151398 research outputs found
Sort by
Is there truth in fiction? Lessons from readers’ responses to dementia fiction
No full textThis paper addresses the question ‘is there truth in fiction?’, by synthesising a range of disciplinary approaches to the issue, as well as drawing on empirical research carried out with readers of fiction about dementia (hereafter, dementia fiction). We argue that fiction—perhaps because of its fictional status and apparatus—invites readers to consider its truth value, to explore the possibilities of human experience and interrogate issues relative to their subjective experience, community or society. The findings have significant implications for the Medical Humanities’ use of fictional texts to explore lived medical conditions and experiences, as well as claims made about the potential for fiction to affect real-world understandings, awareness and empathy around the conditions depicted. We show that the techniques used in fictional language may be artifice, but they simulate a truth that corresponds with reality.<br/
A theoretically-informed process evaluation in parallel to a feasibility study of a complex oral health intervention using NICE guidelines in a care home setting
No full textBackground: A theoretically-informed process evaluation was undertaken in parallel to a study examining the feasibility of an oral health intervention based on an existing guideline for care homes. The objectives were to explore the factors that influenced the implementation of the intervention in order to understand the potential pathway to impact. The research team initially utilised Pfadenhauer et al.’s framework, which focuses on a number of different implementation factors: intervention characteristics, context, theory, process, strategy, agents, outcomes and setting. Methods: Nine semi-structured interviews were undertaken with care home managers and staff, predominantly within the intervention arm of the study. Interview schedules were originally based on Pfadenhauer et al.’s framework. These were coded and analysed using thematic analysis. Given the range of themes that emerged, the research team ran a reflexive workshop to determine whether Pfadenhauer et al.’s framework was able to capture and frame the authentic voice of those interviewed.Results: The research team found that a systems lens approach better fitted the data from the interviews, capturing the idiosyncrasy of the different settings and the importance of values and beliefs of the key stakeholders. It was clear that unlike the structure proposed by Pfaednhauer et al., many of the factors were interdependent and hierarchical in nature i.e. paradigm and goals within the care home had a direct impact on the system structure, which fed into how the care home was maintained, which led onto how the different actors behaved (care home managers and staff). The process also highlighted key factors for intervention delivery: time poverty, competing needs, staff turnover, differences between shift patterns and between permanent and agency staff. Cognitive capacity of the residents and staff attitudes were also key.Conclusions: Adding a reflexive workshop enabled the research to critically review the Pfadenhauer et al.’s framework and change to a systems lens approach, which better explained the interdependent and hierarchical nature of the findings. It also highlighted a number of key factors that could influence the pathway to impact for the intervention.<br/
Glucagon-like peptide 1 receptor agonists and risk of thyroid cancer: an international multisite cohort study
No full textIntroduction: Concerns have been raised that glucagon-like peptide 1 receptor agonists (GLP1-RAs) may increase the risk of thyroid cancer, but evidence remains conflicting. We therefore investigated if GLP1-RA use, compared with use of dipeptidyl peptidase-4 inhibitors (DPP-4is), was associated with thyroid cancer risk in patients with type 2 diabetes.Methods: This multisite cohort study with subsequent meta-analysis included six population-based databases from Canada (Ontario), Denmark, Norway, South Korea, Sweden, and Taiwan. Study populations comprised patients with type 2 diabetes between 2007 and 2023. Cox regression models estimated hazard ratios (HR) and 95% confidence intervals (CIs) for thyroid cancer among GLP1-RA users compared with DPP-4is. Models were weighted using standardized mortality ratio weights generated from time-specific propensity scores. Site-specific HRs were pooled using a fixed-effects model.Results: We identified 98,147 users of GLP1-RA and 2,488,303 users of DPP-4i, with the median follow-up among users of GLP1-RA ranging from 1.8 to 3.0 years. Overall, use of GLP1-RA relative to use of DPP-4i was not associated with an increased risk of thyroid cancer (pooled weighted HR 0.81, CI 0.59–1.12). Similarly, we observed no increased risk in thyroid cancer with increasing cumulative dose of GLP1-RA among GLP1-RA ever-users. Subgroup analysis of types of thyroid cancer was not possible. Results remained consistent across a range of supplementary analyses.Discussion: In this large multisite study, utilizing data from six population-based databases, we found no evidence that GLP1-RA use is associated with an increased risk of thyroid cancer with follow-up ranging from 1.8 to 3.0 years, providing some reassurance to patients and clinicians about the short-term safety of these drugs. Nevertheless, evidence was insufficient to rule out excess risk with long-term use, due to the short follow-up.<br/
