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Child Outcomes for Mothers Facing Trial (COMFT): sharing learning about linking data across sectors of criminal and family justice.
Get PDFObjectivesThe objectives of the COMFT study (funded by the ESRC) are to generate new knowledge about female defendants who are also involved in the family justice system, and to understand caregiver outcomes for children. This collaborative study aims to assist policy makers as they strive to preserve mother-child relationships, to reduce offending. MethodsAdministrative records for female defendants appearing in the criminal courts (and prisons data), are linked to records for women appearing in the family courts (public and private law). Criminal court records provide information on offence type and case outcomes. Family court data enables children to be linked to their mothers, and provides children’s legal order outcome information. Records are accessed by a highly experienced, interdisciplinary team (inter-university; family justice and crime specialists) of researchers through the SAIL Databank. Year 1 (2025) comprises examination and documentation of data quality, scope, and dataset build. Year 2 (2026) comprises experimental sub-studies which provide new knowledge about dual system involvement. ResultsThe project team will share learning from Year 1 regarding progress towards the creation of cross-justice datasets. This will include all elements of navigating access and responding to governance requirements, new learning about data quality, scope and linkages, cohort design decisions and outcome definitions. Provisional descriptive results about the populations of mothers and their children will be shared, including demographic information which addresses questions of dual system involvement according to deprivation and ethnicity. Sharing Year 1 results will enable other researchers to understand the opportunities and limitations of linking data across justice systems (England and Wales). The team will also share learning about working with project partners, including mothers with cross-justice lived experience. ConclusionsThe project has been designed collaboratively with partners: the Ministry of Justice (MoJ), Cafcass and Cafcass Cymru, Birth Companions and COMFT-Together (Mothers with Lived Experience). It builds on the MoJ’s Data First programme and addresses questions that are long overdue about mothers and children at the intersection of criminal justice
Win ratio analysis of the LANDMARK trial
No full textThe LANDMARK trial reported the non-inferiority of the Myval transcatheter heart valve (THV) series compared with the contemporary standard THV series (Sapien and Evolut) for a 30-day composite endpoint in patients with severe aortic stenosis. This exploratory study compared the performance of the Myval THV series with the contemporary THV series using the win ratio analysis
Developing a Cyber-Physical-Social Metaverse System for Interactive Cultural Heritage Experiences
No full textThe Metaverse is significantly impacting the field of Digital Cultural Heritage, providing new opportunities for preserving, presenting, engaging, and interacting with historical and cultural artifacts through immersive virtual environments. This paper presents the development and implementation of an Intelligent Reality Virtual Museum prototype system for interactive digital cultural heritage experiences, within the context of a Cyber-Physical-Social System (CPSS) architectural framework for Metaverse applications development. The prototype integrates advanced Artificial Intelligence and Large Language Models in fusion with Digital Twins, Robotic and Gaming technologies to deliver immersive cultural heritage experiences that blend the real with the digital worlds. The paper presents the system architecture, system design, and development process, and the results of a user evaluation study assessing the usability and user engagement with the system during an interactive cultural heritage experience. The results revealed a usable system capable to offering engaging and entertaining interactive experience to its users, highlighting the potentials to be used for supporting and enhancing cultural heritage accessibility and engagement in our current digital age. System limitations and plans for future work are presented, focusing on refining and expanding the system capabilities towards the development of a new type of a Cyber-Physical-Social Eco-Society of systems for Metaverse applications to support and enhance the way users interact with and experience cultural heritage
The Notion of Deaf People as Disabled and the Emergence of Deaf Culture in China
No full textThis chapter explores the emergence of Deaf culture in China and the roles of the media and education in improving the social status of deaf people. Traditionally, deaf people have been regarded as bearing a physical disability and this has led to paternalistic views of deaf people in accordance with the pathological perspective. China’s commitment to protecting its vulnerable citizens is commendable and comes from a position of caring and goodwill, but this has unintentionally led to assumptions that all deaf people require care and support in order to function in daily life. Social care and employment policies are effective in many contexts but can lead to forms of oppression by reinforcing notions of disability. The longstanding association of deaf people with disability is considered in this chapter in relation to the struggle for the rights of the Chinese Deaf community, and attention is paid to the importance of government administration and disability organizations’ support in all aspects of social inclusion. In addition, the relationship between the education of deaf children and societal attitudes towards deaf people is discussed and the vital role of the family in the well-being of the deaf child is highlighted. Misconceptions of Deaf culture in China have led to a belief that all deaf people are skilled in art and drawing. Deaf children are often regarded as best expressing themselves through the medium of art, and colleges and universities readily offer art courses to deaf applicants, assuming some form of innate skill and pleasure in this field. However, there is no basis for assuming that deaf people are any more or less likely to excel in art than their hearing counterparts
Prescription of Pharmacologic Venous Thromboembolism Prophylaxis Upon Hospital Discharge After Surgery for Lower Limb Fracture—A 3-Center Study in the North-West of England
Get PDFPurpose
The risk of venous thromboembolism (VTE) after surgery for lower limb trauma may be reduced with pharmacologic prophylaxis upon hospital admission and hospital discharge. To determine the rate and duration of prescription of VTE pharmacologic prophylaxis upon hospital discharge in patients who have surgery for a lower limb fracture.
