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When is ‘the end of the road’ reached? Observing the presumption of parental involvement through systems theory
Get PDFIn 2014 the Children Act 1989 was amended to include a presuption that involvement of a parent in a child’s life will further the child’s welfare unless there is evidence of the risk of harm. Kaganas published two seminal articles which concluded that the government’s ideological rationale for introducting the presumption of parental involvement not only failed to materialise but had some unintended, possibly detrimental, consequences for mothers. This article examines the operation and effects of the presumption of parental involvement in recent years based on an analysis of private law family court judgments between July 2020 and December 2023. Drawing on Luhmann’s theory of autopoietic social systems, it examines the possibilities for and limitations on using law to drive social change beyond the operations of the legal system itself. It concludes that the statutory presumption has failed to serve its stated purpose and has even had the unintended consequence of generating legal communications about the risks of parental involvement. From a feminist perspective, it concludes that positive changes observed in the family court response to domestic and child abuse are an achievement, in light of the limits on steering society, at least until something changes in the unknowable future
Comprehensive geriatric assessment for people with both COPD and frailty starting pulmonary rehabilitation: a mixed-methods feasibility trial
Get PDFData availablility: All data requests should be submitted to M. Maddocks ([email protected]) for consideration. Access to anonymised data might be granted following investigator review.Supplementary material is available online at: https://publications.ersnet.org/content/erjor/10/4/00774-2023/DC1/embed/inline-supplementary-material-1.pdf . Please note: supplementary material is not edited by the Editorial Office, and is uploaded as it has been supplied by the author.Introduction:
Many people with COPD experience frailty. Frailty increases risk of poor health outcomes, including non-completion of pulmonary rehabilitation. Integrated approaches to support people with COPD and frailty throughout and following rehabilitation are indicated. The aim of the present study was to determine the feasibility of conducting a randomised controlled trial of integrating comprehensive geriatric assessment (CGA) for people with COPD and frailty starting pulmonary rehabilitation.
Methods;
A multicentre mixed-methods randomised controlled feasibility trial (“Breathe Plus”; ISRCTN13051922) was carried out. People with COPD, aged ≥50 years, Clinical Frailty Scale ≥5 and referred for pulmonary rehabilitation were randomised 1:1 to usual pulmonary rehabilitation, or pulmonary rehabilitation plus CGA. Remote intervention delivery was used during COVID-19 restrictions. Outcomes (physical, psychosocial, service use) were measured at baseline, 90 and 180 days, alongside process data and qualitative interviews.
Results:
Recruitment stopped at 31 participants (mean±sd age 72.4±10.1 years, 68% Medical Research Council Dyspnoea Scale 4–5), due to COVID-19-related disruptions. Recruitment (46% eligible recruited) and retention (87% at 90- and 180-day follow-up) were acceptable. CGAs occurred on average 60.5 days post-randomisation (range 8–129) and prompted 46 individual care recommendations (median 3 per participant, range 0–12), 65% of which were implemented during follow-up. The most common domains addressed during CGA were nutrition and cardiovascular health. Participants valued the holistic approach of CGA but questioned the optimal time to introduce it.
