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Fidelity of intervention delivery in psychosocial and behavioral programs (FIPP): A modified Delphi study and final guideline
Get PDFIntroduction:Fidelity – ensuring interventions are implemented as intended – is a key focus in implementation science. Despite its benefits in research and practice, data on the fidelity of implementation are often overlooked, measured inconsistently, or underreported. In 2024, we proposed a preliminary guideline for one component of fidelity – the fidelity of delivery in parenting interventions. This study builds upon that work, refining the guideline for psychosocial and behavioral interventions.Methods:Using a modified Delphi technique, we refined the Fidelity of Intervention delivery in Psychosocial and behavioral Programs (FIPP) guideline. The process included survey responses (n = 34), two panel consensus meetings (n = 10), and email feedback (n = 5) resulting in six rounds of iterative revisions to produce the final FIPP.Results:The modified Delphi technique resulted in a final FIPP with 35 items across six categories: intervention, facilitator, fidelity measure, and fidelity assessor characteristics; fidelity assessment method; and fidelity results and discussion. The final FIPP was produced based on engagement and data from the survey participants, consensus meeting panelists, and email panelists.Conclusions:This study advances reporting on fidelity of delivery in psychosocial and behavioral interventions by refining the FIPP guideline through a rigorous, consensus-driven process. The FIPP provides a comprehensive structure to improve the consistency and transparency of fidelity of delivery assessment. By promoting standardized reporting, the FIPP enhances the quality of implementation science, ultimately supporting more effective interventions and better participant outcomes. Researchers and practitioners are encouraged to adopt the FIPP to strengthen intervention fidelity and drive meaningful progress in the field
A one health scoping review of human health risks beyond heavy metal exposure in Ghana’s artisanal and small-scale gold mining sector
No full textArtisanal and small-scale gold mining (ASGM) remains a vital economic activity in Ghana, supporting the livelihoods of thousands. However, the sector poses multifaceted risks to human health that extend beyond the well-documented exposure to heavy metals such as mercury and lead. This scoping review adopts a One Health framework to synthesise peer-reviewed literature on the broader spectrum of health impacts associated with ASGM in Ghana, recognising the interconnectedness of human, animal, and environmental health risk outcomes. Using a systematic search strategy across major academic databases (PubMed, Google Scholar, Web of Science) and manual reference screening, we identified and analysed 70 studies published from 2006 to 2025. The findings reveal a complex interplay of occupational, environmental, and public health hazards, including respiratory illnesses, musculoskeletal disorders, noise-induced hearing loss, mental health challenges, zoonotic and infectious diseases, and ecological degradation. Notably, we observed that heavy metal exposure is frequently conceptualised as a direct health outcome rather than a modulating factor influencing broader disease patterns in mining communities. This review highlights critical gaps in the literature, particularly the underrepresentation of specific communicable and non-communicable disease outcomes and the limited integration of animal and ecosystem health risk considerations. By moving beyond a narrow toxicological lens, we underscore the urgent need for integrated health interventions and policy reforms that align with One Health principles. Such approaches are essential for addressing the complex and interdependent risks faced by ASGM workers, residents of mining communities, and mineral-rich sub-Saharan contexts
Responsible Generative AI for SMEs in UK and Africa (RAISE): A Legal AI Case Study
Get PDFThis report presents a series of case studies developed under the Responsible Generative AI for SMEs in the UK and Africa (RAISE) project, examining how small and medium-sized enterprises (SMEs) understand, adopt, and operationalise generative AI in practice. Drawing on in-depth qualitative engagement with participating organisations across diverse sectors, the case studies explore anticipated benefits, technical and organisational challenges, and the ethical, legal, and social considerations shaping AI integration. The RAISE case studies demonstrate how responsible AI principles are interpreted pragmatically by SMEs and illustrate the value of context-sensitive, actionable guidance in supporting responsible adoption. Collectively, the cases provide empirical insight into the realities of generative AI use in resource-constrained environments and inform the development of practical frameworks for responsible AI implementation in SMEs
Shifted Poisson structures on higher Chevalley-Eilenberg algebras
No full textThis paper develops a graphical calculus to determine the n-shifted Poisson structures on finitely generated semi-free commutative differential graded algebras. When applied to the Chevalley-Eilenberg algebra of an ordinary Lie algebra, we recover Safronov’s result that the (n = 1)- and (n = 2)-shifted Poisson structures in this case are given by quasi-Lie bialgebra structures and, respectively, invariant symmetric tensors. We generalize these results to the Chevalley-Eilenberg algebra of a Lie 2-algebra and obtain n ∈ {1, 2, 3, 4} shifted Poisson structures in this case, which we interpret as semi-classical data of ‘higher quantum groups’
Social inclusion of people with severe mental illness: a review of current practices, evidence and unmet needs, and future directions
