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Implementing a new clinical service – what’s your elevator pitch?
Get PDFBackground:
People with multiple sclerosis (PwMS) identify emotional well-being as a key unmet care need. Mindfulness-based interventions (MBI) can improve emotional well-being in PwMS; however, there is a lack of information on their implementation in routine care. Healthcare policy influencers may provide critical insight as to the implementation process. The aim of this study was to explore the needs and priorities of healthcare policy influencers for implementing MBIs for PwMS in Canada.
Methods:
A qualitative descriptive approach was adopted using semi-structured interviews with an inductive thematic analysis. Healthcare policy influencers (e.g., senior clinical leaders, provisional health service commissioners, healthcare policymakers) in various settings across Ontario were recruited.
Results:
Twelve individuals with an average age of 51.1 ± 8.9 years participated in the semi-structured interviews. Interviews ranged from 12 to 60 min. Four themes were identified in thematic analysis: (1) Need for evidence with a personal connection is foundational; (2) People Power: Need for Implementation champions; (3) Finding its place: Need for embedding interventions into existing systems; and (4) Sustainability: Need for focus on long-term impact.
Conclusion:
Our study provides novel insight into complex factors which affect implementation of new interventions, such as MBIs for PwMS, into the healthcare landscape in Ontario. Six key steps were identified for implementors to consider when seeking to implement a new intervention: (1) identify the problem and the need for intervention, (2) establish evidence highlighting evidence of effectiveness for an intervention, (3) build a team of implementation champions, (4) pilot the novel intervention to establish proof of concept, feasibility, and ecological integration within current landscape, (5) identify decision makers for intervention implementation, and (6) develop an ‘elevator pitch’ for decision makers. The implementation process is convoluted and can lack clarity. This is a major challenge for implementers. We have identified six key steps for implementers to consider, making this process more transparent and hopefully more successful. Future research should explore, test, and bridge the gaps in the implementation pathway we have identified, as this may be critical in closing the gaps that exist in our healthcare systems
Fast delamination of fuel cell catalyst-coated membranes using high-intensity ultrasonication
Get PDFThis study demonstrates a rapid and facile method for separating the central membrane and catalyst-coated material from production scrap fuel cell catalyst-coated membranes (CCMs), facilitating a circular economy of technologically critical metals. A novel approach is presented using high-intensity ultrasonication with two distinct sonotrode configurations for rapid delamination at ambient temperature in water. This technique utilises cavitation, where high-frequency sound waves create, expand, and collapse microbubbles, generating high-speed jets, shockwaves, and acoustic streaming. This process effectively separates the membrane and catalyst while maintaining their overall integrity of the former. A cylindrical sonotrode (20 mm diameter) was used to optimise process parameters for smaller CCM samples to minimise time and energy consumption. To scale up the delamination process for industrial-size CCMs, a blade sonotrode (15 mm x 210 mm) was employed to enable a flow process for rapid and continuous delamination. Cavitation at the sonotrode-CCM interface was shown to facilitate the selective and rapid breakdown of the catalyst layers, enabling full delamination of the catalyst-loaded membrane within tens of seconds. This efficient and fast delamination approach offers a promising strategy for CCM recycling
Universities in the face of the climate and nature crises: Redoubling our commitment to a sustainable future. The Guild Insight Paper No. 6
Get PDFThrough this paper, written at a time of growing popular disquiet about the role of science and the societal contribution of universities, The Guild urges European policymakers to keep their focus on the Green Deal’s objectives. Precisely at a time when policymakers prioritise Europe’s security and its preparedness for future shocks, it is essential that policymakers recognise the holistic support Europe’s universities can provide to support these endeavours, and align them with the urgent need to address the climate and nature crises. As universities, we also recognise the need to maximise our own contribution to addressing the climate and nature crises in a holistic way. By seeking to further stimulate a wider debate in Europe’s higher education sector, not least through the provision of best-case examples from our members, the Guild urges the university sector to redouble its efforts to strengthen its contributions to addressing the climate and nature crises, supporting the sustainable and just transition of Europe and its constituent nations and regions
Mapping the empirical literature of the GDPR’s (in-)effectiveness: a systematic review
