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Effectiveness of Psychosocial Interventions for Adults With Substance Use Disorder That Have a Co-Occurring Common Mental Health Disorder:An Umbrella Review
Get PDFIssues: People with substance use disorders can have co‐occurring mental disorders. Approach: An umbrella review was conducted to identify evidence of the effectiveness of psychosocial interventions for adults (aged 18+) with substance use disorders and co‐occurring common mental health disorders. Systematic reviews were sought of randomised controlled trials of psychosocial interventions compared to each other, treatment as usual or wait‐list. Five databases were systematically searched in February 2024. Data, including critical appraisal (Joanna Briggs Institute Checklist), were extracted by one reviewer and checked by another. Data were discussed in a narrative review. Key Findings: Of 5420 unique records, 28 systematic reviews were included. The methodological quality of the reviews was good. Most reviews focused on depression, anxiety or post‐traumatic stress disorder. There was much heterogeneity between reviews, and randomised controlled trials within reviews. Most of the interventions and many of the treatment‐as‐usual comparators resulted in significant improvement in substance use and mental health disorders. Results suggested integrated (co‐ordinated) treatment for co‐occurring diagnosis patients was better than treating one condition alone, and usually better than parallel uncoordinated services. There was limited evidence assessing sequential treatment, but this suggested similar effectiveness to integrated treatment. Implications: Implications for current practise could not be recommended due to heterogeneity. Improvement shown by all types of psychosocial intervention including active comparators precluded recommending one type of intervention over another. Conclusion: Further research is needed comparing integrated with parallel or sequential treatment, with follow‐up of 6 months or longer, and sample size large enough to encompass dropout
Healing-assessment tools for perineal and cesarean section wounds in postpartum women:A scoping review
Get PDFIntroduction: Approximately 85% of women who undergo vaginal birth sustain childbirth‐related perineal trauma. Worldwide, 21% of women give birth by cesarean section. These wounds therefore affect the vast majority of women after birth; however, there is a lack of validated tools to accurately identify women with abnormal wound healing in the postpartum period. Consequently, in clinical settings, validated wound‐assessment tools are not generally used to assess wound healing in this population. We performed a scoping review to identify and characterize wound‐assessment tools that have been used to determine the healing of childbirth‐related wounds in existing research (to include women who experience perineal trauma or a cesarean section). Material and Methods: Medline, EMBASE, CINAHL, and Google Scholar were searched from inception to April 2024. Studies were included where wound‐assessment tools were used to assess wound healing, after women had sustained either childbirth‐related perineal trauma or a cesarean section, as an outcome of a primary research article. For studies that assessed wound healing in women with perineal trauma, this included all types of childbirth‐related perineal trauma, sustained at spontaneous or assisted vaginal birth. Studies were eligible for inclusion where the wound‐assessment tool was used at any time‐point in the postpartum period. Results: There were 95 studies eligible for inclusion; 72 of which utilized wound‐assessment tools for the assessment of healing after women sustained childbirth‐related perineal trauma and 23 for women with cesarean section wounds. The REEDA tool (redness, oedema, ecchymosis, discharge, approximation) was used in 91 of the 95 studies, with the remainder using alternative wound‐assessment tools, including the use of the ASEPSIS tool (additional treatment, serous discharge, erythema, purulent exudate, separation of deep tissues, isolation of bacteria, and length of inpatient stay). Conclusions: There are limited wound‐assessment tools to determine healing after women sustain childbirth‐related wounds. The REEDA tool is the most commonly used in research settings. There is a clear need for the development of a clinically robust and inclusive wound‐ assessment tools, which comprehensively reflect the postpartum healing process among diverse populations
Patient perceptions of pituitary incidentaloma diagnosis and follow-up:A Pituitary Society international patient survey
Get PDFPurposeDetection of pituitary incidentalomas is increasing in frequency with the use of advanced imaging techniques. As an adjunct to publication of consensus guidelines on management of pituitary incidentalomas, the Pituitary Society sought to understand patient perceptions of their diagnosis, prognosis, and follow-up.MethodsAn electronic survey developed in English and translated into Japanese and Portuguese was sent to the World Alliance of Pituitary Organizations, Australian Pituitary Foundation, Pituitary Foundation UK, Associação Brasileira Addisoniana, Instituto Vidas Raras, and Pituitary Patient Advocacy Group Japan. These organizations subsequently disseminated the survey to their patient members. Survey responses were analyzed using a mixed-methods approach to capture qualitative and quantitative data.Results275 patients responded to the survey, primarily from the United Kingdom (31%), Australia (20%), Japan (18%), and Brazil (15%). Respondents were mostly aged 30–69 years, although distribution differed significantly between the English-, Japanese-, and Portuguese-language surveys (p = 0.003). Only 44% of all respondents reported learning of the incidentaloma from a specialist in neurologic disorders or endocrinology. 60% were told they had a tumor and only 38% were told it was benign or noncancerous. 58% said they were worried about the treatment or long-term complications and 26% said they were scared about having cancer or about dying. 17% received little or no specific information about what was likely to happen to the incidentaloma over time.ConclusionResults from this survey highlight gaps in physician–patient communication about pituitary incidentalomas. Our findings underscore the need for enhanced education to improve patient perceptions of their disease
