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Illuminating the "black box" of complex suicide prevention interventions: towards a theory of implementation using the normalisation process theory
Get PDFIntroduction: Although there has been some investigation into what works in suicide prevention, exploration into the mechanisms by which implementation strategies impact outcomes or how and why strategies work remains largely under-studied. Consequently, implementation efforts often lack a clear strategy, and may contribute little toward the desired outcomes. This study aims to explore and examine the role of context and mechanisms involved in the implementation of complex suicide prevention interventions. Methods and materials: In-depth qualitative interviews were used to explore relevant stakeholder experiences of implementing complex suicide prevention interventions. Stakeholders (nine intervention leaders, five implementors and two lived experience advocates) from six interventions were purposively recruited for their experiences involved in implementing complex interventions in real-world settings. The Normalisation Process Theory translational coding manual was used to map data related to the primary and secondary constructs defined in the theory and its extensions. Results: Three domains pertaining to implementation context, mechanisms, and outcomes (CMO) were explored. Participants expressed their agency by: using contextual influences to modify the design and plan for delivery; making adaptations to the form and function of interventions and characteristics of the implementation environment to suit intervention needs; and, leveraging the intervention environment to integrate the intervention into existing systems and practices. Activities and strategies served multiple mechanisms involved in: understanding what the work entails; who does the work; developing the capacity to implement the work; and, understanding the work. An interdependent and interacting relationship between mechanisms emerged. Outcomes related to: change in existing practices; the ways in which people are organised; changes in existing norms; and, incorporation of the intervention into daily practice were observed. Conclusion: This study is notable in its exploration of mechanisms underlying implementation of complex suicide prevention interventions. Data from this study can help inform the development, refinement and use of specific implementation strategies and understand the applicability of strategies across varied contexts. The study also demonstrates the use of an implementation theory to inform practice and potentially contributes to an understanding of what works, why, for whom and in what context. There is a need for a paradigm shift towards the use of more theory based and informed approaches to understand causal links between implementation strategies, context, mechanisms, and outcomes.Full Tex
Metabolic Reprogramming of Cancer Cells and Therapeutics Targeting Cancer Metabolism
Get PDFBackground
Cancer metabolism is a field focused on the unique alterations in metabolic pathways that occur in cancer cells, distinguishing them from the metabolic processes in normal cells.
Methods
An extensive review of the current literature on the metabolic adaptation of cancer cells was carried out in the current study.
Results
The rapidly proliferating cells require high levels of molecules, such as glucose, amino acids, lipids, and nucleotides, along with increased energy demand (ATP). These requirements are met through alterations in the processes involving glucose, amino acid, lipid, and nucleotide metabolism. Modifications in glucose metabolism in cancer cells involve changes in glucose uptake, glycolysis, the pentose phosphate pathway, and the tricarboxylic acid cycle. Similarly, alterations in amino acid metabolism in cancer cells relate to upregulated amino acid transport and glutaminolysis. Cancer cells also have increased lipid intake from the extracellular microenvironment, upregulated lipogenesis, and enhanced lipid storage and mobilization from intracellular lipid droplets. These rapidly proliferating cells also achieve their increased demand for nucleotides by changing the expression of enzymes in the salvage and de novo nucleotide pathways. Consequently, these metabolic processes are targets for developing cancer therapeutics. However, it is important to note that the metabolic changes in cancer cells can also contribute to resistance against various cancer therapies.
Conclusion
This review will explore the various ways in which cancer cells reprogram metabolic processes to sustain rapid proliferation and survival. The information presented in this report could help in the therapeutics designed to target them, and the challenges of cancer drug resistance arising from these metabolic adaptations.Full Tex
The influence of children on female underemployment in Australia
Get PDFThis study analyses the influence of children on female underemployment in Australia, by both (1) the age of the child(ren) and (2) the age of the youngest child. Furthermore, it examines educational attainment in determining female underemployment. The study utilises fixed effects models on 2001–2020 panel data based on the Household, Income and Labour Dynamics in Australia (HILDA) Survey to test relevant hypotheses on how the presence of children can impact the likelihood of female underemployment. While the presence of children significantly reduces the likelihood of reporting underemployment, results suggest that it is negatively related to the probability of female underemployment for children below 15 but positively associated with children 15 and above. This positive relationship with older children disappears only when restricted to the youngest child. Education matters once children are of school-going age: lower-educated mothers having children aged 5–14 are significantly less likely to be underemployed, whereas higher-educated mothers with children aged 15 and above are considerably more likely to be underemployed. The study contributes to the literature by exploring the age of the child(ren), the age of the youngest child and educational attainment in determining female underemployment.Full Tex
