This study aimed to assess the relationship between metabolic control factors, socio-demographic characteristics, personality traits, and self-perceived health status in diabetes. This cross-sectional study included 318 patients with type 1 and 2 diabetes (DM). Participants completed a questionnaire-based survey, which included the NEO Personality Inventory-Revised to measure five personality dimensions and the SF-12 survey to assess self-perceived health status. Binary logistic regression was performed to analyze the data, with socio-demographic characteristics, clinical data, and nutrition status as independent variables, and self-perceived health status (categorized as poor or good condition) as the dependent variable. Unadjusted and adjusted binary logistic regression analyses were used to examine the association between personality traits (high vs. low) and metabolic control factors (good control vs. bad control) with health status scores. 60.7% of the participants with diabetes in the study described their health as "good." The results indicated that female gender (OR: 0.314, 95%CI: 0.105–0.938, P = 0.038), age > 60 years (OR: 0.263, 95%CI: 0.117–0.592, P = 0.001), comorbidities (OR: 0.314, 95%CI: 0.178–0.556, P = 0.001), DM complications (OR: 0.531, 95%CI: 0.337–0.838, P = 0.007), diabetic neuropathy (OR: 0.562, 95%CI: 0.356–0.886, P = 0.013), and diabetic ulcer (OR: 0.130, 95%CI: 0.023–0.747, P = 0.022) were independent variables associated with a "poor" health status. However, regular physical activity (OR: 3.144, 95%CI: 1.209–8.175, P = 0.019) and a healthy nutritional diet (OR: 2.456, 95%CI: 1.421–4.245, P < 0.001) were associated with a higher likelihood of a "good" self-perceived health status. Preventive programs and interventions aimed at improving self-perceived health among patients with diabetes should focus on increasing regular physical activity and promoting a healthy nutritional status. These actions should be particularly targeted towards female and older patients with higher neuroticism traits.
Introduction Support following a dementia diagnosis in the UK is variable. Attending a Recovery College course with and for people with dementia, their supporters and healthcare professionals (staff), may enable people to explore and enact ways to live well with dementia. Recovery Colleges are established within mental health services worldwide, offering peer-supported short courses coproduced in partnership between staff and people with lived experience of mental illness. The concept of recovery is challenging in dementia narratives, with little evidence of how the Recovery College model could work as a method of postdiagnostic dementia support. Methods and analysis Using a realist evaluation approach, this research will examine and define what works, for whom, in what circumstances and why, in Recovery College dementia courses. The ethnographic study will recruit five case studies from National Health Service Mental Health Trusts across England. Sampling will seek diversity in new or long-standing courses, delivery methods and demographics of population served. Participant observations will examine course coproduction. Interviews will be undertaken with people with dementia, family and friend supporters and staff involved in coproducing and commissioning the courses, as well as people attending. Documentary materials will be reviewed. Analysis will use a realist logic of analysis to develop a programme theory containing causal explanations for outcomes, in the form of context-mechanism-outcome-configurations, at play in each case. Ethics and dissemination The study received approval from Coventry & Warwickshire Research Ethics Committee (22/WM/0215). Ethical concerns include not privileging any voice, consent for embedded observational fieldwork with people who may experience fluctuating mental capacity and balancing researcher ‘embedded participant’ roles in publicly accessible learning events. Drawing on the realist programme theory, two stakeholder groups, one people living with dementia and one staff will work with researchers to coproduce resources to support coproducing Recovery College dementia courses aligned with postdiagnostic services.
Social constructivism is considered the main driver of curriculum overhaul for the new set of learning in the digital age. Implementation of cost-effective solutions of social constructivism in higher education is a challenge. The paper circumnavigates around the principle and practice methods and implemented in a module design for robotics teaching to students from diverse academic backgrounds and familiarity levels. A gap analysis between the current practices of a generalized module design and a social constructive approach revealed the specific areas for a focussed approach to consider. Such strategies are employed in the module redesigning strategy and found cost-effective and impactful in Engineering higher education. The designed module is presented to engineering students in an integrated robotics education in the context of control, communication, sensing and biomechatronics. Multiple implemented innovations for social constructivism in different aspects of the module have not only made it a popular option among engineering students but also resulted in better engagement, student achievement, inclusivity, and resource utilization.
