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Towards the development of a national patient transfer document between residential and acute care—A pilot study
No full textBackground
A lack of standardisation of documentation accompanying older people when transferring from residential to acute care is common and this may result in gaps in information and in care for older people. In Ireland, this lack of standardisation prompted the development of an evidence based national transfer document.
Objectives
To pilot a new national transfer document for use when transferring older people from residential to acute care and obtain the perceptions of its use from staff in residential and acute care settings.
Methods
This was a pre‐ and post‐study design using purposive sampling following the STROBE guidelines. The pilot was conducted in 26 sites providing residential care and three university hospitals providing acute care. Pre‐pilot questionnaires focused on current documentation and were distributed to staff in residential care (n = 875). A pilot of the new paper‐based transfer document was then conducted over three months and post‐pilot questionnaires distributed to staff from both residential and acute care settings (n = 1085). The findings of the pilot study were discussed with multidisciplinary expert advisory and stakeholder groups who recommended some revisions. This consensus informed the development of the final design of the new revised transfer document.
Results
Pre‐pilot: 23% response rate; 83% (n = 168) participants agreed/strongly agreed that existing documentation was straightforward to complete but could be more person‐centred. Post‐pilot: 11% response rate; 75% (n = 93) of participants agreed/strongly agreed that the new transfer document promoted person‐centred care but recommended revisions to the new document regarding layout and time to complete.
Conclusions
This study highlighted some of the challenges of providing safe, effective and relevant transfer information that is feasible and usable in everyday practice.
Implications for practice
Standardisation and being person‐centred are important determining factors in the provision of relevant up to date information on the resident being transferred.PUBLISHEDpeer-reviewe
Rehydration properties of regular and agglomerated milk protein concentrate powders produced using nitrogen gas injection prior to spray drying
No full textThis study evaluated the effect of high-pressure nitrogen (N2) gas injection prior to spray drying on the subsequent rehydration properties of regular and agglomerated milk protein concentrate (MPC) powders. Conductivity measurements demonstrated a slower release of ions for powders produced using N2 injection (NI) as they took longer to wet and sink due to their lower density. However, analysis of particle size distribution on reconstitution at both 23 and 50 °C showed an improvement in powder dispersion with NI. Powder solubility, when measured at 23 °C, was higher for the NI powders, while agglomeration negatively impacted solubility. Confocal laser scanning microscopy analysis showed a faster diffusion of dye into MPC powder particles produced using NI. The improvement in powder dissolution with NI was attributed to higher porosity and the presence of air voids which facilitated increased water transfer and accelerated the breakdown of primary powder particles
Examining the concept of temporal complexity in information systems development
No full textOver the past number of decades, information systems development (ISD) has been a central topic within the information systems (IS) field. ISD operates in complex environments, where the main focus for ISD mangers is increasing speed and increasing time to market. While time is a central concept within ISD, studies which explicitly explore time are rare. Instead, time is often ignored and viewed as simple, objective, and quantifiable. Many IS and ISD researchers have called for studies which explore the socially embedded, subjective, and complex aspects of time. Based on the lack of time in ISD research and based on the numerous calls for future research within the area, this doctoral research undertakes three research studies which examines the phenomenon. In each study, the Ancona et al., (2001) temporal complexity framework is used as a theoretical lens.
In Study 1, the research focuses on identifying, classifying and analysing temporal complexity in ISD literature. The systematic literature review examines the body of knowledge concerning time in ISD. It is the first literature review that explicitly focuses on time in ISD. It gives direction to researchers and practitioners by pinpointing the exact gaps in the field. Specifically, the systematic literature review contributes to ISD by discovering that there are several major gaps in the literature. Within ISD, the broad, interrelated, and complex concept of time is ignored. Instead, time is largely viewed as objective and simplistic, ignoring other types of time. The temporal characteristics associated with mapping activities to time are often neglected. Further, the actor’s relationship to time is also rarely studied in ISD. Although ISD has been a pillar for IS research for the last number of decades, ISD methodologies such as agile and lean have rarely contributed to time research. In particular, ISD have lacked in contributions to guidelines, lessons learned, and advice/implications.
In Study 2, the research focuses on examining the temporal complexity that exists within ISD teams. In particular, ISD flow based teams. It is the first empirical study that explicitly focuses on time in ISD flow. Specifically, the study identifies seven challenges and four recommendations of ISD flow techniques. Practitioners can take these lessons learned and apply them to their own ISD context. The study also develops an extensive roadmap for future research to address the current dearth of solutions in existing literature. These are comprised of 14 research questions which academics can use for future research.
In Study 3, the research focuses on examining the temporal complexity that exists within remote ISD workers. In particular, Covid-19 affected remote ISD workers. It is the first empirical study that explicitly focuses on time in Covid-19 affected remote ISD workers. Specifically, the study provides a set of six challenges and four recommendations for Covid-19 affected remote workers. These can be used to assist ISD professionals with temporal complexity management in remote ISD working.
