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Evaluating the co-designed “kalmer” relaxation intervention for people with aphasia: a feasibility case series
Get PDFBackground: People with aphasia are at increased risk of developing anxiety and depression. There is a need for accessible psychological interventions to be evaluated for this clinical group. Relaxation is a promising treatment option. Aims: This case series study aimed to assess the feasibility of the “Kalmer” relaxation intervention. Methods and Procedures: Twelve participants with aphasia were recruited via online social media/websites for people with aphasia. After 4 weeks of baseline assessment which included for mood the Behavioural Outcomes of Anxiety Scale (BOA) and Stroke Aphasic Depression Questionnaire − 10 item (SADQ-10), participants accessed the relaxation intervention on Vimeo© for 5 weeks. Participants were encouraged to practice relaxation 5 times a week. Vimeo© analytics were collected to measure participants’ preferences and use of the intervention. Immediately post intervention and at 3- and 6-month follow up time points, BOA and SADQ-10 scores were collected again. The Reliable Change Index was used to determine the impact of the intervention. Outcomes and Results: Whilst recruitment was slow, once participants were enrolled the trial appeared feasible. Vimeo© analytics demonstrated participants engaged well in the treatment and preferred imagery-based relaxation recordings. Anxiety symptoms improved for 5/12 participants (42%) immediately post intervention and 7/11 participants (63%) at 3 and 6 month follow-up time points. Depressive symptoms improved for 6/12 participants (50%) immediately post intervention, 4/11 participants (36.3%) at 3-month follow-up and 5/11 participants (45.5%) at 6-month follow-up. Conclusions: The Kalmer relaxation intervention appears feasible and shows potential to reduce anxiety and depressive symptoms in people with aphasia. Considerations for future trials include the need for expanding both recruitment (e.g. community and hospital rehabilitation services) and methods of delivery for the intervention (e.g. DVD and in person groups)
Patient safety improvement in the ear, nose and throat (ENT) speciality: a scoping review of improvement initiatives and involvement of frontline staff
Get PDFBackground
The success of patient safety improvement initiatives depends on frontline staff engaging with improvement efforts. However, in the ENT speciality, there is less patient safety research compared to other healthcare specialities, and limited evidence on staff perspectives regarding safety improvement and the factors influencing their engagement.
Objectives
To map the literature on safety improvement efforts in the ENT speciality in UK settings, and to explore staff involvement and engagement with initiatives to improve patient safety in ENT.
Methods
A literature search was conducted using the PubMed, Ovid MEDLINE and SCOPUS databases to retrieve studies reporting the implementation of patient safety initiatives in ENT departments in the UK, and studies exploring frontline staff perspectives on improving safety in ENT. The selected studies were peer-reviewed, written in English and published between 2013 and 2023. Data were extracted and synthesised in accordance with the predefined research questions.
Results
1,661 studies were screened, and 10 met the selection criteria. Findings demonstrated evidence of staff initiating, designing and implementing safety improvement initiatives. Frontline staff engagement and senior staff/managerial involvement were identified as key contributors to successful implementation. Only one study addressed frontline staff priorities for safety improvement, in the context of improving tracheostomy, with the author stating that results indicated that frontline staff are unwilling to implement low priority interventions.
Conclusion
Further research is needed to explore the factors influencing staff perspectives on how patient safety can be improved in ENT and the factors influencing their engagement. This could lead to recommendations for the development of successful, sustainable initiatives. The authors of this review recommend establishing the following as standard practice: (a) appointing staff as quality/safety champions, and (b) involving frontline staff and senior managers in co-developing improvement strategies
Behaviour of circular SSC-FST beams and columns subjected to short-term static loading
Get PDFThe research presented in this paper is aimed to assess both flexural and axial compressive behaviour of circular steel slag concrete-filled steel tube (SSC-FST) members subjected to short-term static loading. The tests of circular SSC-FST beams and columns were first performed with different replacement ratio of steel slag aggregate (SSA) and slenderness ratio, followed by finite element (FE) modelling to replicate the behaviour of circular SSC-FST beams as well as columns with various slenderness ratio. The results indicate that, both beam and column specimens show good deformability and load-carrying capability, and three phases are observed in the measured moment (load) vs. deformation diagrams. At the end of tests, several symmetrically distributed mild local bulges of steel tube and tiny tensile cracks together with inconspicuous compressive crushing of concrete core were observed for the beam specimens, while one major and a few minor tube local bulges and severe compressive crushing of concrete core for the column specimens were observed. In general, the SSC-FST specimens possess a superior capacity and ductility as well as a lower flexural stiffness than the reference CFST specimens, and the axial compressive capacity and ductility of SSC-FST column specimens show a decreasing trend when increases. In the end, simplified formulae to compute the flexural capacity and axial compressive capacity of circular SSC-FST members were proposed
Communication Patient Reported Outcome Measures for Adults With Communication Disorders: A Systematic Review of Content Validity
Get PDFBackground
Content validity is a key measurement property that should be considered when selecting or reviewing a patient‐reported outcome measure (PROM). In the field of communication disorders, there are several PROMs available, most of which are disease specific. It is unknown what the quality of the content validity of these PROMs is.
