6,604 research outputs found

    Improving diagnostic procedures for epilepsy through automated recording and analysis of patients’ history

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    Transient loss of consciousness (TLOC) is a time-limited state of profound cognitive impairment characterised by amnesia, abnormal motor control, loss of responsiveness, a short duration and complete recovery. Most instances of TLOC are caused by one of three health conditions: epilepsy, functional (dissociative) seizures (FDS), or syncope. There is often a delay before the correct diagnosis is made and 10-20% of individuals initially receive an incorrect diagnosis. Clinical decision tools based on the endorsement of TLOC symptom lists have been limited to distinguishing between two causes of TLOC. The Initial Paroxysmal Event Profile (iPEP) has shown promise but was demonstrated to have greater accuracy in distinguishing between syncope and epilepsy or FDS than between epilepsy and FDS. The objective of this thesis was to investigate whether interactional, linguistic, and communicative differences in how people with epilepsy and people with FDS describe their experiences of TLOC can improve the predictive performance of the iPEP. An online web application was designed that collected information about TLOC symptoms and medical history from patients and witnesses using a binary questionnaire and verbal interaction with a virtual agent. We explored potential methods of automatically detecting these communicative differences, whether the differences were present during an interaction with a VA, to what extent these automatically detectable communicative differences improve the performance of the iPEP, and the acceptability of the application from the perspective of patients and witnesses. The two feature sets that were applied to previous doctor-patient interactions, features designed to measure formulation effort or detect semantic differences between the two groups, were able to predict the diagnosis with an accuracy of 71% and 81%, respectively. Individuals with epilepsy or FDS provided descriptions of TLOC to the VA that were qualitatively like those observed in previous research. Both feature sets were effective predictors of the diagnosis when applied to the web application recordings (85.7% and 85.7%). Overall, the accuracy of machine learning models trained for the threeway classification between epilepsy, FDS, and syncope using the iPEP responses from patients that were collected through the web application was worse than the performance observed in previous research (65.8% vs 78.3%), but the performance was increased by the inclusion of features extracted from the spoken descriptions on TLOC (85.5%). Finally, most participants who provided feedback reported that the online application was acceptable. These findings suggest that it is feasible to differentiate between people with epilepsy and people with FDS using an automated analysis of spoken seizure descriptions. Furthermore, incorporating these features into a clinical decision tool for TLOC can improve the predictive performance by improving the differential diagnosis between these two health conditions. Future research should use the feedback to improve the design of the application and increase perceived acceptability of the approach

    “We Need a Big Revolution in Email Advertising”: Users’ Perception of Persuasion in Permission-based Advertising Emails

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    Persuasive tactics intend to encourage users to open advertising emails. However, these tactics can overwhelm users, which makes them frustrated and leads to lower open rates. This paper intends to understand which persuasive tactics are used and how they are perceived by users. We first developed a categorization of inbox-level persuasive tactics in permission-based advertising emails. We then asked participants to interact with an email inbox prototype, combined with interviews (N=32), to investigate their opinions towards advertising emails and underlying persuasive tactics. Our qualitative findings reveal poor user experience with advertising emails, which was related to feeling surveilled by companies, forced subscriptions, high prior knowledge about persuasive tactics, and a desire for more agency. We also found that using certain persuasive tactics on the inbox level is perceived as ethically inappropriate. Based on these insights, we provide design recommendations to improve advertising communication and make such emails more valuable to users

    Facilitating prosociality through technology: Design to promote digital volunteerism

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    Volunteerism covers many activities involving no financial rewards for volunteers but which contribute to the common good. There is existing work in designing technology for volunteerism in HumanComputer Interaction (HCI) and related disciplines that focuses on motivation to improve performance, but it does not account for volunteer wellbeing. Here, I investigate digital volunteerism in three case studies with a focus on volunteer motivation, engagement, and wellbeing. My research involved volunteers and others in the volunteering context to generate recommendations for a volunteer-centric design for digital volunteerism. The thesis has three aims: 1. To investigate motivational aspects critical for enhancing digital volunteers’ experiences 2. To identify digital platform attributes linked to volunteer wellbeing 3. To create guidelines for effectively supporting volunteer engagement in digital volunteering platforms In the first case study I investigate the design of a chat widget for volunteers working in an organisation with a view to develop a design that improves their workflow and wellbeing. The second case study investigates the needs, motivations, and wellbeing of volunteers who help medical students improve their medical communication skills. An initial mixed-methods study was followed by an experiment comparing two design strategies to improve volunteer relatedness; an important indicator of wellbeing. The third case study looks into volunteer needs, experiences, motivations, and wellbeing with a focus on volunteer identity and meaning-making on a science-based research platform. I then analyse my findings from these case studies using the lens of care ethics to derive critical insights for design. The key contributions of this thesis are design strategies and critical insights, and a volunteer-centric design framework to enhance the motivation, wellbeing and engagement of digital volunteers

    An exploration of adherence and persistence in overactive bladder and other long-term conditions

