214 research outputs found

    A Conceptual Spaces Model of Socially Motivated Language Change

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    This paper outlines a formal model of socially motivated language change which unites insights from identity-oriented theories of language change with formal theories of language use and understanding. We use Gärdenfors\u27s (2000) Conceptual Spaces framework to formalize socially motivated ideological change and use signaling games with an iterated best response solution concept (Franke, 2009; Frank and Goodman, 2012) to formalize the link between ideology, linguistic meaning and language use. We then show how this new framework can be used to shed light on the mechanisms underlying socially-motivated change in French grammatical gender

    A comparison of the nationally important infection prevention and control documents in NHS England and NHS Scotland

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    Background: The devolution of health to Scotland in 1999, led for the first time in the NHS to different priorities and success indicators for infection prevention and control (IPC). This project sought to understand, compare and evaluate the national IPC priorities and available indicators of success. Aim: To identify the national infection prevention and control priorities alongside national indicators of success. Methods: Critical analysis of nationally produced documents and publicly available infection related data up to March 2018. Findings: For both NHS Scotland and England the local and national infection prevention and control priorities are evidenced by: a) People being cared for in an IPC safe environment, b) Staff following IPC safe procedures and c) organisations continuously striving not just to attain standards, but to improve on them. If national agencies that produce data were also charged with using a Continuous Quality Improvement (CQI) model, then there would be further opportunities to detect and improve on successes

    The Clinicians’ Skills, Capability, and Organisational Research Readiness (SCORR) Tool

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    A research-active healthcare workforce contributes to improved quality of care. Clinicians may be unaware that they are applying early research skills during their everyday practice. Greater understanding of their level of research attainment may improve their awareness and confidence in their research skills. This article describes the development of the Clinicians Skills, Capability, and Organisational Research Readiness (SCORR) Tool, a simple innovation that assesses and captures research skills and attainment at 1) clinician, and 2) organisational level. The SCORR Tool was initially developed to assess levels of research attainment and to promote discussion during annual appraisals for podiatrists working across secondary and community care in a northern region of England. The levels (1 to 5) of attainment recognise UK Health and Care Professions Council (HCPC) registration requirements for chiropodists/podiatrists (Standards 12 to 14). Following testing and feedback, research levels were adapted (Levels 0 to 5) to accommodate all healthcare professionals (with the exception of doctors and dentists). The SCORR Tool may be used individually by clinicians, or in collaboration with their manager, to better understand the level of research attainment and to prompt discussion to increase research activity. It may also be used across a workforce (e.g. during an appraisal) to understand the organisational research readiness. The SCORR Tool requires additional testing and evaluation to validate it as a tool for use across a variety of organisational environments

    Thirty years of evidence on the efficacy of drug treatments for chronic heart failure with reduced ejection fraction: A network meta-analysis

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    Treatments that reduce mortality and morbidity in patients with heart failure with reduced ejection fraction, including angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), β-blockers (BB), mineralocorticoid receptor antagonists (MRA), and angiotensin receptor–neprilysin inhibitors (ARNI), have not been studied in a head-to-head fashion. This network meta-analysis aimed to compare the efficacy of these drugs and their combinations regarding all-cause mortality in patients with heart failure with reduced ejection fraction

    A cluster randomized controlled trial of a modified vaccination clinical reminder for primary care providers

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    Objective: Adult vaccination rates in the United States fall short of national goals, and rates are particularly low for Black Americans. We tested a provider-focused vaccination uptake intervention: a modified electronic health record clinical reminder that bundled together three adult vaccination reminders, presented patient vaccination history, and included talking points for providers to address vaccine hesitancy. Method: Primary care teams at the Atlanta Veterans Affairs Medical Center, who saw 28,941 patients during this period, were randomly assigned to receive either the modified clinical reminder (N = 44 teams) or the status quo (N = 40 teams). Results: Uptake of influenza and other adult vaccinations was 1.6 percentage points higher in the intervention group, which was not statistically significant (CI = [-1.3, 4.4], p = 0.28). The intervention had similar effects on Black and White patients and did not reduce the disparity in vaccination rates between these groups. Conclusion: Provider-focused interventions are a promising way to address vaccine hesitancy, but they may need to be more intensive than a modified clinical reminder to have appreciable effects on vaccination uptake

    Independent evaluation of ARMED service: final report.