Aims
This study aimed to evaluate the content validity of existing communication PROMs used with adults with communication disorders.
Methods
This study evaluated PROMs drawn from a previously published systematic literature review. Of 31 measures, 25 measures were included in this review, covering a range of communication‐related constructs in different communication disorders. The process of rating followed the COnsensus‐based Standards for the selection of health Measurement INstruments (COSMIN) methodology for assessing the content validity of PROMs. There were three stages to the evaluation process comprising Step 1: evaluating the quality of the PROM development, Step 2: evaluating the quality of content validity studies on the PROM (if available) and Step 3: evaluating the content validity of the PROM overall, based on the quality and results of the available studies and the PROM itself.
Main Contribution
Step 1: With regards to the quality of the PROM development, 21 of 25 PROMs were rated as inadequate. Step 2: Content validity studies were available for five of the PROMs. All of these studies were rated doubtful or inadequate. Step 3: The quality of the available evidence on content validity of the included PROMs was overall very low. Only the evidence on the content validity of the Communication Participation Item Bank (CPIB) and the Neuro‐QoL (Quality of Life in Neurological Disorders) was rated as of moderate quality.
Conclusions
Results of this study highlight the scarcity of high‐quality evidence on the development and content validity of PROMs that aim to capture the construct of communication. This review is a call to action for future PROMs to include both the target population and professionals in development and content validity testing, using rigorous methodology in the process.
WHAT THIS PAPER ADDS
What is already known on this subject
There are several patient reported outcome measures (PROMs) available for adult communication disorders. Many of these PROMs have been assessed on one or more psychometric properties, typically reliability and validity aspects. Content validity is often overlooked in research.
What this study adds
Clinimetric and psychometric experts recommend content validity as the first and most important measurement property to consider when selecting a scale. This study is the first to provide a systematic assessment of the quality of content validity of communication PROMs used in adult communication disorders.
What are the potential or clinical implications of this work?
Using measures with good content validity during outcome measurement ensures that researchers and clinicians capture constructs that are relevant and important to clients. It also ensures that the measures used are accessible to the clients and comprehensively address their needs
ALL-Net: integrating CNN and explainable-AI for enhanced diagnosis and interpretation of acute lymphoblastic leukemia
Get PDFThis article presents a new model, ALL-Net, for the detection of acute lymphoblastic leukemia (ALL) using a custom convolutional neural network (CNN) architecture and explainable Artificial Intelligence (XAI). A dataset consisting of 3,256 peripheral blood smear (PBS) images belonging to four classes—benign (hematogones), and the other three Early B, Pre-B, and Pro-B, which are subtypes of ALL, are utilized for training and evaluation. The ALL-Net CNN is initially designed and trained on the PBS image dataset, achieving an impressive test accuracy of 97.85%. However, data augmentation techniques are applied to augment the benign class and address the class imbalance challenge. The augmented dataset is then used to retrain the ALL-Net, resulting in a notable improvement in test accuracy, reaching 99.32%. Along with accuracy, we have considered other evaluation metrics and the results illustrate the potential of ALLNet with an average precision of 99.35%, recall of 99.33%, and F1 score of 99.58%. Additionally, XAI techniques, specifically the Local Interpretable Model-Agnostic Explanations (LIME) algorithm is employed to interpret the model’s predictions, providing insights into the decision-making process of our ALL-Net CNN. These findings highlight the effectiveness of CNNs in accurately detecting ALL from PBS images and emphasize the importance of addressing data imbalance issues through appropriate preprocessing techniques at the same time demonstrating the usage of XAI in solving the black box approach of the deep learning models. The proposed ALL-Net outperformed EfficientNet, MobileNetV3, VGG-19, Xception, InceptionV3, ResNet50V2, VGG-16, and NASNetLarge except for DenseNet201 with a slight variation of 0.5%. Nevertheless, our ALL-Net model is much less complex than DenseNet201, allowing it to provide faster results. This highlights the need for a more customized and streamlined model, such as ALL-Net, specifically designed for ALL classification. The entire source code of our proposed CNN is publicly available at https://github.com/Abhiram014/ALL-Net-Detection-of-ALL-using-CNN-and-XAI
An overview of the quantum cognition research programme
No full textThe quantum cognition research programme concerns the application of quantum probability theory (the rules for how to assign probabilities to events from quantum mechanics, without the physics) to cognitive modeling. We review quantum cognitive models in several areas of psychology, including conjunction/ disjunction fallacies in probabilistic judgment, conceptual combinations, similarity, order effects on judgments, causal inference, the disjunction effect in decision making, measurement and interference effects on judgments and decisions, memory, perception, and other judgment and decision-making applications. For each area, we first present the empirical findings that have motivated the application of quantum models, emphasizing any characteristics which are particularly puzzling or have resisted coherent theoretical explanations previously; we then discuss the quantum cognitive models, noting the key features of the models that help explain the empirical data; we finally cast a critical eye on the models and explore comparisons with non-quantum models
Diet, fruit and vegetables and One Health: benefits for health, environment, society and the consumer—proceedings of the 9th edition of EGEA conference
Get PDFPurpose
To present the outcomes of the EGEA Conference on the state of knowledge regarding the contribution of diets rich in fruit and vegetables (FV) to human and planetary health, commonly included in the One Health concept.
