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Healthcare professionals’ experiences and thoughts on eating and drinking with acknowledged risks in older adults: a comparison of Japan and the UK
Full text linkPurpose: Older adults are commonly restricted of oral intake due to concerns of aspiration. Eating and drinking with acknowledged risks (EDAR) is an alternative pathway that facilitates comfort, dignity and autonomy. However, EDAR decision-making is difficult, with guidance only existing in the UK, and support not readily available. This study was the third in a mixed-methods project aiming to understand how to develop EDAR further whilst providing clinicians with optimal support. This study aimed to reveal the factors that shape confidence in healthcare professionals regarding EDAR decision-making.
Methods: We performed a survey regarding the experiences of healthcare professionals in Japan and the UK with EDAR in older adults. We developed the survey based on themes extracted from our previous qualitative study.
Results: There were 1452 responses (1058 Japanese, 394 UK). Confidence towards EDAR was higher in UK-based respondents (β = 2.358, SE = 0.137, P < .001), with greater years of experience (β = 0.028 per year, SE = 0.005, P < .001), higher rate of clinical work related to EDAR (β = 0.341, SE = 0.022, P < .001), a more involved role in the decision-making, and being clinicians who are not doctors. Similar results were observed regarding likeliness to support EDAR, likeliness to acknowledge perceived benefits, and lower levels of difficulty in undertaking EDAR. Framework (such as guidelines/protocols) and education were ranked to be most beneficial in both countries.
Conclusions: Confidence towards EDAR-decision making was shaped through multiple internal and external factors. Acknowledging these allows us to identify areas in need and provide culturally adapted support, leading to improved experiences in patients, families and healthcare professionals
Indigenous Peoples and local communities as agents of transformative change for sustainability
Full text linkAchieving just, equitable, and effective sustainability transformations requires diverse social engagement. This paper identifies five key roles played by Indigenous Peoples and local communities as agents of transformative change: embodying sustainable lifeways, resisting harm and defending rights, extending their practices to influence broader systems, and offering foundational models for care-oriented economies and governance. Through illustrative examples, we show how Indigenous Peoples and local communities actively contribute to global transformation. We emphasize the importance of engaging with a wide range of actors in supporting, expanding, and deepening these contributions to realize meaningful, systemic change toward a sustainable and just future
The impact of managerial attention to digital transformation on stock price synchronicity from the dynamic capability perspective
No full textThis study examines how two components of digital transformation (DT), DT integration and DT innovation, influence stock price synchronicity. We view this question through a corporate governance lens, drawing on dynamic capabilities theory. Using textual analysis of MD&A disclosures from Chinese listed firms from 2010 to 2021, we measure managerial attention to DT integration and innovation, revealing their distinct roles in governance. DT integration, which often generates verifiable metrics, reduces stock price synchronicity by enhancing transparency, attracting long-term institutional investors, improving financial reporting quality, and refining analyst forecasts. In contrast, soft information about DT innovation fails to mitigate opacity and increases synchronicity in weak governance environments. Cross-sectional analyses show that integration’s governance benefits persist across institutional settings, while innovation’s effects hinge on external safeguards. Our findings emphasize that DT integration, which reflects a firm’s ability to reconfigure resources for sustained competitiveness, serves as a robust governance tool to enhance market efficiency. Policymakers and firms should prioritize integration-driven strategies to foster transparency while treating innovation’s speculative narratives with caution. This research redefines DT as a dual-process phenomenon, offering actionable insights for aligning digital strategies with governance frameworks in emerging markets
Barriers or catalysts? Traditional institutions and social mobility in rural India
Full text linkWe examine how village-level social group dominance affects the educational and occupational mobility of minority and other social groups in rural India across multiple generations. Theoretically, we distinguish between upper caste and own group dominance and examine the mechanisms underpinning inequality in mobility outcomes. We find inequality in upward educational mobility to have significantly narrowed over time. Scheduled Castes (SCs) have higher educational mobility in upper caste and own dominated villages, while Scheduled Tribes (STs) and Muslims perform worse in own dominated villages. In contrast, for occupational mobility, we find that Muslims used to be on par with upper castes but have experienced setbacks in the recent generation. There is no
evidence of other minority groups catching up with upper castes while SCs and STs are particularly disadvantaged. SCs, once more, perform better in their own dominated villages. Exploring mechanisms that explain the relationships between land dominance regimes and intergenerational mobility, we find notable inequalities in the provision of a wide range of public goods with Muslim and ST dominated villages being particularly disadvantaged. We find location in unfavorable agroecological zones, village infrastructure, and social cohesion to be pathways through which upper caste and own group dominance affect the educational and occupational mobility of minority groups. Our findings suggest that traditional institutions can be both a barrier to or catalyst for social
mobility, depending on the social identity of the dominant group in the village
Continuous manufacturing of 3D-printed chewable pediatric gummies by coupling hot melt extrusion with direct extrusion additive manufacturing
Full text linkBackground
3D printing has been extensively explored as a novel approach to fabricating customized pharmaceuticals due to its adaptability. In this study, a continuous 3D (3-dimensional) printing platform was developed for the fabrication of chewable, gummy-like pediatric tablets by coupling Hot Melt Extrusion and Direct Extrusion Printing.
