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Towards Critical Multiplexity in International Relations
No full textMultiplexity is a promising concept in International Relations (IR) to describe the emerging world order. For Amitav Acharya, a multiplex world is a world of complex interconnectedness and interdependence, with cross-cutting international orders and globalisms led by non-western actors. In a multiplex world, the West will have ‘to negotiate accommodation’ with these global South voices and influence ‘to salvage aspects of the liberal order’. This article interrogates the theoretical foundations of multiplexity by arguing that its claims of foregrounding the significance of the global South—which is, in turn, democratizing power relations—are problematic. Multiplexity as a concept ends up broadening the basis of oligarchy rather than democratizing power relations and empowering ordinary people. We show how this co-optation dynamic is implicit in the concept of multiplexity, where the deep-rooted commitment to the western neo-liberal ideology remains central. In the post-Second World War context, we use specific empirical examples such as the New International Economic Order, the BRICS and the G20, where the much-trumpeted arrival of a new multiplex world was co-opted by great powers. Ultimately, we call for critical multiplexity. The article synthesizes the insights of Gramscian hegemonic projects and Kautskyian ultra-imperialism, and focuses on the struggles of the people rather than on elite prerogatives. Critical multiplexity is a world that is attentive to the challenges against entrenched political and economic power relations and identity politics, without which multiplexity remains in closer communion with a superficially ‘diverse’ but still elitist and class-based international order
Why Black-Box Bayesian Safety Assessment of Autonomous Vehicles is Problematic and What Can be Done About it?
No full textThis paper deals with the Bayesian safety assessment of autonomous vehicles (AV) conducted via driving AVs on the public roads, often referred to as “driving to safety.” A key safety measure is the probability of catastrophic failure (i.e., a road accident) per mile of driving (pfm), assumed a random variable.
We argue that a Bayesian prediction based on a univariate (“black-box”) probabilistic model has an intrinsic deficiency: it cannot accommodate the variation of pfm due to changing road conditions, which in turn may affect significantly the predicted pfm and may lead to optimistic predictions.
A multivariate probabilistic model is developed to overcome this limitation of the univariate model. Using a set of contrived examples the predictions of the multivariate model are compared with those derived with univariate models. Our results provide an intriguing insight that even when AV driving does not lead to accidents at all, the pfm predictions with the multivariate model may be more pessimistic than the assumed prior, and those derived with a black-box model, including the predictions using the recently developed “conservative Bayesian inference”.
The multivariate Bayesian safety assessment can be applied to autonomous vehicles and to other complex intelligent systems such as robots, UAVs, etc., where the operating conditions vary
Telemedicine for diabetic retinopathy screening
Full text linkThis is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the effectiveness of telemedicine diabetic retinopathy screening versus traditional in-person eye exams in people with type 1 or 2 diabetes mellitus on screening uptake, screening adherence, and referral adherence
Person-centred care education in practice: Students’ and academics’ evaluation of a postgraduate radiography module
Full text linkBackground: Person-centred care (PCC) is fundamental to contemporary radiography practice. However, limited educational opportunities exist to enable radiographers to embed PCC in their practice, as most learning is assumed to occur while practising. To fill this gap, and ensure customised knowledge for specific patient groups, a postgraduate PCC-focused module for radiographers covered person-centeredness philosophy and practice. The aim of this study was to explore and describe the experiences of students and educators who participated in a postgraduate PCC-focused module.
Methods: This study employed a participatory action research (PAR) design. The sample comprised ten students and six faculty members who completed an online qualitative survey on Qualtrics. Additional qualitative data was collected using Mentimeter’s word cloud. The
qualitative survey data were analysed using Tesch’s eight steps of coding. The word cloud was interpreted using literature to compare student participants’ responses with literary meanings of PCC. Diffusion of innovations theory was employed as a theoretical framework to understand how educational innovation can enable personal and organisational change over time.
Findings: Four themes were generated: 1) stimulating a culture of person-centred care for both patients and staff, 2) module aspects that limited relatability and learning, 3) the ideal person-centred care module: suggestions for improvement, and 4) becoming champions of
person-centred care: reflections on module impact.
