Paving the way : a future without inertia is closer than you think

Unless you have been hibernating in a remote cave for the past decade, you will have noticed the explosion of variable renewable generation. Wind power and solar photovoltaics (PVs) have been the subject of dozens of articles, just within the pages of IEEE Power & Energy Magazine. Charts illustrating relentless growth, such as the example from the United States shown in Figure 1 with futures tending toward 100% renewable energy, are common. This figure, provided by the National Renewable Energy Laboratory (NREL), reflects a low-cost, high-renewable projection scenario

Promoting integrated care in prostate cancer through online prostate cancer-specific holistic needs assessment : a feasibility study in primary care

Purpose This study assessed the feasibility of implementing a novel model of integrated prostate cancer care involving an online prostate cancer-specific holistic needs assessment (sHNA) and shared digital communication between patients and their healthcare professionals (HCPs). The sHNA produces a semi-automated care plan that is finalised in consultation between the patient and their practice nurse. Methods Men living with and beyond prostate cancer were invited to participate in a 9-month non-randomised cluster controlled feasibility study. The intervention group was asked to complete the sHNA on three occasions. Data were collected using Patient Reported Outcome Measures (PROMs) at baseline, 10 and 24 weeks, and 9 months. Outcomes included recruitment, retention, acceptability, and engagement with the sHNA and PROMs. Results Fourteen general practices (8 intervention and 6 control), and 41 men (29 intervention and 12 control) participated. Initial patient engagement with the sHNA was high, with all but one receiving practice nurse-led follow-up and an individualised care plan. The sHNA proved useful in identifying ‘red flag’ symptoms, and helping practice nurses decide when to seek further medical care for the patients. There was a high level of acceptability for patients and HCPs. However, integration of care did not occur as intended because of problems linking hospital and general practice IT systems. Conclusion While the study demonstrated the feasibility of implementing the sHNA, it did not meet the a priori progression criteria; as such, undertaking a definitive randomised controlled trial is not appropriate until the identified methodological and technical issues have been addressed

Theoretical framework focusing on learning in polycentric settings

This deliverable provides the theoretical underpinning of the NEWCOMERS project, including the key concepts and definitions as well as the formulation of research propositions in order to enhance the project’s coherence. To this end, it develops a novel theoretical framework based on polycentric governance theory, combined with elements from socio-technical systems theory, social innovationtheory, and value theory in order to facilitate the analysis of the emergence and diffusion of new clean energy communities and explore opportunities for learning in different national and local polycentric settings.The deliverable is structured as follows. Chapter 2 provides the background of the NEWCOMERS project and introduces the theoretical perspectives that will be used in the analyses, including polycentric governance theory, socio-technical systems theory, and social innovation theory. Chapter 3 explores the concept of clean energy communities and develops a definition of new clean energycommunities to be used in the project. Chapter 4 provides a state-of-the-art account of current thinking about polycentric governance and identifies the main themes of polycentric governance theory that are relevant for studying new clean energy communities. Chapter 5 summarises the set of research propositions to be tested in the NEWCOMERS project

A web-based prostate cancer–specific holistic needs assessment (CHAT-P) : multimethod study from concept to clinical practice

Background: Men with prostate cancer experience immediate and long-term consequences of the disease and its treatment. They require both long-term monitoring for recurrence or progression and follow-up to identify and help manage psychosocial and physical impacts. Holistic Needs Assessment aims to ensure patient-centered continuing cancer care. However, paper-based generic tools have had limited uptake within cancer services, and there is little evidence of their impact. With the expansion of remote methods of care delivery and to enhance the value of generic tools, we developed a web-based Composite Holistic Needs Assessment Adaptive Tool-Prostate (CHAT-P) specifically for prostate cancer. Objective: This paper described the context, conceptual underpinning, and approach to design that informed the development of CHAT-P, starting from the initial concept to readiness for deployment. Through this narrative, we sought to contribute to the expanding body of knowledge regarding the coproduction process of innovative digital systems with potential for enhanced cancer care delivery. Methods: The development of CHAT-P was guided by the principles of coproduction. Men with prostate cancer and health care professionals contributed to each stage of the process. Testing was conducted iteratively over a 5-year period. An initial rapid review of patient-reported outcome measures identified candidate items for inclusion. These items were categorized and allocated to overarching domains. After the first round of user testing, further items were added, improvements were made to the adaptive branching system, and response categories were refined. A functioning version of CHAT-P was tested with 16 patients recruited from 3 outpatient clinics, with interviewers adopting the think-aloud technique. Interview transcripts were analyzed using a framework approach. Interviews and informal discussions with health care professionals informed the development of a linked care plan and clinician-facing platform, which were incorporated into a separate feasibility study of digitally enhanced integrated cancer care. Results: The findings from the interview study demonstrated the usability, acceptability, and potential value of CHAT-P. Men recognized the benefits of a personalized approach and the importance of a holistic understanding of their needs. Preparation for the consultation by the completion of CHAT-P was also recognized as empowering. The possible limitations identified were related to the importance of care teams responding to the issues selected in the assessment. The subsequent feasibility study highlighted the need for attention to men’s psychological concerns and demonstrated the ability of CHAT-P to capture red flag symptoms requiring urgent investigation. Conclusions: CHAT-P offers an innovative means by which men can communicate their concerns to their health care teams before a physical or remote consultation. There is now a need for a full evaluation of the implementation process and outcomes where CHAT-P is introduced into the clinical pathway. There is also scope for adapting the CHAT-P model to other cancers

