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The impact of psychiatric decision units on mental health crisis care pathways: a synthetic control study
Get PDFPsychiatric crisis care is under great pressure, with the number of psychiatric presentations to emergency departments increasing and inpatient wards operating with occupancy rates above recommended levels. Internationally, hospital-based short-stay crisis units (named Psychiatric Decision Units; (PDU) in the UK) have been introduced to address these challenges, but the current evidence for their effectiveness is limited. We estimated the effects of PDUs in four geographic locations in England, linked to three National Health Service (NHS) mental health trusts and six NHS acute hospital trusts. Using national data sets to create synthetic controls from areas without PDUs (following the generalised synthetic control method), we estimated trust-wide changes to the primary outcomes of psychiatric inpatient admissions and psychiatric presentations to emergency departments (ED), compared to the synthetic controls, alongside secondary outcomes. We used meta-analysis to robustly combine outcomes. We analysed NHS hospital activity data for adults aged between 18 and 75 years covering 24 months preceding and following the introduction of each PDU (November 2012 to January 2021). We found no significant impacts of PDUs on primary outcomes, except at Sheffield Teaching Hospitals NHS Foundation Trust with 1.5 fewer psychiatric presentations to ED per 10,000 trust population per month (relative difference: 24.9%, p = 0.034) than the synthetic control. We found mixed effects of the opening of PDUs on secondary outcomes. Meta-analyses indicated a significantly lower mean length of stay for psychiatric admissions (-6.4 days, p < 0.001) for patients in mental health trusts with a PDU compared to the synthetic control and no significant effects on other outcomes. Heterogeneity of effect across sites probably reflects variation in PDU configuration and implementation. Further research should explore the intended aims of PDUs alongside how they operate in practice
Model-driven engineering for digital twins: opportunities and challenges
Get PDFDigital twins are increasingly used across a wide range of industries. Modeling is a key to digital twin development—both when considering the models which a digital twin maintains of its real-world complement (“models in digital twin”) and when considering models of the digital twin as a complex (software) system itself. Thus, systematic development and maintenance of these models is a key factor in effective and efficient digital twin development, maintenance, and use. We argue that model-driven engineering (MDE), a field with almost three decades of research, will be essential for improving the efficiency and reliability of future digital twin development. To do so, we present an overview of the digital twin life cycle, identifying the different types of models that should be used and re-used at different life cycle stages (including systems engineering models of the actual system, domain-specific simulation models, models of data processing pipelines, etc.). We highlight some approaches in MDE that can help create and manage these models and present a roadmap for research towards MDE of digital twins
Securing accountability for systemic human rights violations in Europe? Taking stock of pilot judgments
No full textWhen they were introduced in the early 2000s, pilot judgments issued by the European Court of Human Rights represented a radical move away from the Court’s traditional individual justice approach, and marked a step change in responding to systemic human rights violations. They have been utilised in an attempt to address some of the most prevalent structural breaches across the continent of Europe, including dire prison conditions, excessively lengthy legal proceedings and the failure to implement decisions of national courts, as well as targeting grave problems for particular states, such as the restitution of nationalised property in Romania and individuals’ loss of permanent residency status and foreign currency deposits after the dissolution of Yugoslavia. These judgments have led to significant legislative and policy changes in many Council of Europe states; however, questions have also been raised about the detrimental consequences to individuals who are left without redress, and whether the reforms carried out are in fact sufficient to fully address the serious problems raised.
