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Frailty nurse and GP-led models of care in care homes: the role of contextual factors impacting Enhanced health in care homes framework implementation
Get PDFBACKGROUND: The Enhanced Health for Care homes (EHCH) framework is an innovative response to provide more proactive, preventative approaches to care for residents living in care homes. It involves co-producing a shared vision with primary care. As part of EHCH a UK clinical commissioning group supported GP's in two localities to implement their preferred delivery approach involving a new Frailty Nurse-led (FN-led) model in care homes alongside an existing General Practitioner-led (GP-led) model. This paper focuses on implementation of the new FN-led model.
METHODS: A qualitative study design was adopted. Forty-eight qualitative semi-structured interviews were undertaken across six care home sites in a Northern locality: three implementing the FN-led and three engaged in an existing GP-led model. Participants included residents, family members, care home managers, care staff, and health professionals working within the EHCH framework.
RESULTS: Two overarching themes were generated from data analysis: Unanticipated implementation issues and Unintended consequences. Unsuccessful attempts to recruit Frailty Nurses (FN) with enhanced clinical skills working at the desired level (UK NHS Band 7) led to an unanticipated evolution in the implementation process of the FN-led model towards 'training posts'. This prompted misaligned role expectations subsequently provoking unexpected temporary outcomes regarding role-based trust. The existing, well understood nature of the GP-led model may have further exacerbated these unintended consequences.
CONCLUSION: Within the broader remit of embedding EHCH frameworks, the implementation of new FN roles needed to evolve due to unforeseen recruitment issues. Wider contextual factors are not in the control of those developing new initiatives and cannot always be foreseen, highlighting how wider factors can force evolution of planned implementation processes with unintended consequences. However, the unintended consequences in this study highlight the need for careful consideration of information dissemination (content and timing) to key stakeholders, and the influence of existing ways of working
Whose geography do we review?
Get PDFIn the context of discipline-wide efforts to produce more inclusive, just, and equitable norms of geographical knowledge production, section editors for Geography Compass identify five concrete practices by which to address systemic inequities, injustices, and exclusions through their editorial work
An analysis of the effect of data processing methods on magnetic propeller models in short GRBs
Get PDFWe present analysis of observational data from the Swift Burst Analyser for a sample of 15 short gamma-ray bursts with extended emission (SGRBEEs) which have been processed such that error propagation from Swift’s count-rate-to-flux conversion factor is applied to the flux measurements. We apply this propagation to data presented by the Burst Analyser at 0.3-10 keV and also at 15-50 keV, and identify clear differences in the morphologies of the light-curves in the different bands. In performing this analysis with data presented at both 0.3-10 keV, at 15-50 keV, and also at a combination of both bands, we highlight the impact of extrapolating data from their native bandpasses on the light-curve. We then test these data by fitting to them a magnetar-powered model for SGRBEEs, and show that while the model is consistent with the data in both bands, the model’s derived physical parameters are generally very loosely constrained when this error propagation is included and are inconsistent across the two bands. In this way, we highlight the importance of the Swift data processing methodology to the details of physical model fits to SGRBEEs
Human–robot interactions in the restaurant setting: the role of social cognition, psychological ownership and anthropomorphism
Get PDFPurpose: The usage of robot waiters in the hospitality industry is growing, thus increasing the number of human–robot interactions in frontline services. Focusing on robot waiters in restaurants, this study aims to propose the social cognition (SC)–psychological ownership (PO)–customer responses (CR) model, while examining the association between SC, PO, robot anthropomorphism and CR. Design/methodology/approach: The hypotheses of this study are tested using a three-step mixed-method approach that includes partial least squares structural equation modeling (PLS-SEM), necessary condition analysis (NCA) and fuzzy-set qualitative comparative analysis (fsQCA). Findings: PLS-SEM demonstrates the mediating role of psychological ownership on the relationship between SC, customer attitudes regarding being attended by a robot and revisiting intentions. Robot anthropomorphism enhances the relationship