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Identifying the landscape and contribution of advanced nurse practitioners in supporting healthcare provision in Ireland in the 21st century: An integrative review
No full textBackground: In Ireland the role of advanced nurse practitioner has developed significantly since 2001. This evolution is rooted in the growing recognition of the need for highly skilled nursing professionals to address complex healthcare demands and improve patient outcomes. Objective: To scope the landscape and identify the effect of advanced nurse practitioners on healthcare provision in Ireland. Design: A systematic search of eight academic databases (CINAHL, Embase, PsycINFO, Scopus, Medline and Academic Search Complete, Cochrane, Web of Science) relevant to nursing and health care were performed. Setting(s): Nursing care environment. Participants: Advanced nurse practitioners delivering care. Methods: A pre-defined systematic search of eight academic databases was conducted, and two reviewers screened each study against the inclusion criteria. Additional hand-searching of the reference lists (backward chaining) and citations (forward chaining) of papers that met the inclusion criteria was conducted. The methodological details of each paper were extracted and assessed for quality and rigour utilising the Mixed Methods Appraisal Tool and the Authority, Accuracy, Coverage, Objectivity, Date, Significance checklist for appraising grey literature. Data were mapped and analysed onto the six domains of advanced nurse practitioner practice, and the review was reported in line with Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Results: All papers included in this review spanned across the last 20 years. In total, 45 papers met the inclusion criteria: quantitative (n = 11), qualitative (n = 15), mixed methods (n = 4), and discussion/clinical cases (n = 15) papers. Advanced nurse practitioners in Ireland contribute substantial impacts on management and team competence, clinical-decision making, leadership and professional scholarship, professional values and conduct, communication and interpersonal competence, and knowledge and cognitive competence domains. Advanced nurse practitioners in Ireland enhance healthcare outcomes through expertise, coordination, and patient-centred approaches, emphasising their critical role in healthcare delivery and system improvements. Conclusions: We have highlighted the active role advanced nurse practitioners play in enhancing patient care, improving management and team coordination, and advancing professional scholarship. These insights have provided a foundation for future research and policy development to optimise the advanced nurse practitioner role.</p
On the estimation of the number of components in multivariate functional principal component analysis
No full textHapp and Greven developed a methodology for principal components analysis of multivariate functional data observed on different dimensional domains. Their approach relies on an estimation of univariate functional principal components for each univariate functional feature. In this article, we present extensive simulations to investigate choosing the number of principal components to retain. We show empirically that the conventional approach of using a percentage of variance explained threshold for each univariate functional feature may be unreliable when aiming to explain an overall percentage of variance in the multivariate functional data, and thus we advise practitioners to exercise caution.</p
Linguistic Diversity in German youth media—the use of English in professionally produced instagram memes and reels
No full textWhile speakers of German have adopted many loanwords from other languages throughout history, recent diversification of language use in Germany is mainly driven by the global mobility of English. Previous research has therefore focused on various domains in which English linguistic resources are used, particularly in traditional media and social media communication. Furthermore, many studies on social media communication have also examined English language internet memes more broadly. Despite this plethora of research, little attention has been paid to how English is used in internet memes and reels produced by professional journalists in Germany. Playing a significant role in communication amongst young people, internet memes and reels are used by many German youth media organisations. In particular for youth radio stations in Germany, which have become multimedia outlets, online communication via Instagram is vital for their audience interaction. This paper examines the use of English linguistic resources in a professionally produced Instagram corpus of internet meme and reel captions produced by journalists working for one of the largest youth radio stations in Germany. Data for the analysis of Instagram content were collected as part of the larger ethnographic research project CIDoRA (funded by the European Union). For this project, a mixed methods approach was applied. Methods of data collection and analysis include linguistic ethnography both at the youth radio station and on the station’s Instagram profile page, informal interviews and 20 semi-structured interviews with journalists, and a quantitative and qualitative analysis of 980 meme and reel captions produced for the station’s Instagram profile. Since the youth radio station’s