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The MyRelief Digital Educational Self-Management Program for Persistent Low Back Pain: Feasibility Uncontrolled Trial
Get PDFBackground: Low back pain (LBP) is a leading cause of work absence globally. Digital interventions have the potential to increase access to self-management support for individuals with persistent LBP. Objective: This study aims to evaluate the feasibility, usability, and acceptability of a digital educational program (MyRelief) designed to support self-management strategies for people with persistent LBP. Methods: A prospective uncontrolled feasibility study was conducted across 4 countries (Italy, Portugal, Sweden, and the United Kingdom) between 2020 and 2021. Adults in employment with nonspecific persistent LBP (>3 mo) with access to the internet were eligible to participate. Participants were given access to MyRelief, an 8-unit evidence-based educational self-management program. The feasibility of the MyRelief program was assessed using recruitment rates, an a priori success threshold of >70% of the target sample (50 participants), and a retention <35% dropout rate. Pre- and postintervention measures of functional disability were assessed using the Oswestry Disability Index (ODI), and health-related quality of life using the 5-level EuroQol questionnaire. Additional postintervention measures included the Patient Enablement Instrument and the System Usability Scale. Quantitative data were analyzed descriptively, and qualitative feedback was analyzed using a reflexive analytical approach. Results: The recruitment feasibility threshold was met, and 40/50 (80%) participants (19 male and 21 female; mean age 57 years) were enrolled in the study. A total of 17 participants (11 male and 6 female) completed both the baseline and 12-week follow-up questionnaires. This represented a retention rate of 42.5% (17/40) and a dropout rate of 57.5%, which did not meet the a priori criteria of <35% dropouts. Approximately half of the participants presented with low baseline disability scores (mean ODI 24.0; 95% CI 18‐31) with no significant change at follow-up (mean ODI 23.9; 95% CI 16‐31). The 5-level EuroQol questionnaire scores improved from 0.68 (95% CI 0.608‐0.76) to 0.72 (95% CI 0.66‐0.79), indicating a clinically significant change. Patient Enablement Instrument scores postintervention were high (mean 5.31), indicating good perceived enablement. The mean System Usability Scale score was 72.4 (95% CI 67.5‐73.3), indicating a good level of perceived ease-of-use. Overall, the quality of outcome measure completion was high (100%). Qualitative feedback indicated areas for improvement relating to challenges around access and navigation within the website. Conclusions: The MyRelief study demonstrated feasibility in terms of recruitment but not retention. However, low baseline disability levels are not representative of the wider persistent LBP population. Future studies should broaden recruitment strategies, in particular, by recruiting from health care settings to improve representativeness. Although usability met industry standards, qualitative feedback suggests that navigation and accessibility require further optimization to better align with end user preferences for digital health interventions.</p
Is rurality associated with higher probability of conveyance to hospital following diabetes-related ambulance callouts? A retrospective observational study
Get PDFRevenue composition and financial health of nonprofit humanitarian and emergency health services
Get PDFPurposeEmergency health and humanitarian nonprofits work under volatile circumstances that strain nonprofits' financial resources. This study investigates the impact of revenue composition on the financial health of these nonprofits and the impact of financial health on the likelihood of financial distress.Design/methodology/approachA sample of 11,335 emergency nonprofits from 2003 to 2020 was obtained through form 990 data and studied through a difference generalized method of moments (GMM) approach for the impact of revenue composition on financial health. The impact of financial health on financial distress was studied through panel logistics regression.FindingsRevenue diversification adversely affects the financial health of nonprofit emergency health and humanitarian organizations contrary to the implications of modern portfolio theory. The financial health of nonprofit emergency health and humanitarian organizations is persistent through the significant positive effect of lags in most cases.Originality/valueThe emergency health subsector of nonprofits was studied separately due to the unique nature of the sectors' operations and operating environment. The impact of revenue composition was investigated on key dimensions of financial health. Omitted variable bias, simultaneity and dynamic endogeneity were handled through difference GMM
Manipulating embryogenesis and testing for potential:Two real problems for the regulation of stem cell-based embryo models
Get PDFStem cell-based human embryo models (SCBEMs), generated in vitro from stem cells, currently exist outside the scope of regulatory frameworks that govern in vitro embryo research in most jurisdictions. A widely discussed proposal suggests using a’Turing test’ framework, whereby regulatory oversight is triggered if an SCBEM is found to be’equivalent’ to a human embryo. In this paper, we argue that such a proposal faces two major complications. First, sophisticated laboratory techniques such as trophoblast replacement allow researchers to manipulate normal embryogenesis, obscuring whether a given SCBEM meets embryo-like regulatory thresholds. Second, attempts to assess SCBEMs’ developmental potential—especially through non-human analogues—rest on tenuous epistemic assumptions that may not align with human-specific developmental trajectories. Given SCBEMs’ potential manipulability and uncertain biological and potentiality benchmarks, we argue that reliance on equivalence-based frameworks alone is highly problematic. We conclude by urging a cautious, flexible approach that recognises both the scientific promise of SCBEMs and the normative need to prevent the circumvention of regulatory safeguards.</p
