26199 research outputs found
Sort by
Enhanced Retention of Historical Information with Empathetic Pedagogical Conversational Agents (PCAs)
No full textEmbodied learning using extended reality (XR) technology can enhance learning and satisfaction during field trips to historical sites. This study evaluates the impact of Empathetic Pedagogical Conversational Agents (PCAs) on historical information retention within a simulated XR environment. PCAs employ verbal and nonverbal behaviors to attract attention, with variations in humorous versus serious tones. These behaviors can evoke emotions that motivate learning and influence cognitive processes. The study used facial expressions and eye tracking to measure the impact on the retention of historical information, comparing attention-grabbing PCAs (AG-PCA) with non-attention-grabbing PCAs (NAG-PCA). Results show that AG-PCAs triggered curiosity and positive emotions, but also some dislike, leading to better retention of historical information among NAG-PCAs, particularly among female participants. The study concludes with recommendations for designing PCAs and multimodal content to enhance historical information retention and learner satisfaction
EMpowering Pregnant women Affected by Trauma HistoRY: The EMPATHY study
Get PDFOver a quarter of pregnant women (~150,000) each year in the UK have suffered trauma such as domestic abuse, adverse childhood experiences, or sexual assault. These experiences can have a lasting effect on mental and physical health, and impact pregnancy and parenting. Despite this prevalence and the potential consequences, discussing prior trauma is not standard practice in maternity care in the United Kingdom. This critical participatory action research study aimed to address the research question: How can maternity services empower pregnant women affected by previous trauma to access support?
The study was underpinned by critical social theory and guided by a Research Collective comprising experts by experience, voluntary sector practitioners, and maternity care professionals. A systematic literature review and qualitative evidence synthesis was conducted which included 25 papers from 5 countries, representing the views of 1602 women and 286 healthcare professionals and experts from the voluntary sector. Interviews were then undertaken with women with lived experience of trauma (n=4), healthcare professionals (12), and voluntary sector experts (n=7).
Findings from the qualitative synthesis and interviews were reported separately and then integrated with insights from the Research Collective to develop an evidence-based framework of guiding principles for routine discussion of previous trauma in the perinatal period. The development process included a rigorous public consultation with 52 responses.
The framework contains 23 recommendations based on six core principles. Routine trauma discussion should be introduced as part of a system-wide change; maternity care providers should let women know previous trauma can affect their well-being and help them access support; trauma conversations need to be carried out sensitively, to build trust and relationships; staff must be provided with adequate training and support; trauma discussions should be tailored to local needs and services; and services should systematically assess the implementation and impact of routine trauma discussions and seek to continuously improve trauma pathways based on these insights.
The research marks a unique contribution to knowledge by offering a new model for trauma discussions, informed by meaningful engagement with trauma survivors and stakeholders. Further research is needed to determine whether implementation of the framework improves maternal and neonatal outcomes
Racial dissonance in the unexplained spaces of the ethnicity awarding gap: A critical exploration of undergraduate, UK domicile, South Asian male student journeys in a university business school.
Get PDFThe focus of my thesis is the ethnicity awarding gap, a phenomenon prevalent across the higher education sector, whereby proportionately fewer first-class and 2:1 degree classifications are awarded to students from minoritised ethnic backgrounds in comparison to White students. This phenomenon sits within a wider backdrop of inequitable outcomes for people from minoritised ethnic backgrounds across areas such as the criminal justice system, employment, housing and education. Academics and policymakers alike have not been able to come to a consensus as to the definitive reasons for the awarding gap or what the solutions may be, confirming the complexity of the phenomenon and perhaps pointing to it being a ‘wicked’ issue. My research takes place specifically with undergraduate, UK domicile, South Asian male students in a business school, in a university in the northwest of England. In particular I consider contributory factors that may provide further insights into the ethnicity awarding gap between this grouping of South Asian male students and White students. My research draws on the experiences of South Asian male students through in-depth interviews and focus groups as well as in-depth interviews with tutors from the business school. My research operates in the area that I refer to as the unexplained space of the ethnicity awarding gap, i.e., that part of the awarding gap that is not easily explained by more quantifiable factors such as socio-economic status or prior qualifications.