Conclusions: The participants experienced this PCC module as empowering and motivating, as it provided them with practical strategies to embed PCC in their everyday practice for different patient groups. it is hoped that this module can serve as the basis for similar educational provisions in other academic institutions and geographical locations in the future
What's Emotional Labour Got to Do With It? On the Indefensibility of a Sociological Concept
Full text linkStrong discrete Morse theory
Full text linkThe purpose of this work is to develop a version of Forman’s discrete Morse theory for simplicial complexes, based on internal strong collapses. Classical discrete Morse theory can be viewed as a generalization of Whitehead’s collapses, where each Morse function on a simplicial complex K defines a sequence of elementary internal collapses. This reduction guarantees the existence of a CW-complex that is homotopy equivalent to K, with cells corresponding to the critical simplices of the Morse function. However, this approach lacks an explicit combinatorial description of the attaching maps, which limits the reconstruction of the homotopy type of K. By restricting discrete Morse functions to those induced by total orders on the vertices, we develop a strong discrete Morse theory, generalizing the strong collapses introduced by Barmak and Minian. We show that, in this setting, the resulting reduced CW-complex is regular, enabling us to recover its homotopy type combinatorially. We also provide an algorithm to compute this reduction and apply it to obtain efficient structures for complexes in the library of triangulations by Benedetti and Lutz
Mealtime interventions for carers of school-aged children who have oropharyngeal dysphagia: A systematic review
Full text linkPurpose
Oropharyngeal dysphagia (eating, drinking, and swallowing difficulties) in children with neurodisability impacts their whole life. Speech-language pathologists optimise safe, efficient, and enjoyable mealtimes by providing interventions that require carers to adapt their mealtime assistance behaviours. This systematic review identifies and evaluates peer-reviewed mealtime interventions evidence, including content, child, and carer outcomes targeted and effectiveness.
Method
Eleven database and manual searches were completed (January 2024). Eligible studies reported on school-aged children with neurodisability and oropharyngeal dysphagia carer mealtime interventions in any setting against any comparator. Data extraction and quality assessment were completed leading to narrative synthesis.
Result
From 9627 reports, 29 studies (34 reports) were included in this review. Studies had variable designs, only one randomised controlled trial. There were 941 child and 457 carer participants, variably described. Multiple mealtime interventions by varied healthcare professionals targeted different carer behaviours. Twenty-four studies met quality criteria for synthesis with data too heterogeneous for meta-analysis. Studies demonstrated positive outcomes for child and carer mealtime safety, efficiency, and enjoyment using multiple measures.
Conclusion
Mealtime interventions appear better than none. Study evidence is low quality and heterogeneous, with no optimum approach evident. Good quality studies using consistent participant descriptions and core outcome set are required
Co-Centre Research Spotlight ‘How to write a policy brief for engagement and impact’
Full text linkBeyond the pilot phase: exploring the sustainable implementation of artificial intelligence in the English NHS
Full text linkBackground
We explore the experiences of Artificial Intelligence (AI) innovators who had received funding to pilot their innovation in the English NHS, with the aim of understanding what hinders and supports, from their perspective, the sustainable implementation of their innovation beyond the funding period.
Methods
We first identified a list of companies that had received funding from two national schemes supporting AI innovations in the NHS, focusing on early rounds of these schemes. We then used personal contacts to identify key individuals from these companies, and used a snowball approach as well as LinkedIn contacts to increase our sample. We interviewed participants individually, using semi-structured interviews and analysed the data thematically.
Results
We interviewed 18 individuals from 11 AI companies, who had received funding from two national schemes. Our findings show that the funding offered the companies a unique opportunity to pilot their innovations, show early successes and grow recognition around AI and its potential. Yet, innovators faced several barriers in their effort to implement their AI innovations beyond the pilot phase, including misaligned expectations regarding the programmes’ goal, fragmented adoption efforts with little national coordination, and inadequate evaluation mechanisms to generate the evidence needed for wider adoption.
Conclusion
The UK has set great ambitions for the adoption of AI in the NHS and has invested significantly in public funding to support its use. Our findings show that public investment alone is not sufficient to achieve this ambitious target. A better understanding of the implementation challenges of using AI innovation in practice is needed
Community health intervention through musical engagement (CHIME) in South Africa: A formative exploration of the feasibility and development of a music-based intervention to support perinatal mental health
Full text linkIn South Africa, perinatal depression, stress or anxiety affect an estimated 16% to 50% of women posing serious concerns for both mothers and infants. The vast majority of women receive no perinatal mental healthcare through the public health system, partly due to high levels of stigma and a lack of culturally sensitive mental health care. South African musical traditions such as group singing are culturally significant for supporting social connection and coping with challenges experienced in everyday life. However, there is little research on how group music making could be used to support perinatal mental health in South Africa. This study aimed to explore the potential for developing a culturally embedded, music-based intervention to support women in the perinatal period. Using Community-Based Participatory Research, we held five focus group discussions with: 1) community health workers, 2) music experts, 3) traditional healers, 4) professional healthcare workers, and 5) the management team of a rural health NGO. Through thematic analysis, four themes were identified. Theme 1 encompasses the various challenges that contribute to perinatal mental distress, including social determinants of mental health, unhelpful coping strategies, stigma, and isolation. Theme 2 reflects existing community music practices: the way music is embedded in culture, processes of cultural change, and musical practices associated with perinatal health. Theme 3 encompasses the perceived benefits of music making in supporting social connections and effecting transformation in relation to individual mood and spiritual experiences. Theme 4 includes consideration of factors that are important for the development of a music-making intervention to support perinatal mental health. The findings suggest strong potential for implementing music-based mental health interventions in South Africa, adaptable to various facilitators and community contexts
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