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Introduction to A Research Agenda for Patent Law
No full textThe book aims to explore critical areas for future research, focusing on issues that emerge at the crossroads of patent law, new technologies and evolving societal demands. By investigating how patents can promote innovation, the volume seeks to offer guidance for researchers, policymakers and practitioners as they navigate the dynamic landscape of patent rules and policies. Additionally, the book intends to pinpoint and analyse research topics within patent law that are expected to gain significant relevance in the coming decade
A Game Worth the Candle? French Journalists and Their Illusio in the Face of Disinformation
Get PDFOngoing disruptions to information ecosystems place unabatedpressure on journalists to identify false news stories. In France,the 2017–2022 period epitomised such challenges, as they had tograpple with an outpouring of disinformation throughincreasingly sophisticated methods. As economic, organisationaland political pressures often leave them with inadequateresources to counter the issue, why do journalists still believetheir job is worth doing? To answer this question, Bourdieu’sconcept of illusio, summarised as the idea that “the game isworth the candle/the effort”, has been applied in guidinginterviews with 15 participants working for French mainstreamnews organisations. Findings hint at a shift in the traditionalbuttresses of journalistic illusio, many no longer considering thatthey have the capacity to influence in the current informationdisorder. Crucially, most of the interviewees admit questioningthe impact of their work, in particular since the COVID-19pandemic, which points to a gap between ideals and practice.While self-reflection is always beneficial in a professiontraditionally reluctant to consider its own shortcomings,understanding the factors that erode this illusio is key at a timewhen a journalist’s career in France only lasts, on average, 15 years
“It’s sink or swim for us”: The lived experiences of Filipino nurses in the UK during the COVID-19 pandemic
Get PDFBackground
The United Kingdom has recruited Filipino nurses since the late 1990s to meet the country’s healthcare needs. Currently, over 40,000 Filipinos are working in the National Health Service, and it is suggested that 36 % of all known healthcare worker (HCW) deaths from COVID-19 within the first two-month period (March and April 2020) were Filipinos, despite accounting for 8 % of the NHS nursing workforce. There was a clear disparity in social media exposure between the celebrated heroism of Filipino HCW and the coverage of disproportionate death rates within the Filipino HCW community in the UK. This study aimed to explore the lived experiences of Filipino nurses in the UK during the COVID-19 pandemic.
Methods
A qualitative study was conducted using interpretative phenomenological approach (IPA). Six nurses were recruited using purposive and snowball sampling, and interviews were transcribed verbatim and analyzed using IPA.
Findings
Drawing on interview data, two themes are presented: inescapability and relentlessness of COVID-19 and “It’s sink or swim”: psychological welfare.
Interpretation
Filipino nurses experienced the COVID-19 pandemic as an all-consuming phenomenon, as they were perceived as the embodiment of threat and placed at disproportionate risk perpetuated by racial, systemic, and political factors. Despite this, they had no choice but to battle through, engaging in culturally specific ways of coping
Patient and caregiver experiences with hydrocortisone injections in adrenal crisis: a mixed-methods cross-sectional study
Get PDFBackground
Adrenal crisis is the leading cause of death in patients with adrenal insufficiency, and prevention requires immediate parenteral hydrocortisone administration. However, most patients do not receive their home emergency hydrocortisone injection. Our study aimed to investigate barriers and enablers to using emergency hydrocortisone injections in managing adrenal crises.
Methods
This mixed-methods observational study utilized an online survey distributed through two U.S.-based patient advocacy groups. A total of 688 respondents completed the survey, including 485 (70%) parents/caregivers of individuals with adrenal insufficiency and 203 (30%) adults with adrenal insufficiency. Qualitative free-text responses were analyzed using thematic content analysis, with subsequent quantification of identified barriers and enablers to administering parenteral hydrocortisone during adrenal crises.