In this chapter, Alice Donald and Philip Leach assess the impact of the pilot judgment
procedure, after almost twenty years. They assess to what extent systemic violations have been resolved, and how this happened (at both the international level and through domestic developments). They consider the stumbling blocks in the most difficult cases, discerning the real obstacles to change, and analysing the efficacy of the contributions of the European Court of Human Rights and the Committee of Ministers. This leads on to their conclusions as to how and why pilot judgments can be most effective, and an overall assessment of the pilot judgment procedure since its inception
Living “gender empowerment” in disaster and diverse space: youth, sexualities, social change, and post-Hurricane Katrina generations
Get PDFThis article explores the notion of “gender empowerment” in relation to feminist claims around collectivity and the real lives of young women and non-binary people who grew up in post-Katrina New Orleans. Drawing on participants’ narratives, the article calls into question the assumption that collectivity and isolation are diametrically opposed experiences. Instead, it offers a more nuanced view of “alone space” as forced aloneness—not as inherently negative or disconnected, but as a vital and generative terrain through which participants navigated recovery, identity, and empowerment. The findings suggest that meaningful collective action and participation often emerged not despite but through moments of solitude that allowed for reflection on individual passions, desires, and agency. In this way, individualist approaches were intricately linked to collectivity. Participants carved out unique spaces for change that were both personal and social, finding that their most powerful engagements with collectivity were often rooted in the growth fostered during periods of isolation. These journeys were nonlinear and fraught with complexity, marked by feelings of insecurity and powerlessness, particularly around decision-making and identity formation in the wake of disaster. Yet, within the altered landscape of post-Katrina New Orleans, the experience of aloneness became an unexpected catalyst for empowerment, offering routes back into collective life on renewed and self-defined terms
A Kripke semantics for Monadic BL Chains
No full textWe provide a generalisation of Kripke semantics for Monadic first-order Basic Logic of Chains (MBLC) of Petr Hájek and prove its soundness and completeness with respect to our semantics. This paper extends the insights of [10] from BL to the case of MBLC
Performance enhancement mechanisms and optimization of multi-pass parallel flow condensers with liquid-vapor separation
Get PDFThis study employed a distributed-parameter model developed by the authors to investigate the mechanisms of condensation heat transfer enhancement using liquid vapor separation (LS) in multi-pass parallel flow condensers (MPFCs). Additionally, tube pass arrangements for MPFCs with LS were optimized. Simulations characterized relationships among refrigerant flow rate, vapor quality, flow patterns, heat-transfer coefficient and pressure drop at tube level, along with heat-transfer coefficient and tube wall temperature distributions at the segment level. An entropy analysis based on the second law of thermodynamics quantified contributions from heat transfer and pressure drop. The results demonstrate that introducing LS leads to (1) a 9.1% increase in the average heat-transfer coefficient, (2) a 50.4% reduction in pressure drop, (3) similar entropy generation numbers due to heat transfer for both MPFC and MPFC-LS, (4) significantly higher entropy generation 1 numbers due to pressure drop in the last two tube passes, and (5) a 51.4% lower average entropy generation number for MPFC-LS compared to MPFC. Compared to a baseline serpentine condenser, MPFCs-LS reduced pressure drop by 84% to 98% while maintaining nearly the same heat transfer rate, resulting in an overall performance improvement of 5% to 9%. The optimal tube-pass arrangement for MPFCs-LS was identified as 3-3-2-2-2-2-2-1-1-1-1
Learning to mine: integrating channel quality patterns for enhanced AI-assisted scheduling decisions in 6G multimedia networks
Get PDFThis paper addresses the growing complexity of 6G Radio Resource Management (RRM) due to the integration of
new multimedia services and sophisticated network functionalities. To handle complex RRM control issues, machine learning is recognized as a valuable tool for improving decision-making in scheduling. However, the effectiveness of intelligent scheduling methods can be limited without efficiently managing the large volumes of data produced by network measurements, such as Channel Quality Indicator (CQI) reports. To tackle this, we propose a low-complexity framework that compresses extensive CQI data into a compact, usable form for machine learning applications. The framework adopts a metaheuristic approach
with simulated annealing to perform clustering and identify
global CQI data centers. These centers are then used to train
a Radial Basis Function Network (RBFN), enabling efficient
classification of CQI data into distinct patterns. These patterns inform reinforcement learning-based scheduling decisions, which, in turn, achieve significant gains, up to 20% improvement, in fairness performance when scheduling multimedia consumers
Digital skills infusion in curriculum development: investigating instructors’ perspectives