Methods
Retrospective analysis of patients who had surgery for a lower limb fracture at 3 National Health Trust hospitals in the North-West of England.
Findings
Data from 127 patients were collected. All patients were prescribed pharmacologic VTE prophylaxis upon hospital admission, and 125 (98%) upon discharge, with 91.3% of patients discharged with low-molecular weight heparin. There was substantial variation in the duration of pharmacologic VTE prescription upon hospital discharge, with a median duration of 42 days (interquartile range, 28–42 days; range, 1–84 days). In our cohort, 7 (5.5%) of patients were prescribed VTE prophylaxis for less than 14 days, and 30(23.6%) prescribed for less than 35 days.
Implications
This study reported that pharmacologic prophylaxis for VTE was prescribed for almost all patients upon hospital discharge. However, there was substantial variation in the duration of the prescribed prophylaxis upon hospital discharge, with almost a quarter of patients prescribed less than 35 days. National level prescription guidance for VTE prophylaxis upon hospital discharge may improve consistency within and between centers
Global Footprint, Local Imprint: How Institutions and Distance Influence the Corporate Social Performance of Foreign Subsidiaries Across Service Industries
No full textResponding to the scarcity of research on the corporate social responsibility of multinational companies in service industries and the need to enhance our understanding of the dimensions affecting this, we contribute to this special issue in two ways. First, we indicate that the efficiency of host-country institutions positively influences the ESG performance of foreign subsidiaries. Secondly, we determine the CAGE dimensions that are relevant to services and examine the impact of CAGE distance between the home and host countries on the ESG performance of people-processing, possession-processing, and information-based services subsidiaries. By using a sample of 1331 subsidiaries in 54 different countries and applying the Bayesian Model Averaging methodology, we provide evidence and significant insights into the institutions influencing the ESG performance of foreign subsidiaries in service industries, the importance of resource commitment, and the home-host distance dimensions which create challenges for subsidiaries in enhancing their ESG performance
Effect Of Obesity On Thyroid Function & Its Treatment-a Review
No full textObjective: To examine the link between hypothyroidism and obesity, and the role of nutrition and micronutrients in thyroid function. Method: A comprehensive review of existing literature and studies was conducted to examine the prevalence of hypothyroidism in obese individuals and the possible reversibility of thyroid changes with weight reduction. The role of micronutrients, particularly iodine and goitrogenic foods, was also evaluated in relation to thyroid function and structure. Special attention was given to populations in iodine-deficient and environmentally susceptible areas. Results: Findings indicate a high prevalence of hypothyroidism and secondary endocrine changes among individuals with obesity. However, it remains unclear whether thyroid dysfunction leads to increased adiposity or is a consequence of it. Nutritional deficiencies, especially iodine, play a significant role in thyroid hormone production, with T3 and T4 levels being particularly affected. Other dietary factors, such as cruciferous vegetables, pearl millet, and soy products, may contribute to thyroid issues if consumed excessively. Environmental exposure to goitrogens through contaminated water also emerged as a contributing factor in some regions. Evidence suggests that many thyroid-related changes are reversible after weight loss. Conclusion: There is a complex and bidirectional relationship between hypothyroidism and obesity. Nutritional deficiencies and environmental factors further compound thyroid dysfunction. It is crucial to establish dietary guidelines that minimize goitrogen intake and ensure adequate iodine consumption, especially in endemic regions. Future research should focus on understanding hormonal fluctuations in early stages of obesity and developing targeted micronutrient-based interventions for thyroid health
Indications for Use of Drug-Coated Balloons in Coronary Intervention Academic Research Consortium Position Statement
