4,907 research outputs found

    Implementing screening and brief Interventions for excessive alcohol consumption in primary health care

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    O consumo de bebidas alcoólicas é um dos principais fatores de risco da morbilidade e mortalidade prematura a nível mundial. As pessoas que consomem este género de bebidas têm um risco aumentado de vir a desenvolver mais de 200 problemas de saúde diferentes. A maioria do impacto do consumo de álcool na saúde humana é determinado por duas dimensões: o volume total de álcool consumido e o padrão de consumo. Existem várias medidas com comprovada eficácia que podem ser empregues para reduzir o risco associado ao consumo de álcool, entre as quais se encontra a deteção precoce e intervenção breve ao nível dos Cuidados de Saúde Primários. A maioria dos profissionais de saúde neste nível de cuidados considera o consumo de álcool como um importante problema de saúde e manifesta o seu apoio a medidas que visem reduzir o seu impacto. No entanto, poucos são os profissionais dos Cuidados de Saúde Primários que de forma sistemática identificam e aconselham os seus doentes relativamente aos seus hábitos etílicos. Como tal, o objetivo geral desta tese foi investigar como implementar a deteção precoce e intervenção breve no consumo excessivo de álcool nos Cuidados de Saúde Primários. Foi realizada uma revisão sistemática das barreiras e facilitadores à implementação da deteção precoce e intervenção breve no consumo excessivo de álcool nos Cuidados de Saúde Primários. As barreiras e facilitadores identificados nesta revisão foram analisados à luz da teoria de modificação comportamental para compreender a ligação destes fatores aos determinantes da mudança de comportamento, e para identificar as estratégias conceptualmente mais eficazes para abordar as barreiras e facilitadores à mudança de comportamento dos profissionais dos Cuidados de Saúde Primários no sentido de aumentar as taxas de deteção precoce e intervenção breve no consumo excessivo de álcool. Esta metodologia foi utilizada para desenhar um programa de implementação com base em pressupostos teóricos que foi testado num estudo experimental randomizado e controlado em clusters. Esta tese identificou diversas barreiras à implementação, ligadas a todos os domínios teóricos da mudança comportamental. As barreiras mais frequentemente mencionadas pelos profissionais foram: preocupação sobre as suas competências e eficácia para realizar a deteção precoce e intervenção breve; falta de conhecimento específico sobre o consumo de álcool; falta de tempo; falta de materiais; falta de apoio; e atitudes para com o doente com consumos excessivos de álcool. Esta tese mostrou também a existência de dois grupos distintos de médicos de família com base nas suas atitudes para com estes doentes, um com atitudes mais positivas, o outro com atitudes mais negativas. Esta tese mostrou ainda que um programa de implementação da deteção precoce e intervenção breve, desenhado com base em pressupostos teóricos de modificação comportamental, adaptado às barreiras e facilitadores da implementação, aumenta de forma significativa as taxas de identificação precoce dos consumos de álcool. Esta tese contribui para aumentar o conhecimento atual no sentido em que põe à disposição dos investigadores evidência prática sobre como abordar os fatores com influência na implementação da identificação precoce e intervenção breve para o consumo de álcool ao nível dos Cuidados de Saúde Primários. Esta tese contribui também para um melhor entendimento dos mecanismos subjacentes à resistência e à mudança de comportamento dos profissionais dos Cuidados de Saúde Primários no que respeita à implementação da deteção precoce e intervenção breve do consumo de álcool. Os resultados desta tese poderão ser usados por investigadores e decisores políticos para desenhar novos programas de implementação tendo como objetivo modificar esta prática clínica ao nível dos Cuidados de Saúde Primários.Alcohol use is among the leading risk factors for the global burden of disease and premature death. People who drink alcoholic beverages are at risk of developing more than 200 diseases and injury conditions. Most of the impact of alcohol consumption on human health and well-being is determined by two dimensions of drinking: the total volume of alcohol consumed and the pattern of drinking. Several effective strategies exist to reduce the harmful use of alcohol, which includes screening and brief interventions for excessive alcohol use in primary health care. The majority of primary health care providers agree that the excessive consumption of alcohol is an important health issue and express their support to policies for reducing the impact of alcohol on the health of their patients. Notwithstanding, implementation of screening and brief interventions is low at the primary health care level. Therefore, the overall aim of this thesis is to investigate how to implement screening and brief interventions for excessive alcohol consumption in primary health care. This thesis reviewed the barriers of, and facilitators for, the implementation of alcohol screening and brief interventions in primary health care. Behaviour change theory was used to understand how these factors linked to the determinants of behaviour change and how they could be addressed in order to change primary health care providers’ behaviour, i.e. to increase the delivery of alcohol screening and brief interventions. A comprehensive theory-based implementation programme was designed and tested in a cluster randomized controlled trial. This thesis identified several barriers to implementation which were mapped to all the theoretical domains of behaviour change. Primary health care providers concerns about their ability to deliver alcohol screening and brief interventions and to help patients to cut down, lack of alcohol-related knowledge, lack of time, lack of materials and support, and providers’ attitudes towards at-risk drinkers were among the most commonly cited barriers. This thesis found evidence that the attitudes of family physicians could be used to divide practitioners into two distinct groups, one with more positive and the other with more negative attitudes towards at-risk drinkers. This thesis also found that a behaviour change theory-based programme, tailored to the barriers for, and facilitators of, the implementation of screening and brief intervention in primary health care is effective in increasing alcohol screening rates. This thesis contributed to the evidence base by providing researchers with practical evidence on how to address the factors influencing the implementation of screening and brief interventions in primary health care. This thesis also provides researchers with insight into the behavioural mechanisms mediating primary health care providers’ decision to deliver alcohol screening and brief interventions. The results of this thesis could be used by researchers and policymakers to inform the design of novel theory-oriented interventions to support the implementation of alcohol screening and brief interventions in primary health care

