Establishing an evidenced-based dietetic model of care in haemodialysis using implementation science

To establish an evidence-based dietetics service in an in-centre haemodialysis unit utilising implementation science.The service was developed through the Knowledge-to-Action Framework. The steps of the Action Cycle were addressed through a literature review, identification of evidence-based guidelines, benchmarking and local staff engagement. The theoretical domains framework (TDF) was used to identify barriers/enablers, and behaviour change wheel to determine appropriate interventions. To monitor, evaluate outcomes and assess sustained knowledge use we employed multidisciplinary team engagement and database use. Audit data were collected at baseline, 6 and 12 months on nutrition assessment (Patient-Generated Subjective Global Assessment), intervention timeliness and alignment to dietetic workforce recommendations. Descriptive statistics, McNemar tests and a linear mixed model were applied.Barriers existed in the knowledge, skills, environmental context and resources TDF domains. Suitable interventions were identified with training on nutritional management of haemodialysis patients delivered to 148 nurses, and nutrition management recommendations summarised into local procedural resources. A database to prompt and monitor outcome measures was created and indicated that over 18 months post-service commencement, eligible patients received nutrition assessment at least 6-monthly, aligning with recommendations. Prevalence of malnutrition was 28% (n = 9/32) at baseline, 23% (n = 5/22) at 6 months and 20% (n = 4/20) at 12 months (P = 0.50).We demonstrated benefits to service development and implementation with implementation science providing a structured and methodical approach to translating guidelines into practice. Development of training, resources and prompts for outcome measures has supported the establishment of an evidence-based dietetics service in a haemodialysis unit

Nutrition process improvements for adult inpatients with inborn errors of metabolism using the i-PARIHS framework

This project aimed to implement consensus recommendations and innovations that improve dietetic services to promote timely referral to optimise nutritional management for adult inpatients with inborn errors of metabolism (IEM).The i-PARIHS framework was used to identify service gaps, implement innovations and evaluate the innovations within this single-site study. The constructs of this framework are: (i) review of the evidence; (ii) recognising patients and staff knowledge and attitudes; (iii) acknowledging the local context; and (iv) the facilitators role. This included a literature review and metabolic centre service comparisons to investigate dietetic referral and foodservice processes to inform the innovation. A 12-month chart audit (6 months retrospective and prospective of implemented innovation, respectively) to evaluate newly established dietetic referral and IEM nutrition provision procedures was also completed.The innovations implemented encompassed a clinical alert triggering urgent referral, nutrition sick day plans and metabolic diet and formula prescription via an 'alert' tab in electronic records. Eleven metabolic protein-restricted diets and nine formula recipes were introduced. Prior to the innovations, only 53% (n = 19/36) of inpatients with IEM were assessed by the dietitian and received appropriate nutrition within 24 hours. Following implementation of the innovations, 100% (n = 11/11) of inpatients with IEM received timely dietetic assessment and therapeutic nutrition.Implementation of innovations developed using the i-PARIHS framework is effective in timely notification of the metabolic dietitian of referrals. This ensures optimal nutritional management during admissions which is required in this group of high-risk patients

Creating room for citizen perspectives in ‘smart city’ Amsterdam through interactive theatre

The ‘smart city’ vision is popular, but it lacks citizen perspectives. The aim of this study was to gain insight into whether and how art-based citizen engagement can create more room for citizen perspectives in smart cities by developing and testing an art-based citizen engagement project in Amsterdam, the Netherlands. To that end, a combination of interactive theatre, interaction design and social research methods was used to bring together diverse publics and innovation professionals for joint exploration of increased dataveillance in cities. The events were studied through observations, and through interviews with participants and organisers. Data analysis was guided by the outcomes, processes and challenges of the responsible innovation dimensions: inclusion, reflexivity, anticipation and responsiveness (Stilgoe et al., 2013). The most important achievements of art-based citizen engagement were: engaging people who would not have engaged with the topic otherwise, encouraging participants to question common phrases and assumptions, exploring future social implications of technologies, and staging meaningful interactions between citizens and professionals. The most significant challenge was to involve citizens in a way that could influence innovation trajectories

Parameterization of dust emissions in the global atmospheric chemistry-climate model EMAC: impact of nudging and soil properties

Abstract. Airborne desert dust influences radiative transfer, atmospheric chemistry and dynamics, as well as nutrient transport and deposition. It directly and indirectly affects climate on regional and global scales. Two versions of a parameterization scheme to compute desert dust emissions are incorporated into the atmospheric chemistry general circulation model EMAC (ECHAM5/MESSy2.41 Atmospheric Chemistry). One uses a globally uniform soil particle size distribution, whereas the other explicitly accounts for different soil textures worldwide. We have tested these two versions and investigated the sensitivity to input parameters, using remote sensing data from the Aerosol Robotic Network (AERONET) and dust concentrations and deposition measurements from the AeroCom dust benchmark database (and others). The two versions are shown to produce similar atmospheric dust loads in the N-African region, while they deviate in the Asian, Middle Eastern and S-American regions. The dust outflow from Africa over the Atlantic Ocean is accurately simulated by both schemes, in magnitude, location and seasonality. Approximately 70% of the modelled annual deposition data and 70–75% of the modelled monthly aerosol optical depth (AOD) in the Atlantic Ocean stations lay in the range 0.5 to 2 times the observations for all simulations. The two versions have similar performance, even though the total annual source differs by ~50%, which underscores the importance of transport and deposition processes (being the same for both versions). Even though the explicit soil particle size distribution is considered more realistic, the simpler scheme appears to perform better in several locations. This paper discusses the differences between the two versions of the dust emission scheme, focusing on their limitations and strengths in describing the global dust cycle and suggests possible future improvements

