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Assessing the feasibility of measuring residents’ quality of life in English care homes and the construct validity and internal consistency of measures completed by staff proxy: a cross-sectional study
Get PDFObjectives To assess the feasibility of capturing older care home residents' quality of life (QoL) in digital social care records and the construct validity (hypothesis testing) and internal consistency (Cronbach's alpha) of four QoL measures. Design Cross-sectional data collected in wave 1 of the DACHA (Developing resources And minimum dataset for Care Homes' Adoption) study, a mixed-methods pilot of a prototype minimum dataset (MDS). Setting Care homes (with or without nursing) registered to provide care for older adults (>65 years) and/or those living with dementia. All homes used a digital record system from one of two suppliers. Participants Data were extracted from 748 residents. All permanent residents, aged 65 years or older, were eligible to participate, including those lacking capacity to consent. Temporary residents and residents in their last weeks of life were excluded. Outcome measures and analysis The English language versions of Adult Social Care Outcomes Toolkit (ASCOT)-Proxy-Resident, ICEpop CAPability measure for Older people (ICECAP-O), EQ-5D-5L proxy and the QUALIDEM were added to the digital record. As there have not been any previous studies of the structural validity of the English language version of the QUALIDEM, ordinal exploratory factor analysis (EFA) was applied for this measure only. Feasibility (% missing by software provider and measure), % floor/ceiling effects (>15% at lower/upper end of the scales), convergent or divergent construct validity (criterion of >75% of hypotheses accepted) and internal consistency (Cronbach's alpha ≥0.7) were assessed for all four measures. Results The ordinal EFA of QUALIDEM did not replicate the findings of previous research. A six-factor (36 item) solution was proposed and used in all subsequent analyses. There were low rates of missing data (<5%) for all items, except ASCOT-Proxy-Resident Control (5.1%) and Dignity (6.2%) and QUALIDEM item 35 (5.1%). Ceiling effects were observed for the ASCOT-Proxy-Resident and two of the QUALIDEM subscales. None of the scales had floor effects. Cronbach's alpha indicated adequate internal consistency (α ≥0.70) for the ASCOT-Proxy-Resident, ICECAP-O and EQ-5D-5L proxy. There were issues with two QUALIDEM subscales. Construct validity for all measures was adequate. Conclusions The findings support the use of EQ-5D-5L, ASCOT-Proxy-Resident and the ICECAP-O in care homes for older people. The choice of measure will depend on the construct(s) of interest. More research is needed to establish the psychometric properties of the QUALIDEM in an English care home setting
The Boundaries of Modern Slavery: The Role of Exemplars in New Category Formation
Get PDFModern slavery is one of the most prominent grand challenges facing organizations today. Yet, its precise meaning, and the scope of people and practices it subsumes, remain hotly contested. The recent formation of a legal category of "modern slavery" represents a critical point in establishing clear meanings and boundaries. While existing research on categories has shed light on how such new category meanings and boundaries may be shaped, we lack insight on how this happens in the absence of category prototypes that demarcate the meaning and membership of categories. We turn to category exemplars as an important but, as yet, poorly understood tool influencing category formation and subsequent membership. We conduct a systematic analysis of discourse surrounding the formation of the new category of modern slavery to identify three distinct forms of exemplars (typifying, familiarizing, and scoping), and develop a model that links actors' use of these exemplars to specific boundary effects across four phases of category formation. We also reveal the conditions under which different exemplars were successful in influencing the final category. We thereby contribute to the literature an exemplar-based theorization of new category formation that explains how categories associated with grand challenges like modern slavery are formed
Catalytic and kinetic investigation into 4-dimethylamino pyridine/1,3-diphenyl thiourea catalyzed synthesis of chloromethyl ethylene carbonate under pure CO₂ and simulated flue gas conditions
Get PDFSynthesis of chloromethyl ethylene carbonate (CMEC) via CO2 cycloaddition to epichlorohydrin (ECH) has been investigated using a simple metal-free and halide-free catalyst comprising 4-dimethylamino pyridine (DMAP) and N–H type hydrogen bond donors (HBDs). Combining DMAP and 1,3-diphenyl thiourea (DPTU) had the strongest synergistic effect, which resulted in the highest improvement in CMEC yield. DMAP/DPTU was active in the presence of a simulated flue gas (15 % C02 in N2) at low temperatures (30 – 60 °C), reaching a high CMEC yield (93 %) and selectivity (98 %) at 40 °C in 24 h. The presence of O2 in simulated flue gas had no effect on catalytic activity; however, excessive H2O in the reactor had a negative effect, resulting in low yield and selectivity. The reaction obeyed pseudo-first-order kinetics in terms of ECH, DMAP, and DPTU concentrations. The addition of DPTU increased the observed rate constant (kobs) by a factor of 1.52 while decreasing the activation energy (Ea) of the reaction by 7.37 kJ/mol, indicating that the synergistic action of DPTU (HBD) and DMAP (nucleophile) influenced catalytic performance. The positive enthalpy (ΔH‡) and Gibbs free energy (ΔG‡) values indicate an endergonic and kinetically controlled reaction
A clinical decision support tool for acute pain within an electronic health record to improve analgesic prescribing practice
Get PDFDevelopmental programming: Sex-specific effects of prenatal exposure to a real-life mixture of environmental chemicals on liver function and transcriptome in sheep