    Securing NextG networks with physical-layer key generation: A survey

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    As the development of next-generation (NextG) communication networks continues, tremendous devices are accessing the network and the amount of information is exploding. However, with the increase of sensitive data that requires confidentiality to be transmitted and stored in the network, wireless network security risks are further amplified. Physical-layer key generation (PKG) has received extensive attention in security research due to its solid information-theoretic security proof, ease of implementation, and low cost. Nevertheless, the applications of PKG in the NextG networks are still in the preliminary exploration stage. Therefore, we survey existing research and discuss (1) the performance advantages of PKG compared to cryptography schemes, (2) the principles and processes of PKG, as well as research progresses in previous network environments, and (3) new application scenarios and development potential for PKG in NextG communication networks, particularly analyzing the effect and prospects of PKG in massive multiple-input multiple-output (MIMO), reconfigurable intelligent surfaces (RISs), artificial intelligence (AI) enabled networks, integrated space-air-ground network, and quantum communication. Moreover, we summarize open issues and provide new insights into the development trends of PKG in NextG networks

    Authentication enhancement in command and control networks: (a study in Vehicular Ad-Hoc Networks)

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    Intelligent transportation systems contribute to improved traffic safety by facilitating real time communication between vehicles. By using wireless channels for communication, vehicular networks are susceptible to a wide range of attacks, such as impersonation, modification, and replay. In this context, securing data exchange between intercommunicating terminals, e.g., vehicle-to-everything (V2X) communication, constitutes a technological challenge that needs to be addressed. Hence, message authentication is crucial to safeguard vehicular ad-hoc networks (VANETs) from malicious attacks. The current state-of-the-art for authentication in VANETs relies on conventional cryptographic primitives, introducing significant computation and communication overheads. In this challenging scenario, physical (PHY)-layer authentication has gained popularity, which involves leveraging the inherent characteristics of wireless channels and the hardware imperfections to discriminate between wireless devices. However, PHY-layerbased authentication cannot be an alternative to crypto-based methods as the initial legitimacy detection must be conducted using cryptographic methods to extract the communicating terminal secret features. Nevertheless, it can be a promising complementary solution for the reauthentication problem in VANETs, introducing what is known as “cross-layer authentication.” This thesis focuses on designing efficient cross-layer authentication schemes for VANETs, reducing the communication and computation overheads associated with transmitting and verifying a crypto-based signature for each transmission. The following provides an overview of the proposed methodologies employed in various contributions presented in this thesis. 1. The first cross-layer authentication scheme: A four-step process represents this approach: initial crypto-based authentication, shared key extraction, re-authentication via a PHY challenge-response algorithm, and adaptive adjustments based on channel conditions. Simulation results validate its efficacy, especially in low signal-to-noise ratio (SNR) scenarios while proving its resilience against active and passive attacks. 