No full textSocial inclusion means being able to participate in activities valued within one’s community or wider society as one would wish. People with severe mental illness (i.e., psychoses, bipolar disorder, and severe depression) experience some of the highest rates of social exclusion compared to people with other disabilities. This is the case regardless of the availability of specialist mental health services. Therefore, questions arise about the extent to which mental health services can and do prioritize social inclusion as a goal of service provision, and what strategies are needed outside of mental health services, at the levels of legislation and policy, statutory services, and civil society. In this paper we consider what social inclusion means in different cultures and contexts, since the value attached to different activities varies by culture and by life stage and gender. We discuss the subjective impact of low levels of social inclusion in terms of loneliness, and the evidence base for interventions to address it. We then turn to strategies to increase observable forms of social inclusion, considering them at the levels of legislation, services and other community assets. While evidence for some interventions is largely based on the Global North, we use evidence and examples from the Global South to the extent that we have found them. We also consider the predominant frameworks for social inclusion used in health services, followed by alternatives that may offer a more empowering approach to social inclusion for some people. We then describe strategies to reduce social exclusion through interventions to address stigma and discrimination, directed at key target groups or at population level. We make recommendations for policy makers, researchers, health professionals, and advocates based on the evidence and examples we have found, covering various forms of legislation, services and mental health research. Our conclusions identify the next steps for interventions, including development, evaluation, implementation or modification for better contextual adaptation
Decision-making involvement and quality of life in people with dementia: the mediating role of psychological needs
Get PDFObjectives: Decision-making involvement is important for maintaining a sense of self and quality of life in people with dementia. To date, few studies have explored the factors behind this relationship. We explored whether decision-making benefits quality of life by enabling fulfilment of basic psychological needs: autonomy, competence, and relatedness. Method: We analysed one-year longitudinal data from 787 people recently diagnosed with dementia from the DETERMIND cohort. Path analysis examined cross-sectional and longitudinal associations between decision-making involvement and quality of life. Parallel mediation analysis tested whether psychological needs explained this relationship. Cognitive impairment was tested as a moderator of longitudinal associations. Results: At baseline, decision-making involvement was positively associated with quality of life, fully mediated by satisfaction of all three psychological needs. Despite declines in cognitive function, decision-making involvement remained high and quality of life stable over one year. No significant longitudinal associations were found between decision-making involvement and quality of life. Conclusion: Decision-making involvement may support quality of life through psychological needs fulfilment. Stability in decision-making and quality of life suggests resilience among people with dementia in early stages. Supporting psychological needs through tailored interventions and decision-aid tools may have the potential to enhance quality of life as dementia progresses
Spotting childhood abdominal tumours: a systematic review and meta-analysis of the clinical presentation
Get PDFBackground We performed a systematic review and meta-analysis to identify pre-diagnostic symptoms/signs for childhood abdominal tumours to inform ongoing efforts to achieve earlier diagnoses of childhood cancers.Methods Medline (OVID), Embase (OVID) and PubMed were searched for studies published between January 2005 and December 2023, including children (<18 years) diagnosed with abdominal tumours, with no language restrictions. Pooled proportions of symptoms/signs were calculated. Sub-analyses were performed according to tumour location and age.Results 133 eligible studies were identified, totalling 8611 cases. The most frequently reported symptoms/signs were abdominal mass (39.3% (31.5% to 47.5%)), pain (14.5 (10.9% to 18.5%), abdominal swelling/distension (7.2% (3.3% to 12.1%)), haematuria (7.2% (2.9% to 6.2%)), fever (3.9% (2.2% to 5.9%)) and/or hypertension (2.6% (1.4% to 4.2%)).For adrenal tumours, precocious puberty (20.6% (2.8% to 46.8%)), Cushing’s syndrome (16.4% (5.9% to 30.1%)) and/or hypertension (12% (2.8% to 25.3%)) were reported.For liver tumours, abdominal mass (42.9% (0.0% to 100.0%)), abdomen mass and/or discomfort (16% (0.0% to 73.1%)), hepatomegaly (9.7% (0.0% to 60.7%)), abdominal swelling/distension (9.4% (0.0% to 64.0%)) and/or abdominal pain (7.7% (0.0% to 28.3%)) were reported.For renal tumours, abdominal mass (49.7% (39.0% to 60.5%)), abdominal pain (12.3% (8.5% to 16.6%)), haematuria (10% (7.4% to 13.0%)), abdominal swelling/distension (5.4% (1.5% to 11.2%)), hypertension (4.7% (2.5% to 7.5%)) and/or fever (3.5% (1.9% to 5.5%)) were reported.For neuroblastoma, abdominal mass (24% (7.0% to 46.4%), abdominal swelling/distension (9.2% (0.0% to 27.9%)), fever (7.4% (0.3% to 20.4%)), hepatomegaly (4.8% (0.0% to 19.8%)), anaemia/pallor (4.1% (0.0% to 13.3%)), abdominal pain (4% (0.0% to 13.4%)), screening/antenatal screening (3.4% (0.4% to 8.2%)) and/or opsoclonus-myoclonus-ataxia syndrome (2.7% (0.0% to 8.3%)) were reported.Conclusions The clinical presentation of childhood abdominal tumours varies according to location and tumour type. These variations in presentation should be used to guide interventions to facilitate earlier diagnosis, such as the UK’s new Child Cancer Smart campaign