Are Sensory-Motor Relationships Encoded ad hoc or by Default?: An ERP Study

Published: 03 May 2019In this event-related potentials study we tested whether sensory-motor relations between concrete words are encoded by default or only under explicit ad hoc instructions. In Exp. 1, participants were explicitly asked to encode sensory-motor relations (e.g., “do the following objects fit in a pencil-cup?”), while other possible semantic relations remained implicit. In Exp. 2, using the same materials other group of participants were explicitly asked to encode semantic relations (e.g., “are the following objects related to a pencil-cup?”), and the possible sensory-motor relations remained implicit. The N400 component was sensitive to semantic relations (e.g., “desk” related to “pencil-cup”) both under implicit (Exp. 1) and explicit instructions (Exp. 2). By contrast, most sensory-motor relations (e.g., “pea” fitting in “pencil-cup”) were encoded ad hoc under explicit instructions (Exp. 1). Interestingly some sensory-motor relations were also encoded implicitly, but only when they corresponded to “functional” actions associated with high-related objects (e.g., “eraser” fitting in “pencil-cup”) and occurring at a late time window (500–650 ms; Exp. 2), suggesting that this type of sensory-motor relations were encoding by default.This research was supported by the Spanish MINECO (Grant Nos. PSI2015-66277-R to MdV and PSI2016-79624-P to HB) and the European Regional Development Funds

Exploring the temporal dynamics of speech production with EEG and group ICA

Speech production is a complex skill whose neural implementation relies on a large number of different regions in the brain. How neural activity in these different regions varies as a function of time during the production of speech remains poorly understood. Previous MEG studies on this topic have concluded that activity proceeds from posterior to anterior regions of the brain in a sequential manner. Here we tested this claim using the EEG technique. Specifically, participants performed a picture naming task while their naming latencies and scalp potentials were recorded. We performed group temporal Independent Component Analysis (group tICA) to obtain temporally independent component timecourses and their corresponding topographic maps. We identified fifteen components whose estimated neural sources were located in various areas of the brain. The trial-by-trial component timecourses were predictive of the naming latency, implying their involvement in the task. Crucially, we computed the degree of concurrent activity of each component timecourse to test whether activity was sequential or parallel. Our results revealed that these fifteen distinct neural sources exhibit largely concurrent activity during speech production. These results suggest that speech production relies on neural activity that takes place in parallel networks of distributed neural sources

Electrophysiological signature of the interplay between habits and inhibition in response to smoking-related cues in individuals with a smoking habit: An event-related potential study

First published: 24 February 2023The rigid, stimulus-bound nature of drug seeking that characterizes substance use disorder (SUD) has been related to a dysregulation of motivational and early attentional reflexive and inhibitory reflective systems. However, the mechanisms by which these systems are engaged by drug-paired conditioned stimuli (CSs) when they promote the enactment of seeking habits in individuals with a SUD have not been elucidated. The present study aimed behaviourally and electrophysiologically to characterize the nature of the interaction between the reflexive and reflective systems recruited by CSs in individuals with a smoking habit. We measured the behavioural performance and associated event-related potentials (ERPs) of 20 individuals with a smoking habit and 20 controls, who never smoked regularly, in a modified Go/NoGo task during which smoking-related CSs, appetitive and neutral pictures, presented either in first or third-person visual perspective were displayed 250 ms before the Go/NoGo cue. We show that smoking-related cues selectively influence early incentive motivation-related attention bias (N2 after picture onset), motor readiness and behavioural inhibition (Go-P3, NoGo-P3 and Pc) of individuals with a smoking habit only when presented from a first-person visual perspective. These data together identify the neural signature of the aberrant engagement of the reflexive and reflective systems during the recruitment of an incentive habit by CSs presented as if they had been response-produced, that is, as conditioned reinforcers.This work was conducted at the Laboratory of Cognitive Neuroscience and Psycholinguistics, University of La Laguna. J.D. was supported by a Postdoctoral fellowship from the University of La Laguna (Programa Agustin de Betancourt). HAB was supported by the Spanish Ministry of Science and Innovation (grant PID2020-118487GBI00). D.B. was supported by a Medical Research Council Programme grant (MR/N02530X/1) to DB, Barry Everitt, Amy Milton, Jeffrey Dalley and Trevor Robbins. The authors would to thank Dr Tristan Hynes for their careful reading of the proof of this manuscript

The value of usage scenarios for thesaurus alignment in cultural heritage context

Thesaurus alignment is important for efficient access to heterogeneous Cultural Heritage data. Current ontology alignment techniques provide solutions, but with limited value in practice, because the requirements from usage scenarios are rarely taken in account. In this paper, we start from particular requirements for book re-indexing and investigate possible ways of developing, deploying and evaluating thesaurus alignment techniques in this context. We then compare different aspects of this scenario with others from a more general perspective