No full textThe Drug-Coated Balloon (DCB) Academic Research Consortium project originated from the need to overcome the lack of standardization and comparability among studies focusing on drug-coated balloon treatment. The DCB Academic Research Consortium represents a collaborative effort between academic research organizations and the most renowned interventional cardiology societies focusing on percutaneous coronary intervention in Europe, the United States, and Asia. The present consensus document provides a classification of DCB technologies, antiproliferative drugs, and types of elution and coatings. Moreover, by reviewing the available evidence on the use of DCBs for several lesion (restenosis, de novo small and large vessels, bifurcations) and clinical (acute coronary syndromes, diabetes mellitus, multivessel disease, high bleeding risk) settings, it seeks to provide reasonable suggestions for their clinical use. Last, this paper outlines the processes involved in optimal “lesion preparation” before the use of DCBs and the criteria used for assessing results following their use
Evaluating the environmental sustainability of AI in radiology: a systematic review of current practice
No full textObjective: Data-heavy and energy-heavy artificial intelligence (AI) technologies are increasingly being applied in healthcare, particularly for clinical imaging, often without consideration of their environmental impacts. We aimed to assess current practice in considering and evaluating environmental sustainability (ES) impacts of AI-enabled clinical pathways in radiology. Methods and analysis: We searched MEDLINE and Embase on 5 November 2024 for quantitative clinical radiology studies which used a machine learning approach to aid in radiological diagnosis or intervention and discussed its ES impacts. We included peer-reviewed, English language studies published from 2015 onwards. Our primary outcome was any quantitative reporting of ES impacts, and our secondary outcome was any within-text qualitative discussion of ES impacts. For quantitative outcomes, we conducted synthesis without meta-analysis based on effect direction and size, with our secondary outcome synthesised narratively. Results: Of 4449 records screened, 18 met our inclusion criteria. Six (33.33%) reported quantitative ES outcomes and 15 (83.33%) included qualitative discussion of ES. When applied to the same tasks, algorithms designed to be ‘lightweight’ demonstrated from 2.19 to 17.15 times reduction in carbon emissions (median 7.81, 16 datapoints) and from 1.60 to 751.62 times reduction in energy consumption (median 3.22, 16 datapoints) compared with state-of-the-art alternatives, while maintaining similar or improved clinical performance. No quantitative studies compared ES outcomes for an AI-enabled pathway versus standard-of-care, and 75.00% of studies reporting only on our secondary outcome included just a single sentence on sustainability. Conclusion: Despite increasing concern about the climate impacts of AI, environmental outcomes are rarely considered within evaluations of AI technologies in clinical radiology. However, there are approaches available with smaller carbon footprints. To meet their stated aims on sustainability, funders and governance bodies should consider how to promote integration of environmental impact assessment into AI health research and evaluation. PROSPERO registration number: CRD42024601818
Guiding First-Line Treatment Decisions In Advanced Urothelial Carcinoma: A Global Survey
No full textBackground Enfortumab vedotin combined with pembrolizumab (EV-P) has become the new standard first-line therapy for patients with advanced urothelial carcinoma (aUC), based on its superior efficacy over platinum-based chemotherapy. As this regimen is increasingly adopted in routine care, treatment decisions may often occur in sites without dedicated genitourinary oncology expertise. This global survey aimed to explore how physicians perceive clinical factors that may influence the safe and effective use of EV-P in daily practice. Material and Methods A panel of international physicians with experience in treating patients with genitourinary cancers developed a 17-question survey addressing practice settings, experience in managing aUC, and clinical considerations relevant to the use of EV-P. The participants were recruited through a network-based convenience sampling method. The responses were descriptively analyzed. Results 201 genitourinary physicians from 32 countries completed the questionnaire. The most frequently cited potential absolute contraindications were sensory or motor neuropathy grade ≥2 (64.2%), ECOG-PS ≥3 (59.2%), and non-urothelial component >50% of the tissue sample (59.2%). Other notable concerns included severe corneal/retinal abnormalities, HbA1c >11%, severe skin comorbidities, liver impairment grade ≥2, and dialysis dependence. Conclusions and relevance This survey provides practical insights into real-world physician perspectives on patient selection for EV-P. The findings highlight the need for guidance to support personalized risk assessment, facilitate early identification of patients who may require enhanced monitoring, and optimize safe integration of EV-P into clinical practice