Telephone triage for management of same-day consultation requests in general practice (the ESTEEM trial): A cluster-randomised controlled trial and cost-consequence analysis

Telephone triage is increasingly used to manage workload in primary care; however, supporting evidence for this approach is scarce. We aimed to assess the effectiveness and cost consequences of general practitioner-(GP)-led and nurse-led telephone triage compared with usual care for patients seeking same-day consultations in primary care

Old World Monkeys Compare to Apes in the Primate Cognition Test Battery

Understanding the evolution of intelligence rests on comparative analyses of brain sizes as well as the assessment of cognitive skills of different species in relation to potential selective pressures such as environmental conditions and social organization. Because of the strong interest in human cognition, much previous work has focused on the comparison of the cognitive skills of human toddlers to those of our closest living relatives, i.e. apes. Such analyses revealed that apes and children have relatively similar competencies in the physical domain, while human children excel in the socio-cognitive domain; in particular in terms of attention sharing, cooperation, and mental state attribution. To develop a full understanding of the evolutionary dynamics of primate intelligence, however, comparative data for monkeys are needed. We tested 18 Old World monkeys (long-tailed macaques and olive baboons) in the so-called Primate Cognition Test Battery (PCTB) (Herrmann et al. 2007, Science). Surprisingly, our tests revealed largely comparable results between Old World monkeys and the Great apes. Single comparisons showed that chimpanzees performed only better than the macaques in experiments on spatial understanding and tool use, but in none of the socio-cognitive tasks. These results question the clear-cut relationship between cognitive performance and brain size and – prima facie – support the view of an accelerated evolution of social intelligence in humans. One limitation, however, is that the initial experiments were devised to tap into human specific skills in the first place, thus potentially underestimating both true nonhuman primate competencies as well as species differences

Documentary style as post-truth monstrosity in the mockumentary horror film

This article argues that the mockumentary horror film uses its stylistic hybridity to address the ontological and epistemic challenges posed to factual media in a post-truth and post-modern age through an analysis of the film Apollo 18 (Gonzalo López-Gallego, 2011). By adopting the visual aesthetics associated with factual media, and particularly those associated with post-9/11 surveillance culture, the form challenges the endurance of longstanding cultural structures (news, documentary, factual broadcasting) upon which our conceptualisation of the world is founded. In this respect, the boundary-crossing aesthetics parallel longstanding conceptualisation of the monster in horror. This aesthetic approach is most clearly manifested through the emulation of medium-specific textural artefacts which accrue across the film in a structured manner to create a situation in which the documentary investigation records its own destruction. The mockumentary horror film literalises the broader conceptual failure of the documentary project to work through and make sense of unresolved traumas and stand up to the threats posed by the epistemic horrors of a post-truth cultural turn

Effect of Service-learning Participation on High School Attendance and Science Achievement

Students at an alternative high school located in a northern Midwest state demonstrated low science achievement and high rates of student absenteeism. Students who do not attend school regularly and achieve in science courses are at risk of not graduating from high school, so teachers at the study school implemented a 16-day service-learning project embedded in a Grade 10 environmental science unit. The purpose of this study was to determine the effect of 10th-grade students’ participation in the service-learning project on student science achievement and attendance. The theoretical framework was Kearsley and Shneiderman’s engagement theory. Archival data from school and teacher records were used for this quasi-experimental pretest–posttest control group study. Data from 114 students enrolled in 6 sections of Grade 10 general science classes were retrieved. The Mann-Whitney U test was calculated to determine the difference in science achievement change scores and the difference in number of absent days between students who participated in the service-learning project and students who did not. The findings showed a significant difference for science achievement gain scores (U = 1,982.5, p = .042) but not for days absent (U = 2,048, p = .008). A professional development project was created for high school science teachers focused on implementing service-learning projects, which included suggestions on how to get students excited about attending the service-learning project and school. The findings from this study could be used to guide district decision-making about embedding service-learning projects into science courses to improve student achievement in science, thus, achieving positive social change

The potential of peer support to extend the reach of digital health

Abstract Background Peer support groups have proliferated since the 1960s, providing safe, informal environments where peers can share experiences and information. A common model for the group is for those who have progressed further along a care pathway or in dealing with a particular medical condition or psycho-social problem, to encourage those at an earlier stage of recovery. Online support groups now co-exist with face to face models, providing a complementary or alternative resource for those with digital access and competence. As the paradigm of health care has moved towards the incorporation of health promotion, patient empowerment and self-management, peer support has extended to include more focussed activities. In particular peer support is included in a range of behaviour change interventions to promote engagement and adherence. Increasingly these interventions are delivered online. While this aims to extend their reach, it leaves those without digital access disadvantaged in terms of the ability to make use of online health resources.Main text Though peer support has been used to maintain adherence to online programmes, its potential in assisting with access and thus widening participation has remained unknown. We successfully piloted the use of a paid peer supporter to help men without experience of IT to take part in an online intervention involving a prostate specific holistic needs assessment. Lessons were learnt from this innovation in relation to training needs and support for the supporter and around data security, confidentiality and safeguarding. Alternative models of voluntary peer support maybe appropriate, particularly in the implementation phase of an intervention and require exploration. Additionally a specific framework for best practice in relation to Digital Health interventions is needed to guide future development of the role. Conclusion Health services are predicted to increasingly rely on digital technology over the next decade. Research into the impact of these seek to include participants representative of the entire population. Efforts must be made to include those who are currently underrepresented in research such as the elderly and other disadvantaged groups. Innovative research designs involving peer support in a research project may be valuable in addressing the current barriers to participation