Exploring perspectives of people with type-1 diabetes on goalsetting strategies within self-management education and care

Background. Collaborative goal-setting strategies are widely recommended for diabetes self-management support within healthcare systems. Creating self-management plans that fit with peoples’ own goals and priorities has been linked with better diabetic control. Consequently, goal-setting has become a core component of many diabetes selfmanagement programmes such as the ‘Dose Adjustment for Normal Eating (DAFNE) programme’. Within DAFNE, people with Type-1 Diabetes (T1D) develop their own goals along with action-plans to stimulate goal-achievement. While widely implemented, limited research has explored how goal-setting strategies are experienced by people with diabetes.Therefore, this study aims to explore the perspectives of people with T1D on theimplementation and value of goal-setting strategies within DAFNE and follow-up diabetes care. Furthermore, views on barriers and facilitators to goal-attainment are explored.Methods. Semi-structured interviews were conducted with 20 people with T1D who attended a DAFNE-programme. Following a longitudinal qualitative research design, interviews took place 1 week, and 6-8 months after completion of DAFNE. A recurrent cross-sectional approach is applied in which themes will be identified at each time-point using thematic analyses.Expected results. Preliminary identified themes surround the difference in value that participants place on goal-setting strategies, and the lack of support for goal-achievement within diabetes care.Current stage. Data collection complete; data-analysis ongoing.Discussion. Goal-setting strategies are increasingly included in guidelines for diabetes support and have become essential parts of many primary care improvement schemes. Therefore, exploring the perspectives of people with T1D on the value and implementation of goal-setting strategies is vital for their optimal application

Mainstreamed genetic testing in ovarian cancer: A case study of BRCA1/2 tumour testing

Background With the advent of targeted therapies in ovarian cancer (OC), there is an impetus to identify patients with a BRCA1/2 mutation. Germline testing has already been integrated into the oncology setting using a mainstreamed model (MGT). Tumour testing is now available to detect the presence of somatic BRCA1/2 mutations. Aim To explore the introduction of mainstreamed BRCA1/2 tumour testing (MTT) in OC, focusing on clinical outcomes and patient experience. Methods A case study approach, using different research methods, was taken to gain an in depth understanding of the case (MTT) within its context. Results A service evaluation of the current state of MGT at UCLH found that in the 122 patients who were tested over 12 months, germline BRCA1/2 mutation prevalence was 14.8%. Developing the MTT pathway was feasible but challenging; delays were related to retrieval and review of archived tumour tissue. First-line MTT was provided for fifty patients; one somatic and eight germline mutations were identified. More than half this sample (52.6%) required follow-up germline testing. A prospective study using validated measures found no change in distress or quality of life scores before, during and after MTT. Patients reported low decisional conflict scores and no decision regret over MTT. After results disclosure patients with a genetic alteration had significantly more testing-related distress. Qualitative interviews revealed MTT was a brief, transient experience in the context of facing OC. Genetic misconception was common, with patients incorrectly attributing a hereditary component to tumour testing. Primary motivations for testing were related to clarifying genetic risk information for family, rather than personal benefit for treatment options. Conclusion A more streamlined process of providing MTT is needed. While MTT appears to have little psychosocial impact, poor understanding of the distinction between germline and somatic mutations indicates the need for improved communication and information provision in OC

De-Individuation of the Modern Subject in the Age of Artificial Intelligence. The Case of Self-Driving Cars and Algorithms for Decision Making.

