Design Fiction Diegetic Prototyping: A Research Framework for Visualizing Service Innovations

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.Purpose: This paper presents a design fiction diegetic prototyping methodology and research framework for investigating service innovations that reflect future uses of new and emerging technologies. Design/methodology/approach: Drawing on speculative fiction, we propose a methodology that positions service innovations within a six-stage research development framework. We begin by reviewing and critiquing designerly approaches that have traditionally been associated with service innovations and futures literature. In presenting our framework, we provide an example of its application to the Internet of Things (IoT), illustrating the central tenets proposed and key issues identified. Findings: The research framework advances a methodology for visualizing future experiential service innovations, considering how realism may be integrated into a designerly approach. Research limitations/implications: Design fiction diegetic prototyping enables researchers to express a range of ‘what if’ or ‘what can it be’ research questions within service innovation contexts. However, the process encompasses degrees of subjectivity and relies on knowledge, judgment and projection. Practical implications: The paper presents an approach to devising future service scenarios incorporating new and emergent technologies in service contexts. The proposed framework may be used as part of a range of research designs, including qualitative, quantitative and mixed method investigations. Originality: Operationalizing an approach that generates and visualizes service futures from an experiential perspective contributes to the advancement of techniques that enables the exploration of new possibilities for service innovation research

An examination of the factors that influence the publication or non-publication of mental health nursing research presented at national or international nursing conferences

Mental health nurses are required to be able to identify and access the current evidence surrounding a particular topic and evaluate and decide upon the best care approach to people with mental health problems. This is aided by specific guidance on how to facilitate access to and deliver the best quality evidence-based care. This is most commonly acquired by accessing evidence through hand searching publications or through electronic sources (databases, web search engines or internet publications). However, evidence indicates that only a small proportion of mental health nursing research is published and that many nurses carry out research that is not published. Although, it is difficult to judge the quality of unpublished research the likelihood is that a number of high quality mental health nursing research projects are not published and are therefore not available to be evaluated as part of the evidence base of care. There has been relatively little examination of the reasons underpinning publication of nursing research. This project examined the factors that influence the publication or non-publication of mental health nursing research presented at national or international nursing conferences in the UK

Adipokines and the Right Ventricle: The MESA-RV Study.

ObjectiveObesity is associated with changes in both right (RV) and left (LV) ventricular morphology, but the biological basis of this finding is not well established. We examined whether adipokine levels were associated with RV morphology and function in a population-based multiethnic sample free of clinical cardiovascular disease.MethodsWe examined relationships of leptin, resistin, TNF-α, and adiponectin with RV morphology and function (from cardiac MRI) in participants (n = 1,267) free of clinical cardiovascular disease from the Multi-Ethnic Study of Atherosclerosis (MESA)-RV study. Multivariable regressions (linear, quantile [25th and 75th] and generalized additive models [GAM]) were used to examine the independent association of each adipokine with RV mass, RV end-diastolic volume (RVEDV), RV end-systolic volume (RVESV), RV stroke volume (RVSV) and RV ejection fraction (RVEF).ResultsHigher leptin levels were associated with significantly lower levels of RV mass, RVEDV, RVESV and stroke volume, but not RVEF, after adjustment for age, gender, race, height and weight. These associations were somewhat attenuated but still significant after adjustment for traditional risk factors and covariates, and were completely attenuated when correcting for the respective LV measures. There were no significant interactions of age, gender, or race/ethnicity on the relationship between the four adipokines and RV structure or function.ConclusionsLeptin levels are associated with favorable RV morphology in a multi-ethnic population free of cardiovascular disease, however these associations may be explained by a yet to be understood bi-ventricular process as this association was no longer present after adjustment for LV values. These findings complement the associations previously shown between adipokines and LV structure and function in both healthy and diseased patients. The mechanisms linking adipokines to healthy cardiovascular function require further investigation

Analysis for Racial and Gender Disparities in the Stanford School of Medicine Clerkship Evaluation System

Stanford School of Medicine completed an analysis of our assessment system, the Criterion-Based Evaluation System (CBES), from 2011-2019, investigating for gender- and race-based disparities. Since January 2022, the USMLE Step 1 examination is now pass/fail2. In January 2021, Step 2 Clinical Skills was eliminated3. With these two changes, accurate clerkship assessments will be playing an increased role in residency applications. Concurrently, several medical schools have presented their findings on disparities and bias within their systems of medical student evaluation4,5,6. Medical schools nationwide must re-examine their methods of assessment of medical students

Association of low level viremia with inflammation and mortality in HIV-infected adults.

