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“You like to be in control of your own destiny to a degree, don't you?”: conscientious autonomy and planning for future care with dementia
Get PDFBackground: We explored people with dementia and their family carers’ experiences of future care planning, guided by Kukla's model of conscientious autonomy. This relational autonomy concept focuses on the alignment of self-managed health-care practices with people’s authentic goals and values. It involves people adopting recommended practices for their own authentic reasons, questioning them where necessary, and being supported by the health and care system to understand their rationale and implement them effectively. Methods: In-depth interviews were conducted with 16 people recently diagnosed with dementia and 31 family carers, purposively and selectively sampled from a large research cohort on the basis of their 'conscientiousness,' using the indicator of already having had informal family conversations about future care. Data were analysed thematically using NVivo software and methods informed by interpretive grounded theory. Findings: Participants sought to feel secure by following recommended practices, manage uncertainty, avoid crises, share burdens within families, and avoid poor end-of-life experiences. However, supportwas often lacking. Many were unable to speak with specialists and described limited conversations with GPs, leaving them with unaddressed questions. Some described feelings of abandonment. Disease progression was commonly poorly explained, with some participants later encountering information they found confronting. Carers who continued researching the condition felt responsible but under-resourced for discussing disease progression with their relative and believed this should be undertaken by a professional. Formal processes—e.g. Lasting Power of Attorney (LPAs), advance care planning, Do Not Attempt Cardio-Pulmonary Resuscitation (DNACPR) could prompt informal discussions but gaining an overview was difficult, with confusion about how they would be utilised, what information to include and apparent overlap between processes. Misunderstandings about medical and end-of-life decision-making were commonplace. Conclusion: If even those who are most conscientious about planning for future care struggle to access adequate support, others likely face greater challenges. Clearer communication, at an individual and public level, about disease progression, the practical challenges of medical and end-of-life decision-making, and palliative care options is urgently needed. Early group education sessions and communication strategies that engage with existing lay concepts and public discourse are likely to be helpful. Formal care planning processes should be clearer, more streamlined, and better aligned with the practical goals of people with dementia and their family carers
Analysis of Circulating Current in Electrical Machines Using Mesh-Based Magnetic Equivalent Circuit
Get PDFThis study introduces a novel method to rapidly estimate the circulating current between the strands in electrical machines. By utilizing a mesh-based magnetic equivalent circuit (M-MEC), key parameters of each strand are obtained based on their positions in the slot and used for circulating current calculation. The modeling and calculation process of the proposed method is demonstrated using a permanent magnet synchronous machine (PMSM) as a baseline. The results calculated from the proposed method closely align with those from the finite element analysis (FEA) and are further supported by experiments conducted on a segment of the stator, validating the effectiveness and efficiency of the proposed method. Notably, the proposed technique is applicable for various slot shapes and machine types, serving as a powerful tool for optimizing winding to minimize ac losses
Toward a unified approach: Considerations for bioinformatic and sequencing activities & data in wastewater surveillance of biologic public health threats
Get PDFGenomic technologies like PCR and next-generation sequencing (NGS) have greatly advanced public health surveillance, especially during COVID-19, by enabling detailed tracking of pathogen spread, origins, and variants. While PCR is vital for targeted detection, falling NGS costs have made large-scale, high-throughput sequencing more feasible, supporting broader pathogen monitoring—including the detection of vaccine escape variants and new strains. NGS applied to wastewater offers valuable population-level insights but faces challenges such as variable sample complexity, the need for skilled staff, suitable platforms, and robust IT infrastructure. Although there are currently a lot of efforts towards defining guidelines for sampling, analysis, and integrating wastewater data into public health policy, such as the recently published International Cookbook for Wastewater Practitioners, they often lack universal applicability, emphasizing the analytical approaches in favour of the NGS-based ones. However, standardising protocols for sampling, sequencing, and analysis is crucial to ensure reliable, comparable data across surveillance systems worldwide. Pilot studies and continuous refinement are recommended to overcome implementation hurdles and fully realise the benefits of NGS in wastewater surveillance. This work attempts to outline these challenges and opportunities across the entire wastewater surveillance workflow, from data generation to reporting, and provide some concrete suggestions and considerations across the spectrum of activities
