922017 research outputs found
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An Incremental Cognitive Architecture of Consciousness with Global Workspace Theory
No full textThis paper revisits the GlobalWorkspace Theory as a neuroscientifically plausible theory for developing conscious cognitive architecture. Based on the discussion of the authors’ previous implementations, the Global Workspace Theory’s compatibility with the working mechanisms underneath human brains is enhanced by demonstrating cognitive features of attention and consciousness. To progress in the incremental research pathway for the architecture implementation, two principles of work are stressed. The primitive cognitive mechanisms are emphasised more than the functional complexity and the revision-update cycle for implementation is appreciated for its engineering feasibility. Along the incremental pathway, the idea for possible following attempts is shared. Based on the discussion of completed and following implementations, the authors’ works are consistent with the Biologically Inspired Cognitive Architecture roadmap
The impact of performance-based financing within local health systems: Evidence from Mozambique
No full textMost evidence on Performance Based Financing (PBF) in low-income settings has focused on services delivered by providers in targeted health administrations, with limited understanding of how effects on health and care vary within them. We evaluated the population effects of a programme implemented in two provinces in Mozambique, focusing on child, maternal and HIV/AIDS care and knowledge. We used a difference-in-difference estimation strategy applied to data on mothers from the Demographic Health Surveys, linked to information on their closest health facility. The impact of PBF was limited. HIV testing during antenatal care increased, particularly for women who were wealthier, more educated or residing in Gaza Province. Knowledge about transmission of HIV from mother-to-child, and its prevention, increased, particularly for women who were less wealthy, less educated, and residing in Nampula. Exploiting the roll-out by facility, we found that the effects were concentrated on less wealthy and less educated women, whose closest facility was in the referral network of a PBF facility. Results suggest that HIV testing and knowledge promotion increased in the whole district as a strategy to boost referral for highly incentivised HIV services delivered in PBF facilities. However, demand-side constraints may prevent the use of those services
Impact of abolishing primary care financial incentives on selected indicators of quality-of-care in Scotland: national controlled interrupted time series analysis
No full textObjectives: The UK Quality and Outcomes Framework (QOF) primary care scheme pays financial incentives for achieving performance targets in chronic disease and was abolished in Scotland in 2016. We determined the impact of financial incentive withdrawal in Scotland on selected recorded quality-of-care, compared to England where financial incentives continued.Design: Interrupted time-series regression study of QOF indicator data.Setting: General practices in Scotland and England.Participants: People registered at general practices in Scotland and England.Intervention: Withdrawal of QOF financial incentives in Scotland at the end of the 2015-2016 financial year.Main outcome measures: Changes in quality-of-care at 1-year and 3-years post-abolition for 16 indicators measured annually from 2013-2014 to 2018-2019 financial years.Results: In Scotland, performance reduced significantly compared to England on 12 of the 16 quality-of-care indicators 1-year after QOF was abolished, and on 10 of 16 indicators 3-years after abolition. At 3-years, the absolute percentage-point difference in Scotland compared to England was largest for ‘tick-box’ recording of mental health care planning (-40.2 percentage-points, 95%CI -45.5 to -35.0) and diabetic foot screening (-22.8 percentage-points, 95%CI 33.9 to -11.7). However, there were also substantial reductions for intermediate outcomes including blood pressure control in patients with peripheral arterial disease (-18.5 percentage-points, 95%CI -22.1 to -14.9), stroke (-16.6 percentage-points, 95%CI -20.6 to -12.7), diabetes (-10.4 percentage-points, 95%CI -13.0 to -7.8), coronary heart disease (-12.8 percentage-points, 95%CI -14.9 to -10.8) and hypertension (-13.7 percentage points, 95% CI -19.4 to 7.9), and for HbA1c control in diabetes (-5.0 percentage-points, 95%CI 8.4 to -1.5 for HbA1c less than 75mmol/l). There were no significant differences between Scotland and England 3-years after incentive withdrawal for treatment indicators (influenza immunisation and antiplatelet/anticoagulant treatment).Conclusion: Removal of financial incentives in Scotland was associated with reductions in recorded quality of care for most indicators. Changes to pay-for-performance should be carefully designed and implemented to monitor and respond to any reductions in care quality. <br/
Nurses perception of what makes a good care experience for children and young people with intellectual disabilities align with parents' perceptions.
No full textCommentary on: Mimmo L, Hodgins M, Samir N, Travaglia J, Woolfenden S, Harrison R. 'Smiles and laughter and all those really great things': Nurses' perceptions of good experiences of care for inpatient children and young people with intellectual disability. J Adv Nurs. 2022 Sep;78(9):2933-2948. doi: 10.1111/jan.15256. Epub 202
Nurses perception of what makes a good care experience for children and young people with intellectual disabilities align with parents' perceptions.
No full textCommentary on: Mimmo L, Hodgins M, Samir N, Travaglia J, Woolfenden S, Harrison R. 'Smiles and laughter and all those really great things': Nurses' perceptions of good experiences of care for inpatient children and young people with intellectual disability. J Adv Nurs. 2022 Sep;78(9):2933-2948. doi: 10.1111/jan.15256. Epub 202
Cholesteryl ester transfer protein (CETP) inhibition is associated with reduced risk of Sjögren’s disease
No full textThe impact of performance-based financing within local health systems: Evidence from Mozambique
No full textMost evidence on Performance Based Financing (PBF) in low-income settings has focused on services delivered by providers in targeted health administrations, with limited understanding of how effects on health and care vary within them. We evaluated the population effects of a programme implemented in two provinces in Mozambique, focusing on child, maternal and HIV/AIDS care and knowledge. We used a difference-in-difference estimation strategy applied to data on mothers from the Demographic Health Surveys, linked to information on their closest health facility. The impact of PBF was limited. HIV testing during antenatal care increased, particularly for women who were wealthier, more educated or residing in Gaza Province. Knowledge about transmission of HIV from mother-to-child, and its prevention, increased, particularly for women who were less wealthy, less educated, and residing in Nampula. Exploiting the roll-out by facility, we found that the effects were concentrated on less wealthy and less educated women, whose closest facility was in the referral network of a PBF facility. Results suggest that HIV testing and knowledge promotion increased in the whole district as a strategy to boost referral for highly incentivised HIV services delivered in PBF facilities. However, demand-side constraints may prevent the use of those services
B-fields do not suppress star formation in low metallicity dwarf galaxies
No full textMany studies have looked at the impact of magnetic fields on star formation in molecular clouds and Milky Way like galaxies, concluding that the field suppresses star formation. However, most of these studies are based on fully developed fields that have reached the saturation level, with little work on investigating how the growth phase of a primordial field affects star formation in low metallicity environments. In this paper, we investigate the impact of the growth phase of a primordial field on low metallicity dwarf galaxies. We perform high-resolution arepo simulations of 5 isolated dwarf galaxies. Two models are hydrodynamical, two start with a primordial B-field of 10−6µG, and one with a saturated B-field of 10−2µG. All models include a non-equilibrium, time-dependent chemical network that includes the effects of gas shielding from the ambient UV field. Sink particles form directly from the gravitational collapse of gas and are treated as star-forming clumps that can accrete gas. We vary the metallicity, UV-field, and cosmic ray ionization rate between 1% and 10% of solar values. We find that the magnetic field has little impact on the star formation rate, which is in tension with previously published results. We show that an increase in the mass fractions of both molecular hydrogen and cold gas, along with changes in the perpendicular gas velocity dispersion’s and the B-field acting in the weak-field model overcomes the expected suppression in star formation.<br/