8364 research outputs found
Sort by
What are the practices and experiences of prescribing practitioners in the United Kingdom? A mixed-methods study
Full text linkBackground Pharmacological treatment is the most common form of healthcare intervention; 1.1billion items were dispensed in the community in England alone in one year. With increasing numbers of prescribers being educated, and a growing number of professions being eligible to undertake the course, it is imperative to understand the reasons why some prescribers do not use their qualification, or why severe constraints are restricting practice for some. The restricted or nonuse of the qualification is wasteful of the expense of education and invested time. Prescribing rights, for healthcare professionals other than doctors, began in the United Kingdom (UK) with nurses and health visitors in 1992. Currently, the UK has more professions eligible to prescribe than any other country: nurses, midwives, podiatrists, pharmacists, physiotherapists, radiographers, dietitians and advanced practice paramedics. Although they all undergo identical education and assessments in the V300 course as all other professions, dietitians and diagnostic radiographers are restricted to supplementary prescribing where everyone else have independent prescribing rights. Study Design This is a mixed methods investigation of the practice and experience of prescribing practitioners in the United Kingdom. An integrative literature review was undertaken and Role Theory, encompassing identity theory, social theory and organisational theory, was used as the theoretical framework. Phase 1 is a quantitative survey with an original questionnaire. There were n409 valid responses. Descriptive statistics were analysed with the use of SPSS. Phase 2 consisted of n11 qualitative semi-structured interviews. Reflexive thematic analysis was used to analyse the data. Findings from both phases were discussed together. Findings The key findings show that the use of supplementary prescribing is increasingly restrictive in the rising use of advanced clinical practice roles. Newly qualified prescribers are in a vulnerable position as confidence is low at this point, and almost half declared they do not have the level of support they need. There are healthcare practitioners who have qualified and never prescribed; lack of support, lack of confidence, lack of need to prescribe in their clinical area are cited as reasons. Colleague support and supervision, along with CPD, are recognised as highly influential to a prescriber flourishing or failing to prescribe. There are still prescribers who experience significant delays due to IT systems that are unable to accommodate their profession. The Competency Framework for All Prescribers became a mandatory part of prescriber education in 2018 and there is currently a wide variation of prescriber awareness of or experience using the Framework. Underpinning all these aspects is how they affect, or are affected by, prescriber confidence. These findings have implications for Higher Education Institutes, practice and further research
Quantitative Data Analysis using PLS-SEM (SmartPLS): Issues and Challenges in Ethical Consideration
Full text linkIn research, ethical issues are crucial, including the preservation of participants' rights, privacy, and well-being to secure informed consent and minimize potential harm. Throughout the study, researchers must maintain transparency, honesty, and integrity, promoting trust and credibility in the pursuit of knowledge. In the realm of quantitative research, the process of data analysis plays a fundamental role, serving as a critical element in the generation of reliable and precise findings. The purpose of this concept paper is to provide the growing recognition of the ethical importance of quantitative data analysis in research. This paper delves into the ethical aspects of quantitative data analysis, underscoring the necessity for researchers to approach matters related to data collection, storage, and analysis with meticulous attention when using SmartPLS. This study highlights that preserving privacy and confidentiality requires the secure handling of various data types, especially those containing personally identifiable or health information. Additionally, it is crucial to subject biases and discrimination in data analysis to rigorous examination to ensure fair representation and mitigate potential negative consequences. The current prevalence of privacy breaches and the accompanying ethical concerns underscore the critical importance of prioritizing ethical considerations. This paper also explores the ethical complexities unique to Partial Least Squares Structural Equation Modelling (PLS-SEM), a widely used statistical technique across multiple disciplines by using SmartPLS software. SmartPLS enables researchers to analyse intricate relationships, facilitating the derivation of significant conclusions. Nevertheless, researchers employing SmartPLS must remain attentive to distinct ethical dilemmas, particularly those related to the interpretation, management, and disclosure of data. The exercise of ethical vigilance becomes essential when the conclusions drawn from SmartPLS have an impact on various stakeholders, such as employees, consumers, and shareholders. Researchers can ensure the integrity, accountability, and ethicality of their research endeavours by adhering to ethical guidelines, conducting comprehensive analyses, and exercising caution when making generalizations while utilizing SmartPLS
Modelling of energy use and greenhouse gas emissions from a quick service restaurant
No full textEfficient refrigeration and cooking equipment and other innovating technologies in the food service sector need to be considered to reduce energy use and greenhouse gas emissions. In quick service restaurants (QSRs), there is a strong interaction between the structure, internal machinery, customers, and the store HVAC system. The impact of these interactions was modelled using EnergyPlus in a UK-based QSR, validating results against other research studies. It explored the effects of applying carbon saving technologies and predicted climate change impacts and grid conversion factors from 2020 to 2050. Findings revealed that among the individual technologies applied, enhanced efficiency of 20% in refrigeration and kitchen equipment gave the most favourable outcome, contributing to a 15.6% reduction in carbon emissions. Results also showed that combining technologies could achieve 39.7% savings in carbon emissions while predicted changes in electrical carbon factors could potentially yield 98.5% reduction in carbon emissions between 2020 and 2050