Instagram profile functions as a means of the station’s online self-advertisement, the analysis of this article also draws on a previous study by the researcher. This study analysed possible facilitating factors for the use of catachrestic and non-catachrestic anglicisms in radio station imaging (radio self-advertisement) of six German adult contemporary radio stations. The article therefore includes an analysis of the possible facilitating factors lexical field, brevity of expression, diachronic development of the pragmatic value of lexical items and semantic reasons for the use of English in Instagram content. It thereby explores the differences in anglicism use between these two media formats (radio broadcasting and social media communication) and whether possible facilitating factors for the use of English in adult contemporary radio station imaging are also facilitating factors for the use of English in meme and reel captions produced by the youth radio station.</p
Character virtues and hope for peace in Pakistan in the face of religious extremism
No full textReligious extremism continues to fuel violence in Pakistan, underscoring the urgent need to identify factors that may foster hope for peace. This study examines character virtues as predictors of hope for peace, focusing on dispositional measures of patience, forgiveness, gratitude, dispositional hope, and spiritual jihad (a form of moral striving in Islam). Across two studies involving university students in Pakistan (Study 1 N = 261; Study 2 N = 304), correlations showed positive associations for all predictors, and multiple regressions showed that patience and spiritual jihad uniquely predicted greater hope for peace=. While gratitude and hope showed mixed results in regressions, forgiveness did not uniquely predict hope for peace. These findings highlight the potential for interventions that cultivate patience and spiritual jihad to promote reconciliation. This research provides a foundation for future studies to explore causal mechanisms and develop interventions to foster hope for peace in Pakistan and beyond.</p
Diabetes technology use in young adults living with type 1 diabetes in Ireland: A qualitative interview study
No full textBackground: The challenges of living with and managing type 1 diabetes during youth and emerging adulthood are well documented. The management burden may be alleviated in part using diabetes technologies including continuous glucose monitoring and hybrid closed-loop insulin pumps. However, young people's experiences of diabetes technology during this life stage are not well understood. This study aims to address that gap. Methods: This study will recruit 30–40 young people living with T1D, aged 16–21 years, from paediatric, transition and adult T1D clinics. Semi-structured qualitative interviews will be conducted. The data will be analysed using framework analysis. Results: TBC (registered report format).</p
Adverse Childhood Experiences (ACEs) in young adult carers relative to non-carer peers and relations with mental health, caregiving and socio-demographics
No full textYoung adult carers (YACs) report poorer mental health than their peers. Adverse childhood experiences (ACEs) constitute a mental health risk factor. Prior quantitative research has not investigated ACEs in YACs. Hence, this study explores ACEs in YACs and aims to: (1) compare ACEs in two groups of YACs (chronically ill parent and chronically ill non-parent family member contexts) with non-carer peers; (2) examine relations between caregiving and ACEs; (3) explore relations between socio-demographics and ACEs; (4) examine relationships between ACEs and mental health (depression, anxiety, well-being). A total of 1,823 Italians aged 18–29 completed an online survey. Of these, 1,458 reported no ill family member (non-carers) and 365 reported an ill family member (YACs); 268 with an ill parent, 97 with an ill non-parent family member. As predicted, YACs reported significantly higher ACEs than non-carers regardless of care context. Most reported ACEs in YACs: emotional neglect, emotional abuse, household mental illness, separation-divorce. Unexpectedly, caregiving was not significantly correlated with ACEs. Lower socio-economic status was correlated with higher ACEs. As hypothesised, higher ACEs predicted higher depression and anxiety and lower well-being. Results show that YACs are at greater risk of ACEs than non-carer peers, and that higher ACEs predict poorer mental health, hence supports should be developed that mitigate the harmful mental health effects of ACEs in YACs.</p
Enablers and barriers to an experience‐based co‐design process to develop service improvements in enhanced community care in Ireland: a qualitative study