Project control practices to enable sustainable project management
Get PDFPurpose: Project control is essential for ensuring that sustainability goals are achieved in sustainable project management (SPM). However, research into the specific and holistic control practices that can be adopted at the execution phase in SPM remains limited. This study explores the project control practices that enable the control and attainment of sustainability goals in SPM, drawing on data from expert panels.Design/methodology/approach: A novel hesitant-fuzzy Delphi approach was integrated with hesitant-fuzzy interpretive structural modelling (ISM) and cross-impact matrix multiplication applied to classification (MICMAC).Findings: The results show that, of the 21 control practices identified in the literature, 12 were selected by panels of 13 experts as the prioritised practices relevant to the control and attainment of sustainability goals in SPM. Expanding on control theory, we further show the characteristics of the prioritised practices by categorising them using the novel MICMAC and ISM conceptual frameworks across low, medium and high uncertainty scenarios.Practical implications: Our managerial implications provide recommendations for adopting flexible, actionable and context-sensitive execution control practices to influence outcomes and behaviours towards targeted sustainability goals in both project processes and deliverables.Originality/value: This study offers an original contribution to the SPM literature by identifying and empirically testing the contextual relevance of project execution control practices, revealing how their prioritisation and interdependence shift across varying project contexts.<div/
Cooperation versus social welfare
Get PDFUnderstanding and promoting cooperative behaviour among self-interested individuals is a critical concern in physical, biological, and social sciences. Numerous foundational mechanisms for the evolution of cooperation have been identified, and these mechanisms have served as the basis for developing tools and interventions designed to sustain and enhance cooperative behaviour. However, since both foundational mechanisms and the derived tools and interventions often involve costs affecting individuals or institutions, striving for maximum cooperation can sometimes harm social welfare, defined as the total population payoff. Herein, we review existing evolutionary mechanisms for the evolution of cooperation as well as tools and interventions based on these mechanisms, emphasising the often-overlooked hidden costs that may lead to a misalignment between cooperation and social welfare. By explicitly incorporating these hidden factors into the models, we analyse the conditions under which they reduce social welfare, across a broad range of social dilemma games and evolutionary forces. Additionally, we review experimental studies that support and inform mathematical models and agent-based simulations. We highlight when considering social welfare is crucial, as misalignment is most likely to occur. Ultimately, we argue that social welfare, not just cooperation, should be the primary optimisation objective when designing interventions for social good. We also suggest several key directions to further explore this often-overlooked issue in the literature. Overall, we reveal that hidden costs often influence the alignment between cooperation and social welfare, challenging the common prioritisation of cooperation alone
Redefining service recovery:critical insights into proactive strategies and a future research agenda
Get PDFPurpose: This study critically reviews proactivity in service recovery in the hospitality and tourism industry. The research identifies three unexplored areas of research: (1) proactive recovery pathways (antecedents, mechanisms, and consequences of proactivity in service recovery), (2) proactive service recovery measurements and methods, and (3) proactive service recovery management—developing a conceptual framework that connects these key areas, proposing specific research directions to provoke further advancements in proactivity in service recovery knowledge within the hospitality and tourism industry and key recommendations for various stakeholders. Design/methodology/approach: A narrative synthesis approach was used to critically review the role of proactivity in service recovery within the hospitality and tourism context. Findings: Proactive service recovery is increasingly recognized as a core capability in hospitality. However, the literature often emphasizes reactive recovery, lacks clarity around psychological mechanisms, and underrepresents cultural, situational, and contextual factors that shape recovery outcomes. This research stream highlights the key gaps and the need for a more comprehensive investigation of its different aspects.Practical implications: The rapid advancement of AI and related innovations presents significant opportunities for research and the enhancement of proactive service recovery. The proposed recommendations serve as a foundational guide for researchers, practitioners, policymakers, and technology developers enabling them to harness the benefits of proactivity in service recovery with creativity and critical insight.Originality/value: This study critically examines the key role of proactivity in service recovery and highlights the key differences between proactive versus reactive service recovery across key dimensions and thus contributes to hospitality and tourism research by critically reviewing the past literature and offering key recommendations for various stakeholders.<br/