L'abstract è presente nell'allegato / the abstract is in the attachmen

A decisional trust implementation on a maintenance system by the means of decisional DNA and reflexive ontologies

This article introduces the elements that we replaced together in order to achieve a decisional technology that can offer trust. Thus, we refer to it as Decisional Trust. Enhancing a decisional knowledge system with trust means that the user relies on what the system knows and that the system possesses a qualified reliance on received knowledge. Our proposal works in two fronts:(i) the construction of Reflexive Ontologies; and (ii)the construction of Decisional DNA. Then, we add trust models in order to gain certainty based upon the past decisional experience, and just until then, we can refer to the system as a Decisional Trust System. Additionally, an augmented reality (AR)maintenance system is improved by adding the elements of decisional trust. This framework improves the quality of decision-making, and advances the notion of administering trustable knowledge in the current decision making environment

New Fundamental Technologies in Data Mining

The progress of data mining technology and large public popularity establish a need for a comprehensive text on the subject. The series of books entitled by "Data Mining" address the need by presenting in-depth description of novel mining algorithms and many useful applications. In addition to understanding each section deeply, the two books present useful hints and strategies to solving problems in the following chapters. The contributing authors have highlighted many future research directions that will foster multi-disciplinary collaborations and hence will lead to significant development in the field of data mining

The Social Coast Guard: An Ethnographic Examination of the Intersection of Risk Communication, Social Media, and Government Public Relations

The contemporary communication context includes heightened risk, increasing the need for dialogic or relational risk communication with key stakeholders. Scholars have identified social media's potential to improve dialogic communication, yet governments may face challenges when using social media, particularly in a risk communication context. This study explored social media use in "the complex communication context of risk communication" (Sellnow et al., 2009, p. 53) within the under-studied U.S. public sector and applied a complexity and relational theoretical framework to explore the intersection of government public relations, risk communication, and social media. Questions focused on how government communicators in high-risk environments perceived the public sector context influences their risk communication and social media communication; how they viewed social media's role in risk communication; the extent to which they engaged in social-mediated relational risk communication; and, how they planned and executed social media communication. An ethnographic case study of the U.S. Coast Guard's social media program was conducted, including analysis of 205.25 participant observation hours at the headquarters social media office, 10 interviews, and 49 documents. Findings suggest that organizations with risk-related missions or responsibilities may have a "risk communication mindset" that spurs and constrains social media communication and integrates social-mediated risk communication into ongoing public affairs. Intersecting, overlapping influences within public sector contexts also influenced social media strategies and tactics. Data suggest a continuum exists between organizations participating in and hosting social media engagement. Findings suggest moving toward a multivocal conversational relational communication model that encompasses the distributed public relations model (Kelleher, 2009). The dissertation adds depth to the human conversational voice construct (e.g., Bruning, et al., 2004; Kelleher, 2009; Sweetser & Metzgar, 2007) and online relational maintenance strategies by offering a behind-the-scenes understanding of why and how government organizations can be engaging and conversational hosts via social media by inviting audiences to engage without organizations having to maintain conversations. The study offers practical recommendations such as reducing blog content to increase efforts using more engaging platforms like Facebook; increasing use of visually-rich and engaging content; cultivating internal relationships to improve personnel compliance and participation; and, improving strategic integration and evaluation

Eye witness testimony; understanding post identification feedback and witness confidence inflation as system variables: a review of police practice

The confidence witnesses experience in their selection decisions, when participating in formal identification parades, has been the subject of much criminological research. The findings suggest that confidence is far from being a static construct; instead it is understood to be highly malleable and capable of being ameliorated by post-identification information. Although the effects of post-event feedback are well documented, no research has been conducted that establishes the nature and extent of information passed to witnesses by police investigators in real crime case scenarios. The dissertation reviews the current training provision for detectives and establishes an absence of any official guidance in regard to the information that should or should not be provided to witnesses post-identification. This is indicative of the current belief that witness confidence is conceptualised as being outside of the control of the criminal justice system. The research in this thesis challenges this position and suggests that information provided by police investigators is capable of affecting witness confidence, and, in addition, is also wholly capable of being placed within the scope of statutory control. The research establishes the views and practices of operational investigators and concludes that witnesses are frequently provided with positive reinforcement. The altering of witness confidence in this way has serious ramification for the judicial system, meaning that the confidence a witness displays at trial is unlikely to be indicative of that they experienced at the point of identification. In my conclusion I suggest that witness confidence should be understood as being equally susceptible to contamination as any other form of forensic evidence. That being the case, its management should be safeguarded within a legal framework and subject to intrusive scrutiny to establish its integrity at court