Conclusion:
Integrating CGA alongside pulmonary rehabilitation is feasible and identifies unmet multidimensional need in people with COPD and frailty. Given challenges around timing and inclusivity, the integration of geriatric and respiratory care should not be limited to rehabilitation services.This project was funded by a National Institute for Health and Care Research (NIHR) Career Development Fellowship (CDF-2017-10-009) held by M. Maddocks. L.J. Brighton was funded by an ESRC Post-Doctoral Fellowship (ES/X005259/1). C.J. Evans was supported by a Health Education England/NIHR Senior Clinical Lectureship (ICA-SCL-2015-01-001). This research was supported by the NIHR Collaboration for Leadership in Applied Health Research and Care South London, now recommissioned as NIHR Applied Research Collaboration South London
Investigating the effects of artificial baroreflex stimulation on pain perception: A comparative study in no-pain and chronic low back pain individuals
Get PDFData availability statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.Supporting Information is available online at: https://physoc.onlinelibrary.wiley.com/doi/10.1113/JP286375#support-information-section .The autonomic nervous system (ANS) and pain exhibit a reciprocal relationship, where acute pain triggers ANS responses, whereas resting ANS activity can influence pain perception. Nociceptive signalling can also be altered by ‘top-down’ processes occurring in the brain, brainstem and spinal cord, known as ‘descending modulation’. By employing the conditioned pain modulation (CPM) paradigm, we previously revealed a connection between reduced low-frequency heart rate variability and CPM. Individuals with chronic pain often experience both ANS dysregulation and impaired CPM. Baroreceptors, which contribute to blood pressure and heart rate variability regulation, may play a significant role in this relationship, although their involvement in pain perception and their functioning in chronic pain have not been sufficiently explored. In the present study, we combined artificial ‘baroreceptor stimulation’ in both pressure pain and CPM paradigms, seeking to explore the role of baroreceptors in pain perception and descending modulation. In total, 22 individuals with chronic low back pain (CLBP) and 29 individuals with no-pain (NP) took part in the present study. We identified a differential modulation of baroreceptor stimulation on pressure pain between the groups of NP and CLBP participants. Specifically, NP participants perceived less pain in response to baroreflex activation, whereas CLBP participants exhibited increased pain sensitivity. CPM scores were associated with baseline measures of baroreflex sensitivity in both CLBP and NP participants. Our data support the importance of the baroreflex in chronic pain and a possible mechanism of dysregulation involving the interaction between the ANS and descending pain modulation.This study was funded by the EFIC-Grunenthal Award 2019. MH was supported by the NIHR Biomedical Research Centre and Clinical Research Facility at South London and Maudsley NHS Foundation Trust and King's College London
Movement synchrony among dance performers predicts brain synchrony among dance spectators
Get PDFData availability: The data supporting this study are openly available at https://openneuro.org/datasets/ds004783 . The dance video shown in the scanner is available at https://research.gold.ac.uk/id/eprint/34238/ .Supplementary Information is available online at: https://www.nature.com/articles/s41598-024-73438-0#Sec28 .Performing dance is an intrinsically social art form where at least one person moves while another person watches. Dancing in groups promotes social bonding, but how does group dance affect the people watching? A group of dancers and dance novices watched a 30 min dance video individually in an fMRI scanner. In a follow-up behavioural study, the same people watched the video again and provided continuous enjoyment ratings. Firstly, we computed cross-recurrence of continuous enjoyment ratings and inter-subject correlations (ISCs) in fMRI separately for both groups, and with the choreographer of the dance work. At both behavioural and neural levels, dancers responded more similarly to each other than novices. ISCs among dancers extended beyond brain areas involved in audio-visual integration and sensory areas of human movement perception into motor areas, suggesting greater sensorimotor familiarity with the observed dance movements in the expert group. Secondly, we show that dancers' brain activations and continuous ratings are more similar to the choreographer's ratings in keeping with sharing an aesthetic and artistic perspective when viewing the dance. Thirdly, we show that movement synchrony among performers is the best predictor of brain synchrony among both expert and novice spectators. This is consistent with the idea that changes in emergent movement synchrony are a key aesthetic feature of performing dance. Finally, ISCs across perceptual and motor brain areas were primarily driven by movement acceleration and synchrony, whereas ISCs in orbital and pre-frontal brain areas were overall weaker and better explained by the continuous enjoyment ratings of each group. Our findings provide strong evidence that the aesthetic appreciation of dance involves a common experience between dance spectators and the choreographer. Moreover, the similarity of brain activations and of enjoyment increases with shared knowledge of - and practice in - the artform that is being experienced, in this case contemporary performing dance.This research was funded by an ESCR transformative research grant on synchronous movement cooperation and the performing arts (ES/M000680/2) awarded to GO and DCR; GO, MS and DCR received additional funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (grant agreement No. 864420—Neurolive)
