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Emerging Models of Care Using IT in Long-Term/Post-Acute Care: A Comparative Analysis of Human and AI-Driven Qualitative Insights
Get PDFBy 2050, the proportion of the world’s population that is over 60 will nearly double from 12% to 22%, representing nearly 2 billion older people worldwide. In response, the United Nations declared 2021–2030 to be the Decade of Healthy Aging, aiming to improve the lives of older people, their families, and the communities in which they live. Thus, Long-Term Post-Acute Care (LTPAC) systems that provide care for older adults are a significant global area of interest. In this paper, we use the World Health Organization’s (WHO) definition of LTPAC: “national systems that ensure integrated long-term care that is appropriate, affordable, accessible and upholds the rights of older people and carers alike.” In this definition, LTPAC providers include home care and hospice, assisted living facilities, and nursing homes. LTPAC systems are essential because 70% of older adults will require long term care (e.g., assistance in their activities of daily living [e.g., moving around, bathing, and feeding]) over the course of their long lives. Within LTPAC communities, older adults’ activities are supported through informal caregivers (i.e., family, friends, neighbors) and healthcare professionals to ensure that people maintain the highest quality of life, according to their preferences, with the greatest degree of independence, autonomy, participation, personal fulfillment, and dignity.
As the world’s population gets older, many challenges exist for providing safe, higher quality care for older adults at the individual, institutional and community levels. Older adults in LTPAC systems have a high degree of medical complexity that is often hampered by increasing functional decline and cognitive impairment, and often takes place in environments with low resources. One international strategy for improving quality of care in the world’s LTPAC systems is the efficient and competent use of health information technology (IT). Unfortunately, there are many gaps in our evidence base about how technology can be used to support care of older people in LTPAC systems.
This paper describes the outcomes of an International Summit on Innovation and Technology for the Care of Older People (IS-ITCOP) designed to build a research agenda that can be used to achieve a safer, higher quality, more accessible, and equitable LTPAC healthcare system. The proposed research agenda will promote the timely production of research to identify where facilitators and barriers in the practice and delivery of healthcare for older adults that are supported by technology are most concerned. Four topics were discussed during the two-day IS-ITCOP Summit, including: 1) Emerging Models of Care (EMC) using Technology, 2) Workforce of the Future, 3) Transparency & Accountability in Quality, and 4) Privacy & Safety of IT use in the care of older adults. This report provides outcomes of the thematic analysis of the IS-ITCOP discussions focusing on EMC Using Technology in the care of older adults
Virtual Volunteers: a solution looking for policing problems
No full textThis operational commentary describes an innovative approach to police volunteering that is currently being piloted in Wales, United Kingdom (UK). The programme, named Virtual Volunteers, is a partnership between students, academics and administrative staff at the University of South Wales (USW) and Tarian (the Welsh word for ‘shield’), the Regional Organised Crime Unit (ROCU) for the southern Welsh police forces. Students engage in the university intranet to review and answer policing problems posed to them by the ROCU. Such problems include, romance fraud, AI enabled crime and money laundering. This initiative is untested and while it is currently subject to a number of evaluations it remains in an early developmental stage. The intention here therefore is to record the work that is ongoing, note the progress made in terms of the programme’s development and to recognise its limitations and potential. This commentary will also include some broader insights about the strengths and weaknesses of this form of volunteering
Provocation: Is there an assumed need for Participatory Design with Children?
Get PDFThis paper reflects on participatory design practices within the child–computer interaction (CCI) community, which has a long tradition of advocating the inclusion of children in the design process. The benefits of involving children are widely cited in the CCI literature. However, through a critical analysis of children’s current technology usage, research and industry practice, this paper offers three provocations relating to participatory design and children. The first focuses on what constitutes participatory design, suggesting that the use of children in a single design activity to generate ideas is very distant from traditional participatory design (PD) and thus should not be referred to as PD. the second is that there needs to be a shift toward researching and developing methods to enable children to participate in design activities that align with industry timelines. The final provocation suggests that unless there are some tangible benefits of including children in PD of technology or impact can be demonstrated from the work, then an ethical debate is needed about their role and inclusion. These three provocations are designed to question and stimulate the debate around the benefits and values of including children in the design process. Without a critical reflection on current practices and processes, current trends may continue and design practices within the industry may not evolve
Perceived preparedness and mental health in response to the Coronavirus pandemic in the UK population
Get PDFObjectives: Preparedness levels have been shown to improve the outcomes for people who find themselves in an emergency. However, uptake of preparedness behaviours by the public prior to a major disaster is limited. This two-part study examined perceived preparedness in the UK during the first months of the Covid-19 pandemic (Study 1), and two years later (Study 2).