2. The second cross-layer authentication scheme: Leveraging the spatially and temporally correlated wireless channel features, this scheme extracts high entropy shared keys that can be used to create dynamic PHY-layer signatures for authentication. A 3-Dimensional (3D) scattering Doppler emulator is designed to investigate the scheme’s performance at different speeds of a moving vehicle and SNRs. Theoretical and hardware implementation analyses prove the scheme’s capability to support high detection probability for an acceptable false alarm value ≤ 0.1 at SNR ≥ 0 dB and speed ≤ 45 m/s. 3. The third proposal: Reconfigurable intelligent surfaces (RIS) integration for improved authentication: Focusing on enhancing PHY-layer re-authentication, this proposal explores integrating RIS technology to improve SNR directed at designated vehicles. Theoretical analysis and practical implementation of the proposed scheme are conducted using a 1-bit RIS, consisting of 64 × 64 reflective units. Experimental results show a significant improvement in the Pd, increasing from 0.82 to 0.96 at SNR = − 6 dB for multicarrier communications. 4. The fourth proposal: RIS-enhanced vehicular communication security: Tailored for challenging SNR in non-line-of-sight (NLoS) scenarios, this proposal optimises key extraction and defends against denial-of-service (DoS) attacks through selective signal strengthening. Hardware implementation studies prove its effectiveness, showcasing improved key extraction performance and resilience against potential threats. 5. The fifth cross-layer authentication scheme: Integrating PKI-based initial legitimacy detection and blockchain-based reconciliation techniques, this scheme ensures secure data exchange. Rigorous security analyses and performance evaluations using network simulators and computation metrics showcase its effectiveness, ensuring its resistance against common attacks and time efficiency in message verification. 6. The final proposal: Group key distribution: Employing smart contract-based blockchain technology alongside PKI-based authentication, this proposal distributes group session keys securely. Its lightweight symmetric key cryptography-based method maintains privacy in VANETs, validated via Ethereum’s main network (MainNet) and comprehensive computation and communication evaluations. The analysis shows that the proposed methods yield a noteworthy reduction, approximately ranging from 70% to 99%, in both computation and communication overheads, as compared to the conventional approaches. This reduction pertains to the verification and transmission of 1000 messages in total

    The threat of ransomware in the food supply chain: a challenge for food defence

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    In the food industry, the level of awareness of the need for food defence strategies has accelerated in recent years, in particular, mitigating the threat of ransomware. During the Covid-19 pandemic there were a number of high-profile organised food defence attacks on the food industry using ransomware, leading to imperative questions over the extent of the sector’s vulnerability to cyber-attack. This paper explores food defence through the lens of contemporary ransomware attacks in order to frame the need for an effective ransomware defence strategy at organisational and industry level. Food defence strategies have historically focused on extortion and sabotage as threats, but often in terms of physical rather than cyber-related attacks. The globalisation, digitalisation and integration of food supply chains can increase the level of vulnerability to ransomware. Ransomware is an example of an organised food defence threat that can operationalise both extortion and sabotage, but the perpetrators are remote, non-visible and often anonymous. Organisations need to adopt an effective food defence strategy that reduces the risk of a ransomware attack and can enable targeted and swift action in the event an incident occurs. Further collaboration between government and the private sector is needed for the development of effective governance structures addressing the risk of ransomware attacks. The novelty of this article lies in analysing the issue of ransomware attacks from the perspective of the food sector and food defence strategy. This study is of potential interest to academics, policy makers and those working in the industry

    Configuration Management of Distributed Systems over Unreliable and Hostile Networks

