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The Impact of Perceived Usefulness of Wearable Devices on Treatment Adherence in Fracture Patients : The Chain Mediating Roles of Self-Efficacy and Meaning in Life
No full textBackground: Fractures patients often exhibit low treatment adherence, resulting in prolonged recovery and increased complications. Wearable devices provide real-time monitoring and feedback and are expected to improve adherence, but the psychological mechanisms remain underexplored. This study is among the first to extend the Technology Acceptance Model (TAM) to fracture rehabilitation by incorporating self-efficacy and meaning in life as mediators. Objective: The purpose of this study was to analyze the effect of perceived usefulness of wearable devices on treatment adherence of fracture patients and its internal mechanism. Methods: A cross-sectional study was conducted with 473 fracture patients (45.5% male, mean age 44.42 ± 16.24 years) from four tertiary hospitals in Zhejiang, China, between May and June 2025. Participants completed validated scales assessing perceived usefulness, self-efficacy, meaning in life, and treatment adherence. Structural equation modeling and SPSS Macro Process Model 6 with bias-corrected bootstrapping were used to test direct and mediating effects. Results: Perceived usefulness significantly predicted treatment adherence β = 0.167, 95% CI = [0.042, 0.291]. Self-efficacy (indirect effect = 0.089, 95% CI=[0.019, 0.174]) and meaning in life (indirect effect = − 0.135, 95% CI=[− 0.215, − 0.033]) mediated this relationship, with a chain mediation effect through both variables (indirect effect = 0.149, 95% CI = [0.077, 0.229]). The total effect accounted for 62% of adherence variance. Conclusion: The findings reveal a complex psychological mechanism wherein the perceived usefulness of wearable devices influences fracture patients’ treatment adherence through multiple pathways, involving both positive and negative mediating effects. This underscores the importance of addressing patients’ self-efficacy and meaning in life to maximize the effectiveness of technology-based rehabilitation interventions
Expanding curricular outdoor learning : Teacher-identified current practices and needs for support in schools in England
No full textThe benefits of school-based outdoor learning are well documented; however, there is limited research on the factors influencing teachers’ ability to integrate outdoor learning into the school day and the types of support they seek. This study explores these factors through a sequential mixed-methods design, involving a survey of educational professionals and focus groups with teachers in primary schools in England. The data analysis includes quantitative and qualitative methods to identify key enablers including strong school leadership, access to suitable outdoor spaces, a flexible approach tailored to the specific context, and teacher-determined priorities with ongoing professional development fostering collaboration and the sharing of best practices. These enablers address challenges such as limited resources, curriculum pressures, time constraints, funding issues, staffing levels, and lack of teacher confidence. To expand curricular outdoor learning effectively, teachers emphasise that support must align to the needs of each school, considering context, location, and development stage
Using natural language processing to explore differences in healthcare professionals’ language on Functional Neurological Disorder : a comparative topic and sentiment analysis study
No full textBackground Effective communication is essential for delivering quality healthcare, particularly for individuals with Functional Neurological Disorders (FND), who are often subject to misdiagnosis and stigmatising language that implies symptom fabrication. Variability in communication styles among healthcare professionals may contribute to these challenges, affecting patient understanding and care outcomes. Methods This study employed natural language processing (NLP) to analyse clinician-to-clinician and clinician-to-patient communication regarding FND. A total of 869 electronic health records (EHRs) were examined to assess differences in language use and emotional tone across various professionals—specifically, neurologists and psychologists—and different document types, such as discharge summaries and letters to general practitioners (GPs). Latent Dirichlet Allocation (LDA) topic modelling and two complementary sentiment models (VADER and Flair) were applied to the corpus. Sentiment analysis was also applied to evaluate the emotional tone of communications. Results Findings revealed distinct communication patterns between neurologists and psychologists. Psychologists frequently used terms related to subjective experiences, such as “trauma” and “awareness,” aiming to help patients understand their diagnosis. In contrast, neurologists focused on medicalised narratives, emphasising symptoms like “seizures” and clinical interventions, including assessment (“telemetry”) and treatment (“medication”). Sentiment analysis indicated that psychologists tended to use more positive and proactive language, whereas neurologists generally adopted a neutral or cautious tone. Conclusions These findings highlight differences in communication styles and emotional tones among professionals involved in FND care. The study underscores the importance of fostering integrated, multidisciplinary care pathways and developing standardised guidelines for clinical terminology in FND to improve communication and patient outcomes. Future research should explore how these communication patterns influence patient experiences and treatment adherence