Results
Over 60% of patients with adrenal insufficiency had required parenteral hydrocortisone for an adrenal crisis, yet fewer than 20% managed to self-inject. Thirteen barriers and nine enablers were identified across three thematic domains: device factors, external factors, and emotional factors. Key barriers included the complexity of the multi-step hydrocortisone injection process (81%), injection-related anxiety and lack of confidence (18%), challenges accessing the correct hydrocortisone formulation or equipment (38%), and inadequate support for managing adrenal crises (29%). Key enablers included the effectiveness of hydrocortisone (14%), the convenience of the combined powder-and-diluent hydrocortisone vial (36%), and patient education (4%). Notably, 97% of participants expressed a preference for a hydrocortisone autoinjector to enhance self-injection capabilities.
Conclusion
Effective adrenal crisis management requires comprehensive, evidence-based interventions across patient, healthcare, and societal levels. This should include the development of user-friendly hydrocortisone delivery devices, individualized patient education, healthcare system reforms, and public awareness
Exploring the Potential of a Digital Intervention to Enhance Couple Relationships (the Paired App): Mixed Methods Evaluation
Get PDFBackground:
Despite the effects of poor relationship quality on individuals’, couples’, and families’ well-being, help seeking often does not occur until problems arise. Digital interventions may lower barriers to engagement with preventive relationship care. The Paired app, launched in October 2020, aims to strengthen and enhance couple relationships. It provides daily questions, quizzes, tips, and detailed content and facilitates in-app sharing of question and quiz responses and tagged content between partners.
Objective:
To explore the potential of mobile health to benefit couple relationships and how it may do this, we examined (1) Paired’s impact on relationship quality and (2) its mechanisms of action.
Methods:
This mixed methods evaluation invited Paired subscribers to complete (1) brief longitudinal surveys over 3 months (n=440), (2) a 30-item web-based survey (n=745), and (3) in-depth interviews (n=20). For objective 1, survey results were triangulated to determine associations between relationship quality measures and the duration and frequency of Paired use, and qualitative data were integrated to provide explanatory depth. For objective 2, mechanisms of action were explored using a dominant qualitative approach.
Results:
Relationship quality improved with increasing duration and frequency of Paired use. Web-based survey data indicate that the Multidimensional Quality of Relationship Scale score (representing relationship quality on a 0-10 scale) was 35.5% higher (95% CI 31.1%-43.7%; P=.002), at 7.03, among people who had used Paired for >3 months compared to 5.19 among new users (≤1 wk use of Paired), a trend supported by the longitudinal data. Of those who had used Paired for >1 month, 64.3% (330/513) agreed that their relationship felt stronger since using the app (95% CI 60.2%-68.4%), with no or minimal demographic differences. Regarding the app’s mechanisms of action, interview accounts demonstrated how it prompted and habituated meaningful communication between partners, both within and outside the app. Couples made regular times in their day to discuss the topics Paired raised. Daily questions were sometimes lighthearted and sometimes concerned topics that couples might find challenging to discuss (eg, money management). Interviewees valued the combination of fun and seriousness. It was easier to discuss challenging topics when they were raised by the “neutral” app, rather than during stressful circumstances or when broached by 1 partner. Engagement seemed to be enhanced by users’ experience of relationship benefits and by the app’s design.
Conclusions:
This study demonstrates proof of concept, showing that Paired may have the potential to improve relationship quality over a relatively short time frame. Positive relationship practices became embedded within couples’ daily routines, suggesting that relationship quality improvements might be sustained. Digital interventions can play an important role in the relationship care ecosystem. The mixed methods design enabled triangulation and integration, strengthening our findings. However, app users were self-selecting, and methodological choices impact our findings’ generalizability
Evaluation of a customised, AI-focused educational seminar delivered to final year undergraduate radiography students in the UK: A cross-sectional study
Get PDFIntroduction: AI education is essential to facilitate seamless clinical integration. The HCPC in the UK requires all radiographers to have some level of digital skills to maintain safety of clinical practice. This study aimed to evaluate the impact of a dedicated AI seminar on radiography students.
Methods: A dedicated 1.5-h in-person seminar was delivered by an AI vendor to final year undergraduate diagnostic radiography students at a UK University. The course consisted of both theory and practice training. An online survey was built and piloted, consisting of both closed and open-ended questions, to explore their level of knowledge, skills and confidence in AI, before (pre-test) and after the delivery (post-test) of the seminar using a 10-point scale. Pre-test was distributed two weeks before the seminar and post-test was open two weeks after.