Theoretical models for predicting ventilation performance of vertical solar chimneys in tunnels
Full text linkSolar chimney as a reliable renewable energy system has been primarily utilized for building ventilation, but its application in the tunnel is rarely explored. This study develops theoretical models to predict the ventilation performance of vertical solar chimney in urban tunnel. Five temperature distribution types within the chimney cavity are analyzed, including uniform, vertically linear, horizontally semi-parabolic, two piecewise semi-parabolic in the depth direction, and three-dimensional parabolic profiles. The theoretical models consider the effect of chimney configuration, tunnel geometry, glazing materials, and solar radiation intensity on airflow rate through solar chimney. Validation against experimental data and numerical simulation shows that considering three-dimensional temperature distributions results in an average 11 % deviation from validation data, outperforming assumptions of uniform (29.3 % deviation) or lower-dimensional profiles. The volumetric flow rate through solar chimney exponentially decreased with h/w and h/d that the optimum ratio of h/d is 10. The airflow rate linearly increased with 0.14 power of glazing absorptivity. This analysis provides technical guidance for optimizing solar chimney design in tunnels, enhancing natural ventilation, and reducing energy consumption for mechanical ventilation systems
What's amazing for the adrenals? New treatments and novel monitoring methods in CAH
Full text linkThis presentation focuses on an aspect of adrenal insufficiency, namely congenital adrenal hyperplasia (CAH). It focuses on routine management with hydrocortisone, but also explores new treatment regimes and also novel monitoring methods
Urban Sustainability Assessment: An Analysis of how Weighting and Aggregating Coefficient System was used in the Development of SUCCEED Assessment Tool for Developing Countries.
Full text linkThe development of a weighting and aggregating coefficient system used in urban sustainability assessment tools is a process that needs well-defined procedures using a series of steps, methodology, and a systematic approach in its development. The development of assessment tools has been successful in developed countries but developing countries would need to have a structured process that will assist in the development of an assessment tool that is tailored to its environs. This paper aims to understand the various weighting and aggregating coefficient systems employed in the development of sustainability assessment tools. Alongside using these findings to understand how these weighting and aggregating coefficients can be adopted in the development of sustainability assessment tools for developing countries based on their differences, advantages, and disadvantages. Qualitative Content Analysis (QCA) based on a systematic review of existing literature was used in this study to understand various weighting and aggregating coefficients. It is imperative to note that this research will focus on how assessment tools are developed with a clear focus on sustainability assessment weighting and aggregating. The study also further analyses how a case study SUCCEED (Sustainable Composite Cities Environmental Evaluation and Design Tool) has benefited from the adoption of equal weighting and additive aggregation methods based on validation carried out. The findings of this research show that the selection of weighting and aggregating systems is defined by the relevance, importance, and purpose of the assessment tool. It also develops a guide/recommendations on the process utilised in the development of assessment tools for developing countries
Readiness of artificial intelligence technology for managing energy demands from renewable sources
Full text linkThe use of artificial intelligence (AI) has gained tremendous popularity in recent years, and it has become ubiquitous for use in the energy sector. The newly emerging digitalised tools are reliant on the use of AI which offers seamless possibilities for improved connectivity across the energy supply chains, trade and end-use. In near future, the integration of energy supply, demand and renewable sources into the power grid will be controlled autonomously and this will aid in swift decision-making processes. This review focuses on studies that highlights the realm of AI to benefit the energy sector as key enabler to the growth of renewable energy sources from wind, solar, geothermal, ocean as well as hydrogen-based energy storage. The work presented here alludes to an AI based energy management approach in the context of CO2-neutral hydrogen production and storage landscape. A major intended outcome of this review is that it would allow the readers to compare their AI efforts, ambitions, state-of-the-art applications, challenges, energy efficiency optimisation, predictive maintenance control and global roles in policymaking for the renewable energy sector. Finally, observations and ideas for future research, enhancements and investigations through a summary of key discussions are also made
From hierarchies of exclusion to participant-led inclusion: A qualitative research agenda for health information literacy
Full text linkHealth information literacy links people to the information sources and ways of knowing that they need to make informed decisions about wellbeing. Qualitative research methods provide a powerful way to centre how people use information to learn about health as well as the conditions and social structures that enable and constrain information practice. This approach challenges health information literacy's more traditional focus on the measurement of normative, approved skills. Collaborative enquiry analysis of three recent studies into critical health literacy and children, chronic illness (irritable bowel syndrome) and vaccine hesitancy establishes a research agenda for qualitative health information literacy research. Producing four themes, including positioning information settings as health literate organisations, literacies for life, scaling up infrastructure and empowerment, the research agenda outlines directions for future theoretical, practical, and methodological health information literacy research
Qualitative descriptive study to explore paediatric oncology patients' readiness and preferences towards using a mobile health application for supportive pain management.