between SC and psychological ownership. NCA indicates that SC and psychological ownership are necessary conditions for the presence of favorable attitudes and revisiting intentions. FsQCA suggests that different configurations of the antecedent conditions lead to better attitudes and revisiting intentions. Practical implications: Frontline hospitality robots need to be perceived as warm, competent, responsive and adaptable to customer requests to elicit positive responses. Managers should employ attractive robots displaying anthropomorphic features. Managers need to ensure that customers have some knowledge about robots before interacting with them. Managers should also consider customer heterogeneity and the context in which the robots will be deployed. Originality/value: Based on the psychological ownership theory, this paper analyzes the relationship between SC, psychological ownership and CR. Anthropomorphism moderates the relationship between SC and psychological ownership
Machine Learning Empowered Thin Film Acoustic Wave Sensing
Get PDFThin film based surface acoustic wave (SAW) technology has been extensively explored for physical, chemical and biological sensors. However, these sensors often show inferior performance for a specific sensing in complex environments, as they are affected by multiple influencing parameters and their coupling interferences. To solve these critical issues, we propose a methodology to extract critical information from the scattering parameter and combine machine learning method to achieve multi-parameter decoupling. We used AlScN film-based SAW device as an example, in which highly c-axis orientated and low stress AlScN film was deposited on silicon substrate. The AlScN/Si SAW device showed a Bode quality factor value of 228 and an electro-mechanical coupling coefficient of ~2.3. Two sensing parameters (i.e., ultraviolet or UV and temperature) were chosen for demonstration and the proposed machine-learning method was used to distinguish their influences. Highly precision UV sensing and temperature sensing were independently achieved without their mutual interferences. This work provides an effective solution for decoupling of multi-parameter influences and achieving anti-interference effects in thin film based SAW sensing
I-eAT, a consortium addressing gastronomic solutions for altered taste: A research and development manifesto
Get PDFAn International Altered Taste Consortium (I-eAT) is proposed that seeks to utilise gastronomic and biopsychosocial insights to understand and help people who experience taste alterations. Altered eating experiences and a changed experience of taste is a common and disabling trans-diagnostic, multi-causal entity which has for too long been poorly understood and supported in health research and practice. The phrase Altered Taste is employed (using “taste” in its most commonly understood sense to refer to the overall multi-sensory flavour experience) to emphasise the lived sensory experience of those living with an altered relationship with food. Interdisciplinary collaboration between the domains of medicine, health care, physiology, psychology and gastronomy is considered key to understanding, working with and improving altered taste. This manifesto emerged from ongoing research and practice, and was formulated at a workshop of interdisciplinary experts and patient representatives at the Second International Altered Taste Symposium (2022). Between them they collectively agreed on 1. A shared terminology to maximise stakeholder involvement and 2. An overall research aim to better understand, manage and treat Altered Taste. This aim is implemented in 4 key research objectives
When (deliberate) practice is not enough – the role of intelligence, practice, and knowledge in academic performance
Get PDFIt is well established that academic performance (AP) depends on a number of factors, such as intellectual capacities, practice, and previous knowledge. We know little about how these factors interact as they are rarely measured simultaneously. Here we present mediated-Factors of Academic Performance (m-FAP) model, which simultaneously assesses direct and indirect, mediated, effects on AP. In a semester-long study with 118 first-year college students, we show that intelligence and working memory only indirectly influenced AP on a familiar, less challenging college course (Introduction to Psychology). Their influence was mediated through previous knowledge and self-regulated learning activities akin to deliberate practice. In a novel and more challenging course (Statistics in Psychology), intellectual capacities influenced performance both directly and indirectly through previous knowledge. The influence of deliberate practice, however, was considerably weaker in the novel course. The amount of time and effort that the students spent on the more difficult course could not offset the advantage of their more intelligent and more knowledgeable peers. The m–FAP model explains previous contradictory results by providing a framework for understanding the extent and limitations of individual factors in AP, which depend not only on each other, but also on the learning context