The increased sensation error between the surroundings and the driver is a major problem in driving simulators, resulting in unrealistic motion cues. Intelligent control schemes have to be developed to provide realistic motion cues to the driver. The driver’s body model incorporates the effects of vibrations on the driver’s health, comfort, perception, and motion sickness, and most of the current research on motion cueing has not considered these factors. This article proposes a novel optimal motion cueing algorithm that utilizes the driver’s body model in conjunction with the driver’s perception model to minimize the sensation error. Moreover, this article employs H∞ control in place of the linear quadratic regulator to optimize the quadratic cost function of sensation error. As compared to state of the art, we achieve decreased sensation error in terms of small root-mean-square difference (70%, 61%, and 84% decrease in case of longitudinal acceleration, lateral acceleration, and yaw velocity, respectively) and improved coefficient of cross-correlation (3% and 1% increase in case of longitudinal and lateral acceleration, respectively).
This article offers new insights into the important role that transdisciplinary, participatory action research approaches offer young people as a safe space to ‘act’ on climate change and environmental degradation. Drawing upon methodological meta-reflections on three separate, but interlinked, projects (two UK-based, one in Vietnam), we highlight an evolving approach that fuses knowledge, local context and emotional connection to engage action. We argue that these innovative approaches facilitate the empowerment of young people to co-create and lead solutions, adaptations and mitigations that can make a significant impact on the climate and biodiversity crises whilst influencing policymakers and inspiring collaborative change-making.
Background Unprofessional behaviours (UB) between healthcare staff are rife in global healthcare systems, negatively impacting staff wellbeing, patient safety and care quality. Drivers of UBs include organisational, situational, team, and leadership issues which interact in complex ways. An improved understanding of these factors and their interactions would enable future interventions to better target these drivers of UB. Methods A realist review following RAMESES guidelines was undertaken with stakeholder input. Initial theories were formulated drawing on reports known to the study team and scoping searches. A systematic search of databases including Embase, CINAHL, MEDLINE and HMIC was performed to identify literature for theory refinement. Data were extracted from these reports, synthesised, and initial theories tested, to produce refined programme theories. Results We included 81 reports (papers) from 2,977 deduplicated records of grey and academic reports, and 28 via Google, stakeholders, and team members, yielding a total of 109 reports. Five categories of contributor were formulated: (1) workplace disempowerment; (2) harmful workplace processes and cultures; (3) inhibited social cohesion; (4) reduced ability to speak up; and (5) lack of manager awareness and urgency. These resulted in direct increases to UB, reduced ability of staff to cope, and reduced ability to report, challenge or address UB. Twenty-three theories were developed to explain how these contributors work and interact, and how their outcomes differ across diverse staff groups. Staff most at risk of UB include women, new staff, staff with disabilities, and staff from minoritised groups. UB negatively impacted patient safety by impairing concentration, communication, ability to learn, confidence, and interpersonal trust. Conclusion Existing research has focused primarily on individual characteristics, but these are inconsistent, difficult to address, and can be used to deflect organisational responsibility. We present a comprehensive programme theory furthering understanding of contributors to UB, how they work and why, how they interact, whom they affect, and how patient safety is impacted. More research is needed to understand how and why minoritised staff are disproportionately affected by UB. Study registration This study was registered on the international database of prospectively registered systematic reviews in health and social care (PROSPERO): https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021255490.