Assisted dying, vulnerability, and the potential value of prospective legal authorization
Get PDFConcern for vulnerable people is a crucial issue when considering the legalization of assisted dying (AD), but the meaning and normative significance of vulnerability in this context is under-explored. We examine vulnerability and the protective obligation through the lens of vulnerability theory to improve understanding of vulnerability in the context of AD. By appealing to a more nuanced account of vulnerability, we argue that the current ban on AD in England and Wales is a blunt tool that lacks compassion and fails to recognize the importance of personal autonomy, as well as the relationship between vulnerability and autonomy. Recently, some emerging lawful models of AD purport to better protect the vulnerable via prospective legal authorization. This is also a feature of recent English Assisted Dying bills, with proposals for judicial or quasi-judicial authorization, and so we consider the potential value of prospective legal authorization. Although this approach risks being burdensome for applicants, we suggest that it could, in principle, not only safeguard vulnerable individuals, but also enhance end-of-life autonomy thereby offering support for a restrictive approach to lawful AD.</p
Connecting with the Sustainable Development Goals
Get PDFThis interactive workshop explores practical and theoretical approaches to integrating the Sustainable Development Goals (SDGs) into teaching and learning activities across disciplines. With sustainability gaining prominence in higher education, the SDGs are increasingly emphasised in higher education policy and institutional strategies (Winter & Cotton, 2012). As a result, many educators face pressure to align their teaching, assessment and overall curricula with the SDGs (Vogel et al., 2023). However, challenges are faced when many educators remain unaware of the SDGs, are uncertain about what the SDGs encompass or, most importantly, how they can be meaningfully integrated into their curricula (Higgins & Calvert, 2024). Participants will engage in collaborative activities designed to uncover the links between their subject areas and the SDGs, empowering them to design teaching and learning activities that embed sustainability. The session also delves into the scholarly and theoretical dimensions of the SDGs, critically evaluating their implications for pedagogy and SoTL. Through practical examples and critical reflection, the workshop will support educators in navigating both institutional pressures to align with the SDGs and their own aspirations for transformative, sustainable teaching. Attendees will leave with a clearer understanding of the SDGs, their application to various disciplines, and approaches to fostering a deeper connection between these global goals and local educational practices
MiKAD: Memory-Infused Knowledge Networks for Manufacturing Anomaly Detection
Get PDFMany semiconductor industries have adopted smart manufacturing systems for defect detection, while others still rely on manual inspection methods that can compromise product quality and assurance. To address the limitations of manual inspection, we propose Memory-infused Knowledge Networks for Manufacturing Anomaly Detection (MiKAD), an unsupervised learning technique that combines multiscale knowledge distillation and a dynamic memory bank to detect anomalies of varying sizes and shapes in real industrial image datasets. The knowledge distillation framework consists of a teacher-student architecture, where the teacher is a pretrained network and the student is a trainable network that leverages EfficientNet-B7 as the multiscale backbone. A dynamic memory bank is integrated to support the student network during training by enhancing its ability to learn normal features by updating with new features and suppressing outdated ones. Discrepancy loss at multiple scales between the teacher and student ensures accurate detection and localisation of the anomalies across different sizes and shapes using real industrial datasets. Experiments on two real-world datasets, namely a Seagate Write Pole (WP) and BTAD, demonstrate that MiKAD achieves strong performance in both anomaly detection and localisation, with image level ROC_AUC scores of 97.77% and 96.85% respectively
Universal Design for Learning and the Sustainable Development Goals:Reimagining Inclusive Education – An Alice in Wonderland Journey
Get PDFThis paper critically examines the evolution of inclusive education, tracing its trajectory from disability-centric models towards the more encompassing framework of Universal Design for Learning (UDL) and its alignment with the United Nations Sustainable Development Goals (SDGs), specifically addressing the interconnectedness of SDG 4 (Quality Education) with SDG 8 (Decent Work and Economic Growth) and SDG 10 (Reduced Inequalities). Through a synthesis of past literature and the findings of two systematic literature reviews (SLRs), this paper highlights existing gaps between theory, practice, and the aspirational goals of inclusion. The first SLR revealed a significant absence of research exploring the intersection of UDL and career guidance within an inclusive education philosophy, a crucial link to fostering opportunities for decent work as outlined in SDG 8. The second SLR, focusing on the implementation of UDL in European formal school settings, identified a limited empirical evidence base, predominantly centred on teacher-learner interactions. By bringing together these findings, this paper argues for a more holistic and contextually nuanced approach to inclusion that moves beyond the restrictive medical model of disability and appreciates the diverse cultural