BackgroundWhether HIV viremia, particularly at low levels is associated with inflammation, increased coagulation, and all-cause mortality is unclear.MethodsThe associations of HIV RNA level with C-reactive protein (CRP), fibrinogen, interleukin (IL)-6 and mortality were evaluated in 1116 HIV-infected participants from the Study of Fat Redistribution and Metabolic Change in HIV infection. HIV RNA level was categorized as undetectable (i.e., "target not detected"), 1-19, 20-399, 400-9999, and ≥ 10,000 copies/ml. Covariates included demographics, lifestyle, adipose tissue, and HIV-related factors.ResultsHIV RNA level had little association with CRP. Categories of HIV RNA below 10,000 copies/ml had similar levels of IL-6 compared with an undetectable HIV RNA level, while HIV RNA ≥ 10,000 copies/ml was associated with 89% higher IL-6 (p<0.001). This association was attenuated by ~50% after adjustment for CD4+ cell count. Higher HIV RNA was associated with higher fibrinogen. Compared to an undetectable HIV RNA level, fibrinogen was 0.6%, 1.9%, 4.5%, 4.6%, and 9.4% higher across HIV RNA categories, respectively, and statistically significant at the highest level (p = 0.0002 for HIV RNA ≥ 10,000 copies/ml). Higher HIV RNA was associated with mortality during follow-up in unadjusted analysis, but showed little association after adjustment for CD4+ cell count and inflammation.ConclusionHIV RNA ≥ 10,000 copies/ml was associated with higher IL-6 and fibrinogen, but lower levels of viremia appeared similar, and there was little association with CRP. The relationship of HIV RNA with IL-6 was strongly affected by CD4 cell depletion. After adjustment for CD4+ cell count and inflammation, viremia did not appear to be substantially associated with mortality risk over 5 years

Inflammatory Markers Associated With Subclinical Coronary Artery Disease: The Multicenter AIDS Cohort Study.

BackgroundDespite evidence for higher risk of coronary artery disease among HIV+ individuals, the underlying mechanisms are not well understood. We investigated associations of inflammatory markers with subclinical coronary artery disease in 923 participants of the Multicenter AIDS Cohort Study (575 HIV+ and 348 HIV- men) who underwent noncontrast computed tomography scans for coronary artery calcification, the majority (n=692) also undergoing coronary computed tomography angiography.Methods and resultsOutcomes included presence and extent of coronary artery calcification, plus computed tomography angiography analysis of presence, composition, and extent of coronary plaques and severity of coronary stenosis. HIV+ men had significantly higher levels of interleukin-6 (IL-6), intercellular adhesion molecule-1, C-reactive protein, and soluble-tumor necrosis factor-α receptor (sTNFαR) I and II (all P<0.01) and a higher prevalence of noncalcified plaque (63% versus 54%, P=0.02) on computed tomography angiography. Among HIV+ men, for every SD increase in log-interleukin-6 and log intercellular adhesion molecule-1, there was a 30% and 60% increase, respectively, in the prevalence of coronary stenosis ≥50% (all P<0.05). Similarly, sTNFαR I and II in HIV+ participants were associated with an increase in prevalence of coronary stenosis ≥70% (P<0.05). Higher levels of interleukin-6, sTNFαR I, and sTNFαR II were also associated with greater coronary artery calcification score in HIV+ men (P<0.01).ConclusionsHigher inflammatory marker levels are associated with greater prevalence of coronary stenosis in HIV+ men. Our findings underscore the need for further study to elucidate the relationships of inflammatory pathways with coronary artery disease in HIV+ individuals

A study of causes of a stale metallic flavor in strawberry ice cream together with tests of methods of packing berries

Cover title.Bibliography: p. 430

Convergence markets: Virtual Corpo[reality]

open access articl

Decline in Health for Older Adults: 5-Year Change in 13 Key Measures of Standardized Health

Introduction The health of older adults declines over time, but there are many ways of measuring health. We examined whether all measures declined at the same rate, or whether some aspects of health were less sensitive to aging than others. Methods We compared the decline in 13 measures of physical, mental, and functional health from the Cardiovascular Health Study: hospitalization, bed days, cognition, extremity strength, feelings about life as a whole, satisfaction with the purpose of life, self-rated health, depression, digit symbol substitution test, grip strength, ADLs, IADLs, and gait speed. Each measure was standardized against self-rated health. We compared the 5-year change to see which of the 13 measures declined the fastest and the slowest. Results The 5-year change in standardized health varied from a decline of 12 points (out of 100) for hospitalization to a decline of 17 points for gait speed. In most comparisons, standardized health from hospitalization and bed days declined the least while health measured by ADLs, IADLs, and gait speed declined the most. These rankings were independent of age, sex, mortality patterns, and the method of standardization. Discussion All of the health variables declined, on average, with advancing age, but at significantly different rates. Standardized measures of mental health, cognition, quality of life and hospital utilization did not decline as fast as gait speed, ADLs, and IADLs. Public health interventions to address problems with gait speed, ADLs, and IADLs may help older adults to remain healthier in all dimensions