Get PDFIn the realm of data protection, a striking disconnect prevails between traditional domains of doctrinal, legal, theoretical, and policy-based inquiries and a burgeoning body of empirical evidence. Much of the scholarly and regulatory discourse remains entrenched in abstract legal principles or normative frameworks, leaving the empirical landscape uncharted or minimally engaged. Since the birth of EU data protection law, a modest body of empirical evidence has been generated but remains widely scattered and unexamined. Such evidence offers vital insights into the effectiveness of data protection measures but languishes on the periphery, inadequately integrated into the broader conversation. To make a meaningful connection, we conduct a comprehensive review and synthesis of empirical research spanning nearly three decades (1995 - March 2022), advocating for a more robust integration of empirical evidence into the evaluation and review of the GDPR while laying a methodological foundation for coordinated research. By categorising evidence into four distinct groups– Awareness and Trust, Operational Performance, Ripple Effect, and Normative Clarity, we provide a structured analysis therein and highlight the variety and nuances of the empirical evidence produced about the GDPR. Our discussion offers critical reflections on the current orientations and designs of evaluation work, challenging some popular but misguided orientations that significantly influence public debate and even direction of empirical and doctrinal research. This synthesis also sheds light on several understated aspects, surfaced by our systematic review, including the complex structure of the GDPR and the internal contradictions between components, the GDPR's interaction with other normative values and legal frameworks, as well as unintended consequences imposed by the GDPR on other values not explicitly recognised as regulatory objectives (such as innovation). We further propose a methodological improvement in how empirical evidence can be generated and utilised, stressing the need for more guided, coordinated and rigorous empirical research. By re-aligning empirical focus towards these ends and establishing strategic coordination at the community level, we seek to inform and underpin evaluative work that aligns empirical inquiries with policy and doctrinal needs, while truly reflecting the complexities and challenges of safeguarding personal data in the digital age
Financial Technology: 5th International Conference, ICFT 2024, Singapore, September 23–25, 2024, Proceedings
No full textThis book constitutes the proceedings of the 5th International Conference on Financial Technology, ICFT 2024, held in Singapore during September 23–25, 2024.
The 17 full papers presented in this volume were carefully reviewed and selected from 35 submissions. These papers focus on the current research in Blockchain technology, Financial technology and the application of Artificial Intelligence in these areas
Dihadron azimuthal correlations in deep-inelastic scattering off nuclear targets
Get PDFWe measured the nuclear dependence of the di-pion azimuthal correlation function in deep-inelastic scattering (DIS) using the CEBAF Large Acceptance Spectrometer and a 5 GeV electron beam. As the nuclear-target size increases, transitioning from deuterium to carbon, iron, and lead, the correlation function broadens monotonically. Its shape exhibits a significant dependence on kinematics, including the transverse momentum of the pions and the difference in their rapidity. None of the various Monte Carlo event generators we evaluated could fully replicate the observed correlation functions and nuclear effects throughout the entire phase space. As the first study of its kind in DIS experiments, this research provides an important baseline for enhancing our understanding of the interplay between the nuclear medium and the hadronization process in these reactions
Agricultural commercialization and food security: evidence and policy implications for smallholder farmers in Kenya
Get PDFThis study investigates the relationship between agricultural commercialization and food security among smallholder farmers in Kenya, integrating the Market Structure, Conduct, and Performance (SCP) paradigm with peasant economic theory. Using mixed methods (household survey, participant observations, and expert interviews), we compare the degrees of commercialization between food secure and food insecure households in a rural area of Kenya. Contrary to the assumption that commercialization enhances food security, our findings reveal a more complex reality. Food insecure households exhibit higher overall commercialization indices but face significant challenges, including limited access to resources, market imperfections, and a risk-averse nature prioritizing subsistence over profit maximization. The study highlights the importance of market structure and conduct in shaping food security outcomes. Factors such as farm size, crop diversity, and barriers to market entry are crucial. Food secure households benefit from larger landholdings, diversified crops, and better access to markets and inputs, leading to higher productivity and more stable food supplies. In contrast, food insecure households struggle with smaller landholdings, less diversification, and greater reliance on local markets, making them more vulnerable to food insecurity. Our research underscores the need for a holistic approach to agricultural commercialization that addresses structural issues and provides comprehensive support to smallholder farmers. Policy recommendations include strengthening property rights, improving rural infrastructure, promoting sustainable agricultural practices, and implementing social safety nets. By creating an enabling environment that supports the diverse needs of smallholder farmers, policymakers can enhance food security and promote sustainable agricultural development
