behaviour
Get PDFThis study aims to evaluate the effects of different heat treatment routes on the microstructure, mechanical properties, corrosion resistance, and tribological performance of 440C stainless steel, with comparative analysis against 416 martensitic stainless steel. Scanning electron microscopy (SEM) was employed to examine microstructural changes, while hardness was measured using standard tests. Corrosion behaviour was assessed through potentiodynamic polarization and open circuit potential (OCP) measurements, tribological performance via pin-on-disk tests, and mechanical properties using plastometry. Three heat treatment routes were investigated: double air tempering at 180°C after austenitising and air quenching, double vacuum tempering at 180°C, and nitrogen tempering at 180°C followed by cryogenic quenching and subsequent nitrogen tempering. Results indicate that all heat treatments significantly improve the mechanical properties of 440C stainless steel compared to untreated and heat-treated 416 stainless steel. Cryogenic treatment notably enhances both hardness and corrosion resistance more effectively than other methods, although its tribological performance under higher loads (15N) is inferior. These findings underscore the importance of tailoring heat treatment strategies to optimize 440C stainless steel for applications requiring high mechanical strength and corrosion resistance
Feeding the machine: Practitioner experiences of efforts to overcome AI’s data dilemma
Get PDFThis paper examines the human implications of AI's ‘data dilemma' in three different and contrasting sectors: pharmaceuticals, higher education, and the arts. The ‘data dilemma' refers to the challenge of obtaining sufficient and suitable data to effectively train AI algorithms. The research, conducted in the UK, involved interviews, focus groups, and observations with 65 practitioners employed across these three sectors. The findings reveal that addressing the data dilemma often involves practitioners being pressured to generate data for AI, either passively in the context of data extractivism or actively by engaging in new forms of data production. We explore how this pressure to ‘feed the machine’ manifests differently in each sector, and how modes of resistance to these emergent data practices vary across sectors. We observe that the push to resolve the data dilemma is fundamentally driven by capitalist and technological solutionist values; values that often conflict with those of practitioners who are expected to adapt their practices in the service of AI-driven capitalism. We conclude with a call for exploring different approaches to AI development that align with alternative value systems