contexts influencing educational structures. Furthermore, this paper advocates for building upon the dynamic and flexible nature of UDL to continually challenge and expand the scope of inclusive education. It calls for a genuine push beyond a one-size-fits-all "expert" led approach, emphasising a renewed focus on relationships, a shared multi-professional understanding, and a deep appreciation of culture and context in shaping inclusive practices. It proposes a re-evaluation of terminology and practice, advocating for applied, specific examples that embrace the diversity of all learners, including those with disabilities, and the collaborative roles of all education professionals in achieving truly inclusive and equitable education. This shift toward quality education (SDG 4) aims to reduce inequalities (SDG 10) and promote conditions for decent work and economic growth (SDG 8) by challenging the disabling barriers that prevail in education, limiting quality for those most challenged and historically impeding full participation. Navigating the “wonderland” of inclusive education must now involve considering UDL, the SDGs, and redeveloping inclusive learning for a changing world
Motivating Business Students for Civic Education: Design Principles for Aligning Civic Engagement Programs with Student Motivation
Get PDFCivic education aims to prepare students as responsible, engaged citizens, yet its integration into business education presents unique challenges. Business students often exhibit lower prosocial and civic motivations compared to peers in other disciplines, raising questions about how to design effective civic education for this population. This study examines business students’ educational motivations and their responses to civic education initiatives at a large Dutch university, using Self-Determination Theory (SDT) and the framework of instrumental and substantive rationality. Through focus group discussions, we explore how business students’ careerist orientations shape their engagement with civic education, identifying themes of careerism, autonomy, and practical learning. Our findings highlight the potential of leveraging instrumental motivations, such as career advancement, as entry points for fostering intrinsic motivation and prosocial orientations. We propose that aligning civic education with students’ psychological needs for competence, autonomy, and relatedness can gradually transform extrinsic motivations into more substantive, ethically driven engagement. These insights contribute to SDT by integrating the dual rationalities framework, offering theoretical and practical guidance for designing civic education that balances career relevance with societal responsibility. This study provides actionable design principles for curriculum designers and a foundation for future research into the motivational dynamics of civic education in business schools
Using Computer Vision to Apply Activity Recognition Techniques to the Monitoring of Emotional Wellbeing
Get PDFThe World Health Organization predicts that by 2050 those over the age of 60 will account for 22% of the world's population, up from 12% in 2015. Accompanying this change in demographics will be an increase in age-related health conditions, such as frailty, dementia and Parkinson’s disease which require long-term monitoring and treatment. Dementia and Parkinson’s disease are both progressive neurological conditions. Dementia, commonly presents as changes in mood and behaviour and memory problems. The symptoms of Parkinson’s disease include body tremors and slow, impaired movement, as well as depression and anxiety. Being able to monitor the emotions and emotional well-being of those affected by these conditions, on a long-term basis would allow clinicians, carers and family members to observe trends, supporting diagnosis, management, medication and provision of care.A variety of methods are used to recognise emotion, including video analysis to observe visual and audio signals (if present), or wearable devices to observe physiological signals such as ECG, pulse, and temperature. Taking inspiration from a technique that has been used in human activity recognition, our study employs a pose estimation model generated by the open-source tool OpenPose to extract face, body and hand key-points from video and generating features to input into the algorithms that will classify emotion and/or wellbeing state, rather than activity. Our study aims to demonstrate that combining information about facial expression, body posture and hand gestures will improve categorisation of emotion. For this study we use the Multimodal EmotionLines Dataset (MELD), an acted dataset containing 13,848 video clips of utterances from the TV show “Friends”, which have been labelled using 7 emotion categories. This dataset presents challenges similar to those encountered in a real-life dataset, including multiple people in the frame and occlusion.To address the challenge of multiple people in frame, we have incorporated a mechanism, called pyppbox to enable us to track and identify the person whose emotional state we are observing and extract information for just that person in the frame. This is accomplished by training the facial recognition model FaceNet on images of the 6 main Friends characters, before running pyppbox on the dataset. The output generates bounding box coordinates for each person in each frame with an identity label, which we use to isolate the OpenPose key-points for the person of interest. From these key-points we create a set of pose features, including distances and angles as the input into the algorithms that are used to categorize the emotions, starting with LSTM.We present the results of our study, discussing the performance of the combinations of features for categorising emotion, the effectiveness of the tools used for feature extraction and the future development of this approach for long-term observation of emotional wellbeing in age-related health conditions