No full textThe current study explores college instructors’ perspectives on digital skills integration in early childhood education curricula at higher education institutions. A mixed‐methods approach is adopted with a pre‐existing questionnaire composed of 14 items and semi‐structured interviews. Data were collected from nine universities across the Middle East, targeting 464 college instructors. The findings indicate a disposition among college instructors toward acquiring and refining digital competencies related to pedagogical practices and learning modalities, underscoring the significance of integrating digital elements into curriculum content. College instructors expressed the least favorable views regarding the limited inclusion of digital tools and resources in the curricula. Two themes emerged from the qualitative data: positive perspectives, and negative perspectives to integrate digital skills into the curriculum. The study emphasizes the need for incorporating digital components into curriculum design to better equip educators and learners in early childhood education within higher education settings.Questo studio esplora le prospettive dei docenti universitari sull’integrazione delle competenze digitali nei curricula di educazione della prima infanzia presso le istituzioni di istruzione superiore. È stato adottato un approccio metodologico misto, utilizzando un questionario preesistente composto da 14 domande e interviste semi‐strutturate. I dati sono stati raccolti in nove università del Medio Oriente, coinvolgendo 464 docenti universitari. I risultati indicano una propensione da parte dei docenti ad acquisire e perfezionare competenze digitali legate alle pratiche pedagogiche e alle modalità di apprendimento, evidenziando l’importanza di integrare elementi digitali nei contenuti curriculari. I docenti hanno espresso opinioni meno favorevoli riguardo alla scarsa presenza di strumenti e risorse digitali nei curricula. Dai dati qualitativi sono emerse due tematiche principali: prospettive positive e prospettive negative sull’integrazione delle competenze digitali nel curriculum. Lo studio sottolinea l’urgente necessità di incorporare componenti digitali nella progettazione curricolare per preparare meglio educatori e studenti nel campo dell’educazione della prima infanzia all’interno del contesto universitario
Choosing democracy over party? How civic education can mitigate the anti-democratic effects of partisan polarization
Get PDFHow can the negative effects of partisan polarization on democratic attitudes be mitigated? Can polarized individuals be persuaded to choose democracy over party, i.e., support a candidate from an opposing party who upholds democratic norms when their co-partisan candidate fails to do so? We tested the effect of an online civic education intervention conducted on over 41,000 individuals in 33 countries that was designed to promote the choice for “democracy” by emphasizing the benefits of democratic versus autocratic regimes. The results are striking: exposure to civic education messages significantly dampens the negative effect of partisan polarization on anti-democratic co-partisan candidate choice. Civic education also has a small positive effect on polarization itself, with further exploration showing that this is the result of increased evaluations of parties that uphold democratic norms and practices, resulting in greater
differences between democratic and anti-democratic parties
FACTors: a new dataset for studying the fact-checking ecosystem
Get PDFOur fight against false information is spearheaded by fact-checkers. They investigate the veracity of claims and document their findings as fact-checking reports. With the rapid increase in the amount of false information circulating online, the use of automation in fact-checking processes aims to strengthen this ecosystem by enhancing scalability. Datasets containing fact-checked claims play a key role in developing such automated solutions. However, to the best of our knowledge, there is no fact-checking dataset at the ecosystem level, covering claims from a sufficiently long period of time and sourced from a wide range of actors reflecting the entire ecosystem that admittedly follows widely-accepted codes and principles of
fact-checking.
We present a new dataset FACTors, the first to fill this gap by presenting ecosystem-level data on fact-checking. It contains 118,112 claims from 117,993 fact-checking reports in English (co-)authored by 1,953 individuals and published during the period of 1995-2025 by 39 fact-checking organisations that are active signatories of the IFCN (International Fact-Checking Network) and/or EFCSN (European Fact-Checking Standards Network). It contains 7,327 overlapping claims investigated by multiple fact-checking organisations, corresponding to 2,977 unique claims. It allows to conduct new ecosystem-level studies of the fact-checkers (organisations and individuals).
To demonstrate the usefulness of our dataset, we present three example applications. They include a first-of-its-kind statistical analysis of the fact-checking ecosystem, examining the political inclinations of the fact-checking organisations, and attempting to assign a credibility score to each organisation based on the findings of the statistical analysis and political leanings. Our methods for constructing FACTors are generic and can be used to maintain a live dataset that can be updated dynamically