Methods
The 9th edition of EGEA Conference (20–22 September 2023, Barcelona) provided a transversal and multidisciplinary perspective on the contribution of FV to One Health, in particular to the health of individuals, society and the planet. Nearly 150 international scientists and stakeholders discussed the current state of knowledge. These proceedings are based both on a literature review and the scientific studies presented by the speakers.
Results
Scientific evidence confirms the role of FV in preventing cardiovascular diseases and type 2 diabetes; more evidence is needed on the effects and mechanisms of FV in cancer prevention. FV production and consumption helps ensure territorial cohesion and provides a denser, nutrient-rich diet with less environmental impact (except water use) than other food groups, but use of synthetic pesticides in FV production remains a challenge that could be addressed with agro-ecological solutions. Various factors influence consumer choice and behaviour towards FV consumption across the lifespan, with specific periods being more conducive to change. New research is emerging on the role of FV consumption in regulating gut microbiota and on both mental and brain health; the potential role of FV production and supply in tackling biodiversity loss and climate change; and better monitoring of FV consumption.
Conclusion
Sufficient evidence confirms the contribution of diet rich in FV to One Health, with some emerging research on this topic. Concerted actions are required towards an increased consumption of FV and a more diversified and environmentally neutral FV production
Exploring Deaf And Hard of Hearing Peoples' Perspectives On Tasks In Augmented Reality: Interacting With 3D Objects And Instructional Comprehension
Get PDFTasks in augmented reality (AR), such as 3D interaction and instructional comprehension, are often designed for users with uniform sensory abilities. Such an approach, however, can overlook the more nuanced needs of Deaf and Hard of Hearing (DHH) users who might have reduced auditory perception. To better understand these challenges, our study utilized the single-player AR game Angry Birds AR as a probe to explore how 11 DHH participants and 15 hearing participants experienced AR interactions. Our findings highlight that DHH users prefer interaction based on context, effective haptic cues, audio cue substitutes, and clear instructional design. We, therefore, propose the following design recommendations to enhance the accessibility of AR for DHH users. This includes customizable UI options, modular feedback systems, and virtual avatars for sign language instructions
Teaching Research Methods in a Changing World: Responding to Generative Artificial Intelligence
Get PDFWhile the tools associated with Generative Artificial Intelligence have evolved over some years, they have become widely used and entered widespread public consciousness since 2022. Generative AI has an immediate impact on Higher Education because of its effect on many of the skills that students need to acquire. Immediate responses to the availability of Generative AI have focused on concerns about student cheating and about the need to design its inappropriate use out of assessments. While the discussion of how it affects learning and teaching has moved on to recognise that students do need to understand how Generative AI can be used there is still limited appreciation of where it fits into the teaching of research methods. Generative AI, used carefully and appropriately, can be applied as a research tool and as it evolves it is likely that new opportunities for its use will emerge. Research typically entails a measure of independent work and scholarly writing by students. Generative AI can create wording which, at least superficially, can appear to a reader as professional and fluent but which is often generic and superficial. For a student encountering the need to carry out research for the first time, typically as part of a taught degree course, it can be difficult to distinguish between the legitimate use of Generative AI, for example to assist with creating ideas, and its inappropriate use to produce text which does not reflect research which has been carried out. A useful starting point for discussing the application of Generative AI is to compare it with the involvement of another person. For a student to pretend that something is their own work when it is not, constitutes plagiarism whether the work in fact is produced by somebody else or it is produced by an AI engine. Conversely it would be reasonable to discuss concepts with another person and similarly to discuss them with AI. Framing this introduces some challenges around how to build AI into teaching about research
Diversity of representation in pregnancy research: A national mixed-methods survey of women’s perceptions and experiences in the United Kingdom
Get PDFAim
To explore the experiences and perceptions of women who may take part in antenatal research, including their perceived motivators, enablers, and barriers to participating in research with a sub-analysis of under-represented groups.
Methods
A mixed-methods parallel explanatory design was employed, and a national semi-structured online survey was circulated nationally using a start to end participatory framework. Likert scale responses and participant experience and demographic data were cross-tabulated to explore the differences between groups using descriptive and non-parametric statistics. A content analysis was used to explore open-ended questions and generate coding clusters. The qualitative and quantitative results were then merged using a using a pillar integration process.
Findings
There were 260 survey responses across the UK, from Oct to Nov 2021 as part of wider research. Three meta-themes were developed from the merged integration: 1. Participation being mediated by perceptions and experience of safety, convenience, and communication, 2. Lived experience and education may increase access to research participation, and 3. Sociocultural differences may lead to research hesitancy.
Conclusion
Clinical researchers and research delivery teams working in antenatal settings, have the potential to impact the inclusion of underserved communities through facilitative research designs, well considered communication strategies, and authentic relationships which support participant education about research
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