Methods: Both studies investigated the effect of individual demographics (gender, age, perceived socioeconomic and health status) on perceived preparedness. Next, the studies examined the extent to which perceived preparedness was associated with mental health outcomes (anxiety, depression, and stress symptoms). Participants (Study 1, N = 409) completed an online survey in May to June 2020 during a national lockdown, with another sample (Study 2, N = 87) completing the same survey from March to July 2022.
Results: Across both studies, participants completed two to three different preparedness activities. Greater subjective perceptions of socioeconomic status were associated with perceived preparedness. Preparedness levels were related with better mental health, and unrelated to age and gender.
Conclusions: Encouraging the public to engage with preparedness behaviours may not only have practical benefits but also help to protect mental wellbeing during a disaster
Self-Assembled Magnetic Nanoparticle Layers: Structural Control for Reconfigurable Magnetism and Functional Applications
No full textWe advance soft X-ray vector ptychographic tomography to map the 3D magnetization field in self-assembled superparamagnetic nanoparticles at a liquid–liquid interface, revealing how layered structures influence magnetic ordering. We observe that monolayers with low coordination numbers exhibit weak magnetic order, with magnetic vortices disrupting spin alignment. In contrast, bilayers and trilayers with higher coordination numbers display long-range magnetic order with strong spin correlations across larger distances and a suppression of magnetic vortices. We further quantify the average distance for vortex–antivortex pairs as 26.0 ± 2.0 nm, while vortex–vortex and antivortex–antivortex pairs exhibit larger separations, averaging 44.9 ± 5.2 and 54.1 ± 7.4 nm, respectively. These experimental results are supported by micromagnetic Monte Carlo simulations. Our findings illustrate how layered structures enhance magnetic order and spin correlation in superparamagnetic nanoparticle assemblies, providing a promising approach for tuning magnetic properties in applications such as data storage, microrobotics, and biomedicine
Social dreaming as a method for exploring the unthought known behind decolonisation in higher education
No full textThis paper investigates the use of Social Dreaming (SD) as a method that can contribute to decolonisation efforts through the potential of dream sharing. Decolonisation is desired, yet feared, due to the painful emotions inevitably associated with racism and prejudice. Decolonisation efforts often encounter defences against delving too deeply into the background and essence of colonialism. We explore how SD can contribute to uncovering what is known about colonialism in Higher Education but struggles to emerge, the ‘unthought known’. SD has previously been used in similar contexts, but this paper paves the way for a more sustainable delivery that feeds directly into policy and transformation. The investigation is centred around a series of six online SD matrices in the context of the University of Central Lancashire’s efforts to decolonise the curriculum. The online SD matrices were hosted between January – June 2024. We hope the paper will significantly contribute to the knowledge base and methods at the disposal of HE institutions on a similar journey
Historical context and drivers of forest cover change in Wayanad plateau: a key elephant landscape in India’s Western Ghats
No full textUnderstanding the impact of past human interventions on forest ecosystems is crucial for Asian elephant (Elephas maximus) conservation, given that forest cover serves as the primary determinant of their distribution and abundance. This study aims to analyse the patterns and drivers of deforestation of the Wayanad, a key summer habitat of Asian elephants in the Brahmagiri-Nilgiri-Eastern Ghat landscape of India’s Western Ghats, spanning from pre-colonial period to the present and its implications on Asian elephants. This study integrated historical records, maps, remotely sensed images, to reconstruct the historical context of the landscape. Despite their longstanding cultural and historical significance, elephants have been subjected to significant exploitation, often serving as a tool for the exploitation of their own habitat. Demographic pressures, including population growth from 75,149 in 1901 to 817,420 in 2011, and agricultural intensification, emerged as major drivers of deforestation and habitat fragmentation. Rates of land cover change varied across periods, with the most drastic reduction occurring during the post-colonial era (1816.5 km2 in 1950 to 850.9 km2 by 2023). The loss and fragmentation of forest cover have disrupted traditional migration routes and exacerbated Human-Elephant Conflict, threatening both elephant populations and human livelihoods. This study underscores the importance of adopting a historical perspective as a valuable frame of reference for understanding current patterns and processes to improve the conservation and management of elephants in human-dominated landscapes