Return on investment of the pathways to prevention project from the reduced probability of the onset of serious youth offending
No full textThis paper estimates the return on investment (ROI) of the Pathways to Prevention Project’s Communication Program. The program was an enriched preschool curriculum delivered over two years as part of a broader developmental crime prevention initiative with four-year-old children, their families, and local preschools in an economically disadvantaged urban Queensland community. Results show that for every dollar spent, the Communication Program generated an average return of 7.65 in savings (2024 Australian dollars) from avoided court-adjudicated youth offending. The Pathways to Prevention Project is the first Australian early-in-life crime prevention initiative to present scientifically persuasive evidence for effectiveness in reducing the probability of onset of serious youth offending, offering a counternarrative to prevailing expensive youth justice policies centered on child accountability and harsh punishments.No Full Tex
Online service failure and recovery: An integrated meta-analytic perspective of attribution and justice theories
Get PDFOnline service failure is seldom looked into in totality, from causes of failure to recovery outcomes, with reported effects on both its causes and recovery remaining contradictory and inconsistent. To address these issues, this study proposes and empirically validates an integrated meta-analytic model, grounded in attribution theory and justice theory, that explains online service failure and the subsequent recovery process, using a cumulative sample of 82,901 individuals from 24 countries across 147 studies. Meta-analytic structural equation modeling (MASEM) indicates that customer-related, service provider-related, and technology-related causes of online service failure increase customer complaints and that effective complaint handling elevates perceptions of distributive, interactional, and procedural justice, each of which strengthens positive emotions that, in turn, raise loyalty, trust, and word-of-mouth while reducing switching. Moderation analysis reveals that the differences in marketing-related factors, including brand prestige (high versus low), offering type (product-based services versus true services versus pseudo services), and purchase frequency (low versus high), together with differences in sample-related factors, such as age (young versus old), gender (male versus female), income (low versus high), and status of country development (developed versus developing), help explain the inconsistencies in reported relationships within online service failure and recovery. Therefore, this study consolidates the evidence on these relationships using the integrated model and, in doing so, advances the literature on online service failure while offering actionable insights for recovery design and execution.Full Tex
Pulsated in-Situ Dried Electrostretching Fabrication of Microneedles for Transdermal Drug Delivery
No full textThis paper reports a pioneering technique to fabricate microneedles (MNs) for transdermal drug delivery utilizing pulsated in-situ dried electrostretching (PIDES). This approach applies pulsed voltage to generate electrohydrodynamic forces that stretch and solidify a polymer droplet into a conical shape with a micrometer-scale tip. As the solvent evaporates, the polymer droplet is stretched in-situ into a cone and hardens, forming a sharp MN ideal for transdermal drug delivery. Penetration and mechanical tests confirm that the MNS have the necessary sharpness and strength for effective skin penetration. Furthermore, curcumin loading and a release test show that the MNS can effectively carry drugs and provide a gradual release of drug. These results demonstrate that PIDES is a promising, cost-effective, and straightforward method for developing efficient and painless transdermal drug delivery systems.No Full Tex
A State-Wide Retrospective Cohort Study Examining Effects of Transfusing Old Blood Products in Vascular Surgical Patients
Get PDFIntroduction: We investigated the effects of transfusing blood products close to the expiration date (i.e., ≥35 days packed red blood cells [PRBCs] and >3 days platelets [PLTs]) on vascular patients. Methods: We retrospectively examined all PRBC and PLT transfusions in patients who underwent vascular procedures without cardiopulmonary bypass in Queensland from 2007 to 2013. Mortality, length of stay (LOS), and blood product quantities were compared in patients transfused exclusively with PRBCs 3 days. Results: No significant mortality difference was found between patients transfused fresh vs. old PRBCs (26/493 [5.3%] vs. 6/152 [3.9%]; OR 0.75; 95% CI: 0.3–1.9). Patients transfused fresh PRBCs experienced a longer LOS (11 days [IQR: 7–20] vs. 10 days [IQR: 7–15]; 95% CI: −4.8 to −0.24) and more PRBC units (3.9 ± 4.5 units vs. 2.1 ± 1.3 units; 95% CI: −2.3 to −0.9). Among patients transfused PLTs, there were no significant differences in mortality (24/124 [19.4%] vs. 14/78 [17.9%]; OR 1.0; 95% CI: 0.5–2.3) between patients transfused fresh vs. old PLTs. Conclusion: Within the limitations of the retrospective study design, transfusion of older PRBCs or PLTs was associated with fewer transfused units, shorter hospital stays, but no difference in mortality.Full Tex
Music learning and school-aged children's and adolescents' wellbeing: A scoping review