No full textBackground: Experience‐Based Co‐Design (EBCD) is a popular collaborative process where service users and healthcare providers share their experiences of using and delivering services to identify ways to adapt services to enhance those experiences.Objective: This study aimed to identify enablers and barriers to the successful implementation of EBCD as part of Ireland's recently adopted Enhanced Community Care (ECC) programme.Design: Service users and staff at two sites (N = 17) participated in an accelerated EBCD process designed to enhance service provision for older people and those living with chronic conditions. This included four co‐design working group sessions per site.Methods: Transcripts from the co‐design working groups and from brief follow‐up interviews with individual participants were analysed. Thematic analysis was used to identify enablers and barriers to the EBCD process.Results: We generated six key themes reflecting barriers and enablers; enablers were the fundamental role of the facilitator (Theme 1), a flexible approach that met group members' needs (Theme 2) and active and interactive activities to support participant engagement (Theme 3). The fundamental role of the facilitator was also identified as a barrier (Theme 4); additional barriers included balancing experience‐sharing and decompressing (Theme 5) and the scope of the group as an invisible barrier (Theme 6), which reflected challenges in facilitating dialogue about change when participants were aware of system‐level constraints on the potential for change.Conclusions: The facilitator is critical in ensuring the successful implementation of the EBCD process. Considering how best to draw on the facilitator strengths while also ensuring that the service user perspectives are equally weighted with staff perspectives is important for effective communication within EBCD projects.Patient or Public Contribution: Service users (also including carers) at two sites participated in EBCD projects alongside health and social care professionals, ultimately generating two service improvements for the ECC programme. The participation of these service users was celebrated at an academic conference, which was attended by a number of service users, and where the outcomes of the EBCD project were presented</p
Safe water for the nutrition and heat-related health of displaced women
No full textMost internally displaced people (IDPs) are located in the global tropics, often in heat-exposed shelter without electricity, and are vulnerable to food insecurity, meaning they often experience heat stress and undernutrition simultaneously.1Over the past decade, research has also shown a concerning correlation between exposure to heat stress and undernutrition outcomes;2 however, there has been limited investigation into the exact mechanisms that relate heat stress and undernutrition and none relating these to IDP mobility. As a result, no policies have been made to address these interactions.</p
Comparing large language models and human annotators in latent content analysis of sentiment, political leaning, emotional intensity and sarcasm
No full textIn the era of rapid digital communication, vast amounts of textual data are generated daily, demanding efficient methods for latent content analysis to extract meaningful insights. Large Language Models (LLMs) offer potential for automating this process, yet comprehensive assessments comparing their performance to human annotators across multiple dimensions are lacking.This study evaluates the inter-rater reliability, consistency, and quality of seven state-of-the-art LLMs.These include variants of OpenAI’sGPT-4,Gemini, Llama-3.1-70B, and Mixtral 8×7B.Their performance is compared to human annotators in analyzing sentiment, political leaning, emotional intensity, and sarcasm detection.The study involved 33 human annotators and eight LLM variants assessing 100 curated textual items.This resulted in 3,300 human and 19,200 LLM annotations. LLM performance was also evaluated across three-time points to measure temporal consistency.The results reveal that both humans and most LLMs exhibit high inter-rater reliability in sentiment analysis and political leaning assessments, with LLMs demonstrating higher reliability than humans. In emotional intensity, LLMs displayed higher reliability compared to humans, though humans rated emotional intensity significantly higher. Both groups struggled with sarcasm detection, evidenced by low reliability. Most LLMs showed excellent temporal consistency across all dimensions, indicating stable performance over time.This research concludes that LLMs, especiallyGPT-4, can effectively replicate human analysis in sentiment and political leaning, although human expertise remains essential for emotional intensity interpretation.The findings demonstrate the potential of LLMs for consistent and high-quality performance in certain areas of latent content analysis.</p
Click chemistry-based modified exosomes: Towards enhancing precision in cancer theranostics
No full textExosome-based therapies are at the forefront of precision medicine, offering targeted drug delivery and personalized treatments specifically for cancer. Addressing challenges such as exosome heterogeneity and pH stability is crucial for optimizing therapeutic efficacy. Techniques such as exosome barcoding and profiling enable precise tracking and analysis, essential for the development of targeted cancer therapies. Click chemistry plays a critical role by enhancing the specificity and stability of therapeutic agents attached to exosomes. This modification is pivotal for cancer treatment as it enables exosomes to carry drugs, RNAi molecules, and CRISPR-Cas9 systems, thereby minimizing side effects and reducing toxicity. Furthermore, click chemistry-modified exosomes facilitate non-invasive detection and real-time monitoring of tumor dynamics and therefore allow precision cancer therapy. Despite existing challenges, these advancements in exosome research promise safer, highly precise, and personalized oncological therapies that significantly enhance patient outcomes and quality of life.</p