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    Background and aims Overactive bladder is a common, bothersome, and chronic condition associated with symptoms of urinary urgency, incontinence, increased daytime micturition frequency and nocturia. Despite exerting a significant burden on quality of life, adherence, and persistence behaviours with OAB are particularly poor in comparison with other long-term conditions. The aims of the present work were to explore themes relating to medicine-taking behaviours in OAB and other long-term conditions and to suggest ways to improve them. Methods A systematic literature review was undertaken to understand the current landscape of qualitative work exploring adherence and persistence with OAB patients. A qualitative study involving 1:1 semi-structured interviews was conducted with OAB patients to explore the context and drivers for adherence and persistence behaviours using thematic analysis. A comparative analysis was then undertaken with qualitative papers exploring medicinetaking behaviours in a chronic bowel condition, type II diabetes, and multimorbidity to explore the themes identified in the OAB study for convergence and divergence in other conditions and to contextualise the learnings from the former study. Results The systematic literature review revealed a gap in the literature of qualitative exploration of adherence and persistence behaviours in OAB patients. The OAB study found a range of drivers for non-adherent behaviours including a perceived lack of treatment efficacy, side effects, unclear instructions, and drug and condition hierarchies, as well as the rich context within which these themes sit. The comparative analysis study supported the findings of the OAB study demonstrating evidence of key themes transcending across conditions, including a perceived lack of treatment efficacy and side effects, as well as nuances associated with the OAB experience. Conclusions The present work has identified key drivers for non-adherent behaviours in OAB patients and sets out a number of recommendations categorised within the World Health Organisation’s 5 dimensions of adherence. These include addressing the poor understanding and illness perception of OAB by patients and others, by improving the provision and availability of information, as well as the work of patient support groups; scrutiny on the support within primary care to OAB patients before and after diagnosis; and the encouragement of realistic expectations of the condition and treatment with mindful use of prescriber’s language at the point of prescribing. The present work has further highlighted the utility of conceptual models of adherence such as COM-B and the NCF in understanding medicine-taking behaviours in the context of OAB

    Enhancing primary care psychological therapy for clients with comorbid physical health conditions: A Critical Discourse Analysis investigation into interprofessional identity

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    Background / Aim: Improving Access to Psychological Therapies (IAPT) services are the largest provider in England of primary care psychological therapy for depression and anxiety disorders. Over recent years there has been increased recognition of the importance of therapists and their physical health colleagues (e.g. nurses, physiotherapists or other allied health professionals) integrating care for patients with comorbid long-term health conditions and common psychological disorders. Specialist teams have been creating differentiating Psychological Therapists as Core and Integrated. The aim is to investigate the implications of this shift for Therapists’ professional identity. Method: A Critical Discourse Analysis was conducted based on five focus groups with eighteen professionals from Core IAPT, Integrated IAPT and physical healthcare backgrounds. Key Findings: Discourses related to expertise, responsibility and innovation / creativity emerged from the corpora. The research highlights the niche set of behaviours, skills, values and attitudes under construction by Integrated Therapists and the way in which their role shapes and is shaped by their interactions with their counterparts. Implications: The research makes recommendations for Integrated Therapists’ professional identity including to showcase niche skills and effective collaborative therapy. Future research recommendations are made regarding unheard voices and silenced discourses in professional identity reconstruction. Key Terms: Professional Identity; Integrated Therapy; Cognitive Behaviour Therapy; Long-Term Conditions and Medically Unexplained Symptoms (LTC/MUS

    Do Catholics have an external locus of evaluation? Inauthentic experiences of Catholic guilt in the pursuit of self-forgiveness

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    This two-part mixed methods study investigated emotional response to transgression and selffor-giveness in Catholic individuals in concert with locus of evaluation orientation following a hypothe-sis that Catholics may be particularly unable to find self-forgiveness in the teachings of their reli-gion. Study 1 was a qualitative semi-structured interview with a sample of 20 practicing Catholic participants. Questions focused on the emotive experiences of selfforgiveness and transgressions and the contribution that Catholic practices (prayer and reconciliation) make to the process. Data were analysed using thematic analysis which supported evidence of Catholic guilt but suggested that there may be some inauthenticity and insincerity with which penitents' approach reconciliato-ry practices. Study 2 used a sample of 239 Christian participants in groups of Catholics and Christian non-Catholics. Participants responded to two psychometric questionnaires: the Heartland Forgiveness Scale, and the Locus of Evaluation Inventory. Followed by two additional questions pertaining to self-forgiveness experiences, and one question requiring participants to prioritise types of forgiveness. The results found no difference between Catholics and non-Catholics in their response to self-forgiveness or locus of evaluation orientation. However, in non-Catholic Christians but not in Catholics, the frequency of religious practice correlated with higher total forgiveness and its subscales (including self-forgiveness), with more internal locus of evaluation, and with lower self-regard, suggesting that church attendance does not relate to the propensity for self-forgiveness in Catholic individuals

    Refugees’ Online Learning Engagement in Higher Education:A Capabilitarian Analysis

