324139 research outputs found
Sort by
The development of equitable edtech through the lens of learning experience design
Get PDFDevelopments in digital technology have opened the doors to countless opportunities for educational technology but have also mirrored and magnified many social harms and inequalities. Researchers in the fields of education, technology, and social justice have attempted to build on past theories to create more relevant methods for addressing these challenges. This has led to an increased need for more intentional design methods and practices. Frameworks such as Learning Experience Design (LXD) have been developed and expanded upon to provide edtech practitioners with pragmatic and practical approaches for creating inclusive and equitable products. The research in this study attempts to analyze current methods and practices being employed by practitioners in the field along with how those methods can be used in the design of socially responsible edtech. Examples from professionals in the edtech industry are shared and discussions of culturally responsive and human-centered approaches are analyzed through the lens of LXD to provide a vision for pragmatic and equitable design approaches in the future development of educational technology. Four categories of methods and practices for developing edtech are explored, including methods that are human-centric, theoretically grounded, informed by user experience design methods, and socio-culturally sensitive. Key findings are analyzed through an external and internal lens - from the perspective of both the developers and the users of edtech. Implications for practice are discussed and recommendations for future research are proposed
Weight regain after cessation of medication for weight management: systematic review and meta-analysis
Get PDFObjectives: To quantify and compare the rate of weight regain after cessation of weight management medications (WMMs) in adults with overweight or obesity. Design: Systematic review and meta-analysis. Study selection: Trial registries and databases (Medline, Embase, PsycINFO, CINAHL, Cochrane, Web of Science, and trial registries) were searched from inception until February 2025 for randomised controlled trials (RCTs), non-randomised trials, and observational studies that included WMM (≥8 weeks) with follow-up for ≥4 weeks after cessation of treatment in adults with overweight or obesity. Comparators were any non-drug weight loss intervention or placebo. Data extraction and synthesis: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Two independent reviewers screened titles, extracted data, and assessed the risk of bias using the Cochrane Risk of Bias 2 tool for RCTs and the ROBINS-I tool for non-randomised trials. Data were analysed using mixed effect, meta-regression, and time-to-event models. Weight regain after cessation of WMM was compared with that reported after cessation of behavioural weight management programmes (BWMPs). Main outcome measures: The primary outcome was rate of weight regain from end of treatment, with associated changes in cardiometabolic markers as a secondary outcome. Results: Of the 9288 titles screened, 37 studies (63 intervention arms, 9341 participants) were included. Average treatment duration was 39 (range 11-176) weeks, with average follow-up of 32 (4-104) weeks. The average monthly rate of weight regain was 0.4 kg (95% confidence interval (CI) 0.3 to 0.5) (mixed model 0.3 kg (0.2 to 0.4) monthly v control in RCTs). All cardiometabolic markers were projected to return to baseline within 1.4 years after the cessation of WMM. Weight regain was faster after WMM than after BWMP (by 0.3 kg (0.22 to 0.34) monthly), independent of initial weight loss. Estimates and precision were robust in sensitivity analyses. Conclusions: This review found that cessation of WMM is followed by rapid weight regain and reversal of beneficial effects on cardiometabolic markers. Regain after WMM was faster than after BWMP. These findings suggest caution in short term use of these drugs without a more comprehensive approach to weight management. Systematic review registration: PROSPERO CRD42024532069
National Action Plans for Antimicrobial Resistance in the WHO Western Pacific Region: The Just Transitions Lens
Get PDFAntimicrobial resistance is one of the biggest global health threats, demanding urgent action. However, the threat of AMR and the ability to respond to it are far from evenly distributed. In many parts of the global South, where infectious diseases are more common, healthcare systems are weaker, and the social conditions that shape health are more precarious, the effects of AMR are felt more acutely. Because AMR arises within these unequal conditions, rapid action alone is insufficient; attention to how costs and benefits are distributed, who is prioritised, and whose voices are heard is essential to ensure that efforts do not inadvertently deepen existing inequalities. Hence, as the world prepares to tackle this “complex wicked problem,” it needs to ensure that we not only make a quick transition but also a just one. The first step in ensuring a just AMR transition is examining the fairness of our current strategies. This study critically reviews the National Action Plans of the countries in the WHO Western Pacific Region to examine the extent to which ideas of justice are considered. Findings reveal that there are limited considerations for how the burden and benefits of actions are shared; decision-making is dominated by external and national actors within human health. Access to antibiotics is restricted across the spectrum without adequately expanding and strengthening alternatives. As NAPs undergo revision, there is a need to more consciously and explicitly integrate considerations of justice and equity to avoid unintended harm and ensure effective outcomes
Oogenesis and germinal bed morphology of the brown anole ( A. sagrei )