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    Economic incentives of large criminal profits and the threat of legal consequences have pushed criminals to continuously improve their malware, especially command and control channels. This thesis applied concepts from successful malware command and control to explore the survivability and resilience of benign configuration management systems. This work expands on existing stage models of malware life cycle to contribute a new model for identifying malware concepts applicable to benign configuration management. The Hidden Master architecture is a contribution to master-agent network communication. In the Hidden Master architecture, communication between master and agent is asynchronous and can operate trough intermediate nodes. This protects the master secret key, which gives full control of all computers participating in configuration management. Multiple improvements to idempotent configuration were proposed, including the definition of the minimal base resource dependency model, simplified resource revalidation and the use of imperative general purpose language for defining idempotent configuration. Following the constructive research approach, the improvements to configuration management were designed into two prototypes. This allowed validation in laboratory testing, in two case studies and in expert interviews. In laboratory testing, the Hidden Master prototype was more resilient than leading configuration management tools in high load and low memory conditions, and against packet loss and corruption. Only the research prototype was adaptable to a network without stable topology due to the asynchronous nature of the Hidden Master architecture. The main case study used the research prototype in a complex environment to deploy a multi-room, authenticated audiovisual system for a client of an organization deploying the configuration. The case studies indicated that imperative general purpose language can be used for idempotent configuration in real life, for defining new configurations in unexpected situations using the base resources, and abstracting those using standard language features; and that such a system seems easy to learn. Potential business benefits were identified and evaluated using individual semistructured expert interviews. Respondents agreed that the models and the Hidden Master architecture could reduce costs and risks, improve developer productivity and allow faster time-to-market. Protection of master secret keys and the reduced need for incident response were seen as key drivers for improved security. Low-cost geographic scaling and leveraging file serving capabilities of commodity servers were seen to improve scaling and resiliency. Respondents identified jurisdictional legal limitations to encryption and requirements for cloud operator auditing as factors potentially limiting the full use of some concepts

    Distributed Ledger Technology (DLT) Applications in Payment, Clearing, and Settlement Systems:A Study of Blockchain-Based Payment Barriers and Potential Solutions, and DLT Application in Central Bank Payment System Functions

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    Payment, clearing, and settlement systems are essential components of the financial markets and exert considerable influence on the overall economy. While there have been considerable technological advancements in payment systems, the conventional systems still depend on centralized architecture, with inherent limitations and risks. The emergence of Distributed ledger technology (DLT) is being regarded as a potential solution to transform payment and settlement processes and address certain challenges posed by the centralized architecture of traditional payment systems (Bank for International Settlements, 2017). While proof-of-concept projects have demonstrated the technical feasibility of DLT, significant barriers still hinder its adoption and implementation. The overarching objective of this thesis is to contribute to the developing area of DLT application in payment, clearing and settlement systems, which is still in its initial stages of applications development and lacks a substantial body of scholarly literature and empirical research. This is achieved by identifying the socio-technical barriers to adoption and diffusion of blockchain-based payment systems and the solutions proposed to address them. Furthermore, the thesis examines and classifies various applications of DLT in central bank payment system functions, offering valuable insights into the motivations, DLT platforms used, and consensus algorithms for applicable use cases. To achieve these objectives, the methodology employed involved a systematic literature review (SLR) of academic literature on blockchain-based payment systems. Furthermore, we utilized a thematic analysis approach to examine data collected from various sources regarding the use of DLT applications in central bank payment system functions, such as central bank white papers, industry reports, and policy documents. The study's findings on blockchain-based payment systems barriers and proposed solutions; challenge the prevailing emphasis on technological and regulatory barriers in the literature and industry discourse regarding the adoption and implementation of blockchain-based payment systems. It highlights the importance of considering the broader socio-technical context and identifying barriers across all five dimensions of the social technical framework, including technological, infrastructural, user practices/market, regulatory, and cultural dimensions. Furthermore, the research identified seven DLT applications in central bank payment system functions. These are grouped into three overarching themes: central banks' operational responsibilities in payment and settlement systems, issuance of central bank digital money, and regulatory oversight/supervisory functions, along with other ancillary functions. Each of these applications has unique motivations or value proposition, which is the underlying reason for utilizing in that particular use case