On The Myth of Psychotherapy
Get PDFThomas Szasz famously argued that mental illness is a myth. Less famously, Szasz argued that since mental illness is a myth, so too is psychotherapy. Szasz' claim that mental illness is a myth has been much discussed, but much less attention has been paid to his claim that psychotherapy is a myth. In the first part of this essay, I critically examine Szasz' discussion of psychotherapy in order to uncover the strongest version of his case for thinking that it is a myth. As we'll see, this involves an understanding of psychotherapeutic interventions as treatments of psychopathological problems. In the rest of this essay, I turn to this directly and argue that psychotherapy has an important non-pathocentric dimension. I argue that we fail to appreciate the nature and variety of psychotherapy if we concentrate only on its pathocentric dimensions. Though I use Szasz as a stalking horse, the substantive topic is the nature of psychotherapy. This enquiry falls into the philosophy of psychotherapy as distinct from the philosophy of psychiatry and the philosophy of psychoanalysis
Creep Characterization of Inconel 718 Lattice Metamaterials Manufactured by Laser Powder Bed Fusion
Get PDFLattice metamaterials manufactured by laser powder bed fusion (LPBF) are limited by their performance for critical applications. LPBF materials have microstructural or macroscale anomalies, such as suboptimal grain size, morphology, and lack of fusion. This results in LPBF metamaterials performance degradation for various mechanical properties, such as creep, which has seldom been researched. To understand the creep behavior of LPBF Inconel 718, body‐centered cubic metamaterials are fabricated for creep test at 650 °C. Kachanov's damage modeling is used to predict the creep performance of the metamaterials under different loading conditions. Microstructural characterization is performed with scanning electron microscopy to identify critical microstructure defects affecting the failure mechanisms and creep behaviors of the metamaterials. It is shown in the results that the loading conditions affect the fracture process of the metamaterials owing to different failure mechanisms. In the simulation and test results, the logarithmic decline in creep life is shown when loading increases; also, logarithmic increase in the creep life is shown when relative density increases
Fucoxanthin mitigates mercury-induced mitochondrial toxicity in the human ovarian granulosa cell line
Get PDFMercury (Hg) is known to be a hazardous toxin with a significant negative impact on female reproduction through mechanisms that remain unclear. The carotenoid fucoxanthin (FX) is an antioxidant with several positive effects on human health. This study aimed to examine the potential protective role of FX in reducing the Hg-induced bioenergetic disturbances in a human ovarian granulosa cell line model. (methods briefly) Hg was found to reduce the viability of granulosa cells in a concentration-dependent manner, with an estimated 72-hour EC50 of 10 µM. In contrast, FX (10 and 20 µM) improved cell viability. Hg (1 and 10 µM) significantly reduced cellular ATP levels, mitochondrial membrane potential, oxygen consumption rates, and lactate production. Additionally, Hg impaired the activities and kinetics of mitochondrial complexes I and III and reduced the expression of mitochondrial genes ND1, ND5, cytochrome B, cytochrome C oxidase, and ATP synthase subunits 6 and 8. According to tests on mitochondrial membranes, Hg increased membrane fluidity by reducing saturated fatty acid levels and increasing those of unsaturated fatty acids. Hg also promoted mitochondrial swelling and enhanced the inner mitochondrial membrane permeability to hydrogen and potassium ions. FX (10 µM) was shown to mitigate the negative effects of Hg on the viability of treated granulosa cells, bioenergetics parameters, and mitochondrial membrane integrity in a concentration-dependent manner. Based on these findings, bioenergetic disruption may be a key underlying cause of Hg-induced ovarian dysfunction. Furthermore, FX may have a potential therapeutic role in treating ovarian disorders caused by Hg-induced disruption of granulosa cell bioenergetics
Voluntary HIV Testing and Counselling Initiatives in Occupational Settings: A Scoping Review