The intercultural development and validation of the Indigenous 'Escala de Bienestar Kankuamo' (Kankuamo Well-Being Scale): A capability approach
No full textThis article describes the development and validation of a capability-based well-being scale: 'Escala de Bienestar Kankuamo' (EBK; the Kankuamo Well-Being Scale). The EBK is designed to measure the well-being of the Indigenous Kankuamo community of Colombia from an intercultural perspective. The mixed-methods study was composed of two phases. In phase I, an initial 27 items, which had been generated using qualitative data from a previous study, were reviewed and adjusted through workshops with the Kankuamo community. In phase II, an adapted list of 28 items was piloted within the Kankuamo communities (sample = 213). A preliminary exploratory factor analysis was carried out. The internal consistency of the EBK was measured using McDonald's ω. Convergent and divergent validity were tested with the World Health Organization-Five Well-Being Index (WHO-5) and the Patient Health Questionnaire-9. Incremental validity was tested through a hierarchical regression analysis to determine the effect on the WHO-5 of age, gender, community and EBK. The exploratory factor analysis resulted in a 14-item scale with seven domains: (1) Relating (to others and one's emotions), (2) Guiding principles, (3) Choice of healthcare, (4) Self-grown food, (5) Community contributions, (6) Agency and (7) Respect and equality. The EBK had high internal consistency (McDonald's ω = 0.86). Statistical analyses aimed at determining the convergent and divergent validity were inconclusive, suggesting a need for caution in using western standardised mental health measures in Indigenous communities because these may lack adequate cultural fit. The findings of the current study identify local priorities and needs, and evidence the feasibility of operationalising the capability approach for Indigenous populations
Postdigital citizen science and humanities: a theoretical kaleidoscope
No full textThis collective article presents a theoretical kaleidoscope, the multiple lenses of which are used to examine and critique citizen science and humanities in postdigital contexts and from postdigital perspectives. It brings together 19 short theoretical and experiential contributions, organised into six loose groups which explore areas and perspectives including Indigenous and local knowledge, technology, and children and young people as citizen researchers. It suggests that this collective approach is appropriate because both postdigital and citizen research are founded on and committed to collaboration, dialogue, and co-creation, as well as challenging the tenets and approaches of traditional academic research. In particular, it suggests that postdigital transformations in contemporary societies are both changing citizen science and humanities and making it more important
Robust adaptive nonlinear PID controller using radial basis function neural network for ballbots with external force
No full textThis paper presents a new adaptive nonlinear proportional integral derivative radial basis function neural network (NPID-RBFNN) for ballbots with external force. The proposed controller is designed based on a hybrid of a nonlinear proportional integral derivative (NPID) control, radial basis function neural networks (RBFNN), and balancing composite motion optimization (BCMO). The hybrid NPID-RBFNN controller offers a light-weight computation, chattering-reduction, while providing high robustness against model uncertainties and external disturbance. Therefore, it provides excellent features to control ballbots against the counterpart approaches such as the conventional PID, conventional NPID, which preserves low robustness against disturbances, or sliding mode control (SMC), which provides higher chattering. The BCMO is used to determine the gain values that best fit the system, and RBFNN is learned continuously during the ballbot movement to balance the system in the most stable and smooth way. The NPID-RBFNN controller is proven to be stable through the Lyapunov approach. The simulation and experiment results show that the NPID-RBFNN controller is a robust method for controlling the ballbot system’s motion in applications with external force
Antibiotic prescribing for care-home residents: a population-based, cross-classified multilevel analysis in Scotland, UK