    A Trust Management Framework for Vehicular Ad Hoc Networks

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    The inception of Vehicular Ad Hoc Networks (VANETs) provides an opportunity for road users and public infrastructure to share information that improves the operation of roads and the driver experience. However, such systems can be vulnerable to malicious external entities and legitimate users. Trust management is used to address attacks from legitimate users in accordance with a user’s trust score. Trust models evaluate messages to assign rewards or punishments. This can be used to influence a driver’s future behaviour or, in extremis, block the driver. With receiver-side schemes, various methods are used to evaluate trust including, reputation computation, neighbour recommendations, and storing historical information. However, they incur overhead and add a delay when deciding whether to accept or reject messages. In this thesis, we propose a novel Tamper-Proof Device (TPD) based trust framework for managing trust of multiple drivers at the sender side vehicle that updates trust, stores, and protects information from malicious tampering. The TPD also regulates, rewards, and punishes each specific driver, as required. Furthermore, the trust score determines the classes of message that a driver can access. Dissemination of feedback is only required when there is an attack (conflicting information). A Road-Side Unit (RSU) rules on a dispute, using either the sum of products of trust and feedback or official vehicle data if available. These “untrue attacks” are resolved by an RSU using collaboration, and then providing a fixed amount of reward and punishment, as appropriate. Repeated attacks are addressed by incremental punishments and potentially driver access-blocking when conditions are met. The lack of sophistication in this fixed RSU assessment scheme is then addressed by a novel fuzzy logic-based RSU approach. This determines a fairer level of reward and punishment based on the severity of incident, driver past behaviour, and RSU confidence. The fuzzy RSU controller assesses judgements in such a way as to encourage drivers to improve their behaviour. Although any driver can lie in any situation, we believe that trustworthy drivers are more likely to remain so, and vice versa. We capture this behaviour in a Markov chain model for the sender and reporter driver behaviours where a driver’s truthfulness is influenced by their trust score and trust state. For each trust state, the driver’s likelihood of lying or honesty is set by a probability distribution which is different for each state. This framework is analysed in Veins using various classes of vehicles under different traffic conditions. Results confirm that the framework operates effectively in the presence of untrue and inconsistent attacks. The correct functioning is confirmed with the system appropriately classifying incidents when clarifier vehicles send truthful feedback. The framework is also evaluated against a centralized reputation scheme and the results demonstrate that it outperforms the reputation approach in terms of reduced communication overhead and shorter response time. Next, we perform a set of experiments to evaluate the performance of the fuzzy assessment in Veins. The fuzzy and fixed RSU assessment schemes are compared, and the results show that the fuzzy scheme provides better overall driver behaviour. The Markov chain driver behaviour model is also examined when changing the initial trust score of all drivers

    Experience, evidence and what counts in UK music therapy – an arts-based autoethnographic study