Get PDFThere is compelling evidence that music can support young people’s wellbeing, particularly through music listening to and making. In this article we report a systematic review of music learning and wellbeing literature to offer a new perspective on learning music as a wellbeing strategy. In this review, we investigated (a) what definitions and theories of wellbeing have been used; (b) what methodologies have been employed, particularly measurement tools; (c) what learning contexts and participant demographics have been examined; and (d) what is known about music learning and the wellbeing of school-aged children and adolescents. This review was conducted using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) extension for scoping reviews (PRISMA-ScR) and a protocol was registered. Four hundred and twenty-three sources were retrieved from nine databases, and 30 sources were analyzed after screening. Findings identified that most sources did not adopt a clear definition or theory of wellbeing. Qualitative methods overwhelmingly inform existing knowledge and studies were predominantly situated in Australia and the United Kingdom. All but one source reported that music learning supported wellbeing. Wellbeing outcomes were summarized into three themes (individual, social, and educational) and characteristics of these music programs and approaches were also identified. The review concludes with clear recommendations to direct future research. These include a need for music education scholars to adopt an interdisciplinary approach informed by existing wellbeing knowledge. The field would benefit from developing a quantitative instrument to measure music learning and wellbeing outcomes for use in large-scale studies, including in schools. Future research must closely interrogate the wellbeing outcomes and characteristics of specific music learning activities, how learning music can be a form of wellbeing literacy, and how wellbeing strategies can be integrated into music education.Full Tex
Phase Correcting Miniature Convoluted FSS in a Fabry-Perot Cavity Antenna
Get PDFThis paper presents various designs for enhancing the radiation performance of a conventional Fabry-Perot cavity antenna (FPCA) by improving its aperture phase distribution using miniaturised convoluted frequency selective surfaces (FSS). The FSS behaves as a phase correcting surface (PCS) on electromagnetic (EM) rays as they are reflected inside the cavity of the FPCA. EM rays inside the cavity of the FPCA incur a phase change when reflected off the FSS PCS walls and base, making the aperture phase distribution more uniform, thereby increasing the directivity. To test the effectiveness of the FSS PCS in improving peak directivity, five models of FPCAs were designed to operate at 2 GHz. The first was a conventional FPCA with a polymethyl methacrylate (PMMA) partially reflective surface (PRS), no walls, a patch antenna emitter, and a copper base reflector. The second FPCA was designed so that the open sides of the conventional FPCA were fully enclosed with copper walls, The third FPCA had the copper walls replaced with FSS PCS walls. The fourth FPCA was designed by replacing the copper base reflector of the third FPCA with an FSS PCS base reflector. Finally, to make the antenna lighter and more cost-effective, a fifth FPCA was designed identically to the fourth FPCA, except that the PMMA PRS was replaced by a square-loop FSS PRS. The fifth FPCA design was fabricated and tested. Simulations and measurements demonstrate that the FSS PCS reflecting walls and FSS PCS reflective base significantly enhance the directivity radiation properties of the FPCA. The addition of the FSS PCS walls brought about greater aperture phase uniformity and a 2.06 dBi increase in peak directivity in both planes for the FPCA (PMMA PRS) when compared to the conventional FPCA (PMMA PRS) with no walls. When an FSS PCS base reflector was used instead of the conventional copper base reflector, there was a further increase in the aperture phase uniformity and peak directivity in both the FPCA with PMMA PRS and the FPCA with FSS PRS models. This increased aperture phase uniformity is brought about by the phase alteration of EM rays, as they are reflected off the FSS PCS structures surrounding the FPCA cavity. The maximum peak directivity in both the H and E Planes for the FPCA (PMMA PRS) with FSS PCS walls and an FSS PCS base reflector was 20.48 dBi, which is an increase in peak directivity of 8.3 dBi over the conventional FPCA. The maximum peak directivity in both the H and E Planes for the FPCA (FSS PRS) with FSS PCS walls and FSS PCS base reflector was 20.04 dBi, which is an increase in peak directivity of 7.86 dBi over the conventional FPCA. The high directivity (20.04 dBi) and thin PRS of the fifth FPCA design make it the most prominent. A major outcome of this fifth FPCA design is that its high directivity is achieved, not by adding additional components to a conventional FPCA, but by simply replacing its existing components with the FSS PCS.Full Tex
Effective customer segmentation using the recency, frequency, and monetary framework, combined with density-based clustering
No full textCustomer segmentation underpins Customer Relationship Management (CRM) and growth, yet purchase patterns are often sparse and irregular. This study addresses this gap by integrating an extended RFMI framework (Recency, Frequency, Monetary, and Interpurchase) with the density-based HDBSCAN algorithm and applying it to an H&M transactions dataset. The approach detects non-spherical structure and permits a ‘noise’ label for irregular shoppers. This study derives RFMI features, standardises inputs, and estimates segments with HDBSCAN. The solution yields five segments: Low-Value Inactive, Low-Value Dormant, Mid-Value Occasional, Loyal Mid-tier, and Premium Champions, plus a small noise group (n = 21,011). Each group displayed unique recency, frequency, monetary value, and interpurchase profiles. Product analysis shows shared preferences for upper- and lower-body garments, with high-value customers engaging more broadly. Managerial implications include sharper retention allocation, targeted reactivation, and assortment/promotion design aligned to segmentation and price sensitivity. The RFMI+HDBSCAN pipeline offers a scalable alternative that improves segment fidelity in real-world retail data.No Full Tex