Get PDFBackground: The brown anole is a model species of the genus Anolis, a squamate (encompassing lizards and snakes) group widely studied in evolutionary, behavioral, and developmental biology. Full genome annotation, the establishment of gene editing techniques, and comprehensive description of reproductive tract morphology and embryogenesis in this species have laid the foundation for functional studies. However, analysis of brown anole oogenesis is still required and vital to optimize genome modification, mutant line establishment, and analyses of the evolution of reproductive developmental mechanisms. Results: Here, we characterize ovary morphology and gametogenesis in the female brown anole, Anolis sagrei, using brightfield imaging, microCT, histology staining, electron microscopy, and confocal imaging. We define 10 stages of oocyte maturation, which commences inside the oogonial nest within the germinal bed and concludes with the mature follicle ready to ovulate based on follicle size, yolk acquisition, and follicular, cellular, and basement membrane architecture. Conclusions: We describe the complete oogenesis of the brown anole in 10 stages and report that oogenesis is highly conserved within iguanians, a suborder of lizards. With our staging framework, we lay the foundation for functional studies of oogenesis and optimized gene‐editing
From magma to macrophage: the grand challenges of volcanic environments
Get PDFThe interdisciplinary study of volcanic processes, which extend across all timescales and lengths, requires a multitude of approaches, ranging from analogue and numerical modelling to observations and fieldwork and extending to mathematics. A conference was held at the East African Institute for Fundamental Research, affiliated with the University of Rwanda, a country which, along with the Democratic Republic of Congo, presents a unique geodynamic context. Located along the East African Rift, an active seismic region, Rwanda is close to two of Africa's most active volcanoes, including Nyiragongo, which overlooks Lake Kivu, a deep volcanic lake rich in dissolved carbon dioxide and methane, the latter of which is used for electricity generation. In this context, the conference addressed many “classic” volcanological topics and their modern advances, such as multiphase lava flows, subsurface magma propagation, seismic and deformation signals from a volcano, modelling of volcanic emission dispersion, and volcanic lakes. Yet, it broadened the discussion to the volcanic particle-water interface and its impact on soils, volcanoes and climate change, and volcanoes and health. This article aims to highlight and share the richness of the integration and interconnectedness of the various questions related to a volcanic environment, as well as their impact on society. Ultimately, this conference also demonstrated the importance of promoting science in Africa and developing countries so that the next generation of African researchers is equipped to address the challenges facing their nations
Robyn Murphy - Thesis submitted in partial fulfilment of the degree of Doctor of Clinical Psychology (DClinPsych)
No full textSystematic Review of the LiteratureTitle: The Relationship Between Professional Identity and Burnout in Healthcare Staff: an integrated mixed-methods systematic review.Introduction: Burnout is a widespread problem in healthcare staff, which can lead to problems with health, patient safety, and staff retention. Research has aimed to identify protective factors to mitigate this. One example is professional identity (PI), which is protective in other professions, such as teachers.Aims: This review aimed to systematically synthesize research on the relationship between PI and burnout in healthcare professionals, to investigate the presence of a relationship, and any causality.Methods: A mixed-methods convergent systematic review was conducted.Results: Thirty studies were included: twenty-four used quantitative data, three used qualitative, and three used mixed methods. Varied professional groups were represented. Twenty-eight studies were cross-sectional, two were longitudinal.Most included studies found a negative relationship between PI and burnout. There were some discrepancies in association between PI and burnout for some burnout dimensions and in some professions. As most studies were cross-sectional, causality in this relationship cannot be concluded. Some studies offer suggestions as to the directionality of this relationship by referring to ‘crises’ of PI leading to burnout, and burnout compromising PI. However, it is also clear that other factors contribute to burnout in this group.Conclusion: This review adds to literature by showing PI has a relationship with burnout in healthcare staff – however, further research is required to identify mechanisms and causality in this relationship. Potential implications for research, including the need for a consistent definition of PI and for longitudinal studies, are discussed.Service Improvement ProjectTitle: Staff Wellbeing in the Pharmacy Team in South Warwickshire NHS Foundation Trust. [Project redacted]Theory-Driven Research ProjectTitle: Work Related Psychological Wellbeing and Help-seeking in NHS Staff: the roles of self-stigma and psychological safety within teams.Introduction Despite high levels of reported work-related mental health problems in NHS staff, this population report difficulty in seeking help. Theory suggests that help-seeking intention can be affected by self-stigma about having a mental health problem, as put forward in a model by Corrigan and colleagues (2014). However, this relationship has not been investigated in NHS staff.Aims: The present study tested whether, in NHS staff experiencing a work-related mental health problem, help-seeking intention differed between groups experiencing high and low self-stigma. Secondary analysis tested whether this relationship was moderated by psychological safety within teams.Method: A mixed-methods cross-sectional survey was completed by 133 NHS staff across a range of professions. Measures of psychological safety, self-stigma, help-seeking intention and distress were completed, alongside qualitative questions relating to help-seeking at work.Results: There were significant correlations between team psychological safety and self-stigma, and distress and self-stigma. There were no significant differences in help-seeking intention between groups experiencing high and low self-stigma. Team psychological safety did not moderate the relationship between self-stigma and help-seeking intention.Discussion: Though the quantitative results did not find significant differences in the main analysis, relationships between distress, psychological safety, and self-stigma warrant further investigation. Qualitative results in the present study highlight the importance of considering alternative factors when investigating help-seeking intention in NHS staff, such as identity as ‘helper’ and practical barriers to help-seeking
