136986 research outputs found
Sort by
Postpartum Contraceptive Care: A Qualitative Study of Australian Child and Family Health Nurses' Experiences
No full textAim: To address the gap in existing postpartum care literature by gaining an in-depth understanding of Australian child and family health nurses' experiences of providing postpartum contraceptive care.
Design: A qualitative exploratory study design, using semi-structured interviews.
Methods: Convenience and snowballing sampling methods were employed to recruit child and family health nurses currently practising in Australia. Semi-structured interviews were conducted with 15 nurses in July 2023, and data were analysed using reflexive thematic analysis as outlined by Braun and Clarke. The consolidated criteria for Reporting Qualitative research checklist were used to support the research process.
Results: Despite their frequent contact with postpartum women and acknowledging the importance of postpartum contraceptive care, most participants did not commonly discuss contraception or family planning with mothers and did not feel it was part of their role to do so. Participants cited role ambiguity, limited knowledge of postpartum contraception, lack of clinical practice guidance, time constraints, and competing priorities as contributing to inconsistencies in postpartum contraceptive care provision.
Conclusion: This study highlights critical gaps in the provision of postpartum contraceptive care by child and family health nurses in Australia and underscores the need for systemic changes to promote postpartum contraceptive care as a key component of routine maternal health services.
Implications for the Profession and Patient Care This study provides actionable evidence for improving the delivery of postpartum contraceptive care, ensuring women are provided with accurate information about their options, and supporting contraceptive uptake to reduce the incidence of short interpregnancy intervals.
Impact Our findings provide practical guidance relevant for healthcare policy and practice, emphasising the need to enhance child and family health nurses training in reproductive health, develop clear clinical practice guidelines, and address systemic barriers such as time constraints to improve the provision of postpartum contraceptive care and support women's reproductive health needs
Trustworthiness in the digital world
No full text© 2025 Catherine ThompsonDigital ecosystems are increasingly integral to everyday human activity and the conduct of our societies. While these ecosystems have positive impacts, they are also capable of generating systemic and societal scale harms. Digital ecosystems – complex sociotechnical systems with a technology artefact at their core – evolve more rapidly than efforts to regulate them. Whether accidentally or by design, their operation is not always benign. Yet, the interactions that shape their evolving natures have still to be systematically investigated. In particular, the dynamics that promote and sustain trustworthiness in a digital ecosystem have not been rigorously examined, and the indicators that signal untrustworthiness are yet to be surfaced. These deficiencies are especially troubling in high-risk contexts such as systems of social protection and other forms of e-government.
This interdisciplinary research explores trustworthiness and its absence in digital ecosystems through the lens of the question: “What forces and relationships shape the trustworthiness of a digital ecosystem, and how might we apprehend them?”. It seeks to address the challenge that interpreting function and dysfunction in a complex system presents for systems theorists. It aims to develop exploratory approaches to studying trustworthiness and its absence in conditions of complex causality; to test their explanatory power; and to inspire ecosystems that are more intentionally trustworthy.
The research draws on sociotechnical, complexity and systems theories to explain the nature of digital environments, and on philosophical theories of trust, trustworthiness and truth to explain core concepts. It integrates insights from the information systems (IS) reference disciplines of sociology and management and organisation studies, as well as contributions from science, technology and society (STS) studies, safety science and criminology. It also engages with emerging research fields, including algorithmic and data justice and institutional gaslighting.
Critical realism (CR) provides the research paradigm and many of the techniques on which this qualitative enquiry is founded. The research considers a single case study – the egregious Australian e-government welfare scandal Robodebt – through the lens of our exploratory theoretical framework to develop causal accounts of the forces that influenced this ecosystem’s untrustworthy evolution.
Our findings illuminate how key system roles and their interactions determine ecosystem trustworthiness. We show how opaque ecosystems may signal their true nature and deviance, and we highlight the frailties of formal governance regimes, the mechanisms by which truth narratives may emerge or be suppressed, and the surprising centrality of the role of the Truthteller. We advance an argument for structured moral evaluation as a key system corrective, and from it develop the outline of a virtue ethics theory of technology and explore its implications.
The principal contribution of this research to theory is a CR-informed theoretical framework of trustworthiness in the digital world, including in its absence. Several framework elements represent theoretical contributions in their own right. In particular, the new phenomenon of untrustworthy technology as an entry to the IS dark side canon, and a fully rounded, interdisciplinary conceptualisation of the system role and action of the Truthteller. In addition, a governance model contributes to the discourse on regulating digital-world phenomena, and a playbook of truth suppression and denial techniques, relevant to digital and non-digital settings, completes the theoretical contribution.