Research design and methods
The effects of polymer composition, super disintegrants, and infill density on extrusion, printability, and structural integrity were systematically evaluated. Rheological analysis revealed that optimized inks exhibited stable shear-thinning behavior as low as 1.0x105 to 1.0x106 mPa/s with increasing shear rates, ensuring smooth extrusion and excellent layer adhesion. In vitro dissolution studies demonstrated that tablet geometry, infill density, and ink composition could be tailored to achieve immediate drug release.
Results
30% and 50% infill structures provided reduced compressive resistance suitable for soft, chewable tablets and resulted in nearly 90% drug release within 30 min. Sensory assessment confirmed effective taste masking via hydrogen-bonding interactions, and optimized sweetener – flavor ratios ensured palatability.
Conclusions
3D printing enabled the production of pediatric-friendly, chewable dosage forms with tailored mechanical, dissolution, and sensory properties, supporting personalized medicine and enhanced patient compliance
A UK perspective on responsible education for responsible AI: a multidisciplinary review and evaluation framework
Full text linkResponsible Artificial Intelligence (RAI) education has emerged as a way of approaching the field of AI to address a host of concerns (Bentley et al., 2023). Many education providers have been releasing new RAI-related online courses, programmes, or toolkits. When combined with the issues emerging from the development, deployment, and use of AI, the expansion of RAI education and the proliferation of resources raise two critical questions. First, what can we learn about RAI from examining both the content and structure of publicly available RAI educational resources? Second, how might we understand the quality and impact of these RAI resources? We conducted a systematic search of UK RAI educational resources found online. We first present a descriptive analysis of 211 resources collected, including their type, format, cost, sector, audience, and type of provider. Furthermore, we describe our collaborative approach to analysing four pre-selected resources in-depth, from which we outlined an evaluation framework that we then employed for assessing the content of a subset of 47 resources. The five crucial areas of our framework could guide both learners and developers when approaching RAI resources
Cost-effectiveness of a music therapy intervention for people living with dementia: a model for a UK-based economic evaluation
Full text linkObjectives
Cognitive Stimulation Therapy (CST) is widely used in UK dementia care to support cognitive and social functioning. Music therapy (MT) also shows cognitive benefits for people living with dementia (PLwD) but is not routinely available through the NHS due to limited cost-effectiveness evidence. This study evaluated the combined use of CST and MT compared to CST alone, providing a realistic assessment of the added value of MT within standard care.
Method
A decision analytic model was constructed using a cost utility framework with a healthcare perspective, over a three-month time horizon. It compared CST+MT with CST alone for community-dwelling people with moderate dementia. The clinical effectiveness outcome was cognitive improvement measured by MMSE score. Model parameters were informed by existing literature and clinical trial data where available.
Results
Over a three-month period, MT+CST was more effective than CST alone in improving cognitive function but was not cost-effective due to higher initial costs, including setup and equipment. However, when cognitive benefits were assumed to persist over six months, CST+MT became cost-effective.