AI assisted triage of UK patients in mental health care services: a qualitative focus group study of patients’ attitudes
Get PDFBackground: The referral process between healthcare services can be complex, especially in psychiatry, leading to significant delays and ‘hidden waiting lists’. Digital approaches may be helpful. The CHRONOSIG (CHRONOlogical SIGnature) project aims to improve the referral and triage process by applying machine learning (ML) technology to information in electronic health records. We used a focus group methodology to ascertain the views of patients and participants on using CHRONOSIG and similar digital approaches to support decision making in triaging referrals in difficult to treat depression, and the potential benefits and disadvantages of such an approach. Methods: A lived experience participant focus group (N = 16) was held on 25th September, 2024, with a lived experience chair. Participants were recruited by convenience sampling. Data were analysed thematically and managed using the Framework method, with double coding of transcripts, and reported using COREQ guidelines. Results: Main themes from the analysis were: (i) the complexity of mental health needs assessments; (ii) challenges in the current mental health system; (iii) general challenges of using a computer/artificial intelligence based tool for risk prediction and clinical decision support; (iv) differences and similarities in using a computer-based prediction tool in mental health vs. in physical health; (v) possible benefits and harms; (vi) factors to consider in the future. Conclusions: Patient engagement is a key challenge for digital tools in mental health, but previous studies in digital decision support tools have focussed on clinician feedback. In this study we ascertained the views of lived experience participants in mental healthcare triage and referral in difficult to treat depression. Participants identified delays, errors and confusion in the referral process and expressed positive views on the ability of the CHRONOSIG tool to help to improve waiting times and time spent between services, particularly when used as an addition to a high-quality clinical consultation. In many countries there are shortfalls in mental health care provision with increasing waits in both recorded and unrecorded waiting lists. This study supports a potential route to improve these processes; by more accurately and efficiently identifying the needs of patients and matching these to suitable services and research opportunities
The role of perceived parental differential treatment, sibling relationship, and peer relationships for children with and without siblings in China
Get PDFSibling relationships play a crucial role in adolescent development, yet research on this topic within the Chinese context remains scarce, primarily due to China’s long-lasting onechild policy. The unique cultural and historical factors in China suggest that insights from Western sibling studies may not be directly applicable, highlighting the need for studies focused specifically on Chinese sibling dynamics. This study aims to explore: (1) the impact of perceived paternal versus maternal differential treatment on the quality of sibling relationships among Chinese adolescents; (2) the influence of sibling relationship quality on peer relationships; and (3) differences in peer relationships between children with and without siblings. A total of 516 Chinese primary school students were recruited for the study (aged 9-13, M=11 years and 8 months, SD=0.71, 51.9% boys), with 74.8% of them having siblings. Data were collected through quantitative questionnaires assessing perceived parental differential treatment, sibling relationship quality, and peer relationships. Participants without siblings were only assessed on peer relationships. The findings revealed that perceived maternal favouritism was associated with greater sibling warmth and reduced sibling conflict, while higher levels of perceived differential treatment, whether from mothers or fathers, correlated with poorer sibling relationships, characterized by more sibling conflict and less sibling warmth. Furthermore, sibling warmth was positively and significantly related to the quality of peer relationships. Variations in these relationships were observed based on sibling-gender composition. Notably, there were no significant differences in peer relationships between children with and without siblings, nor were there gender differences. This study offers critical insights into the influence of parental differential treatment on sibling and peer relationships among Chinese adolescents, emphasizing the importance of cultural context. These findings have practical implications for parents, educators, and policymakers aiming to foster family harmony and support adolescent development
Modern simulation methods for vibrational and electronic spectroscopy
Get PDFSpectroscopy offers a convenient way to collect information about molecular systems in a non-invasive way. Vibrational and electronic spectra may both be simulated by calculating response functions and Fourier transforming them to obtain spectra.
