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Do we need audiogram-based prescriptions? A systematic review.
No full textOBJECTIVE: Hearing aids are typically programmed using the individual’s audiometric thresholds and verified using real-ear measures. Developments in technology have resulted in a new category of direct-to-consumer devices, which are not necessarily programmed using the individual’s audiometric thresholds. This review aimed to identify whether programming hearing aids using the individual’s validated audiogram-based prescription, and verified using real-ear measures, results in better outcomes for adults with hearing loss.DESIGN: The review was registered in PROSPERO and reported in accordance with PRISMA guidelines.STUDY SAMPLE: After screening more than 1,370 records, seven experimental studies met the eligibility criteria.RESULTS: Studies were categorised under three methods of fitting: (i) comparative fitting evaluating different settings based on the beliefs of the audiologist; (ii) client choice of preset responses; and (iii) self-fit by adjustment. The findings suggest that using a prescription based on the individual’s audiogram improves outcomes relative to the comparative and client choice fitting approaches. Self-adjustment during daily use may produce equivalent (or better) outcomes than an audiogram-based prescription. The quality of evidence for the outcomes ranged from low to very low. CONCLUSIONS: This review has highlighted the dearth of high-quality studies on which to make evidence-based decisions on hearing aid fitting methods. <br/
How is the NHS Low-Calorie Diet Programme expected to produce behavioural change to support diabetes remission: An examination of underpinning theory
No full textBackground: In 2020, the National Health Service Low-Calorie Diet Programme (NHS-LCD) was launched, piloting a Total Diet Replacement intervention with behaviour change support for people living with Type 2 Diabetes and excess weight. Four independent service providers were commissioned to design and deliver theoretically grounded programmes in localities across England. Aims: To (1) develop a logic model detailing how the NHS-LCD programme is expected to produce changes in health behaviour, and (2) analyse and evaluate the use of behaviour change theory in providers’ NHS-LCD Programme designs. Methods: A documentary review was conducted. Information was extracted from the NHS-LCD service specification documents on how the programme expected to produce outcomes. The Theory Coding Scheme was used to analyse theory use in providers’ programme designs documents. Results: The NHS-LCD logic model included techniques aimed at enhancing positive outcome expectations of programme participation and beliefs about social approval of behaviour change to facilitate programme uptake and behaviour change intentions. This was followed by techniques aimed at shaping knowledge and enhancing the ability of participants to self-regulate their health behaviours, alongside a supportive social environment and person-centred approach. Application and type of behaviour change theory within providers’ programme designs varied: One provider explicitly linked theory to programme content; two providers linked 63% and 70% of intervention techniques to theory; and there was limited underpinning theory identified in the programme design documents for one of the providers. Conclusions: The nature and extent of theory use underpinning the NHS-LCD varied greatly amongst service providers, with some but not all intervention techniques explicitly linked to theory. How this relates to outcomes across providers should be evaluated. It is recommended that explicit theory use in programme design and evidence of its implementation becomes a requirement of future NHS commissioning processes.<br/
Statistical Disclosure Control and Developments in Formal Privacy: In Memoriam to Chris Skinner
No full textI provide an overview of the evolution of Statistical Disclosure Control (SDC) research over the last decades and how it has evolved to handle the data revolution with more formal definitions of privacy. I emphasize the many contributions by Chris Skinner in the research areas of SDC. I review his seminal research, starting in the 1990’s with his work on the release of UK Census sample microdata. This led to a wide-range of research on measuring the risk of re-identification in survey microdata through probabilistic models. I also focus on other aspects of Chris’ research in SDC. Chris was the recipient of the 2019 Waksberg Award and sadly never got a chance to present his Waksberg Lecture at the Statistics Canada International Methodology Symposium. This paper follows the outline that Chris had prepared in preparation for that lecture
Effect of Temperature on the Preferential Intergranular Oxidation Susceptibility of Thermally-Treated Alloy 600