Introduction The handheld fan (‘fan’) is useful for chronic breathlessness management, however little is known about clinicians’ implementation of the fan in clinical practice. Aim To explore clinicians’ experiences and views of fan implementation. Methods A qualitative approach, using semi-structured interviews. Participants were purposively sampled from clinicians who had completed an on-line fan implementation survey and were willing to participate. A topic guide was developed using the Theoretical Domains Framework (TDF). Data were analysed using an inductive approach informed by the TDF. Findings Twelve clinicians participated (doctors n = 4; nurses n = 4; allied health professionals n = 4) from respiratory and palliative care. Analysis generated three major themes: i) Clinician knowledge and skills in fan implementation, ii) environmental constraints on fan use and iii) clinician beliefs about the consequences of fan use. Implementation by clinicians was positively influenced by having a scientific rationale for fan use presented (mechanism of action). Clinicians believed that the fan relieved breathlessness and did not carry a significant infection risk. Opportunity for fan use varied across healthcare settings; key environmental influences were COVID-19 restrictions, lack of access to resources and funding to provide fans, particularly in acute and respiratory services. Clinicians commonly encountered scepticism among patients and colleagues who felt the fan was an implausible intervention for breathlessness. Conclusion Implementation of the fan is motivated by clinician beliefs about patient-benefit, a scientific rationale to counter clinician and patient scepticism, and access to fans in clinic. Funding to allow patients to be supplied with and taught how to use a fan would support uptake. Research is needed to address concerns about infection risk.
This Element shows that existing models of global slavery derived from sociology and modelled closely on antebellum American slavery being normative should be replaced a global slavery that is less American and more global. It argues that we can understand the global history of slavery if we connect it more closely to another important world institution – empires in ways that historicise the study of history as an institution with a history that changes over time and space. Moreover, we can learn from scholars of modern slavery and use more than we do the enormous proliferation of usable sources about the lives, experiences and thoughts of the enslaved, from ancient to modern times, to make these voices of the enslaved crucial drivers of how we conceptualise and describe the varied kinds of global slavery in world history. This title is also available as Open Access on Cambridge Core.
Background Respiratory viral infections (RVIs) are major drivers of chronic obstructive pulmonary disease (COPD) exacerbations. Interferon beta (IFN-β) is key in host defence against viruses but can be suppressed by virus or host factors locally at the site of infection. Inhalation of SNG001 (IFN-β-1a nebuliser solution) aims to restore lung IFN-β levels. SG015 (NCT03570359) was a randomized, placebo-controlled Phase 2 clinical study of inhaled SNG001 conducted in COPD patients. Here we describe lung antiviral biomarker and sputum viral clearance data from Part 2 of the study which was conducted in patients with a confirmed RVI. Methods 109 COPD patients with worsening symptoms and a positive respiratory viral test were randomized 1:1 to SNG001 or placebo once-daily for 14 days in two Groups: A (no moderate exacerbation); B (moderate COPD exacerbation [i.e.,acute worsening of respiratory symptoms treated with antibiotics and/or oral corticosteroids]). Sputum samples were collected on days 1, 4, 7, 10, 13, 17 and 28 for analysis of lung antiviral biomarker responses (interferon-stimulated genes (ISGs): Mx1, OAS1 and CXCL10) and lung viral load by RT-qPCR. Results Mx1 and OAS1 sputum cell gene expression were significantly upregulated on day 7, 10 and 13 (p< 0.05) overall and in Groups A and B with SNG001 treatment compared to placebo. CXCL10 sputum cell gene expression was significantly upregulated in the overall population with SNG001 treatment compared to placebo on days 7 