Using principles of grounded theory and the use of inductive processes, a number of themes emerged from the data which provided insight into their experiences as students, and which provides a theory which provides some insight into that gap and means to further consider it. Those themes included the centrality of culture and family, identity, transition, relationship building by the students with peer groups and tutors, and issues of mental health. I argue that these facets of life, grounded in culture reveal cultural touchpoints, i.e., points of contact between the university and aspects of student lives which are grounded in family and culture have some relevance to how students engage with university. I further suggest that these cultural touchpoints may create some level of dissonance in that interaction. I refer to this dissonance as racial dissonance. The theory that emerged from the data suggests that for some South Asian students, the themes that were revealed by the data, and grounded in family and culture, are aspects of South Asian male student lives that the university is not sufficiently able to take account of, thereby creating a level of racial dissonance in students’ journeys through higher education, and which may adversely impact the ethnicity awarding gap.
My findings are discussed in the context of the literature review relating to the ethnicity awarding gap and in particular through bringing together and presenting a combined theoretical framework of Pierre Bourdieu’s habitus, cultural capital and field, and the key tenets of Critical Race Theory (CRT). My research highlights the importance of universities listening to and understanding, in a nuanced and intersectional manner, the experiences, lives and perspectives of its students. I posit that better engagement by the university with these processes will provide greater opportunities to transform its approaches to education and its environment in order to make progress in addressing the gap. Furthermore, my research goes on to make a number of practical recommendations that will be of value to the higher education sector
Forces experienced at different levels of the musculoskeletal system during horizontal decelerations
Get PDFHorizontal decelerations are frequently performed during team sports and are closely linked to sports performance and injury. This study aims to provide a comprehensive description of the kinetic demands of decelerations at the whole-body, structural, and tissue-specific levels of the musculoskeletal system. Team-sports athletes performed maximal-effort horizontal decelerations whilst full-body kinematics and ground reaction forces (GRFs) were recorded. A musculoskeletal model was used to determine whole-body (GRFs), structural (ankle, knee, and hip joint moments and contact forces), and tissue (twelve lower-limb muscle forces) loads. External GRFs in this study, especially in the horizontal direction, were up to six times those experienced during accelerated or constant-speed running reported in the literature. To cope with these high external forces, large joint moments (hip immediately after touchdown; ankle and knee during mid and late stance) and contact forces (ankle, knee, hip immediately after touchdown) were observed. Furthermore, eccentric force requirements of the tibialis anterior, soleus, quadriceps, and gluteal muscles were particularly high. The presented loading patterns provide the first empirical explanations for why decelerating movements are amongst the most challenging in team sports and can help inform deceleration-specific training prescription to target horizontal deceleration performance, or fatigue and injury resistance in team-sports athletes
Factors influencing cranial variation between prehistoric Japanese forager populations
Get PDFUnderstanding the factors shaping human crania has long been a goal of biological anthropology, and climate, diet, and population history are three of the most well-established influences. The effects of these factors are, however, rarely compared within a single, variable population, limiting interpretations of their relative contribution to craniofacial form. Jomon prehistoric foragers inhabited Japan throughout its climatic and ecological range and developed correspondingly varied modes of subsistence. We have previously demonstrated that a large sample of Jomon crania showed no clear climatic pattern; here we examine variation in Jomon crania in more detail to determine if dietary factors and / or population history influence human intrapopulation variation at this scale. Based on well-established archaeological differences, we divide the Jomon into dietary groups and use geometric morphometric methods to analyse relationships between cranial shape, diet, and population history. We find evidence for diet-related influences on the shape of the neurocranium, particularly in the temporalis region. These shape differences may be interpreted in the context of regional variation in the biomechanical requirements of different diets. More experimental biomechanical and nutritional evidence is needed however, to move suggested links between dietary content and cranial shape from plausible to well-supported. In contrast with the global scale of human variation, where neutral processes are the strongest influence on cranial shape, we find no pattern of population history among individuals from these Jomon sites. The determinants of cranial morphology are complex and the effect of diet is likely mediated by factors including sex, social factors, and chronology. Our results underline the subtlety of the effects of dietary variation beyond the forager / farmer dichotomy on cranial morphology and contribute to our understanding of the complexity of selective pressures shaping human phenotypes on different geographic scales
Chapter 10 “I have undertaken this vengeance”: Echoes of Race and Spectres of Slave Revolt in Frankenstein"
No full textNot applicabl
Maintaining remission in Crohn’s disease post surgery: what can we learn from Cochrane?
Get PDFSurgery is a vital pillar in the management of Crohn’s disease and medical options for prevention of recurrence after surgery are a key consideration. The main classes of effective induction therapies have very different efficacy data for maintenance and this is more pronounced in the postsurgical setting.