Inflammatory pseudotumour presenting as a cervical extradural mass in a 1‐year‐old Bernese Mountain dog
No full textAbstractA 1‐year‐old, male, neutered Bernese Mountain dog presented with a 2‐week history of acute‐onset progressive signs of right C6–T2 myelopathy and neck pain. Magnetic resonance imaging of the cervical vertebral column revealed a right‐sided extradural mass at the level of the C6 vertebra causing severe spinal cord compression. A right C5–C7 modified dorsal laminectomy was performed to remove the mass, resulting in its complete excision, except for residual tissue attachments to the ligamentum flavum. Successful spinal cord decompression was achieved, as confirmed by postoperative magnetic resonance imaging. Histopathology and immunochemistry showed a proliferative lesion dominated by a mixture of spindle and histiocytic cells, with associated infiltrates of T‐lymphocytes, B‐lymphocytes and plasma cells suggestive of an inflammatory pseudotumour. Subsequently, the dog underwent a 2‐month course of prednisolone treatment and showed complete recovery. At the 2‐year follow‐up, the dog was neurologically normal
The impact of molecular alterations in patients with advanced biliary tract cancer receiving cisplatin, gemcitabine and durvalumab: a large real-life worldwide population
No full textBackground & Aims Cisplatin, gemcitabine, and durvalumab (CGD) combination is a standard first-line treatment for advanced biliary tract cancer (BTC). This study aimed to assess the impact of genetic alterations on outcomes in patients with advanced BTC treated with CGD in real-world clinical practice. Methods Patients with unresectable, locally advanced, or metastatic BTC treated with CGD across 39 centers in 11 countries (Europe, United States, and Asia) were included in this analysis. Results The cohort included 513 patients with advanced BTC. The five most frequently altered genes were TP53 (22.1%), KRAS (13.7%), CDKN2A/B (13.6%), ARID1A (12.2%), and IDH1 (9.2%). In multivariate analysis, SMAD4 mutations were associated with improved progression-free survival (PFS) (HR 0.49, p = .018) and overall survival (OS) (HR 0.11, p = .023), while TP53 mutations were linked to worse PFS (HR 1.62, p = .0047) and TERT mutations to worse OS (HR 8.92, p = .0012). No other genomic alterations were significantly associated with outcomes. Subgroup analysis showed that TP53 mutations negatively impacted PFS and OS in intrahepatic cholangiocarcinoma (iCCA), while KRAS mutations were associated with poorer PFS in extrahepatic cholangiocarcinoma (eCCA). No gene alterations were linked to outcomes in gallbladder cancer. Conclusions This large-scale analysis, with comprehensive molecular profiling, supports the positive prognostic impact of SMAD4 mutations for PFS and OS and highlights the negative prognostic roles of TP53 (PFS) and TERT (OS) mutations, providing valuable insights for personalized treatment strategies in BTC
Group-based interventions to reduce gambling involvement among male football fans: a synopsis of findings from a feasibility study
Get PDFWomen entrepreneurs in Saudi Arabia face significant challenges: legal, regulatory, social, and others related to the traditional family norms. Despite these constraints, many women succeed. Using a social constructionist feminist lens, we analyze the experiences of 27 women entrepreneurs in Saudi Arabia, focusing on their ethnic/tribal origin and related religious ideology to answer the question: How do Saudi women from tribal origin develop an entrepreneurial identity? Through a qualitative-interpretivist approach, we explore the narratives of women from tribal origins who start businesses and examine how their tribal and gender identities shape their entrepreneurial identity. Using the metatheoretical framework of liminality, we identify three phases of entrepreneurial identity formation for tribal women: separation, transition, and incorporation. We discuss the conditions prompting separation from their tribal and gender identity, the dynamics of identity work during the transition phase, and the issues faced in the incorporation phase. Our findings offer new insights into identity work in entrepreneurship by analyzing the interplay between gender and tribalism, we show that women from tribal backgrounds encounter great barriers and engage in identity work to incorporate their entrepreneurial identity
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