151398 research outputs found
Sort by
Factors associated with adult mental health and children’s social care professionals’ family-focused practice when parents have mental illness
No full textWhile family focused practice can improve outcomes for families affected by parental mental illness, globally there is limited understanding regarding associated factors and enablers. This mixed methods study aimed to identify associated factors and enablers of family focused practice. A range of adult mental health and children’s social care professionals in Northern Ireland completed the Family Focused Mental Health Practice Questionnaire (n = 868). The survey measured the extent of professionals’ family focused behaviours (Referral; Psycho–Education; and Skills and Knowledge to support parent and their parenting) and four organizational (e.g. Workplace Support) and four individual professional factors (e.g. Connectedness) associated with these activities. The STROBE checklist for cross-sectional research was adhered to. Nested regressions identified nine factors associated with family focused practice; most significant were professionals’ gender, professional discipline, years of experience, training in the Family Model and other training in child or family focused practice. Male professionals, social workers and those with more years of experience and who had received training in the Family Model and other training in child and family focused practice were most family focused. Subsequently 30 professionals and 21 service users participated in semi-structured interviews to elaborate on factors associated with family focused practice. Both professionals and service users described the importance of family focused training while social workers more often discussed receiving the training and engaging in family focused practice than other disciplines. As clear skill, knowledge, and confidence differences are indicated between the professions they require consideration by organizations in developing training, policy and initiatives to promote FFP within adult mental health and children’s social services in Northern Ireland and internationally
Rate of MGUS progression to haematological malignancies: a systematic review
No full textMonoclonal gammopathy of undetermined significance (MGUS) is an asymptomatic pre-cancerous condition which precedes plasma cell dyscrasias, including multiple myeloma (MM). Current clinical guidelines report that MGUS’s rate of malignant progression to hematological malignancy (HM) is ~1% per year, however reported rates have varied widely. To address this discrepancy, a systematic review was conducted, investigating MGUS’s rate of malignant progression to HM, and MM alone. Four electronic databases were searched from inception to 28/3/24 for articles reporting these outcomes; articles were summarised using meta-analysis and narrative synthesis. Findings were incorporated from n=46 studies, published between 1991-2024 and conducted across n=17 countries. Median follow-up ranged from 1.3-34.2 years and sample sizes ranged from n=63-17,963. In random-effects meta-analysis, n=13 studies reported on MGUS progression to HM and n=12 reported on progression to MM. The overall estimates of malignant progression events were 12 per 1,000 person-years to HM, equivalent to 1.2% per year (95%CI: 1.0-1.5%) and 8 per 1,000 person-years to MM, or 0.8% per year (95%CI: 0.7-1.1), with substantial heterogeneity between studies (I²: 96.7% and 95.8%, respectively). Progression rates varied widely in narrative synthesis; at 10 years, studies reported annual MGUS progression rates of 6.6-33.6% to HM and 7.0-28.5% to MM. While progression rates aligned with clinical guidelines overall, studies’ varied findings present opportunities for further research, exploring the impact of world region, follow-up duration and study methods. Considering this, caution should be taken when informing clinicians and patients about the risk of progression from MGUS to MM
Flavonoid intake and telomere length attrition among middle-aged women: a cross-sectional analysis of the Nurses’ Health Study
No full textImpact of RIS size on machine learning-enabled beam sweeping for user localization
No full textThis paper investigates machine learning (ML)-assisted user localization in reconfigurable intelligent surface (RIS)-aided millimeter-wave (mmWave) systems using minimal beam probing. A system model with three RIS apertures (10×10, 20×20, and 30×30) is considered, where the surface sequentially applies a limited set of probing beams, and the user equipment (UE) records the corresponding received power. Using ML regression, we train the regressor models to predict the UE positions from these measurements and update the RIS phase distributionfor efficient beam forming towards the intended UE. Simulations show that small RIS arrays achieve accurate predictions with limited probing, whereas larger apertures need deeper sweeps to curb outliers. The best approach attains mean errors below 1.5 dB for a 10 × 10 aperture and improves further on larger apertures with six probing beams. This underscores a trade-off among RIS size, probing overhead, and ML method choice for efficient RIS-aided localization in future sixth-generation (6G) wireless network
Integration of a circularly polarized array with a holographic metasurface converter for dual- polarization
No full textOn temporally bounded spatial dynamic sampling for metrology optimization
