21827 research outputs found
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Pharmacist-led osteoporosis review: perceptions of current practice, care gaps and implementation challenges
Get PDFBACKGROUND: Adherence to oral bisphosphonates for osteoporosis is poor; the challenges and complexity of follow-up reviews in general practice are implicated as a contributory cause. Clinical pharmacists in general practice are an expanding professional group within the UK NHS workforce and could provide person-centred, medicines optimisation interventions. AIM: To explore clinician and patient perceptions towards a pharmacist-led osteoporosis review, including identifying current practice, care gaps and implementation barriers and facilitators. DESIGN & SETTING: Qualitative interview study with patients, clinical pharmacists, GPs, osteoporosis specialists and service commissioners. METHOD: Semi-structured interviews were transcribed verbatim and analysed thematically, informed by a Normalisation Process Theory approach. RESULTS: In total, 32 participants were interviewed in 22 one-to-one interviews and 4 small group interviews. Three themes relevant to the design and implementation of a pharmacist-led osteoporosis follow-up review were identified: dissonant views about current provision and needs ; suitability and acceptability of pharmacists to deliver the review and training needs for this; and contextual issues affecting implementation. CONCLUSION: Our study found that current practice with respect to following-up patients initiated on oral bisphosphonate treatment in primary care is variable. Although pharmacists were highlighted as well placed to conduct osteoporosis reviews, varying views about the need for this were highlighted along with a number of contextual barriers, including lack of financial and policy drivers in primary care, workload challenges, varying pharmacist skills and autonomy and lack of coordination across the health system
Playful leisure design: A study on the intersection of play, work and leisure among dual-earner couples
Get PDFCan play at work ripple into healthier, more engaged lives? Grounded in the Work–Home Resources model and spillover perspective, this study develops a model to examine the contextual conditions (when) and mechanisms (how) that connect playful work design (PWD) to health-related outcomes—that is, healthy eating motives and self-care. We introduce and validate the novel concept of playful leisure design (PLD), which captures proactive strategies to infuse leisure with fun and competition. A pilot study established the construct validity of PLD. Using a 15-day diary study with 65 dual-earner couples across the United States (resulting in 910 matched surveys), our findings reveal that PWD positively influences healthy eating motives and self-care through PLD. We also examine the role of individuals' motivation for healthiness as a potential boundary condition. This study contributes to the conversations in playful work design and work–leisure literature by showing how proactive and playful behaviours across domains contribute to resource building and employee well-being
Low-carbon cementitious paving systems with ladle furnace slag and fine recycled aggregate: A multi-scale experimental study
Get PDFReusing and recycling wastes and byproducts in construction materials is seen a circular economy practice efficient to preserve natural resources and address environmental issues. Cement-base urban architectural pavements -extensively used in cities- are the focal point of attention of this research due to the elevated CO2 footprint of Portland cement (PC) production, and the massive consumption of natural resources. In this context, ladle furnace slag—an industrial byproduct of refining/secondary steel treatment—, limestone powder, and fine recycled aggregate derived from construction and demolition waste have been incorporated in the cementitious matrices to examine the feasibility of producing paving blocks. The literature review indicates a lack of comprehensive research on the simultaneous replacement of both cement and natural aggregates in paving applications using ladle furnace slag and fine recycled aggregates. Mechanical performance and drying shrinkage of matrices with various slag dosages (50–75 %) and sizes up to 2 mm were characterized in laboratory. Further, the weathering resistance of the samples was characterized through water absorption and accelerated wet-dry cycles. Microstructural and chemical analysis techniques, including SEM, BSEM, XRD and XRF, were applied to complete the tests. Taking as reference 100 % PC paving blocks produced by vibro-compaction in industrial facilities, the samples with 50 % slag as PC substitution achieved 28-day average compressive and flexural tensile strengths of 11.4 MPa and 5.8 MPa, respectively. These represent a 55 % and 30 % reduction respect to the reference samples. The 50 % slag sample exhibited ∼15 % higher water absorption than the control, with no strength degradation after wet-dry cycles. These results allowed concluding that this low-impact material—achieving approximately 45 % and 25 % reductions in embodied carbon and energy, respectively, compared to the control—can be used for urban paving in areas with moderate service loads, such as pavements designed for light-load vehicles or pedestrians