“Onto-Balance Sheet” Accounting under Principle-Based Consolidation Standards : Evidence from State-Owned Enterprises in China
Get PDFTo prevent firms from hiding losses and risks in unconsolidated subsidiaries, standard setters have progressively broadened the scope of consolidation, which results in greater managerial discretion in adding entities for consolidation. We examine whether state-owned enterprises (SOEs) with higher state ownership, hence stronger empire-building incentives, are more inclined to exploit this discretion to consolidate additional investees. China’s mixed-ownership reform, which introduces nonstate blockholders and reduces state ownership, provides an ideal setting. We find that SOEs are less likely to exploit the discretion to consolidate their investees after the reform. The decline is sharper when accounting standards allow greater discretion, when consolidation yields larger asset increases, and when the government places greater emphasis on expansion. Further analyses reveal that consolidation accounting generates real benefits, which diminish after the reform. Our study provides novel evidence on aggressive consolidation under principle-based accounting standards and offers insights for standard setters refining the consolidation boundary
Speculation for RE : Addressing Unanticipated Consequence
Get PDFContext Software innovations frequently lead to unanticipated consequences with significant impacts, a problem exacerbated by emerging technologies and inherent uncertainty in problem domains. Traditional Requirements Engi-neering (RE) practices are often inadequate for addressing this complexity. Our work is motivated by the need to prefigure emergent properties early in the development process to mitigate such risks. Objectives This paper introduces the Consequences and Futures Model, a conceptual framework designed to help software development teams better understand the potential impacts of software innovations at the pre-design phase. The overarching goal is to equip developers with techniques to facili-tate proactive risk evaluation and mitigation planning. Methods The model draws on three real-world case studies of software sys-tems with unintended consequences: the UK Post Office’s Horizon system, Apple’s AirTags, and DJI drones in Ukraine. The model draws on exist-ing research outwith the Software Engineering domain, which was evaluated through three qualitative workshops using speculative strategies to provoke forward-thinking analysis. Results The workshops successfully demonstrated the model’s potential to help participants understand technology’s potential impacts and identify areas for further exploration. The model encouraged development teams to consider design decision consequences from multiple perspectives: the orga-nization, users and non-users, the technology itself, and the wider world. It prompted teams to explore both probable and plausible futures using spec-ulative strategies. The model stimulated creativity, aiding participants in aligning their understanding of subject technologies and broadening their perspective on social implications. Conclusions The Consequences and Futures Model enhances RE by in-tegrating Speculative Design techniques to address the risks of innovation. It offers structured exercises for exploring a problem space beyond tradi-tional requirements gathering. While not predictive, it supports imaginative scenario-building to uncover hidden risks. The model’s operationalisation is preliminary and we outline a lightweight protocol for practitioner use. Inte-gration into RE processes is left to future work
Professional perspectives on barriers to accessing maternity care in England : a qualitative study
Get PDFBackground Women living on low income in England are at an increased risk of experiencing stillbirth, neonatal death, preterm birth, low birth weight and maternal mortality. Women with poor access to financial, educational, and social and health resources engage less with health and care services throughout their pregnancy, due to social stressors, low health literacy, digital exclusion, lack of support, language barriers, transport difficulties, and stigma and judgement from healthcare professionals. Existing evidence documents the experiences of women facing socioeconomic disadvantage, little is known about how healthcare professionals understand and respond to these barriers. The aim of this qualitative study was to explore professionals’ perceptions of the barriers pregnant women living on low income face when accessing maternity care. Methods Data were collected through one-to-one semi-structured interviews with professionals (i.e., midwives, health visitors, VCSE practitioner) working in the NHS, local authority or Voluntary, Community and Social Enterprise (VCSE) organisations in the North East of England. Purposive snowballing sampling was used to recruit participants. Anonymised interview data was thematically analysed and incorporated Ecological Systems Theory (EST). Results Seventeen participants were interviewed (NHS maternity services n=6; local authority n=3 and VCSE n=8). Data highlighted three interlinked levels of barriers that professionals