and 10, in Group B on days 7, 10 and 13, and there was no significant difference in Group A. Patients had a broad range of RVIs, the most common being human rhinovirus. A post-hoc analysis was therefore conducted in the subgroup of patients who had detectable rhinovirus viral load in sputum. By Day 4 the proportion of patients receiving SNG001 who had detectable rhinovirus reduced to 40.0% (compared to 94.7% of patients receiving placebo; p=0.052), with a further reduction to 20.0% on Day 7 (versus 89.5% receiving placebo; p=0.014). Conclusion Inhaled SNG001 upregulated lung antiviral defenses as assessed using sputum cell biomarker responses and accelerated viral clearance, supporting the proposed mechanism of action as an antiviral treatment for severe viral lung infections. Disclosures Phillip D. Monk, PhD, Synairgen Research Plc: Employee of Synairgen Research Plc and has options on shares|Synairgen Research Plc: Stocks/Bonds Jody L. Brookes, BSc, Synairgen Research Ltd: Share options Victoria J. Tear, PhD, Synairgen Research Ltd.: Stocks/Bonds Marcin Mankowski, MD MFPM (Dis), Multiple companies: Advisor/Consultant|Synairgen: Advisor/Consultant Michael G. Crooks, MBChB (hons), MD, FRCP, AstraZeneca: Advisor/Consultant|AstraZeneca: Grant/Research Support|AstraZeneca: Honoraria|Chiesi: Advisor/Consultant|Chiesi: Honoraria|Gilead: Honoraria|Synairgen: Advisor/Consultant Dave Singh, MD, AstraZeneca: Advisor/Consultant|Chiesi: Advisor/Consultant|gsk: Advisor/Consultant|Novartis: Advisor/Consultant|Orion: Advisor/Consultant|Pulmatrix: Advisor/Consultant|Sanofi: Advisor/Consultant|Synairgen: Advisor/Consultant|Synairgen: Grant/Research Support|Therevance: Advisor/Consultant Rekha Chaudhuri, MD, AstraZeneca: Grant/Research Support|AstraZeneca: Honoraria|Chiesi: Honoraria|GSK: Honoraria|Novartis: Honoraria|Sanofi: Honoraria|Teva: Honoraria Sarah Dudley, N/A, PhD, Synairgen Plc: Employed by Synairgen Research Ltd which is a subsidiary of Synairgen Plc|Synairgen Plc: Stocks/Bonds Felicity Gabbay, MbChb, Synairgen: Board Member Stephen T. Holgate, FMedSci, MD, Synairgen Research Plc: Board Member|Synairgen Research Plc: Stocks/Bonds Ratko Djukanovic, MD, GlaxoSmithKline: Advisor/Consultant|GlaxoSmithKline: Honoraria|KyMab: Advisor/Consultant|Sanofi: Advisor/Consultant|Synairgen: Advisor/Consultant|Synairgen: Stocks/Bonds Tom Wilkinson, PhD, PhD, Synairgen: Advisor/Consultant|Synairgen: Grant/Research Support|Synairgen: Honoraria
Reversing the negative impacts anthropogenic habitat fragmentation have on animal movement is a key goal in management of landscapes and conservation of species globally. Accurate assessment of measures to remediate habitat fragmentation, such as fish passage solutions in rivers, are imperative but are particularly challenging for territorial species which are less likely to leave their existing home range or populations composed of both migratory and resident individuals (i.e., partial migration). This investigation quantified the movements of translocated (captured upstream of the impediment and released downstream) and non‐translocated (captured and released downstream of the impediment) riverine brown trout ( Salmo trutta L.), a species known to perform a homing movement, through a fish pass using Passive Integrated Transponder (PIT) telemetry. A significantly higher proportion of translocated fish approached, entered and passed (on a wider range of flows) compared to non‐translocated fish, consistent with the theory that motivation is a key driver in fish pass use. Translocated fish that entered the pass were significantly larger than those that approached but did not enter, presumably due to physiological capability. Translocated fish were a more reliable indicator of the fish passage solution effectiveness than non‐translocated fish. Our findings hence imply that many fish passage solutions globally, and potentially measures to remediate habitat fragmentation for other taxa, may have been mistakenly assessed for unmotivated animals. Studying both non‐translocated and translocated fish is recommended to provide more accurate and cost‐effective fish passage solution assessments. This article is protected by copyright. All rights reserved.
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