In this review article, the up-to-date Cochrane reviews on the topic are presented, including a network meta-analysis. The Cochrane evidence shows a high relapse rate in the first 5 years after surgery with placebo or no treatment. The reviews demonstrate that 5-aminosalicylic acid (5-ASA) agents are probably more effective than placebo on pairwise and network meta-analysis, with moderate certainty evidence of a number needed to treat (NNT) of 13. The Cochrane evidence demonstrates that adalimumab may be more effective than placebo on pairwise and network meta-analysis, with low certainty evidence of an NNT of 2. Thiopurine analogues may be effective on pairwise analysis, but may not be effective on network meta-analysis. There was no evidence to support the use of any other agent but these findings are of low and very low certainty.
It is proposed that clinicians should consider adalimumab, 5-ASA and thiopurine analogue agents based on the findings of the Cochrane synthesis. The use of the evidence, including the Grading of Recomendations, Assessment, Development, and Evaluations (GRADE) certainty and magnitude of effect data, can support discussions with patients. Future research is needed to consider other therapies that are effective in medically induced maintenance given the low certainty of evidence limiting conclusions, either supporting or refuting their use
DOP02 Developing explicit thresholds for outcomes to inform (GRADE) Evidence to Decision frameworks for Inflammatory Bowel Disease guidelines
No full textBackground
Evidence to decision (EtD) frameworks are a key recent development in Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) methodology. They aim to ensure that decisions about healthcare interventions are based on a thorough, transparent and unbiased assessment of the available evidence. Core to this is to agree the importance of outcomes to be used, the specific measures for each outcome that have the most consensus and finally to develop explicit thresholds for interpretation of effect sizes of outcomes to inform (GRADE) evidence to decision frameworks. This ensures decisions are made in an unbiased fashion and allows stakeholders to focus on discussions based on their significant experience and expertise, rather than interpretation of evidence. Therefore, our study aims to develop these thresholds for the EtD framework to establish their use in several key IBD guidelines.
Methods
This online survey using Survey Monkey was conducted by inviting experts and stakeholders from the United Kingdom and British Society of Gastroenterology. Each expert was asked to select important clinically relevant outcomes and were asked about what magnitude of the effect they consider large, moderate, small, or trivial for each of the clinical, endoscopic, radiological, biochemical, histological outcomes and adverse events. Questions were framed as neutral statements without introducing a specific direction. Response options included sliding bars going from 1 to 100% for the desirable magnitude of effect for each outcome (Figure 1). The mean average of responses of experts were calculated.
Results
A total of 89 clinical experts/stakeholders participated in this online survey. Clinical remission, clinical response, endoscopic remission, withdrawal due to adverse events, and serious adverse events were considered critical outcomes. Trivial to small, small to moderate and moderate to large thresholds were as follows - clinical remission (10%, 20% and 31%), clinical response (13 %, 24% and 36%), endoscopic remission (9%, 17% and 28%), withdrawal due to AE (7 %, 14% and 23%), serious AE (6%, 11% and 17%) (Table 1).
Conclusion
This is the first study to develop thresholds for outcomes in IBD which can be used in EtD for the development of IBD guidelines. These thresholds have been used in the development of upcoming British Society of Gastroenterology guidelines for the management of IBD
The impacts of housing conditions on physical and mental health – A mini-review informed by a rapid conversion of evidence from Alidoust and Huang (2021)
Get PDFThis article provides a summary and critical appraisal of the systematic review conducted by Alidoust et al. (1) regarding the various effects of housing on both physical and psychological well-being. We aim to discuss the review’s findings against existing published evidence to draw out policy and practical implications. Our mini-review illuminates a wide range of housing-related factors which impact on health around which we draw evidence-based policy initiatives and implications, and outline avenues for future research. This mini-review is part of the wider Rapid Conversion of Evidence Summaries (RaCES) program which aims to critically appraise systematic reviews and highlight evidence-based policy and practice implications
Essentials of Mental Health Nursing (2nd Edition)
No full textAre you studying mental health nursing and want a book that covers all you need to know?
Look no further. As it says in the name, this is an essential text for students. Split into 5 parts, this book delves into the context of mental health, key concepts and debates, skills for care and therapeutic approaches, tailoring care to people with specific needs, and transition to practice.
Updated to include more content from those with lived experience, this new edition also includes:
- Voices of mental health service users and practitioners, giving you a real insight in the field
- Critical thinking stop points and debates, allowing you to develop your wider skills and knowledge
- Case studies to bring the content to life
- Chapter summaries, so you know what the main takeaways are for each chapter
- Further reading and useful websites, allowing you to do your own research
The editors, Karen M. Wright and Mick McKeown come with a wealth of experience in mental health nursing. The variety of contributors also reflect different experiences in different contexts