Twin trigger generative networks for backdoor attacks against real-time object detection
Get PDFReal-time object detectors, which are widely used in real-world applications, are vulnerable to backdoor attacks. This vulnerability arises because many users rely on datasets or pre-trained models provided by third parties due to constraints on data and resources. However, most research on backdoor attacks has focused on image classification, with limited investigation into real-time object detection. Furthermore, the triggers for most existing backdoor attacks on real-time object detection are manually generated, requiring prior knowledge and consistent patterns between the training and inference stages. This approach makes the attacks either easy to detect or difficult to adapt to various scenarios. To address these limitations, we propose novel twin trigger generative networks in the frequency domain to generate invisible triggers for implanting stealthy backdoors into models during training, and visible triggers for steady activation during inference, making the attack process difficult to trace. Specifically, for the invisible trigger generative network, we deploy a Gaussian smoothing layer and a high-frequency artifact classifier to enhance the stealthiness of backdoor implantation in object detectors. For the visible trigger generative network, we design a novel alignment loss to optimize the visible triggers so that they differ from the original patterns but still align with the malicious activation behavior of the invisible triggers. Extensive experimental results and analyses prove the possibility of using different triggers in the training stage and the inference stage, and demonstrate the attack effectiveness of our proposed visible trigger and invisible trigger generative networks, significantly reducing the mAP 0.5 of the object detectors by 70.0 % and 84.5 %, including two real-time object detectors with different settings, respectively
Test accuracy of glomerular filtration rate estimation with creatinine and cystatin C in adults with moderate chronic kidney disease: prospective cohort study
No full textObjective To study the performance of two contemporary sets of estimating equations for glomerular filtration rate, published by CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) and EKFC (European Kidney Function Consortium) that include one (creatinine or cystatin C only) and combined (creatinine and cystatin C) biomarkers, to assess their accuracy in a population with moderate chronic kidney disease.Design Prospective cohort study.Setting Primary, secondary, and tertiary care in six centres in England. Participants were recruited from April 2014 to January 2017.Participants 1167 adults, aged ≥18 years, with moderate chronic kidney disease (estimated glomerular filtration rate 30-59 mL/min/1.73 m2 sustained over at least three months before recruitment).Main outcome measures Accuracy of estimating equations CKD-EPIcreatinine, CKD-EPIcystatin, CKD-EPIcreatinine-cystatin, EKFCcreatinine, EKFCcystatin, and EKFCcreatinine-cystatin compared with measured glomerular filtration rate (iohexol clearance). Remodelled 2021 versions of the CKD-EPI equations were also studied. Accuracy was expressed as P30 (percentage of estimates within 30% of measured glomerular filtration rate).Results Median age was 67.5 years, 58.3% of patients were men, 86.9% were white participants, and 27.8% had diabetes. Median measured glomerular filtration rate was 47.0 mL/min/1.73 m2; 57.0% of participants had albuminuria. Test calibration critically affected measurement of cystatin C. After recalibration of cystatin C, P30 values were 90.2% (CKD-EPIcreatinine), 89.5% (CKD-EPIcystatin), 94.9% (CKD-EPIcreatinine-cystatin), 88.0% (CKD-EPI(2021)creatinine), 94.9% (CKD-EPI(2021)creatinine-cystatin), 89.4% (EKFCcreatinine), 91.0% (EKFCcystatin), and 94.9% (EKFCcreatinine-cystatin). Creatinine based equations showed varying bias depending on the glomerular filtration rate level; inclusion of cystatin C in the equations improved this effect. Differences in accuracy in age, sex, and glomerular filtration rate level subgroups varied by equation. Equations combining creatinine and cystatin performed equally across age, sex, diabetes status, albuminuria status, and body mass index categories.Conclusions The CKD-EPIcreatinine equation had acceptable accuracy in a white population in England with moderate chronic kidney disease. Combined dual biomarker equations showed higher accuracy than the CKD-EPIcreatinine equation and their equivalent creatinine only equations. Further research is needed to determine the most accurate equation to use in people of black and South Asian origin living in England
Harmonic Current Injection Based Online Rotor Time Constant Estimation Method for IM
Get PDFAccurate rotor time constant (RTC) is the key to achieving high-performance induction motor (IM) drives. To obtain an accurate RTC, a new robust online RTC estimation method based on harmonic current injection is presented. In the proposed method, the RTC is estimated from the speed response corresponding to the injected harmonic current. Compared with the existing schemes, the parameter mismatches will not influence the steady-state identification results of RTC. Thus, it has stronger robustness to parametric uncertainties. Finally, the effectiveness and correction of the proposed method is verified by simulations and experiments
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