Exploring the benefits of hydrogen-water injection technology in internal combustion engines: A rigorous experimental study
Get PDFPrevious hydrogen researchers have demonstrated the great potential of hydrogen as a zero-carbon fuel and its wider operational ability to directly replace the existing fossil-fuelled internal combustion engines (ICE). Hydrogen direct-injection technology can operate at stoichiometric combustion conditions, fully eliminating the intake backfire phenomena, which has the benefit of low airflow requirements and is a suitable solution for naturally aspirated ICE platforms. However, significant challenges must be addressed when operating an H2 ICE at or near stoichiometric. These include rapid pressure rise rate, high in-cylinder gas pressure and temperature and the consequential higher engine-out NOx emissions. This study provides a comprehensive experimental analysis of the effect of water injection on a light-duty H2 engine’s performance, efficiency, burn durations and NOx emission. The engine was modified to operate with hydrogen via a centrally-mounted direct H2 injector and an intake port-mounted water injection system. The study included water vapour measurements, NOx concentrations and other exhaust gases. The practical implications of these findings are significant. The results demonstrated that the NOx emissions were reduced by 79% when the water was injected at a rate of 5 kg/h at 10 bar IMEP and 2000 rpm. This reduction in emissions, coupled with the observed decrease in cylinder pressure and the rate of pressure rise, could substantially improve engine performance and efficiency. At higher load regions, the water injection extended the maximum engine load to 24 bar IMEP and increased the engine torque output by 10%. The maximum Indicated Thermal Efficiency (ITE) increased from 41% at 16.5 bar IMEP to 42.5% at 18 bar IMEP at a lower lambda, with a corresponding reduction in the intake-air-boost pressure requirement. Of particular note, the use of water injection decreased the engine-out NOx emissions under high-load conditions by more than 55%, even at richer AFR compared to pure hydrogen operation.The author(s) received no financial support for the research, authorship, and/or publication of this article
Spectral network based on lattice convolution and adversarial training for noise-robust speech super-resolution
Get PDFData Availability: Data are available on request to the authors.Speech super-resolution aims to predict a high-resolution speech signal from its low-resolution counterpart. The previous models usually perform this task at a fixed sampling rate, reconstructing only high-frequency spectrogram components and merging them with low-frequency ones in noise-free cases. These methods achieve high accuracy, but they are less effective in real-world settings, where ambient noise and flexible sampling rates are presented. To develop a robust model that fits practical applications, in this work, we introduce Super Denoise Net (SDNet), a neural network for noise-robust super-resolution with flexible input sampling rates. To this end, SDNet's design includes gated and lattice convolution blocks for enhanced repair and temporal-spectral information capture. The frequency transform blocks are employed to model long frequency dependencies, and a multi-scale discriminator is proposed to facilitate the multi-adversarial loss training. The experiments show that SDNet outperforms current state-of-the-art noise-robust speech super-resolution models on multiple test sets, indicating its robustness and effectiveness in real-world scenarios
Critique, Vision and Cosmology: Millenarian Ideas in Melanesia
Get PDFAn essential connection between critique and the millenarian has been proposed with particular reference to the study of Melanesian cargo cults. It is argued here that all critique is not necessarily millenarian. Rather, what is crucial for critique to have a millenarian form is for local cosmological ideas and practices to become transformed into the source of a new kind of future; a future that appears delimited by outside power relations (colonial, mission, capitalist) that now define what is possible. Often this involves altering local cosmological ideas of the outside (e.g. the dead) as the new source of future fecundity. The article considers two cases, among Fuyuge and Manus Islands peoples, where forms of critique and the millenarian have radically different outcomes
A "conscious" loss of balance: Directing attention to movement can impair the cortical response to postural perturbations