Methodologically, this research advances the use of critical realism in IS as a research paradigm for developing causal explanations of complex sociotechnical realities at different levels of analysis. A sensemaking model developed for the research contributes to extending the emerging fields of algorithmic and data justice with causal reasoning Smaller methodological contributions include a novel use of dynamic capabilities to explore the microfoundations of the truthtelling journey.
Several of the findings will have practical application for policymakers, system designers and other practitioners. The Regulatory pyramid offers a blueprint for professionals with responsibilities for developing regulatory approaches to emerging technologies and their evolving use cases. We also describe and collate indicators of system untrustworthiness to provide an assessment tool for use by risk professionals in sensitive and regulated environments, as well as by designers seeking to create systems that are more intentionally trustworthy. Lastly, we propose an approach to the systemic design of trustworthy new digital ecosystems, together with concrete actions to improve the trustworthiness of those that already exist
Antidepressant Effects of Nitrous Oxide in Major Depressive Disorder: A Phase 2b Randomized Clinical Trial
No full textBACKGROUND: Nitrous oxide ("laughing gas") is an NMDA receptor antagonist. In the current study, our aim was to investigate the efficacy, safety, and likely optimal dose of nitrous oxide in adults with major depressive disorder (MDD). METHODS: In this phase 2b randomized, double-blind trial, 81 patients with MDD were allocated on a 1:1 basis to receive nitrous oxide or oxygen/air (control); the nitrous group was further randomized to either 50% or 25% inspired nitrous oxide. All participants received four 1-hour-long treatment sessions at 1-week intervals and were followed for an additional 4 weeks. The primary outcome was the change in the 21-item Hamilton Depression Rating Scale (HAM-D) over the 4 treatment sessions. Secondary outcomes included remission (HAM-D ≤7 points), the Computerized Adaptive Test-Depression Inventory (CAT-DI) and Computerized Adaptive Test-Suicide Scale (CAT-SS). RESULTS: The mean averaged change in HAM-D scores over the 4 weeks of treatment was lower with nitrous oxide than with control (-1.9 [95% CI, -3.9 to 0.0], p = .051). In the first week, 15 of 39 (38%) in the nitrous oxide group and 5 of 39 (13%) in the control group were remitted (p = .031). The mean averaged change in CAT-DI scores was -7.7 (95% CI, -14.1 to -1.4), p = .017; the mean averaged change in CAT-SS scores was -8.3 (95% CI, -14.4 to -2.1), p = .008, both favoring nitrous oxide. CONCLUSIONS: In this study, we confirmed that nitrous oxide has likely beneficial antidepressant effects in people with MDD
Drug target deconvolution in the parasitic protist Giardia duodenalis
No full text© 2025 Yu Fung Alexander LamGiardia duodenalis (syn Giardia intestinalis, Giardia lamblia) is a neglected parasitic protist that colonises the host's gastrointestinal tract to cause gastrointestinal symptoms and long-term post-infectious sequelae. Symptomatic infections (giardiasis) affect up to 200 million people annually and are globally prevalent, with health and socioeconomic impacts disproportionately affecting those in low- and middle-income countries, burdening their public health systems. Moreover, giardiasis is correlated with malabsorption, malnutrition, failure to thrive, stunting and wasting, where these consequences are particularly pronounced in children from low- and middle-income countries. Chemotherapeutic interventions have remained the gold standard for treating giardiasis for the past seven decades, with little development into preventative vaccines. Worryingly, treatment failure has become more prevalent over the recent years and is presumed to be based on the continued overuse and misuse of the same class of 5-nitroheterocyclic class of broad-spectrum antibiotics, namely metronidazole, deriving drug-resistant clinical cases. The call for new antigiardial chemotherapeutics is urgent yet remains unmet. Protein kinases in G. duodenalis are attractive druggable targets, with the parasite hosting a highly divergent and disproportionate kinome relative to mammalian counterparts. Therefore, in the quest to discover novel antigiardial compounds, we performed a kinase-driven drug discovery project through the standard drug discovery pipeline to identify potent and selective chemical scaffolds (chemotypes) or to identify druggable kinase targets in G. duodenalis which are susceptible to inhibition by small-molecules which ultimately kill the parasite. Progression of antigiardials through the drug discovery pipeline required high-throughput, phenotype-based screening to identify ‘hits’ and a subsequent target deconvolution stage, which identified and validated (biochemically and genetically) the receptor target(s) of the ‘hit’.
