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Undertaking ‘soft’ and ‘whole’ systems approaches in realistic policy contexts: a comparative case study
Get PDFThe past 20 years have seen a growing interest in the use of ‘soft’ and ‘whole’ systems approaches within various public health policy domains. Two of the most prominent of these topics are healthy weight/obesity and physical activity promotion. This paper reports on grounded evaluations of two concurrently delivered systems-based projects in these domains and was structured in a comparative case study form using survey, non-participant observation and focus group methods. Beyond the affirmative consensus that exists around systems approaches, it critically explores three areas related to its manifestation in these contexts: the role of foundational systems theories, specifically the articulation between ‘hard’ systems and ‘soft’ systems; expectations of systems-derived outputs; and ultimately, their fit with existing policy circumstances. It indicated that the project facilitators were conscious of theory and implicitly accommodated it in their approaches. It also showed that the systems elements identified were highly heterogeneous and contested. By means of advancement and derived from grounded inquiry from the workshops, it suggests the need for a more ‘context-conscious’ orientation within systems approaches. It offers three specific pointers: a typology of varied approaches that can used locate any specific systems-based project; the suggestion of the need to see systems-related developments in a staged, progressive and long-term way; and mapping of these potential positions, ranging from a modest mapping exercise of what is already happening in any domain through to the systems-based processes being used to foster novel and potentially innovative ‘cross cutting’ actions
An individual treatment effect approach to predict response to mineralocorticoid receptor antagonists in patients with heart failure and reduced ejection fraction
Get PDFAims:
Mineralocorticoid receptor antagonists (MRAs) are often underused in patients with heart failure (HF) and reduced ejection fraction (HFrEF). Individual treatment effect (ITE) may assist physicians in making timely decisions about which patients are the best suited for personalized therapy. We aimed at developing and validating a model to estimate ITE of MRAs in patients with HFrEF.
Methods and results:
RALES and EMPHASIS‐HF trials were the derivation trials used to estimate ITE of MRAs versus placebo on cardiovascular death or HF hospitalization in HFrEF over a 2‐year period using counterfactual random forest method. ITE prediction models were built using linear regression and applied to the EPHESUS trial in patients with left ventricular systolic dysfunction and/or HF after myocardial infarction. In the RALES and EMPHASIS‐HF trials ( n = 3887), age, body weight, blood pressure, heart rate, hypertension and diabetes prevalence, stroke history, left ventricular ejection fraction, renal function, and serum sodium and potassium concentrations were identified to determine ITE scores (adjusted R 2 = 0.25). As ITE scores increased, hazard ratio for treatment effect decreased from 0.82 (95% confidence interval [CI] 0.67–1.02) at ITE score 5 to 0.47 (95% CI 0.35–0.63) at ITE score 20 ( p for interaction = 0.014). In the EPHESUS trial ( n = 6472), a similar pattern was observed, with greater treatment effects in patients with higher ITE scores ( p for interaction = 0.007).
Conclusions:
In HFrEF across various clinical settings, our simple ITE model predicted individual responses to MRA therapy. Although treatment effects may be attenuated at lower ITE scores, point estimates with wide CIs still generally favour benefit, suggesting that these patients still benefit
Late Quaternary evolution of a large rock slope deformation (Robinson, English Lake District) – a first such exploration by cosmogenic exposure dating in the British mountains
Get PDFThe temporal dynamics of the Robinson rock slope failure (RSF), the largest such feature in the Lake District of northwest England, have been assessed through cosmogenic (10Be) surface-exposure dating of quartz veins on the headscarp/rupture surface and an upper-mid-slope antiscarp. Movement along the headscarp/rupture surface began during the Lateglacial ~ 15.4–14.3 ka, and movement could have continued, incrementally or episodically, until the mid-Holocene ~ 4.6 ka. Displacement rates for the headscarp/rupture surface averaged over that time are in the range 3–4.5 mm/a. These are the first rates to be reported for an RSF in Britain and Ireland. Ages from the upper-mid-slope antiscarp (~ 8–6.5 ka) indicate early-mid-Holocene movement, although 10Be inheritance may have aged these samples somewhat. Reasons for RSF activity at Robinson at those times are complex, but probably involved paraglacial stress release augmented by the concentrated erosion of bedrock in a trough below a glacial breach, along with the structural characteristics of the local bedrock. The cosmogenic ages suggest that other RSFs in this area may have a longer history of instability than hitherto thought
Decolonizing human rights education, eurocentrism and human rights universals
No full textCritical reflection on the history, conceptual underpinnings, and practices of human rights education (HRE) has prompted calls for the field to be decolonized, in response to the injustices of colonial history and persisting present-day coloniality. We sympathize with current calls to decolonize and value their effect in prompting critical reflection on Empire in all its facets, yet we also regard HRE as having a credible role to play in response to both colonialism and continuing coloniality.