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    The field of music therapy is not bland: therapists train because of deep belief in the dignity of people and the power of music; participants begin therapy because something significantly challenging is present in their lives; fundraisers share stories which are painful, life affirming, uncomfortable; receptionists juggle quiet spaces with loud spaces with stimulation without sensory triggers; carers listen, absorb, give and give some more, often beyond the limits of their energy. And pulse and meter and melody and dynamics and bodies and voices and wood and skin and metal are the raw materials.However, it might be argued that the search for evidence in music therapy has led to something akin to a parallel reality, - one in which measured, analytical reporting of certain aspects of the work is shared, often in official documents. The vital, sensory, embodied, relational experience which is music making, and which lies at the heart of the therapy is rendered in careful and dispassionate text. There are good reasons for this, and for the steady growth of ‘evidence-based practice’, which lie in the history of the profession and its search for validation. Yet the evidence which is shared in these texts has tended to become increasingly disconnected from many features of the musical therapeutic encounter that music therapists value.In this study, conceived from a critical realist perspective, I ask ‘what is experience in music therapy’, ‘what is evidence in music therapy’, ‘are evidence and experience in fact the same thing, or could they be’? I look at my own experiences, and evidencing of these experiences, gained across 24 years of working as a music therapist. In so doing, I find I cannot maintain a single role or persona. Unexpectedly, in the course of this reflexive exploration, four Roles arrive noisily and will not go away (Music Therapist, Researcher, Musician and Carer). They debate, argue and probe at the heart of what counts, and at the cultures of music therapy which systematise and perpetuate what counts. They consider the turn to evidence-based practice in music therapy and ask ‘what is the evidence of’, and ‘does this make sense to insiders, outsiders, either, both’?This multivocal, dialogical approach allows me to adopt the different positions taken by each of the four Roles as they ask ‘does this make sense to me’, and to advocate for culture change in both music therapy and academia. It resonates with the focus of this research – experience, evidence and what counts in music therapy, and invites various different methodological approaches - autoethnography, arts-based research, phenomenology, and Aesthetic Critical Realism which is introduced to the field of music therapy for the first time. A complex web of different kinds of experience and evidence emerges through poems, stories, vignettes, images and mobile making and results in a concept of four phases of experience, leads to defined categories of different kinds of experience, and to the proposition that in music therapy, experience is evidence of personhood.The thesis is relational: those engaging with it are part of the network of experiences in the field of music therapy, because I conceptualise this field as including all musical, logistical, contractual, academic, public and informal encounters of all stakeholders, from participants to next-door neighbours. Because you are engaging with this thesis, I regard you as a Collaborator, but it is not necessary for you to be familiar with the field. Thank you for your involvement

    Multidisciplinary perspectives on Artificial Intelligence and the law

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    This open access book presents an interdisciplinary, multi-authored, edited collection of chapters on Artificial Intelligence (‘AI’) and the Law. AI technology has come to play a central role in the modern data economy. Through a combination of increased computing power, the growing availability of data and the advancement of algorithms, AI has now become an umbrella term for some of the most transformational technological breakthroughs of this age. The importance of AI stems from both the opportunities that it offers and the challenges that it entails. While AI applications hold the promise of economic growth and efficiency gains, they also create significant risks and uncertainty. The potential and perils of AI have thus come to dominate modern discussions of technology and ethics – and although AI was initially allowed to largely develop without guidelines or rules, few would deny that the law is set to play a fundamental role in shaping the future of AI. As the debate over AI is far from over, the need for rigorous analysis has never been greater. This book thus brings together contributors from different fields and backgrounds to explore how the law might provide answers to some of the most pressing questions raised by AI. An outcome of the Católica Research Centre for the Future of Law and its interdisciplinary working group on Law and Artificial Intelligence, it includes contributions by leading scholars in the fields of technology, ethics and the law.info:eu-repo/semantics/publishedVersio

    Climate Change and Critical Agrarian Studies

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    Climate change is perhaps the greatest threat to humanity today and plays out as a cruel engine of myriad forms of injustice, violence and destruction. The effects of climate change from human-made emissions of greenhouse gases are devastating and accelerating; yet are uncertain and uneven both in terms of geography and socio-economic impacts. Emerging from the dynamics of capitalism since the industrial revolution — as well as industrialisation under state-led socialism — the consequences of climate change are especially profound for the countryside and its inhabitants. The book interrogates the narratives and strategies that frame climate change and examines the institutionalised responses in agrarian settings, highlighting what exclusions and inclusions result. It explores how different people — in relation to class and other co-constituted axes of social difference such as gender, race, ethnicity, age and occupation — are affected by climate change, as well as the climate adaptation and mitigation responses being implemented in rural areas. The book in turn explores how climate change – and the responses to it - affect processes of social differentiation, trajectories of accumulation and in turn agrarian politics. Finally, the book examines what strategies are required to confront climate change, and the underlying political-economic dynamics that cause it, reflecting on what this means for agrarian struggles across the world. The 26 chapters in this volume explore how the relationship between capitalism and climate change plays out in the rural world and, in particular, the way agrarian struggles connect with the huge challenge of climate change. Through a huge variety of case studies alongside more conceptual chapters, the book makes the often-missing connection between climate change and critical agrarian studies. The book argues that making the connection between climate and agrarian justice is crucial
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