In Chapter 2, we performed high- and medium-throughput screening of curated small-molecule drug-like kinase inhibitor libraries (which are FDA-approved or precursors to FDA-approved chemotherapeutics) against G. duodenalis viability. We discovered that the B-Raf-targeting arylsulphonamide kinase inhibitors are potent antigiardials through a chemotype-based enrichment analysis. Further, we selected a representative arylsulphonamide inhibitor, BRAFi, and performed subsequent drug-susceptibility testing against two other parasitic protists, the causative agent for malaria Plasmodium falciparum, and the pathogen responsible for the most prevalent non-viral sexually-transmitted disease Trichomonas vaginalis, demonstrating sub-micromolar potency of BRAFi against G. duodenalis and these two other parasitic protists. Further, we demonstrate the mechanism of action for BRAFi was likely cytostatic, as trophozoite counts for BRAFi-treated G. duodenalis appear unchanged over 9 hours. In Chapters 3 and 4, we pursued the chemotherapeutic potential of BRAFi. Also, we aimed to discover its kinase target(s), anticipating these targets to be susceptible to small-molecule-perturbations which eventually lead to parasite death. To identify these targets, we performed a Proteome Integral Solubility Alteration (PISA) thermal proteome profiling-based assay (Chapter 3). With stringent experimental design and data-filtering, we identified 49 likely BRAFi-binding proteins; four contained a canonical kinase domain in silico, which we shortlisted as putative BRAFi targets GiK1 – GiK4. To validate these results orthogonally, we covalently immobilised a functionalised BRAFi analogue onto magnetic and agarose supports, which allowed the physical enrichment of BRAFi-binding protein targets (Chapter 4). After a similar stringent experimental design and data-filtering plan, we discovered the enrichment of two new kinase domain-containing proteins (GiK5 and GiK6) but not the four putative targets (GiK1 – GiK4) identified in Chapter 3. This provided six putative kinase domain-containing proteins as primary targets for BRAFi, which required biochemical and genetic validation. In Chapter 5, recombinant expression using the Escherichia coli overexpression system was successful for three of the six putative kinase domains. Biochemically, one of these three kinase domains (GiK5) was verified to engage with BRAFi through differential scanning fluorimetry and native mass spectrometry. Further, GiK5 was catalytically active, as demonstrated by the ADP-Glo assay, and the addition of BRAFi inhibited its enzymatic activity.
In conclusion, this kinase-driven pipeline for discovering novel antigiardials identified a novel chemotype with potential broad-spectrum anti-parasitic properties. We comprehensively demonstrated the engagement of BRAFi to at least one of the six identified kinase targets, and BRAFi inhibited recombinant kinase activity. Together, these findings open opportunities to incentivise a target (GiK5)-centric screening campaign for high-affinity GiK5-binding small-molecules and also rational drug-design of inhibitors against GiK5, motivating the development and repurposing of kinase inhibitors as novel antigiardial agents
Effective coverage for reproductive, maternal, neonatal and newborn health: An analysis of geographical and socioeconomic inequalities in 39 low- and middle-income countries
No full textBackground Inadequate access to quality maternal and child health services leads to poor health outcomes for millions of women, particularly in low- and middle-income countries (LMICs). This study aims to explore the effective coverage of reproductive, maternal, neonatal and newborn health (RMNCH) services and examines socioeconomic and rural and urban disparities in 39 LMICs. Methods Using Demographic and Health Surveys (DHS) data, the research assesses RMNCH service quality by applying an effective coverage framework, which measures service contact, crude coverage, quality-adjusted coverage and user adherence-adjusted coverage. We applied weighted analyses to investigate the rural-urban differences in service coverage based on countries' Human Development Index (HDI) levels as well as crude coverage and socioeconomic levels. Findings Urban areas generally exhibit better effective coverage across all RMNCH services compared with rural areas, with significant disparities in antenatal, childbirth and postnatal care. For instance, 85% (95% CI=85-86%) of urban women received skilled birth attendance compared with 64% (95% CI=64-65%) in rural areas. High-HDI countries show smaller rural-urban gaps in service coverage than low-HDI countries. Socioeconomic inequalities are more pronounced in rural areas, particularly in services that require higher quality and adherence to standards. Socioeconomic disparities are significant in LMICs with lower HDI and are more evident in harder-to-achieve quality indicators, such as user adherence to recommended practices or treatment. For example, in medium-HDI countries, the relative inequality index (RII) for antenatal care user adherence coverage is 3.6 (95% CI=3.4-3.8) in rural areas compared with 1.9 (95% CI=1.8-2.1) in urban areas. Interpretation The research underscores the need for targeted interventions and policies to address these disparities. The evidence supports the need for a shift from focusing solely on access to care to improve the quality of care to address rural-urban and socioeconomic inequalities in RMNCH outcomes