Results: A total of 68 students answered the pre-test and 31 the post-test survey. Students’ theoretical knowledge (Mean = 6.57 vs Mean = 3.85), skills (Mean = 5.39 vs Mean = 3.44) and confidence (Mean = 5.47 vs Mean = 3.43) on AI were all significantly improved after the seminar. Their responses became more focused and specific in the post-test survey. In both surveys students expressed concerns around reliability and accountability of AI, data management and security, patient confidentiality and overreliance on technology in the open-ended questions. They also requested more AI training with hands-on options in their undergraduate degree.
Conclusion: This study confirms the importance of even brief, but customised educational interventions relating to AI for radiographers. The learning needs to be customised to maximise knowledge retention and applicability and to include both theoretical and practical aspects for consolidation of skills.
Implications for practice: These findings will help radiography educators build more focused, tailored AI courses for future students
Improved genetic discovery and fine-mapping resolution through multivariate latent factor analysis of high-dimensional traits
Get PDFGenome-wide association studies (GWASs) of high-dimensional traits, such as blood cell or metabolic traits, often use univariate approaches, ignoring trait relationships. Biological mechanisms generating variation in high-dimensional traits can be captured parsimoniously through a GWAS of latent factors. Here, we introduce flashfmZero, a zero-correlation latent-factor-based multi-trait fine-mapping approach. In an application to 25 latent factors derived from 99 blood cell traits in the INTERVAL cohort, we show that latent factor GWASs enable the detection of signals generating sub-threshold associations with several blood cell traits. The 99% credible sets (CS99) from flashfmZero were equal to or smaller in size than those from univariate fine-mapping of blood cell traits in 87% of our comparisons. In all cases univariate latent factor CS99 contained those from flashfmZero. Our latent factor approaches can be applied to GWAS summary statistics and will enhance power for the discovery and fine-mapping of associations for many traits
Research: When Does Scientific Decision-Making Benefit Startups?
No full textNew research on 261 UK start-ups reveals that adopting a scientific approach to decision-making can have different effects depending on the maturity of the business model. Established ventures that used scientific methods to optimize their existing strategies saw immediate performance gains, whereas early-stage start-ups experienced economic performance declines as they questioned and revised fundamental business assumptions. These findings highlight how the impact of scientific decision-making varies based on a firm’s stage of development, with important implications for founders, investors, and business educators on evaluating start-up performance and supporting entrepreneurial growth
Operationalising Stakeholder Governance: Some Lessons from China’s New Company Law
Get PDFThe shareholder primacy model has come under increasing scrutiny in recent decades, particularly in light of climate change and other pressing global crises, with companies now expected to address the interests of a wider range of stakeholders. Stakeholder governance has thus emerged as a promising alternative model. While many jurisdictions are exploring pathways to advance more stakeholder-oriented governance models, the recent amendments to China's Company Law presents a particularly noteworthy example. This paper critically examines its newly introduced stakeholder-oriented provisions, including the mandated consideration of stakeholder interests, enhanced employee engagement requirements such as the implementation of workforce directors and adjustments to shareholders’ rights and directors’ duties. The paper analyses whether, and to what extent, these reforms represent a shift away from the shareholder primacy model as it was traditionally dominant in China. The paper makes two further contributions: first, it explores potential pathways for future reform to strengthen stakeholder-oriented governance in China; and second, it highlights lessons that can be learned to operationalise stakeholder governance for other jurisdictions
Optimising neonatal services for very preterm births between 27+0 and 31+6 weeks gestation in England: the OPTIPREM mixed-methods study
Get PDFAim
To investigate, for preterm babies born between 27+0 and 31+6 weeks gestation in England, optimal place of birth and early care.
Design
Mixed methods.
Setting
National Health Service neonatal care, England.