Overall, this doctoral research makes specific and distinguishing contributions to ISD research and practice. In terms of contributions to theory, this doctoral research puts forward three studies which show how temporal complexity can be applied to ISD. As a result, this is the first study to present and apply the Ancona et al., (2001) temporal complexity framework to ISD. This is also the first study to systematically examine time in ISD literature. This resulted in a comprehensive review of the current body of knowledge within time in ISD. Furthermore, a research roadmap is provided for future researchers. This gives future researchers direction when applying temporal complexity theory to their own IS or ISD context.
In terms of practical implications, this research answered the call to study time in ISD within an empirically grounded setting. This is the first study to examine time in ISD flow. This is also the first study to examine time in Covid-19 affected remote ISD workers. This study provided ISD mangers, ISD teams and ISD individuals with a temporal complexity framework which can be applied to their ISD environment. By examining time in ISD through an empirical examination, a set of challenges and recommendations were developed. ISD practitioners can take these challenges and recommendations and apply lessons learned to their own ISD context. Through these set of lessons learned, practitioners can gain a deeper understanding for how ISD individuals and teams are influenced by and react towards time. Specifically, ISD practitioners can learn from real life, complex and turbulent ISD environments whereby ISD individuals and ISD teams view, organise, behave and perceive time.2025-05-0
Bioactive potential of natural biomaterials: identification, retention and assessment of biological properties
No full textBiomaterials have had an increasingly important role in recent decades, in biomedical device design and the development of tissue engineering solutions for cell delivery, drug delivery, device integration, tissue replacement, and more. There is an increasing trend in tissue engineering to use natural substrates, such as macromolecules native to plants and animals to improve the biocompatibility and biodegradability of delivered materials. At the same time, these materials have favourable mechanical properties and often considered to be biologically inert. More importantly, these macromolecules possess innate functions and properties due to their unique chemical composition and structure, which increase their bioactivity and therapeutic potential in a wide range of applications. While much focus has been on integrating these materials into these devices via a spectrum of cross-linking mechanisms, little attention is drawn to residual bioactivity that is often hampered during isolation, purification, and production processes. Herein, we discuss methods of initial material characterisation to determine innate bioactivity, means of material processing including cross-linking, decellularisation, and purification techniques and finally, a biological assessment of retained bioactivity of a final product. This review aims to address considerations for biomaterials design from natural polymers, through the optimisation and preservation of bioactive components that maximise the inherent bioactive potency of the substrate to promote tissue regeneration.This publication has emanated from research supported in part by a Grant from Science Foundation Ireland and is co-funded under the European Regional Development Fund under Grant number 13/RC/2073_P2. The authors would like to acknowledge the College of Medicine Nursing and Health Sciences Scholarship, NUI Galway. This project has also received funding from the European Union’s Horizon 2020 research and innovation program iPSpine under the grant agreement No. 825925 and under the Marie Skłodowska-Curie grant agreement No 813263. The authors would like to thank Dr Raghvendra Bohara for proof-reading this manuscript and Maciej Doczyk for preparation of the original figures
On the association between circulating biomarkers and atherosclerotic calcification in a cohort of arterial disease participants
No full textBackground and aims
Atherosclerotic calcification is a powerful predictor of cardiovascular disease. This study aims to determine whether circulating levels of a local/systemic calcification inhibitor or a marker of bone formation correlate with measures of coronary or extracoronary calcification.
Methods and results
Clinical computed tomography (CT) was performed on 64 arterial disease participants undergoing carotid and lower extremity endarterectomy. Coronary artery calcium (CAC) scores and volumes were acquired from the CT scans (n = 42). CAC scores and volumes were used to derive CAC density scores. Micro-CT was performed on excised carotid (n = 36) and lower extremity (n = 31) plaques to quantify the volume and volume fraction of extracoronary calcification. Circulating levels of dephospho-uncarboxylated Matrix Gla Protein (dp-ucMGP), fetuin-A, carboxylated and uncarboxylated osteocalcin (ucOC) were quantified using commercial immunoassays. Carotid participant CAC density scores were moderately negatively correlated with plasma dp-ucMGP (rs = −0.592, P = 0.008). A weak negative association was found between CAC scores and %ucOC for all participants (rs = −0.335, P = 0.040). Another weak negative correlation was observed between fetuin-A and the volume of calcification within excised carotid specimens (rs = −0.366, P = 0.031). Despite substantial differences in coronary and extracoronary calcium measurements, the levels of circulating biomarkers did not vary significantly between carotid and lower extremity subgroups.