Advanced Modeling of Hydrogen Mixture Properties for Production and Transfer Processes Using Machine Learning Techniques
No full textThis study investigates the use of machine learning (ML) techniques to predict the density of hydrogen-methane binary mixtures over a wide range of temperatures and pressures. Accurate density prediction is critical for optimizing hydrogen production, transportation, and utilization. Traditional methods like experimental measurements and equations of state (EoS) are either costly or computationally intensive. To address these challenges, four ML models—XGBoost, Gradient Boosting Decision Trees (GBDT), Random Forest (RF), and k-Nearest Neighbors (KNN)—were trained on 4,000 density data points generated using the GERG-2008 EoS. The models were evaluated using metrics such as RMSE, MAE, and R2. Among the models, GBDT outperformed others with the lowest RMSE (0.44) and MAE (0.23), achieving an R2 of 1.00. XGBoost followed closely, while RF and KNN showed moderate and lower accuracy, respectively. The results demonstrate that ML-based approaches, particularly GBDT, provide a reliable and efficient alternative to conventional methods for predicting the thermophysical properties of hydrogen mixtures, contributing to the development of a sustainable hydrogen economy
Rare Metastasis of Renal Cell Carcinoma to the Breast: A Case Report
Get PDFRenal cell carcinoma is an aggressive urological malignancy, accounting for 2-3% of adult cancers and over 90% of renal cancers. While renal cell carcinoma commonly metastasizes to organs such as the lungs, bones, and liver, breast metastasis is rare, comprising only 0.5% to 2% of all breast neoplasms. This case report describes a 54-year-old female with a history of RCC who developed a metastatic lesion in her breast six years after radical nephrectomy. The lesion, initially detected via routine imaging, was confirmed as renal cell carcinoma through histopathology and immunohistochemistry. A wide local excision was performed, avoiding unnecessary axillary surgery. This case highlights the need for meticulous diagnostic evaluation to distinguish between primary breast carcinoma and metastatic disease, particularly in patients with a history of renal cell carcinoma. The rarity of renal cell carcinoma metastasis to the breast calls for further research to guide appropriate management
Developing an adaptive platform trial for evaluation of medical treatments for Crohn’s disease
Get PDFThere are a growing number of medical treatments demanding evaluation by patients and clinicians in Crohn’s disease. However conventional clinical trial designs may take several decades to provide the answers being sought particularly regarding sequencing of treatments. Adaptive platform trials using a master protocol approach offer an opportunity for more efficient trials i.e. provide answers from fewer patients and in a shorter timeframe. But there are multiple challenges to overcome prior to their implementation. A workshop was convened to consider the opportunities and challenges of developing a platform trial in Crohn’s disease. The workshop and reporting was contributed to by eight clinical experts, four experts in clinical trial methodology and statistics, with further input from two professional representatives from Crohn’s and Colitis UK, and two patient representatives.
Key disease-specific and trial design-specific considerations were discussed and recommendations made based on these discussions. Platform trials enable the evaluation of multiple interventions simultaneously, allowing seamless recruitment of patients, with addition of promising new interventions to an ongoing trial protocol. Crucially platform trials enable halting recruitment to interventions not demonstrating sufficient benefit (or indeed evidence of harm) – allowing resources to be focused on more promising and important questions for patients. Multiple benefits and potential challenges were identified in order to bring adaptive platform trials to Crohn’s disease. Successful delivery and implementation of such trials was considered achievable through commitment and partnership between patients, clinicians, trial methodologists, regulatory authorities, funding agencies and industry partners