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    There are almost 90 million forced migrants globally, many of whom could benefit from online higher education; yet evidence suggests extremely low retention rates of displaced people in online learning. Since retention is often seen as being linked to engagement, this study aimed to understand the nature of student engagement by displaced learners in online higher education (HE) and to identify practical ways in which higher education institutions (HEIs) can support displaced learners to engage in online learning. The methodology included both empirical and theoretical components. The empirical study focused on a qualitative analysis of the lived experiences of ten online Sanctuary Scholars enrolled on an online master’s degree with a UK university. The theoretical analysis involved integrating concepts related to online engagement from the HE literature with those from the Capability Approach. A thematic analysis of the empirical data found that, while conversion factors such as trauma and “lifeload” presented obstacles for all the Sanctuary Scholars, some graduated, whereas others withdrew from the programme without completing it. The findings point to a nuanced web of interactions between resources, enablers and constraints (positive and negative conversion factors), capabilities, engagement and personal agency for each research participant. The original contribution of this thesis is that it proposes a Capabilitarian Online Engagement Model, which shows how engagement along four dimensions is underpinned by specific capabilities; it also illustrates how engagement fuels the capability for further engagement and highlights the role of student agency. The study contributes to theoretical understanding of displaced learners’ engagement in online learning, while practically, it offers insights to HEIs for fostering online engagement. Socially, the thesis adds to the growing body of open research in the social sciences

    Science and corporeal religion: a feminist materialist reconsideration of gender/sex diversity in religiosity

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    This dissertation develops a feminist materialist interpretation of the role the neuroendocrine system plays in the development of gender/sex differences in religion. Data emerging from psychology, sociology, and cognitive science have continually indicated that women are more religious than men, in various senses of those contested terms, but the factors contributing to these findings are little understood and disciplinary perspectives are often unhelpfully siloed. Previous scholarship has tended to highlight socio-cultural factors while ignoring biological factors or to focus on biological factors while relying on problematic and unsubstantiated gender stereotypes. Addressing gender/sex difference is vital for understanding religion and how we study it. This dissertation interprets this difference by means of a multidisciplinary theoretical and methodological approach. This approach builds upon insights from the cognitive and evolutionary science of religion, affect theory and affective neuroscience, and social neuroendocrinology, and it is rooted in the foundational insights of feminist materialism, including that cultural and micro-sociological forces are inseparable from biological materiality. The dissertation shows how a better way of understanding gender/sex differences in religion emerges through focusing on the co-construction of biological materiality and cultural meanings. This includes deploying a gene-culture co-evolutionary explanation of ultrasociality and an understanding of the biology of performativity to argue that religious behavior and temperaments emerge from the enactment and hormonal underpinnings of six affective adaptive desires: the desires for (1) bonding and attachment, (2) communal mythos, (3) deliverance from suffering, (4) purpose, (5) understanding, and (6) reliable leadership. By hypothesizing the patterns of hormonal release and activation associated with ritualized affects—primarily considering oxytocin, testosterone, vasopressin, estrogen, dopamine, and serotonin—the dissertation theorizes four dimensions of religious temperament: (1) nurturant religiosity, (2) ecstatic religiosity, (3) protective/hierarchical religiosity, and (4) antagonistic religiosity. This dissertation conceptualizes hormones as chemical messengers that enable the diversity emerging from the imbrication of physical materiality and socio-cultural forces. In doing so, it demonstrates how hormonal aspects of gender/sex and culturally constructed aspects of gender/sex are always already intertwined in their influence on religiosity. This theoretical framework sheds light on both the diversity and the noticeable patterns observed in gender/sex differences in religious behaviors and affects. This problematizes the terms of the “women are more religious than men” while putting in place a more adequate framework for interpreting the variety of ways it appears in human lives

    Migration Research in a Digitized World: Using Innovative Technology to Tackle Methodological Challenges

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    This open access book explores implications of the digital revolution for migration scholars’ methodological toolkit. New information and communication technologies hold considerable potential to improve the quality of migration research by originating previously non-viable solutions to a myriad of methodological challenges in this field of study. Combining cutting-edge migration scholarship and methodological expertise, the book addresses a range of crucial issues related to both researcher-designed data collections and the secondary use of “big data”, highlighting opportunities as well as challenges and limitations. A valuable source for students and scholars engaged in migration research, the book will also be of keen interest to policymakers

    Building body identities - exploring the world of female bodybuilders

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    This thesis explores how female bodybuilders seek to develop and maintain a viable sense of self despite being stigmatized by the gendered foundations of what Erving Goffman (1983) refers to as the 'interaction order'; the unavoidable presentational context in which identities are forged during the course of social life. Placed in the context of an overview of the historical treatment of women's bodies, and a concern with the development of bodybuilding as a specific form of body modification, the research draws upon a unique two year ethnographic study based in the South of England, complemented by interviews with twenty-six female bodybuilders, all of whom live in the U.K. By mapping these extraordinary women's lives, the research illuminates the pivotal spaces and essential lived experiences that make up the female bodybuilder. Whilst the women appear to be embarking on an 'empowering' radical body project for themselves, the consequences of their activity remains culturally ambivalent. This research exposes the 'Janus-faced' nature of female bodybuilding, exploring the ways in which the women negotiate, accommodate and resist pressures to engage in more orthodox and feminine activities and appearances
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