A comprehensive scoping review of methodological approaches and clinical applications of tear fluid biomarkers
Get PDFTear fluid is an emerging source of disease biomarkers, drawing attention due to its quick, inexpensive, and non-invasive collection. The advancements in detection techniques enable the measurement of ultra-low biomarker levels from small sample volumes typical of tear fluid. The lack of standardized protocols for collection, processing, and analysis of tear fluid remains a significant challenge. To address this, we convened the Tear Research Network Review Taskforce in 2022 to review protocols from the past three decades, providing a comprehensive overview of the methodologies used in tear fluid biomarker research. A total of 1,484 articles published from January 1974 to May 2024 from two electronic databases, Embase and Ovid MEDLINE, were reviewed. An exponential increase in the number of articles on tear fluid biomarkers was observed from 2015 onwards. The two most commonly reported collection methods were; glass capillaries (45.2%), and Schirmer's strips (25%), with glass capillary tube collection remaining the most frequent method until 2019, when Schirmer's strips became the leading method. Most articles analyzed tear fluid proteins (65%) and focused on a single analyte (32.3%). In recent years, an increase was observed in the type and number of examined analytes. The differences in the reported methodologies and protocols underscore the need for standardization and harmonization within the field of tear fluid biomarkers to minimize methodological differences and reduce variability in clinical outcomes. Consistent and detailed reporting is essential for improving the reproducibility and validity of tear fluid studies, in order to advance their potential clinical applications
Next-Generation Ultrasound Tunneling in Suspended Core Optical Fibers
Get PDF[Preprint] We demonstrate the spatial-temporal tunneling of high-frequency ultrasound inside a suspended core fiber (SCF) for the first time. An SCF composed of a 5 μm core suspended by nano bridges and four air holes is analytically and numerically investigated using the 2D and 3D finite element method. We reveal the propagation of ultrasonic modes in the SCF and describe the variation of their properties with increasing frequency from 1 to 100 MHz. Ultrasonic Gaussian modulated pulses traveling with distinct frequencies (25 and 72 MHz) and bandwidths (56 and 10 MHz) are evaluated along the SCF length and time. The induced strain, pressure, and sensing responsivity are reviewed and discussed. Analytical and numerical results show highly confined effective single-mode propagation in the SCF core, amplifying strains along the fiber (up to 18 times) and pressures at the fiber output (up to 3 times). Compared to previous studies, the demonstrated SCF provides the widest 86 MHz high-responsivity bandwidth (with a -218 dB average and -75 dB maximum responsivity at 93 MHz). These achievements are promising for developing smaller, faster, and more efficient acousto-optic modulators for fiber lasers, enhancing simultaneous light-sound guidance and spatial resolution of fiber-based optoacoustic imaging sensors and neurostimulators in biomedicine
Understanding complex ambiguous problems using Soft Systems Methodology and empathetic discourse in the classrooom
No full textThe aim of this paper is to explore the use of empathetic discourse as a complimentary approach to SSM when combined together, as a teaching tool, to allow students to develop better understanding of a problematic situation in organisations. This paper will develop understanding of the connection between empathetic discourse, Soft Systems Methodology (SSM) and complex problem solving within an operations management teaching context. The purpose is twofold. Understanding the connections and then sharing the pedagogical approach to implement these findings in the classroom
Extreme weather event attribution predicts climate policy support across the world