perceived pregnant women living on low income experience accessing maternity care: structural, interactional and individual. Structural barriers included digital exclusion, language-related difficulties and service delivery challenges related to staffing shortages. Interactional barriers included limited social networks, lack of partner involvement, and experiences of racism and discrimination. Lastly, individual level challenges included cost of travel and other pregnancy-related costs, fear of professionals and unfamiliarity with services. Conclusions Findings from this study present professionals’ perspectives of the different challenges pregnant women living on low income face when accessing maternity care. These include language and communication, a lack of social support network, the cost and time of travel and the fear of professionals and unfamiliarity of service. Recommendations to improve access to maternity services include the implementation of recycled smart phones, the use of digital translation apps within appointments and the use of pre-paid travel vouchers
Building Capacity in Crisis : Evaluating a Health Assistant Training Program for Young Rohingya Refugee Women
No full textBackground: The Rohingya refugee crisis is one of the largest humanitarian emergencies of the 21st century, with nearly one million Rohingya residing in overcrowded camps in southern Bangladesh. Women and children face the greatest vulnerabilities, including inadequate access to education and healthcare, which exacerbates their risks and limits opportunities for personal and community development. While international organizations continue to provide aid, resources remain insufficient, particularly in maternal and child healthcare, highlighting the urgent need for sustainable interventions. Objectives: The Hope Foundation for Women and Children in Bangladesh launched a pilot project for the Health Assistant Training (HAT) program to address critical gaps in healthcare and education for the Rohingya community. This nine-month training program equips young Rohingya women with essential knowledge and skills to support maternal health services in both clinical and community settings. Design: We conducted a qualitative evaluation of the HAT Program to explore its acceptance and anticipated benefits for both participants and the community. Methods: The research team used semi-structured interviews, focus groups, and field observations to explore the HAT Program’s impact on young Rohingya women and their community. They analyzed data through thematic analysis, developing a coding framework and identifying key themes to uncover patterns and insights. Results: The results were categorized into four themes: (1) community acceptance of the HAT Program, (2) the HAT Program’s impact on the health assistant trainees, (3) the impact of the HAT Program on the community, and (4) the potential ways to expand the HAT Program. Conclusions: This research underscores the program’s impact on improving healthcare access, enhancing women’s empowerment, and promoting community resilience. By situating this initiative within the broader context of refugee health, education, and capacity-building, this research highlights the HAT program’s potential as a replicable model in Bangladesh and in other humanitarian settings
Evidence for the Collective Nature of Radial Flow in Pb + Pb Collisions with the ATLAS Detector
No full textAnisotropic flow and radial flow are two key probes of the expansion dynamics and properties of the quark-gluon plasma (QGP). While anisotropic flow has been extensively studied, radial flow, which governs the system’s radial expansion, has received less attention. Notably, direct experimental evidence for the global and collective nature of radial flow fluctuations has been lacking. This Letter presents the first measurement of transverse momentum ( p T ) dependence of radial flow fluctuations ( v 0 ( p T ) ) over 0.5 < p T < 10 GeV and demonstrates its collective nature using a two-particle correlation method in Pb + Pb collisions at s NN = 5.02 TeV . The data reveal three key features supporting the collective nature of radial flow: long-range correlation in pseudorapidity, factorization in p T , and centrality-independent shape in p T . The comparison with a hydrodynamic model demonstrates the sensitivity of v 0 ( p T ) to bulk viscosity, a crucial transport property of the QGP. These findings establish a new, powerful tool for probing collective dynamics and properties of the QGP
Corpus Analysis of Online Communication
No full textThe connectivity of the Internet has created new ways of interacting and facilitated new communicative practices. Online communication is of interest to corpus linguists not only as an ever-expanding domain of language interaction, but also with respect to the particular affordances of networked technologies for corpus construction and accessibility. This entry will offer an overview of how procedures from corpus linguistics, which is characterized by the use of software tools to support the investigation of frequency-based patterns in large-scale datasets, have been applied to map out types of online communication and to document features such as emoji that have become emblematic of such interactions. The steps involved in constructing corpora of online communication are discussed, along with the challenges facing corpus linguists looking to explore emergent forms of online communication