No full textBackgroundThere is wide variation in antibiotic prescribing across care-homes for older people, with implications for resident outcomes and antimicrobial resistance.ObjectiveTo quantify variation in antibiotic prescribing and associations with resident, care-home and general practice characteristics.DesignPopulation-based analyses using administrative data.Setting and subjects148 care-homes in two Scottish regions, with 6633 residents registered with 139 general practices.MethodsPrescriptions for any antibiotic and for broad-spectrum antibiotics between 1 April 2016 and 31 March 2017 were analysed using cross-classified multilevel negative binomial regression.ResultsFor any antibiotics, the mean prescription rate was 6.61 (SD 3.06) per 1000 resident bed-days (RBD). In multivariate analysis, prescribing was associated with resident age [incidence rate ratio (IRR) 1.30 [95% confidence interval 1.19 to 1.41] for 90+ versus <80 years old] and comorbidity (1.88 [1.71 to 2.06] for Charlson Comorbidity Index 3+ versus 0), and the care-home’s sampling rate for microbiological culture (1.53 [1.28 to 1.84] for >7 versus <3.5 samples per 1000 RBD), with residual unexplained variation between care-homes (median IRR 1.29 [1.23 to 1.36]) and general practices (1.11 [1.05 to 1.18]). For broad-spectrum antibiotics, the mean rate was 0.98 (0.92) per 1000 RBD. Broad-spectrum prescribing was also associated with resident age, sex, comorbidity and sampling rate, with larger residual unexplained variation between care-homes (1.56 [1.36 to 1.77]) and general practices (1.51 [1.31 to 1.72]).ConclusionVariation in prescribing was influenced by resident case-mix, but there is significant unexplained variation between care-homes and between general practices, indicating a need for antibiotic stewardship to target both.<br/
Do global COVOL and geopolitical risks affect clean energy prices? Evidence from explainable artificial intelligence models
No full textWe investigate the impact of global common volatility and geopolitical risks on clean energy prices. Our study utilizes daily data from January 1, 2001, to March 18, 2024. Using a new framework based on explainable artificial intelligence (XAI) methods, our findings demonstrate that the COVOL index outperforms the geopolitical risk index in accurately predicting clean energy prices. Furthermore, the Extreme Trees algorithm shows superior performance compared to traditional regression techniques. Our findings indicate that XAI improves transparency, thereby making a substantial contribution to agile decision-making in predicting clean energy prices. Practitioners, including investors and portfolio managers, can enhance investment decisions and manage systemic risks by incorporating COVOL into their risk assessment and asset allocation models.<br/
How does earmarked foreign aid affect recipient-country ownership?
No full textHow does earmarked foreign aid affect country ownership, a central principle of the aid effectiveness agenda? Although earmarking was initially purported to reduce donor fragmentation and enhance aid effectiveness, recent evidence suggests that it may undermine ownership. Despite formal commitments to ownership by multilateral institutions and bilateral donors within the Development Assistance Committee (DAC), earmarking potentially strengthens the responsiveness and accountability of international organizations to donors, thereby undermining recipient countries' ownership in formulating policy objectives, use of country-led results frameworks, and implementation of aid through national systems. We test this expectation through a mixed-methods approach. We first employ latent factor analysis on new data from two monitoring rounds of the Global Partnership for Effective Development Cooperation, covering 80 donors and 92 recipient countries, to measure ownership by the degree of donor−recipient alignment. Our multivariate regression analysis then demonstrates that earmarked aid significantly reduces recipient-country ownership. Further examination of institutional and DAC donor policies and discourses reveals limited recognition of the adverse effects of earmarked funding on ownership. We find evidence to support the notion that bilateral donors employ earmarking to both enhance their influence within international development organizations and to pursue national interests, inadvertently sidelining ‘old’ concerns about aid effectiveness and ownership. Our findings thus expose a clear disconnect between donor rhetoric and practice, with significant implications for aid effectiveness and aid allocation more broadly.<br/
Efficient PWS-based computation of the sensing matrix for computational radar imaging systems
No full textThis letter presents an efficient method to compute the sensing matrix of computational imaging (CI) systems based on the plane wave spectrum (PWS) representation of electromagnetic waves. CI has recently been proposed as a promising paradigm to overcome some of the limitations of conventional radar imaging systems (mainly related to low acquisition speeds). As CI resorts to antennas that radiate spatially incoherent patterns to compress the scene information, the system complexity is transferred to the signal processing layer. CI systems are characterized by means of the so-called sensing matrix, which properly accounts for the spatially incoherent behavior of the antennas. The conventional method used to compute the sensing matrix is based on a point-by-point propagation between the aperture fields and the imaged scene, which is significantly time consuming. To address this limitation, this work proposes a PWS-based method, which enables to perform a plane-to-plane propagation. This results in a drastic improvement in the time required to compute the sensing matrix, without affecting its accuracy or the quality of the retrieved radar images. The proposed method has been experimentally validated with a CI system using frequency-diverse antennas.<br/