No full textIn smart semiconductor manufacturing, wafer metrology plays an important role in ensuring production quality and efficiency. Extensive production metrology however implicates substantial costs in terms of equipment and time needed to perform the measurements. Achieving efficient metrology plans is therefore highly desirable. When the characteristics being monitored are spatially correlated it is possible to develop dynamic sampling strategies that exploit this correlation to reduce the number of measurement sites needed for full process visibility. These approaches typically employ historical data to identify the subset of locations to measure for each wafer, and statistical models that can reconstruct the complete data from the reduced set of measurements. Existing dynamic sampling strategies have focused on trading off reconstruction accuracy with the number of measurements points, without considering constraints on the temporal horizon, that is, the number of wafers that need to be processed before all available locations are measured at least once. This is an important parameter in practical applications as it defines the maximum number of wafers for which previously unseen abnormal behavior can go undetected. In this paper we formulate the temporally bounded dynamical sampling problem and explore a number of different strategies for solving it. These strategies focus on the best way to select new sites to visit for each wafer in order to comply with the temporal constraint, while minimizing the impact on process visibility. The effectiveness of the proposed methods is tested using both simulated and real world semiconductor manufacturing case studies. Results show that an algorithm, denoted DFSCA-Greedy, that distributes the number of forced sites evenly across the measurement plan, and selects the sites with a variant of the FSCA optimum site selection algorithm, achieves the best overall performance
Evaluating proposed countermeasures for power analysis of ring oscillator PUFs
No full textThe security of PUF derived secrets against common analysis techniques is integral to their use as a hardware security primitive. As in any secure element, it is essential that designers understand the impact that design choices can have on information leakage in various domains. While PUF designs have been well studied in terms of machine learning attacks from a remote adversary, there has been much less investigation of side channel leakage and how to mitigate it. In this paper we investigate different proposed countermeasures to prevent such attacks and the actual degree of protection provided by each. From these results, we show that only one approach (parallel comparison) results in robust protection. This provides a valuable insight into secure design principles for all RO-based PUFs.<br/
Midwives’ experiences of developing advanced clinical practice roles in complex pregnancy care
No full textBackgroundThe needs of our pregnant population are evolving with more of our service users needing complex maternity care due to a significant number of them choosing pregnancy when living with pre-existing medical comorbidities. In addition, the national maternity service reviews in the UK continue to highlight failures of maternity professionals to identify common medical conditions and recognise deteriorating maternal health of which the consequences can be fatal. Some midwives have developed their clinical skills, knowledge of pathophysiology and disease presentation in pregnancy, to be able to meet the needs of those women requiring additional complex pregnancy care.Aim and ObjectivesTo explore how direct entry midwives develop and practice at an advanced level and to identify the barriers and facilitators to their roles.MethodTen direct entry midwives who have completed or are currently undertaking their advanced clinical practice (ACP) training were interviewed using semi-structured questions. The data was analysed using a thematic analysis model by Braun and Clarke (2021). Ethical approval was not required as all research participants were NHS staff.FindingsFour themes were identified: (1) ‘I didn’t know what I didn’t know’, (2) knowledge as empowerment, (3) challenges and enablers and (4) purpose filled drive. Midwives identified they had a deficit in both knowledge and in the clinical presentation of complex medical disease in pregnancy once they started their ACP training. They had to seek additional external support and resources in order to address this gap.Conclusion and ImpactMidwives need to develop advanced clinical practice skills to meet the increasing demands of complex pregnancies. Direct entry midwives rely on their clinical midwifery leaders who understand and endorse the vision of advanced midwifery practice for mentoring in these roles. Seeking out learning opportunities within general medical environments should be considered to maximise learning for direct entry midwives
Identifying researchers’ and professionals’ priorities for interventions and outcomes with families with parental mental illness
No full textChildren in families where a parent has a mental illness (FaPMI) have increased risk for a range of negative outcomes. Despite increasing recognition of the need for support for these families, there is still little consensus regarding the goals and outcomes services should work towards. This paper reports on a cross-sectional online survey, analysed using template analysis, exploring the perspectives of an international sample of academic (n=33) and practice (n=17) experts as to the most important goals and outcomes for interventions for FaPMI. Findings indicate that these experts prioritize a holistic and family-centred approach, with more importance placed on subjective and relational factors beyond individual symptom reduction. This encompasses whole-family communication and relational factors; meaning and hope for family members; social connectedness; understanding of mental health across the family; impacts of intergenerational trauma; and the family-service alliance. The findings have implications for the development of priorities for interventions and measurement of outcomes in social work and allied professions, which include a central recognition of the importance of the conceptualisation of family relationships, communication and family recovery