Protocol for a review of statistical methods used to estimate risk ratios and risk differences in parallel cluster randomised trials
No full textBackgroundCluster randomised trials randomise groups of individuals, such as clinics, schools, or communities, and are used when interventions apply at the group level, when individual-level interventions risk contamination between participants, or to reflect real-world implementation. When outcomes are binary, treatment effects may be expressed as relative measures (such as odds ratios or risk ratios) or absolute measures (such as risk differences). CONSORT guidelines recommend reporting both, but risk ratios and risk differences are often underreported compared to odds ratios. Estimating these measures in cluster trials is more complex than in individually randomised trials, requiring appropriate handling of clustering, convergence issues, and small sample corrections. There is currently little empirical evidence describing which statistical methods are used to estimate these effect measures in published cluster trials.MethodsThis protocol describes the planned methods for a methodological review of published cluster randomised trials. We will use an existing database of 800 trials conducted in low- and middle-income countries. From this, we will identify a subset of trials with a parallel design and a binary primary outcome. Trials reporting a risk ratio or risk difference for the primary outcome will undergo further detailed data extraction. We will summarise the methods used to estimate these effects, including how clustering and small sample sizes were handled, and whether estimates were adjusted for covariates.DiscussionThis review will provide the first detailed description of how risk ratios and risk differences are currently estimated and reported in cluster randomised trials. The findings will inform the development of methodological guidance and help identify gaps in reporting and implementation. This is particularly important as interest grows in improving estimand specification and the clarity of statistical analysis plans
Abating secondary NH<sub>3</sub> and N<sub>2</sub>O formation on the three-way catalysts:The role of steam
Get PDFEven though water injection has already been proven to reduce NOx formation within the combustion chamber, there is limited research on how this affects the formation of such emissions in three-way catalysts (TWCs). Considering this, the work presented here studies the effect of in-cylinder water injection on the performance of a TWC with respect to the formation of ammonia (NH3) and nitrous oxide (N2O). Experimental testing using a gasoline direct injection (GDI) engine fitted with an intake port water injection system was completed. These tests found a clear reduction in NH3 formation over the TWC when in-cylinder water injection was implemented. The reduction in NH3 formation, particularly pronounced at richer conditions, is attributed to lower engine-out NO concentrations, which in turn reduces secondary NH3 formation over the TWC. Lean engine conditions did not produce any NH3 with or without water injection, due to lower TWC NH3 selectivity. There was minimal formation of N2O during this work as the TWC temperature was greater than the typical N2O formation window. This work highlights the synergistic benefits of reducing secondary emissions during the combustion process and the favourable effect on catalytic technologies through in-cylinder water enrichment.</p
The moral positions taken towards zoos and conservation
Get PDFThe focus on supporting conservation and encouraging related behaviours is changing the emotional experiences of zoos and related moral positions towards animal tourism. Drawing on Haidt's moral emotions and theories of moral judgement, we interpret depth-interviews with zoo stakeholders to theorise four moral positions: the renunciation of captivity to protect animal rights; acts of propitiation that gesture towards a nature that has been harmed; the vindication of animal captivity through arguments about education and species preservation; and valediction through visits to endangered species and habitats as inspiration for conservation. These positions highlight the need for zoos to consider a moral emotion-behaviour gap as part of their conservation work
Robotic disassembly of snap-fit plug connectors in end-of-life electric vehicle batteries
Get PDFDisassembly is the first step in the remanufacturing of End-of-Life (EoL) Electric Vehicle (EV) batteries. Currently, many disassembly procedures for EV batteries are performed by human operators. Robotic disassembly of EV batteries is essential for increasing the efficiency of the process. A common operation in EV battery disassembly is removing plug connectors. This paper introduces a new method for automating the disassembly of a snap-fit plug connector using a specially designed tool. A control strategy combining force and position was implemented. Experiments were performed on a single connector to investigate and validate the proposed method for disassembling snap-fit plug connectors. The results show that the success rate and integrity rate of the method were both 100 % across 100 tests. Finally, the paper presents a case study on disassembling snap-fit plug connectors in an EV battery. The case study shows that the disassembly approach is feasible and practical, and it can facilitate the automated disassembly of EV batteries
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