Get PDFSignificance statement ‘Trying too hard’ is known to interfere with skilled movement, such as sports and music playing. Postural control can also paradoxically worsen when individuals direct conscious attention towards maintaining balance. Yet, the brain mechanisms underpinning the counterproductive effects of such conscious movement processing (CMP) remain unclear. Here, we show that impaired postural control when engaging in CMP is expressed by a reduction in the evoked cortical signal following a perturbation to balance. These findings imply that conscious attempts to minimise postural instability may act as a cognitive dual-task that dampens the sensitivity of the sensorimotor system for future losses of balance.‘Trying too hard’ is known to interfere with skilled movement, such as sports and music playing. Postural control can similarly suffer when conscious attention is directed towards it (termed ‘conscious movement processing’; CMP). However, the neural mechanisms through which CMP influences balance remain poorly understood. We explored the effects of CMP on electroencephalographic (EEG) perturbation-evoked cortical responses and subsequent balance performance. Twenty healthy young adults (age=25.1±5 years; 10 males and 10 females) stood on a force plate-embedded moveable platform whilst mobile EEG was recorded. Participants completed two blocks of 50 discrete perturbations, containing an even mix of slower (186 mm/s peak velocity) and faster (225 mm/s peak velocity) perturbations. One block was performed under conditions of CMP (i.e., instructions to consciously control balance), whilst the other was performed under ‘Control’ conditions with no additional instructions. For both slow and fast perturbations, CMP resulted in significantly smaller cortical N1 signals (a perturbation-evoked potential localised to the supplementary motor area), and lower sensorimotor beta EEG activity 200–400 ms post-perturbation. Significantly greater peak velocities of the centre of pressure (i.e., greater postural instability) were also observed during the CMP condition. Our findings provide the first evidence that disruptions to postural control during CMP may be a consequence of insufficient cortical activation relevant for balance (i.e., insufficient cortical N1 responses followed by enhanced beta suppression). We propose that conscious attempts to minimise postural instability through CMP acts as a cognitive dual-task that dampens the sensitivity of the sensorimotor system for future losses of balance
Innovative methods for edge computing deployment in healthcare
Get PDFThis thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University LondonThis interdisciplinary research explores the integration of edge computing technology
in the healthcare sector, presenting innovative methodologies across three key
contributions.
In Chapter 3, the first contribution introduces the Healthcare Metropolitan Area
Network (HMAN), a novel cooperative hierarchical Edge/Fog computing-based architecture
for urban healthcare systems. HMAN offers offloading scenarios and the
HOSSC algorithm, tailored for versatile data processing. Simulation results demonstrate
its potential as a scalable and robust healthcare system, with efficient computing
capacity and service availability. HMAN also ensures patient privacy through
local data storage and processing, making it a practical solution for serving a large
number of patients.
The second part of this research, expounded upon in Chapter 4, comprises dual
facets: an AI-based priority mechanism to identify urgent cases, aimed at improving
Quality of Service (QoS) and Quality of Experience (QoE) is proposed. Then,
an optimal edge-servers placement (OESP) algorithm to obtain a cost-efficient architecture
with lower delay and complete coverage is presented. Results show reduced
patient latency based on urgency, prioritising critical cases. The OESP algorithm
selects optimal deployment sites, achieving over 80% cost-efficiency improvement. In
summary, the study enhances healthcare system performance, cost-effectiveness, and
reduces latency.
The third part of this research, encapsulated in Chapter 5, introduces an adaptive
load balancing method that combines the strengths of static and Software-Defined
Networking (SDN)-based load balancing algorithms for Edge/Fog-based healthcare
systems. A new algorithm called Load Balancing of Optimal Edge-server Placement
(LB-OESP) is proposed to balance the workload statically in the systems, followed by
the presentation of an SDN-based greedy heuristic (SDN-GH) algorithm to manage
the data flow dynamically within the network. LB-OESP efficiently balances workloads
while minimising edge server requirements, improving system performance, and
reducing costs. The SDN-GH algorithm leverages the benefits of SDN to dynamically
balance the load and provide a more efficient system. Simulation results demonstrate
that this approach provides adaptive load balancing, considering changing network
conditions, resulting in improved system performance and reliability. Furthermore,
it achieves a 12% reduction in system latency and up to 28% lower deployment costs
compared to previous methods, offering a promising, efficient, and cost-effective solution
for Edge/Fog-based healthcare systems
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