Vibrational spectra are often calculated using path integral methods, which can approximately include nuclear quantum effects in the linear response function at a linearly scaling computational cost. This thesis introduces a generalisation of f-QCMD, a promising recently developed method, to the condensed phase, enabling the calculation of the vibrational spectrum of liquid water and ice. The thesis then uses f-QCMD to analyse polariton spectra, which occur when a molecular system is placed in a microcavity. The vibrational spectrum gives a uniquely uncontroversial (compared to other properties like reaction rates) insight into cavity effects. In fact, a simple harmonic oscillator model which takes only the cavity-free spectrum and the geometry of the cavity as input can quantitatively predict cavity molecular dynamics results, implying that the cavity simply acts as an optical filter on the linear vibrational spectrum.
The thesis then moves on to the simulation of two-dimensional electronic spectra. It introduces the mean field method ‘equatorial Ehrenfest’ that qualitatively captures the two-dimensional electronic spectra of Frenkel exciton models, which emulate light harvesting complexes. This approach is inspired by the previously proposed polar Ehrenfest approach, which is 32 times more expensive and less accurate than equatorial Ehrenfest. Substituting Ehrenfest with a more accurate dynamics method only moderately improves the quantitative agreement with exact results, at increased computational cost
Economic evaluation of oral nirmatrelvir-ritonavir for COVID-19 in higher risk outpatients: evidence from the UK PANORAMIC trial
No full textImportance: Nirmatrelvir-ritonavir is an oral antiviral recommended for treating highrisk individuals with COVID-19 in the community. However, there remains uncertainty over its cost-effectiveness in largely vaccinated populations and subgroups defined by age and clinical risk.
Objective: To compare the cost-effectiveness of nirmatrelvir-ritonavir versus usual care based on the UK Platform Adaptative trial of NOvel antiviRals for eArly treatMent of COVID-19 In the Community (PANORAMIC) trial.
Design: A within-trial cost-utility analysis was conducted using data from the PANORAMIC trial and linked routine healthcare data from December 8, 2021 to September 30, 2024, adopting a UK National Health Service (NHS) and personal social services perspective over six months.
Setting: UK NHS.
Participants: Community-dwelling adults (aged ≥50 or 18-49 with comorbidities).
Intervention: Oral nirmatrelvir-ritonavir.
Main outcome and measures: Cost, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER) of nirmatrelvir-ritonavir versus usual care.
Results: There were 1736 participants randomised to receive nirmatrelvir-ritonavir plus usual care, and 1768 to usual care alone; the mean age was 55 years, 68.6% were female, and 98.6% were vaccinated. Nirmatrelvir-ritonavir was cost-effective, on average, lower total costs (£124, 95%CI –1207 to 1455) and higher QALYs (0.0110, 95%CI 0.0062 to 0.0170) over six months compared to usual care (ICER £10897 per QALY). Nirmatrelvir-ritonavir had a 0.65 probability of being costeffective at a £20,000 per QALY cost-effectiveness threshold, indicating decision uncertainty. The intervention remained cost-effective in most sensitivity analyses and prespecified subgroups, although several subgroup analyses were based on small sample sizes and should be interpreted as exploratory.
Conclusion and relevance: In this economic evaluation of nirmatrelvir-ritonavir for COVID-19, cost-effectiveness varied by age, comorbidity and vaccination status. Subgroup findings should be interpreted with caution, but targeted prescribing for atrisk adults aged 18-64 years, those aged 65-69, and adults aged 75 years and above, particularly those with comorbidities and not recently vaccinated, was likely to provide the greatest health system value. Cost-effectiveness was not observed in low-risk adults aged 50-64 years, those aged 70-74 years, or in unvaccinated or recently vaccinated individuals