Get PDFExtreme weather events are becoming more frequent and intense due to climate change. Yet, little is known about the relationship between exposure to extreme events, subjective attribution of these events to climate change, and climate policy support, especially in the Global South. Combining large-scale natural and social science data from 68 countries (N = 71,922), we develop a measure of exposed population to extreme weather events and investigate whether exposure to extreme weather and subjective attribution of extreme weather to climate change predict climate policy support. We find that most people support climate policies and link extreme weather events to climate change. Subjective attribution of extreme weather was positively associated with policy support for five widely discussed climate policies. However, exposure to most types of extreme weather event did not predict policy support. Overall, these results suggest that subjective attribution could facilitate climate policy support
Assessing the factor structure of the Problem and Pathological Gambling Measure (PPGM)
Get PDFThe Problem and Pathological Gambling Measure (PPGM) is widely used to assess problem gambling, showing strong correspondence between population surveys and clinical interviews. However, the literature on its factor structure is limited. This study used confirmatory factor analysis to identify the optimal structural model of the PPGM. Data from the Finnish Gambling Harm Survey (2016, n = 3218; 2017, n = 1250) were used. Five models were compared on fit indices, reliability, and criterion validity, including gambling frequency, expenditure, and harm. The models included one-factor, two-factor, three-factor, two-factor with correlated residuals, and bifactor models. Results supported a two-factor model comprising dependence and harm, with adjustments for two items with correlated residuals. The bifactor model had similar fit levels but poorer reliability and replicability. Permutation tests did not support distinguishing between impaired control and other addictive issues. The models showed stronger associations with gambling harm than gambling behavior (expenditure, intensity, breadth). The study concludes that the two-factor model of the PPGM, measuring harm and dependence, is valid, and scores on these factors can serve as quantitative indices of general severity, dependence, and harm
TFOS DEWS III Editorial
Get PDFThe Tear Film & Ocular Surface Society (TFOS) , a nonprofit organization, was created to advance the research, literacy, and educational aspects of the sci- entific field of the tear film and ocular surface. Since its formation in 2000, TFOS has launched numerous global initiatives. Perhaps the best-known are the TFOS Work- shops, especially those related to dry eye disease (DED). DED afflicts hundreds of millions of people worldwide, is a leading cause of patient visits to eye care practition- ers, and, if moderate or severe, is associated with signifi- cant pain, role limitations, low vitality and poor general health..
Minimal Clinically Important Differences in Measuring Treatment Effects in CIDP: History, Current Use, Limitations and Prospects
Get PDFOutcome measures are essential for evaluating treatment effects and disease progression in chronic inflammatory demyelinating polyneuropathy (CIDP). The concept of the minimal clinically important difference (MCID), which represents the smallest change in a measure deemed clinically meaningful, has become increasingly important in CIDP research, and is also gaining interest in clinical practice. This review explores the history of use in clinical trials and observational studies, as well as potential limitations and future perspectives for MCIDs in CIDP. MCID derivation methods include anchor-based approaches that rely on patient perspectives, and distribution-based methods that calculate the magnitude of changes exceeding statistical error margins. Both approaches have been used in CIDP, yielding MCID cut-offs for key scales such as the Inflammatory Neuropathy Cause and Treatment (INCAT) Scale, Overall Neuropathy Limitation Scale (ONLS), Rasch-built Overall Disability Scale (I-RODS), grip strength, and the Medical Research Council sum score. Challenges include discrepancies in MCID thresholds, particularly for I-RODS and strength measures, and variability related to disease severity and subtype. Despite these issues, MCIDs for disability measures such as INCAT, ONLS, and I-RODS have demonstrated their value through validity and clinical relevance, making them suitable for both research and clinical practice. MCIDs for strength scores, walking tests, sensory scales, and electrophysiological measures lack reliability and direct clinical relevance with regard to the primary concept of clinically meaningful benefit. Future research should focus on optimization of outcome measures, harmonization of MCID derivation methods, and exploration of MCID application with disease-specific Health Related-Quality of Life measures for CIDP
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