No full textThermally-treated Alloy 600 coupons were tested in pressurized water reactor simulated primary water at 320 °C and in high-pressure superheated steam at 400 °C to study the effect of a “semi-continuous” network of intergranular carbides on the stress corrosion cracking “precursors events”: preferential intergranular oxidation (PIO) and diffusion-induced grain boundary migration (DIGM). The intergranular carbides were partially consumed due to the environmental exposure, whereby the Cr released from the carbides contributed to the formation of the external oxide layer that limited both PIO and DIGM. The results were compared with previous studies in which similar coupons were exposed to H2-steam
Improving the environmental sustainability of polyketides colorants production by Talaromyces strain through better hydrodynamic design in bioreactors
No full textOne important step towards the commercialization of microbial-derived colorants is the reproducibility of the cultivation stage in bench-scale bioreactors as well as improving the hydrodynamic design in bioreactors. Aiming to address these technical barriers, Talaromyces amestolkiae was cultivated in a 4-L stirred-tank bioreactor using two types of impellers (Rushton turbine (RT) and Elephant ear (EE) impellers) and aeration modes (cascading and constant airflow), to assess their effects on red colorant production. The results showed that EE under constant airflow (4.0 Lmin-1) promoted the maximum red colorant formation (28.7 UA500nm), thus improving the reproducibility of the process. The volumetric oxygen transfer coefficient of culture broth was correlated to cell morphology, which was a result of impeller geometry of EE through the shear conditions impacting the fungi cells. The hairy pellet morphology favored nutrient and oxygen uptake and allowed an improvement in the colorant’s synthesis. Life cycle assessment was also carried out to identify opportunities for improving the best process design from an environmental sustainability perspective. For example, the total climate change and primary energy demand were estimated at 31.11 kg CO2 eq./g red colorant and 830.7 MJ/g red colorant, respectively, with the cultivation stage contributing with 65% and 63% of these impacts. The electricity consumption was identified as the main hotspot in this stage, a trend that was observed across all other impact categories. This can be improved by optimizing cultivation lengths combined with the use of low carbon electricity sources. These findings ensure a step forward towards the scaling-up at industrial scale of the T. amestolkiae cultivation for the production of bio-based colorants in an environmentally sustainable way
Customized Multi-Energy Pricing in Smart Grids: A Bilevel and Evolutionary Computation Approach
No full textThis paper proposes a customized energy pricing scheme for energy retailers in multi-energy (i.e., electricity and natural gas) retail markets. Microgrids with distributed energy resources (DERs) and demand response (DR) programs are considered on the demand side. We adopt a bilevel single-leader multi-follower model to analyze the customized multi-energy pricing decisions where the retailer’s profit maximization problem is formulated at the upper level, and the microgrids’ operation costs minimization problems are considered at the lower level. A particle swarm optimization (PSO) based evolutionary solution approach is developed to solve the proposed bilevel decision-making problem. Through a numerical case study, we demonstrate the feasibility and effectiveness of the proposed bilevel model and the solution algorithm. We reveal that the proposed customized pricing scheme could offer differentiated optimal pricing decisions to various microgrids characterized by their energy conversion efficiencies
Nurses’ adoption and use of digital technology during the COVID-19 pandemic
No full textAim: to explore nurses’ adoption and use of digital technologies during the COVID-19 pandemicMethods: online survey to obtain nurses’ feedback and ratings of technologiesimplemented and used to support patient care during the COVID-19 pandemic. Survey questions comprised fixed response and free-text questions and a rating of system usability (quantitative and qualitative data). Participants were recruited via nursing networks and social media.Results: 55 respondents provided details on 85 separate technologies. The majority of technologies were used for patient monitoring/data sharing (n=39; 46%), online communication (n=22; 26%) virtual appointments (n=15; 18%). Other technologies included electronic patient records (n=5, 6%), e-Prescribing (n=3; 3%), and for PPE (n=1, 1%). Usability of systems varied significantly across types of technology. Barriers to successful use included accessibility to effective infrastructure.Conclusion: there was a range and breadth of digital technologies adopted and used by nurses during the pandemic. There are ongoing issues with the availability of digital infrastructure to enable effective digital working, and poor usability of some systems that have been implemente