Methods
To investigate whether birth and early care in neonatal intensive care units (tertiary units) compared to local neonatal units (non-tertiary units) influenced gestation-specific survival and other major outcomes, we analysed data from the National Neonatal Research Database, for 29,842 babies born between 27+0 and 31+6 weeks gestation and discharged from neonatal care between 1 January 2014 and 31 December 2018. We utilised an instrumental variable (maternal excess travel time between local neonatal units and neonatal intensive care units) to control for unmeasured differences. Sensitivity analyses excluded postnatal transfers within 72 hours of birth and multiple births. Outcome measures were death in neonatal care, infant mortality, necrotising enterocolitis, retinopathy of prematurity, severe brain injury, bronchopulmonary dysplasia, and receipt of breast milk at discharge. We also analysed outcomes by volume of neonatal intensive care activity. We undertook a health economic analysis using a cost-effectiveness evaluation from a National Health Service perspective and using additional lives saved as a measure of benefit, explored differences in quality of care in high compared with low-performing units and performed ethnographic qualitative research.
Results
The safe gestational age cut-off for babies to be born between 27+0 and 31+6 weeks and early care at either location was 28 weeks. We found no effect on mortality in neonatal care (mean difference −0.001; 99% confidence interval −0.011 to 0.010; p = 0.842) or in infancy (mean difference −0.002; 99% confidence interval −0.014 to 0.009; p = 0.579) (n = 18,847), including after sensitivity analyses.
A significantly greater proportion of babies in local neonatal units had severe brain injury (mean difference −0.011; 99% confidence interval −0.022 to −0.001; p = 0.007) with the highest mean difference in babies born at 27 weeks (−0.040). Those transferred in the first 72 hours were more likely to have severe brain injury. For 27 weeks gestation, birth in centres with neonatal intensive care units reduced the risk of severe brain injury by 4.2% from 11.9% to 7.7%. The number needed to treat was 25 (99% confidence interval 10 to 59) indicating that 25 babies at 27 weeks would have to be delivered in a neonatal intensive care unit to prevent one severe brain injury.
For babies born at 27 weeks gestation, birth in a high-volume unit (> 1600 intensive care days/year) reduced the risk of severe brain injury from 0.242 to 0.028 [99% confidence interval 0.035 to 0.542; p = 0.003; number needed to treat = 4 (99% confidence interval 2 to 29)].
Estimated annual total costs of neonatal care were £262 million. The mean (standard deviation) cost per baby varied from £75,594 (£34,874) at 27 weeks to £27,401 (£14,947) at 31 weeks. Costs were similar between neonatal intensive care units and local neonatal units for births at 27+0 to 29+6 weeks gestation, but higher for local neonatal units for those born at 30+0 to 31+6 weeks. No difference in additional lives saved were observed between the settings. These results suggested that neonatal intensive care units are likely to represent value for money for the National Health Service. However, careful interpretation of this results should be exercised due to the ethical and practical concerns around the reorganisation of neonatal care for very preterm babies from local neonatal units to neonatal intensive care units purely on the grounds of cost savings.
We identified a mean reduction in length of stay (1 day; 95% confidence interval 1.029 to 1.081; p < 0.001) in higher-performing units, based on adherence to evidence- and consensus-based measures. Staff reported that decision-making to optimise capacity for babies was an important part of their work. Parents reported valuing their baby’s development, homecoming, continuity of care, inclusion in decision-making, and support for their emotional and physical well-being.
Conclusions
Birth and early care for babies ≥ 28 weeks is safe in both neonatal intensive care units and local neonatal units in England. For anticipated births at 27 weeks, antenatal transfer of mothers to centres colocated with neonatal intensive care units should be supported. When these inadvertently occur in centres with local neonatal units, clinicians should risk assess decisions for postnatal transfer, taking patient care requirements, staff skills and healthcare resources into consideration and counselling parents regarding the increased risk of severe brain injury associated with transfer.
Study registration
This study is registered as Current Controlled Trials NCT02994849 and ISRCTN74230187.
Funding
This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: 15/70/104) and is published in full in Health and Social Care Delivery Research; Vol. 13, No. 12. See the NIHR Funding and Awards website for further award information
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