Guidelines for releasing a variant effect predictor
No full textComputational methods for assessing the likely impacts of mutations, known as variant effect predictors (VEPs), are widely used in the assessment and interpretation of human genetic variation, as well as in other applications like protein engineering. Many different VEPs have been released to date, and there is tremendous variability in their underlying algorithms and outputs, and in the ways in which the methodologies and predictions are shared. This leads to considerable challenges for end users in knowing which VEPs to use and how to use them. Here, to address these issues, we provide guidelines and recommendations for the release of novel VEPs. Emphasising open-source availability, transparent methodologies, clear variant effect score interpretations, standardised scales, accessible predictions, and rigorous training data disclosure, we aim to improve the usability and interpretability of VEPs, and promote their integration into analysis and evaluation pipelines. We also provide a large, categorised list of currently available VEPs, aiming to facilitate the discovery and encourage the usage of novel methods within the scientific community
Dietary Patterns and Major Depression: Results from 15,262 Participants (International ALIMENTAL Study)
No full textBACKGROUND: Different patterns of food consumption may be associated with a differential risk of depression. Differences in dietary patterns between men and women and across different age groups have been reported, but their influence on the risk of depression has not been fully explored. OBJECTIVES: To investigate the associations between dietary patterns and risk of depression across sex and age groups to identify vulnerable subpopulations, which may inform targeted prevention and intervention strategies. METHODS: The ALIMENTAL study was a cross-sectional, online international survey conducted between 2021 and 2023. Dietary data were collected using a validated food frequency questionnaire; depression data were collected using a self-reported validated questionnaire. Principal component analysis (PCA) was applied to identify distinct food consumption patterns. Multivariate analyses were then conducted to assess the associations between these patterns and depression, adjusting for multiple potential confounders. RESULTS: Among 15,262 participants without chronic diseases or current psychotropic treatments, 4923 (32.2%) were classified in the depression group. Among those aged 18-34, the PCA-derived factor of ultra-processed foods consumption was significantly associated with increased risk of depression in both sexes with similar odds ratios (women 1.21, 95% confidence interval (CI): (1.15; 1.27), men 1.21, 95% CI: (1.07-1.18)). In women aged 18-34, the PCA factors for sodas (aOR 1.10, 95% CI: (1.06; 1.95) and canned and frozen foods (aOR 1.10, 95% CI: (1.04; 1.15) were associated with an increased risk of depression. In participants aged 35-54 years, the association between ultra-processed foods and depression was only observed in women (35-54 years: aOR 1.30, 95% CI: (1.20; 1.42), ≥55 years: 1.41, 95% CI: (1.11; 1.79)), with a significant association between a higher adherence to the PCA-derived "healthy diet" factor (e.g., fruits, nuts, green vegetables) and a lower risk of depression (35-54 years: aOR 0.82, 95% CI: (0.75; 0.89), ≥55 years: aOR 0.79, 95% CI: (0.64; 0.97)). CONCLUSIONS: These results show significant differences between men and women and between age groups regarding associations between dietary patterns and the risk of depression. These findings can help better target public health interventions
Amplitude and Phase Changes in Electrocochleographic Real-Time Recordings During Cochlear Implantation and Its Relation to Pre- and Postoperative Hearing
No full textBACKGROUND: The aim of this study was to relate response patterns of electrocochleography (ECochG) recordings during cochlear implantation to pre- and postoperative hearing. METHODS: Thirty subjects with either flat (FA, n = 9) or sloping (SA, n = 21) audiograms before cochlear implantation were prospectively included. Real-time ECochG recordings were conducted via the cochlear implant. The difference curve (DIF) signal of the ECochG recordings was analyzed regarding alteration of the waveform, amplitude changes, and relative phase shifts during insertion. RESULTS: Five subjects (56%) with FA and 13 (62%) with SA exhibited DIF signal drops in the early phase of the insertion. In subjects with FA, alterations of the DIF signal waveform in the early phase of the insertion occurred in 8 subjects (90%), whereas such changes were detectable in only 2 out of 21 subjects (10%) with SA ( p 0.7 radians but without alterations of the waveform occurred in 5 subjects (56%) with FA and 11 (52%) with SA. Such drops were associated with larger postoperative hearing losses than DIF signal drops without phase changes in both groups (FA: 43 versus 20 dB, p = 0.045; SA: 30 versus 14 dB, p = 0.001). CONCLUSION: Residual cochlear function in basal regions leads to alteration of the DIF signal waveform during insertion, probably not associated with cochlear injury. A decrease of the DIF signal amplitude with a simultaneous relative phase shift but no alteration of the waveform is associated with greater loss of residual hearing independent from the preoperative hearing