Addressing the decolonial criticism of human rights education as undermined by Western, European, universalist underpinnings, we question its account of European thought. In doing so we distinguish between a qualified universalism on the one hand, which we support, and colonial hypocrisy and pseudo-universalism on the other. Favouring a postcolonial stance, we argue that while the practices of HRE must reflect local diversity, its conceptual foundations are neither historically fixed nor geographically determined. We reflect on the prospects for developing a conceptually coherent and programmatically defensible HRE if we embrace the decolonization imperative’s scepticism about European thought and the possibilities for universality that seem so central to the human rights movement
Spectroscopic investigations of a pharmaceutical solid form analogue: pyrimethanil L-tartrate hemi-cocrystal
No full textAn approach towards pharmaceutical cocrystal analysis is reported for a model cocrystal system of pyrimethanil (an anilinopyrimidine fungicide) and L-tartaric acid (PYL-LTA-CC). Single crystal diffraction studies (X-ray and neutron) show PYL-LTA-CC to crystallise in the primitive orthorhombic space group P21212, with the asymmetric unit (1:0.5 stoichiometry) comprising two symmetry independent heterosynthons of pyrimethanil and a half tartaric acid fragment. The neutron diffraction study provides details of the hydrogen bonding in the two adducts and indicates that they are linked by N–H O and N H Ohydrogen bonds. Periodic-density functional theory calculations inform on the vibrational properties of PYL-LTA-CC, with the ab initio treatment validated by agreement between simulated and experimental inelastic neutron scattering spectra. Fourier transform infrared spectroscopy in attenuated total reflection mode (FTIR-ATR) and Fourier-transform Raman spectroscopy are used to probe the cocrystal’s vibrational transitions. Notable deviations between computed and experimental infrared features are observed at higher wavenumbers, reflecting anharmonic contributions within the hydrogenbonded network. Although most of the vibrational modes in the FTIR-ATR spectrum provide little direct information on the key hydrogen bonding interactions, a set of deformation modes in the range 16681618 cm1 are diagnostic of distinct hydrogen bonding interactions within the asymmetric unit. The suitability of Raman spectroscopy for identifying hydrogen bonding is also examined, this technique being less information-rich than FTIR-ATR. Collectively, the study demonstrates how vibrational spectroscopy could be used to supplement investigations on the structure and form of the cocrystal as a potential drug delivery vector for this fungicide
"Pissing in the wind": grappling with the spillovers of "malevolent weathering"
No full textThis commentary engages with Mikko Joronen’s provocative and timely notion of ‘malevolent weathering’
developed to grapple with the formative roles of pollution within the Zionist settler-colonial project unfolding across contemporary Palestine. It argues that while Joronen’s efforts to centre this weathering process as
the main event is welcome and productive, the article less well attuned to grappling with this weathering’s
contradictory spillovers. I argue that addressing such spillovers requires more than simply weighing the costs
of malevolent weathering against its material benefits to the Zionist project. And to do so, I suggest two
things. The first, is to connect this weathering with Zionism’s defining ‘addiction to violence’. The second
is that because of its remarkable success in securing access to a nearly endless supply of Western arms
and largesse, the Zionist project has never been forced to actually bear the full costs of its addiction to violence vis-à-vis its long-term viability. I suggest that this twin focus help us to explore how the spillovers of
malevolent weathering might come to a head or be resolved in Palestine and beyond
Academic anxiety and cognitive reflection in neurodivergence based on evidence from a large international sample
Get PDFAnxiety is commonly experienced by neurodivergent individuals participating in higher education, related to both cognitive performance and academic achievement. Whereas certain anxieties in neurodivergence (e.g., social and general anxiety) have received more attention, scant research has considered mathematics and statistics anxiety. In this study, 1383 university students (679 neurotypical, 704 neurodivergent individuals)—matched on age, gender, education level, and country of origin—completed measures assessing various types of academic-related anxiety, attitudes toward mathematics, self-efficacy, and cognitive reflection. Results showed that neurodivergent students exhibited higher anxiety levels across measures, including mathematics and statistics anxiety. However, only cognitive and somatic anxiety, and social anxiety were related to neurodivergent status after taking into account the effects of the other measures. Despite differing anxiety levels (which showed variability between different neurodivergences), neurodivergent and neurotypical students in general were equivalent in cognitive reflection scores, suggesting similar levels of analytic thinking skills, including reasoning about mathematical content. In both the neurotypical and neurodivergent groups, higher levels of cognitive reflection were associated with male gender, less fear of negative evaluation, and lower mathematics and creativity anxiety, replicating and extending previous work. Our findings have implications for supporting neurodivergent individuals in academic settings and other sectors
The pricing of total loss absorption capacity bonds in a jump-diffusion model with regime-switching
No full textIn corporate finance, we usually face the problem of pricing a type of asset, of which the cash
flow is a linear function of the firm total cash flow up to the first time the latter exits from a given
domain when their claimant receives a lump-sum payoff in addition. We call them standard assets.
We provide a unified explicit pricing formula for all standard assets in a double-exponential jumpdiffusion cash flow model with regime-switching. We explicitly derive prices of corporate securities
involving recently introduced Total Loss Absorption Capacity (TLAC) Bonds in the mixed model.
Our numerical analysis shows that the optimal coupon rate of TLAC bonds in the boom regime is
substantially higher than that in the recession regime; thus, the firm should issue more TLAC bonds
in a better economic environment
Aqueous multi-phase systems from polyacrylamides and poly(ethylene glycol)
No full textAqueous two-phase systems (ATPSs) have attracted considerable attention as environmentally friendly multicompartment systems used for molecular separation and microgel templating that eliminate the need for organic solvents. The limited variety of polymers employed in ATPS applications, however, constrains their potential utility. This study systematically investigates binary combinations of poly(ethylene glycol), poly(acrylamide), and poly(N-acryloylmorpholine) to identify novel ATPSs. The three binary combinations spontaneously form ATPSs, and phase diagrams for all two-phase systems are described. Furthermore, the studied ATPSs can be dispersed to form water-in-water (w/w) emulsions via nanoparticle stabilization. Fluorescently labeled polymers enable visualization of polymer distribution within the emulsion phases. Extension to ternary polymer systems was also investigated, revealing unprecedented ATPSs. Also for the ternary system, polymer behavior in stabilized emulsions was characterized using fluorescent labeling techniques. These findings expand the repertoire of polymer combinations available for aqueous multiphasic systems and provide a foundation for future partitioning studies aimed at developing novel extraction methodologies as well as microgel templates
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