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    ARMED (HAS Technology, Lichfield, UK) is a falls prevention technology that combines a wrist-worn activity tracker with predictive analytics and machine learning to enable early intervention. Data from the tracker is augmented by weekly grip strength and body composition measurements. ARMED-in-a-box is a streamlined version of ARMED that does not use the grip strength or body composition measures, rolled-out in response to the COVID-19 pandemic. This independent evaluation was commissioned by the Digital Health and Care Innovation Centre and conducted by an interdisciplinary team from Robert Gordon University, the University of Aberdeen, and NHS Grampian. The purpose of the evaluation was to inform the potential for scalability of ARMED within the Scottish digital health and care context, and specifically to analyse and appraise the effectiveness of the current ARMED service and business models, aligning with the national technology enabled care (TEC) programme's existing test of change (TOC) activity

    Accounting for ecosystem services – Lessons from Australia for its application and use in Oceania to achieve sustainable development

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    This paper aims to illustrate the conceptual and practical issues that need to be considered if ecosystem service accounting is to be used to achieve sustainable development in Oceania. Recent international activity has focused on setting international standards for accounting for ecosystem services via the System of Environmental-Economic Accounting (SEEA). This includes defining the assets from which ecosystem services are generated. We examine how ecosystem services are incorporated into accounting and the benefits of doing this. This is done using Australia examples from the Great Barrier Reef region and elsewhere. Key lessons relate to: (1) the practical issues facing the producers of ecosystem accounts, including data availability and quality; (2) the need to account for both ecosystem services and ecosystem assets to assess sustainability, and; (3) explaining how ecosystem accounting can assist with sustainable development via policy as well as the management of specific ecosystem assets.Fujitsu Laboratories, Japan; Australian Government National Environmental Science Program Threatened Species Recovery Hu

    Lessons for COVID-19 vaccination from eight federal government direct communication evaluations

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    We discuss eight randomized evaluations intended to increase vaccination uptake conducted by the US General Services Administration’s Office of Evaluation Sciences (OES). These evaluations had a median sample size of 55,000, deployed a variety of behaviorally-informed direct communications, and used administrative data to measure vaccination uptake. The confidence interval from an internal meta-analysis shows changes in vaccination rates ranging from -0.004 to 0.394 percentage points. Two studies yielded statistically significant increases, of 0.59 and 0.16 percentage points. The other six were not statistically significant, although the studies were powered to detect effect sizes in line with published research. This work highlights the likely effects of government communications and demonstrates the value of conducting rapid evaluations to support COVID-19 vaccination efforts

    Readmissions after general surgery: a prospective multicenter audit

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    Background: Readmission rates after surgical procedures are viewed as a marker of quality of care and as a driver to improve outcomes in the United Kingdom, they are not remunerated. However, readmissions are not wholly avoidable. The aim of this study was to develop a regional overview of readmissions to determine the proportion that might be avoidable and to examine predictors of readmissions at a unit level. Methods: We undertook a prospective multicenter audit of readmissions following National Health Service funded general surgical procedures in five National Health Service hospitals and three independent sector providers over a 2-wk period. Basic demographic and procedure data were captured. Readmissions to hospitals were identified through acute admissions lists. Reason for readmission was identified, and the readmission data assessed by a senior surgical doctor as to whether it was avoidable. Results: We identified 752 operations in the study period with all followed up to 30 d. The overall rate of readmissions was 4.7%, with 40% of these judged as being potentially avoidable. Pain and wound problems accounted for the vast majority of avoidable readmissions. The number of unavoidable readmissions was correlated with the workload of each center (r ¼ 0.63, P ¼ 0.06) and as with the higher (British United Provident Association) complexity of surgery (r ¼ 0.90, P ¼ 0.01). Patient and demographic factors were not associated with readmissions. Conclusions: This prospective audit describes readmission rates after general surgery. Volume and complexity of work are associated with readmission rates. A large proportion of readmissions could be reduced by attention to analgesia and outpatient arrangements for wound management
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