Get PDFVoluntary HIV testing and counselling (VCT) in the workplace could reach population groups who may be at risk for HIV but may not readily seek out testing from other services. We conducted a scoping review to understand (a) the nature of evidence related to initiatives and interventions for vocationally active adults on VCT in occupational settings, and (b) any facilitators and barriers to the delivery of and/or engagement with VCT initiatives/interventions in the workplace. JBI scoping review methodology was followed. The protocol was pre-registered. Included studies focused on vocationally active adults (population), VCT interventions or initiatives (concept), and workplaces in any sector or country (context). The review included studies published after 2000, in English, and of any research design. Studies relating to mandatory workplace HIV screening were excluded. MEDLINE, CINAHL, Scopus, PsycINFO, and the Cochrane Central Register of Control Trials were searched. Sources of grey literature included Google Scholar and governmental and organisational websites. One reviewer screened titles and abstracts; a second reviewer independently screened 10%. Data extraction utilised a modified JBI data extraction tool. We identified 17 studies reporting on 12 workplace VCT interventions (20,985 participants, 15–70 years). Studies were conducted in eight countries between 2001 and 2022. Interventions were delivered in organisations of different types, sizes and sectors. Testing included rapid blood tests and oral fluid self-tests. Where reported, the average on-site HIV testing uptake rate was 63%, and the average linkage to care rate was 86.85%. Views of workers, employers and service providers were largely positive. Barriers included being male, masculinity-driven workplace culture, HIV-related stigma, poor knowledge, low risk perceptions, lack of time and low support. Facilitators included on-site testing for convenience and accessibility, rapid and free tests, organisational, managerial and peer support, and embedding HIV tests within general health checks. Evaluation methods varied, although randomised trial designs were uncommon. Despite the limited number of studies, the workplace appears to be a viable route to the delivery of community-based VCT, albeit barriers should be addressed. Reporting quality of interventions and associated evaluations is variable and could be improved with the use of appropriate checklists
Practically re-imagining business education for sustainability
Get PDFIn this reflection piece, we discuss the urgency of transforming business school education in the context of the climate breakdown and biodiversity collapse. We unpack prevailing problematic assumptions in business school education and propose a reflexive framework for business educators based on the heart, head, hand model of pedagogy. We embed this discussion in considerations for place and context. Building on our personal journeys and experiences, we offer tangible examples of how the framework can be used to enable a re-imaging of business education
CapMatch: Semi-Supervised Contrastive Transformer Capsule With Feature-Based Knowledge Distillation for Human Activity Recognition
Get PDFThis article proposes a semi-supervised contrastive capsule transformer method with feature-based knowledge distillation (KD) that simplifies the existing semisupervised learning (SSL) techniques for wearable human activity recognition (HAR), called CapMatch. CapMatch gracefully hybridizes supervised learning and unsupervised learning to extract rich representations from input data. In unsupervised learning, CapMatch leverages the pseudolabeling, contrastive learning (CL), and feature-based KD techniques to construct similarity learning on lower and higher level semantic information extracted from two augmentation versions of the data“, weak” and “timecut”, to recognize the relationships among the obtained features of classes in the unlabeled data. CapMatch combines the outputs of the weak-and timecut-augmented models to form pseudolabeling and thus CL. Meanwhile, CapMatch uses the feature-based KD to transfer knowledge from the intermediate layers of the weak-augmented model to those of the timecut-augmented model. To effectively capture both local and global patterns of HAR data, we design a capsule transformer network consisting of four capsule-based transformer blocks and one routing layer. Experimental results show that compared with a number of state-of-the-art semi-supervised and supervised algorithms, the proposed CapMatch achieves decent performance on three commonly used HAR datasets, namely, HAPT, WISDM, and UCI_HAR. With only 10% of data labeled, CapMatch achieves F1 values of higher than 85.00% on these datasets, outperforming 14 semi-supervised algorithms. When the proportion of labeled data reaches 30%, CapMatch obtains F1 values of no lower than 88.00% on the datasets above, which is better than several classical supervised algorithms, e.g., decision tree and k -nearest neighbor (KNN)
Employers should promote smoking cessation in the workplace
Get PDFThis feature article explores the role of the workplace in smoking cessation. Blake looks into the current measures in place, and explores how employers can benefit from and support employees by implementing smoke-free policy and regulation in the workplace
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