Impact of Roasting Temperature on Antioxidant Activities and Characterization of Polyphenols in Date Seed Beverages From Different Cultivars
No full textThis experiment aimed to analyze the antioxidant capacity and composition of polyphenolic compounds from date seed beverage produced from eight date palm cultivars subjected to three roasting temperatures (180°C, 200°C, and 220°C) from light roasting to dark roasting. Total phenolic content in date seed beverages at light roasting ranged from 4.98 to 14.09 mg GAE/g, higher than that of the medium roasting (3.66–8.65 mg GAE/g) and dark roasting intensity (1.66–6.33 mg GAE/g). Date seed beverages produced from lightly roasted seeds had higher antioxidant capacity than those roasted at medium and dark levels. Using LC-ESI-QTOF-MS/MS, a total of 69 polyphenolic compounds were detected, classified into three groups: 17 phenolic acids, 40 flavonoids, and 12 other phenolic compounds. Our findings demonstrated a decrease in phenolic content as date seed roasting intensity increased from light to dark roasting, accompanied by variations in both phenolic composition and antioxidant capacity across cultivars
Quantifying and Understanding the Effects of Cognitive Biases in Human-Computer Interaction
No full text© 2025 Nattapat BoonprakongModern technologies enable new and complex ways for humans to interact with computers. They tend to impose cognitive demands, time constraints, and ambiguity on users. To cope with such demands, humans apply mental shortcuts to sift through information and effectively make decisions. These shortcuts result in cognitive biases, a concept proposed by Tversky and Kahneman as systematic, automatic tendencies that influence our behaviour and judgment. These biases can both introduce harmful effects and offer swift mental strategies to form good decisions. When it comes to human-computer interaction (HCI), cognitive biases can influence how users engage with computing systems. To better understand this interplay, this thesis forms a systematic understanding of how cognitive biases manifest in HCI. Informed by a scoping review of HCI articles that study cognitive biases, we found that computing systems can be designed to trigger, mitigate, and capitalise on the effects of cognitive biases.
This thesis provides grounds for conducting HCI research on cognitive biases, in which we tackled three challenges: quantifying the effects of cognitive biases, understanding how cognitive biases manifest in the user-system interaction, and designing systems that take cognitive biases into account. In brief, we explored the potential of physiological measurements, especially hemodynamic activity, as an indicator of cognitive biases. We found that cognitive biases do not manifest in every individual and context. Subsequently, we proposed the notion of cognitive bias susceptibility to account for individual and contextual factors that amplify and mediate the effects of cognitive biases. We also note that these factors can be taken into account when designing interventions to mitigate harmful cognitive biases. Finally, we formulated the understanding of cognitive biases into a blueprint of computing systems that encompass bias-awareness: the ability to detect and address cognitive biases that surface in HCI. We describe affordances that allow users to interact with systems without engaging with mental shortcuts that lead to problematic biases, e.g., sharing misinformation or relying predominantly on ideological beliefs.
Our findings motivate the need to bridge the cognition gap between humans and computers. Computing systems, if not carefully designed, can put cognitive demands, such as information overload and time constraints, rendering a fertile environment for problematic cognitive biases. We can also design computing systems to intentionally trigger cognitive biases that benefit users, for example, to facilitate behaviour change. On the other hand, these biases can be abused against the good of people as they open doors for behavioural manipulation. We discuss societal and ethical considerations for designing bias-aware computing systems. We also emphasise that the HCI community should engage with the ongoing discussion in psychology and behavioural science with respect to the evolving definition of cognitive biases