Conclusion
MT combined with CST may offer cost-effective cognitive benefits for PLwD over a six-month period. The model provides valuable evidence for decision-makers considering the broader adoption of MT
Determinants of lecturer readiness to adopt generative AI in Higher Education: survey evidence from UTAUT and self-determination theory
Full text linkGenerative artificial intelligence (GAI) is reshaping higher education, yet lecturers’ readiness remains under-examined. This study integrates the Unified Theory of Acceptance and Use of Technology (UTAUT) with Self-Determination Theory (SDT) and individual attributes (AI literacy, teaching values, personal innovativeness) to explain lecturers’ behavioural intention and GAI use. A cross-sectional survey of 651 university lecturers in mainland China measured UTAUT constructs (performance expectancy, effort expectancy, social influence, facilitating conditions), SDT needs (autonomy, competence, relatedness), and individual attributes. Confirmatory factor analysis and covariance-based structural equation modelling assessed measurement quality and structural paths; bootstrapped mediation tested indirect effects via intention, and latent-interaction moderation examined whether SDT strengthened antecedent–intention links. SDT was the strongest predictor of intention; UTAUT constructs were also significant. Teaching values and personal innovativeness showed positive effects, and AI literacy was positively associated with use/intention, which strongly predicted use, with facilitating conditions and SDT also showing direct effects. Findings conclude the value of professional development in Technology Enhanced Learning (TEL) that builds faculty AI literacy and competence, which supports autonomy and collegial relatedness, and must be underpinned by reliable institutional infrastructures to accelerate responsible GAI integration
Economic assessment of shelled maize and cowpea storage practices among smallholder farmers: evidence from Zimbabwe
Full text linkHermetic storage bags (HSBs) are being introduced to smallholder farmers in sub-Saharan African countries to help mitigate postharvest grain losses. For widespread adoption of storage technologies to occur, they need to be acceptable, effective and economical. This study examined the economic impact of using different grain storage practices among smallholder farmers in selected districts of Zimbabwe. A partial budget analysis was employed to estimate the economic costs and benefits of storage practices and to compute the Marginal Rate of Return (MRR) between alternative storage practices. The results indicated that for maize and cowpeas, the MRR of changing from storing untreated grain in polypropylene bags to using HSBs was 544% and 3059%, respectively; assuming a 3-season lifespan of HSBs. If HSBs only last a single season’s use, they are not economically viable for maize, but when used for two seasons, they yield a marginally acceptable return (MRR = 115%). For cowpeas, even if the lifespan is limited to one or two seasons, use of HSBs remain economically viable, yielding MRRs of 252% and 955%, respectively. This highlights the need for proper handling, hygiene, and maintenance of HSBs to ensure durability and maximise economic benefits. For maize, synthetic chemical grain protectant pesticide (GPP) had a higher cost and lower net benefit than HSBs, so was considered a dominated treatment, indicating HSB use would be preferable. Economically, HSBs offer the best return on investment, helping smallholder farmers reduce losses and pesticide use, in addition to enhancing food, income, and nutrition security
Multi‐user Boolean Keyword Searchable Encryption with fine‐grained access control for Cloud storage
No full textSearchable Encryption (SE) enables users to perform searches on encrypted data while preserving data privacy. Since cloud servers are platforms that provide services for a large number of users, and data owners require access control over their data, SE schemes that support multi‐user settings and access control are therefore more suitable for cloud storage. However, in existing SE schemes that support multi‐user settings and access control, most only support single‐keyword or conjunctive keyword searches, and the search time grows linearly with the total amount of data. These limitations negatively impact both the accuracy and efficiency of search operations. This work proposes an SE scheme specifically designed for multi‐user settings. Data owners can enforce fine‐grained access control policies, while a specialized retrieval structure allows the cloud to assist users in performing Boolean keyword searches with improved efficiency. The search complexity of the proposed scheme is , where denotes the number of files relevant to the queried keyword. We demonstrate the scheme's effectiveness and practicality through performance analysis
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