Information discernment and online reading behaviour: An experiment
Get PDFPurpose. To explore the relationship between participants’ eye fixations (a measure of attention) and durations (a measure of concentration) on Areas of Interest within a range of online articles and their levels of information discernment (a sub-process of information literacy characterising how participants make judgements about information).Methodology. Eye-tracking equipment was used as a proxy measure for reading behaviour by recording eye-fixations, dwell times and regressions in males aged 18-24 (n=48). Participants’ level of information discernment was determined using a quantitative questionnaire.Findings. Data indicates a relationship between participants’ level of informationdiscernment and their viewing behaviours within the articles’ Area of Interest. Those who scored highly on an information discernment questionnaire tended to interrogate the online article in a structured and linear way. Those with high-level information discernment are more likely to pay attention to textual and graphical information than those exhibiting low level information discernment. Conversely, participants with low-level information discernment indicated a lack of curiosity by not interrogating all of the article. They were unsystematic in their saccadic movements spending significantly longer viewing irrelevant areas.Social implications. The most profound consequence is that those with low-level information discernment, through a lack of curiosity in particular, could base health, workplace, political or everyday decisions on sub-optimal engagement with, and comprehension of information or misinformation (such as fake news).Originality/value. Ground-breaking analysis of the relationship between a persons’ self reported level of information literacy (information discernment specifically) and objective measures of reading behaviour
Disgust sensitivity relates to attitudes toward gay men and lesbian women across 31 nations
Get PDFPrevious work has reported a relation between pathogen-avoidance motivations and prejudice toward various social groups, including gay men and lesbian women. It is currently unknown whether this association is present across cultures, or specific to North America. Analyses of survey data from adult heterosexuals ( N = 11,200) from 31 countries showed a small relation between pathogen disgust sensitivity (an individual-difference measure of pathogen-avoidance motivations) and measures of antigay attitudes. Analyses also showed that pathogen disgust sensitivity relates not only to antipathy toward gay men and lesbians, but also to negativity toward other groups, in particular those associated with violations of traditional sexual norms (e.g., prostitutes). These results suggest that the association between pathogen-avoidance motivations and antigay attitudes is relatively stable across cultures and is a manifestation of a more general relation between pathogen-avoidance motivations and prejudice towards groups associated with sexual norm violations
Connexin45 colocalization patterns in the plexiform layers of the developing mouse retina
Get PDFChemical and electrical synapses (gap junctions) are widely prevalent in the nervous system. Gap junctions emerge long before chemical synapses, allowing communication between developing cells, and are thought to be involved in establishing neural circuits. Mounting evidence indicates that these two modalities of synaptic transmission closely interact during retinal development and that such interactions play a critical role in synaptogenesis and circuit formation during the perinatal period. In vertebrates, gap junctions consist of two connexins which in turn are made up of six connexins (Cx). To what extent Cx45 and Cx36, the most abundant connexins in the retina, are involved in synaptogenesis and retinal circuit formation is not known. The here presented immunohistochemical study used stainings of Cx45, Cx36 and Synaptophysin in the outer and inner (IPL) plexiform layers of postnatal day 8–16 mice retinas to shed light on the role of connexins during critical neuronal developmental processes. Cx45 and Cx36 expressions in both plexiform layers of the mouse retina increased till eye opening and dropped afterwards. The percentage of heterotypic Cx45/Cx36 gap junctions is also higher before the critical event of eye opening. Finally, Cx45 is closely located and/or colocalized with Synaptophysin also shortly before eye opening in the IPL of the mouse retina. All findings point towards a pivotal role for Cx45 during postnatal synaptogenesis in the mouse retina. However, a more functional study is needed to determine the role of Cx45 during synaptogenesis and circuit formation