Get PDFHumans are chronically exposed to a mixture of environmental chemicals (ECs), many with metabolic and endocrine disrupting potential, contributing to non-communicable disease burden. Understanding the effects of chronic exposure to low-level mixtures of ECs requires an animal model that reflects real-world conditions, lags behind studies on single ECs. Biosolids, from wastewater treatment, offers a real-life model to investigate the developmental health risks from EC mixtures. Prenatal biosolids exposure studies have documented metabolic perturbations including heavier thyroid glands in male fetuses and reduced bodyweight in prepubertal male lambs followed by catchup growth. We hypothesized that maternal preconceptional and gestational exposure of sheep to biosolids programs sex-specific transcriptional and functional changes in the offspring liver. Ewes (F0) were grazed on either inorganic fertilizer (C) or biosolids-treated pastures (BTP) preconception till parturition. All lambs (n = 15/group with male n = 7/group and females n = 8/group) were raised on Control pastures until euthanasia at 9.5 weeks. Next generation sequencing of liver RNA and DESeq2 was used to identify exposure-specific differentially expressed genes (DEG) and sex-differentially expressed genes (SDG). Liver function was assessed with markers of oxidative stress, triglyceride and fibrosis markers. Control lambs exhibited 647 SDGs confirming the inherent sexual dimorphism in hepatic gene expression. A sex-stratified analysis identified 10 DEG, mostly affecting metabolism, in male and none in female lambs. Biosolids exposure diminished the sexual dimorphism in hepatic gene expression barring 41 genes, potentially due to the increase in androgenic steroids found in F0 maternal circulation. Additionally, BTP male lambs showed elevated plasma triglyceride and a trend towards increased liver triglyceride concentrations. The identified effects of prenatal exposure to low-dose mixture of ECs via biosolids, in a precocial species paralleling human developmental patterns holds translational importance for understanding the sexually dimorphic origin of non-communicable diseases
Land Tenure Security and Sustainable Land Investment: Evidence from National Plot-Level Data in Rural China
Get PDFThe linkage between land tenure security and land quality improvement investment is crucial given that the land tenure security system is a widely applied policy tool for the protection of cultivation land in developing countries. Drawing on the triple land tenure security framework, this paper examines the impact of the de jure and the de facto land tenure security on farming households’ decisions about using organic fertilizer on their plots in China, based on a national survey dataset covering 2308 plots matched with 962 farming households across 8 provinces in China (Shangdong, Shangxi, Jilin, Zhejiang, Henan, Gansu, Hunan, and Sichuan) from January to July 2013. The empirical results show that the de facto land tenure security affected the use of organic fertilizer by the farming households positively. In comparison, the impact of the de jure land tenure security on the use of organic fertilizer by farming households was modest. It is suggested that the government should implement the policies effectively to promote de jure land tenure security and encourage farming households to make sustainable land investment
Confronting multiple global crises: a political economy approach for the twenty-first century
Get PDFThe purpose of this paper is to develop a political economy approach able to examine the multiple, global crises of our times, a crisis of global capitalism, a crisis of global labour relations, a crisis of global gender relations, a crisis of global race relations and a crisis of global ecology. Based on the philosophy of internal relations, I make three claims in this paper. First, we need a historical materialist approach to comprehend the historical specificity of capitalism. Second, we need an expanded conceptualization of capitalist accumulation, understanding that capitalist reproduction depends not only on the exploitation of wage labour in the sphere of production, but equally on different forms of expropriation in the sphere of social reproduction. Third, to reveal the internal relations between these different crises, we need to focus on class struggle in our analysis, defining both class struggle and labour movement broadly when doing so
Informal Institutions and Multinationals' Drive Towards Sustainable Development Goals (SDGs): A Dark-Side Perspective
Get PDFThis study explores the influence of informal institutions (including its dark side) on multinational enterprises (MNEs) in promoting sustainable development goals (SDGs) in a developing nation. Using qualitative interviews, we find that informal institutions, including “crime” and “corruption,” increase telecommunication MNEs' support of SDGs. Our findings underscore the critical role of understanding and harnessing informal institutions, showcasing their significant impact on shaping the actions and contributions of MNEs. This research not only contributes to institutional theory but also provides empirical evidence of MNEs positively influencing local communities for sustainable development including socially embedded projects, knowledge externalities, and rural infrastructure. The study advocates for a collaborative approach involving government, local communities, and MNEs to ensure the effective implementation of SDGs. Consequently, the study offers valuable insights for policymakers, academics, and practitioners navigating the complex dynamics of MNEs' involvement in SDGs within developing countries
Passive Monitoring of Parkinson Tremor in Daily Life: A Prototypical Network Approach
Get PDFObjective and continuous monitoring of Parkinson’s disease (PD) tremor in free-living conditions could benefit both individual patient care and clinical trials, by overcoming the snapshot nature of clinical assessments. To enable robust detection of tremor in the context of limited amounts of labeled training data, we propose to use prototypical networks, which can embed domain expertise about the heterogeneous tremor and non-tremor sub-classes. We evaluated our approach using data from the Parkinson@Home Validation study, including 8 PD patients with tremor, 16 PD patients without tremor, and 24 age-matched controls. We used wrist accelerometer data and synchronous expert video annotations for the presence of tremor, captured during unscripted daily life activities in and around the participants’ own homes. Based on leave-one-subject-out cross-validation, we demonstrate the ability of prototypical networks to capture free-living tremor episodes. Specifically, we demonstrate that prototypical networks can be used to enforce robust performance across domain-informed sub-classes, including different tremor phenotypes and daily life activities
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