Conclusion
Correlations identified between circulating biomarkers and measures of coronary and extracoronary calcium were not consistent among participant subgroups. Further research is required to determine the association between circulating biomarkers, coronary and extracoronary calcium
Comorbidity and COVID-19: Investigating the Relationship between Medical and Psychological Well-being
No full textObjective: The unprecedented occurrence of a global pandemic is accompanied by both physical and psychological burdens that may impair quality of life. Research relating to COVID-19 aims to determine the effects of the pandemic on vulnerable populations who are at high risk of developing negative health or psychosocial outcomes. Having an ongoing medical condition during a pandemic may lead to greater psychological distress. Increased psychological distress may be due to preventative public health measures (e.g. lockdown), having an ongoing medical condition, or a combination of these factors. Methods: This study analyses data from an online cross-sectional national survey of adults in Ireland and investigates the relationship between comorbidity and psychological distress. Those with a medical condition (n=128) were compared to a control group without a medical condition (n=128) and matched according to age, gender, annual income, education, and work status during COVID-19. Participants and data were obtained during the first public lockdown in Ireland (27.03.2020–08.06.2020). Results: Individuals with existing medical conditions reported significantly higher levels of anxiety (p<.01) and felt less gratitude (p≤.001). Exploratory analysis indicates that anxiety levels were significantly associated with illness perceptions specific to COVID-19. Post-hoc analysis reveal no significant difference between the number of comorbidities and condition type (e.g. respiratory disorders). Conclusion: This research supports individualised supports for people with ongoing medical conditions through the COVID-19 pandemic, and has implications for the consideration of follow-up care specifically for mental health. Findings may also inform future public health policies and post-vaccine support strategies for vulnerable populations.Health Research BoardIrish Research CouncilUpdate citation details during checkdate report - RO
Variational autoencoder for image-based augmentation of eye-tracking data
No full textOver the past decade, deep learning has achieved unprecedented successes in a diversity of application domains, given large-scale datasets. However, particular domains, such as healthcare, inherently suffer from data paucity and imbalance. Moreover, datasets could be largely inaccessible due to privacy concerns, or lack of data-sharing incentives. Such challenges have attached significance to the application of generative modeling and data augmentation in that domain. In this context, this study explores a machine learning-based approach for generating synthetic eye-tracking data. We explore a novel application of variational autoencoders (VAEs) in this regard. More specifically, a VAE model is trained to generate an image-based representation of the eye-tracking output, so called scan paths. Overall, our results validate that the VAE model could generate a plausible output from a limited dataset. Finally, it is empirically demonstrated that such approach could be employed as a mechanism for data augmentation to improve the performance in classification tasks
Exploiting individual agent properties for analysis and control of collective network evolution
No full textIn this thesis, we investigate linearly coupled dynamic networks made up of identical oscillators. We study the principles in which the dynamical features of the underlying constituent agents transfer to the collective dynamics of the entire network. This is carried out from two points of view: analysis and control.
In the former case, the objective is to predict the dynamical behaviour of the entire network, by studying the structural properties and the asymptotic dynamical behaviour of the uncoupled agents. However, due to the high complexity that arises when many agents are connected with each other, it is not always possible to determine all the asymptotic solutions of a network. Therefore, we focus on analysing under what conditions we can guarantee a 1-to-1 correspondence between the limit sets of the uncoupled agents and the network. In other words, we investigate the scenario where all network agents behave like a single uncoupled agent. This behaviour, which we refer to as reduced dynamics, extends the subject of network synchronization to a global scale. In some cases, we are able to prove analytically that a region of reduced dynamics exists if the network parameters satisfy certain conditions. In the more general case, we conjecture the conditions for existence of this region and support the conjecture with numerical experimental evidence.
In the latter case, we define a control strategy to obtain a desired global dynamical behaviour while only acting on a small subset of the network nodes, without using any global information. In other words, we design a decentralised control algorithm that drives the entire network towards a desired state, based only on local information of a small subset of nodes and their neighbours.
In order to validate the control algorithm we test it via simulations for networks with different properties and topologies. First, these numerical experiments are conducted on networks of bistable agents with vector field given by a cubic function. We compare the decentralised strategy with three centralised algorithms in order to evaluate its performance. Finally, we extend our experiments to a network of agents where the uncoupled dynamics presents a discontinuity. In particular, we consider the model of a ball or a particle impacting on an oscillating floor. The strong nonlinearity introduced by impacts makes the network dynamics very unpredictable and we show some numerical examples of the complexity that can arise in such systems. Despite the complexity, we also show that with a proper control action we can use the decentralised control algorithm to control the network and thus synchronizing all the agents
China’s spatial fix and ‘debt diplomacy’ in Africa: constraining belt or road to economic transformation?
No full textMounting overaccumulation of capital and material has compelled the Chinese government to seek solutions overseas. The Belt and Road Initiative (BRI), with its transregional infrastructure projects connecting Eurasia and Africa, is the hallmark venture in this effort. Chinese road, railway, port and energy projects, implemented under the BRI banner, have become widespread in Africa. This article traces drivers of the BRI in the post-reform evolution of the Chinese economy and conceptualises the BRI as a multi-vector “spatial fix” aimed at addressing chronic overaccumulation. Focusing on Kenya, Djibouti and Ethiopia, the paper documents how loan financing related to BRI projects reveals contradictions that arise from China’s spatial fix in Africa. Concerns about a looming debt crisis on the continent and the questionable economic sustainability of some BRI projects have become more pressing amidst the COVID-19-induced economic contraction. Hopes for Africa’s economic transformation based on increasing connectivity under the BRI are unlikely to materialise