Full text linkCommentary on: Madi D, Abi Abdallah Doumit M, Hallal M,
Moubarak MM. Outlooks on using a mobile health intervention for supportive pain management for children and adolescents with cancer: a qualitative study. BMC Nurs. 2023 Sep 4;221,:301. doi: 10.1186/s12912-023-01461-z
Single-shot femtosecond laser ablation of nano/polycrystalline titanium investigated using molecular dynamics and experiments
Full text linkLaser ablation, a crucial technique in various scientific and industrial fields, plays a pivotal role in precision manufacturing. Industries such as aerospace rely on laser technology for tasks like drilling microscale holes in jet turbine components to enhance air-cooling efficiency. Moreover, laser-based material processing is indispensable in addressing healthcare challenges with facilitating the postprocessing of 3D-printed bespoke components like patient-specific implants as an example. Ultrashort pulsed laser ablation enables precise micro and nanofabrication, enhancing material properties like wettability, adhesion and biocompatibility. This is particularly important in medical applications like implant development, as it can help reduce the possibility of post-surgery infections.
Scientifically, understanding the intricacies of ultrashort pulsed laser ablation contributes to ongoing research and development efforts in ablation technology, fostering the enhancement of new material properties related to surface modifications. Additionally, laser ablation plays a crucial role in additive manufacturing technology like 3D printing of metals by facilitating the post-processing stage.
This thesis investigates the ultrashort pulsed laser ablation of titanium, utilising a combination of molecular dynamics simulations and experiments. Molecular dynamics simulations are used for their capability to model systems at the atomistic scale and ultrashort timescale (femtoseconds in this work), in contrast to the finite element method, and for their computational efficiency compared to methods employing more detailed calculations like density functional theory. The primary focus of this work is on exploring the size effect by examining variations in beam spot diameter and grain size with profound implications for ultraprecision manufacturing of titanium surfaces in sub-micron length scale, produced by casting and additive manufacturing techniques. It contributes a nuanced understanding of ultrashort pulsed laser ablation by bridging the gap between molecular dynamics simulations and experiments. It extends the boundaries by simulating the largest feasible atomistic models and measuring features at the smallest scale permitted by the available metrology devices in experiments.
The key observations showed the critical importance of the beam spot diameter in determining the laser fluence necessary to achieve average plasma temperatures of around 9,000 K, as well as a direct correlation between the grain size and the response of the material to laser irradiation. Notably, the simulations indicated that the 10 nm laser beam spot diameter compared to the 25 nm requires 59% more absorbed laser energy for ablation. Furthermore, the investigation revealed that by increasing the grain size in alpha-phase titanium, when the number of grains in the volume of 500,000 nm³ were reduce from 500 grains to 10, 36% more absorbed laser fluence was necessary to achieve average plasma temperatures of approximately 9,000 K, despite the material exhibiting higher heat conductivity.
Additionally, a comparative analysis of ultrashort pulsed laser ablation between atomistic models of pure titanium with single crystal and polycrystalline structures were carried out using molecular dynamics simulations. The results revealed that the nanocrystalline sample modelled in this work, which exhibited lower heat conduction, produced a relatively deeper crater compared to its single crystal counterpart. The single crystal sample had a greater resistance to ablation, leading to the formation of a recast layer with rougher edges in contrast to the nanocrystalline sample.
In materials science and engineering "size effect" is attributed to a phenomenon where the mechanical, thermal, optical or electrical properties of a crystalline material changes as a function of its physical size where at least one dimension is in submicron length scale. Experimental examination of the size effect was carried out on commercially pure titanium (consisting of 99.6% titanium and the remaining 0.4% containing carbon, nitrogen, hydrogen, iron and oxygen atoms) and Ti-6Al-4V alloy where craters were formed on both materials using single-shots with identical fluence while varying the diameter of the laser beam. It was observed that reducing the beam spot diameter resulted in relatively shallower craters, suggesting an increased threshold for ablation.
Experiments comparing single-shot laser ablation outcomes between casted and 3D-printed Ti-6Al-4V alloy revealed that the 3D-printed surface (\u1d445\u1d44e = 32 \u1d45b\u1d45a) produced a slightly cleaner crater and smoother recast layer compared to the casted material (\u1d445\u1d44e = 45 \u1d45b\u1d45a). This observation was made after subjecting both substrates to ultrashort pulsed laser irradiation with identical laser parameters