The ConStratO model of handover: a tool to support technology design and evaluation

Handovers are a specific kind of multidisciplinary team meeting. Shift handovers and transfers are both regular features of hospital work but there is currently great variation in how such handovers are conducted, presenting a challenging for those seeking to develop technology to support handover. This paper presents the ConStratO model of handover, which captures aspects of the context that influence how the handover is conducted, a range of different handover strategies relating to different aspects of the handover, and possible outcomes of handover. The model is based on detailed data collection in a range of clinical settings. We present the model as a tool for developing and evaluating technology support for handover

The food safety impact of salt and sodium reduction initiatives

Excessive or high salt or sodium intake is known to cause hypertension and other diseases. Within the United Kingdom voluntary targets for salt reduction have been set and laid out in the Secretary of State responsibility deal. This review considers the options available to food manufacturers to enable them to reduce salt and the potential food safety risks associated with those options. Gaps in research and knowledge within the areas of information supplied to food manufacturers, alternative solutions for salt replacement and the food safety impact of salt reduction are discussed

Perspectives on credit scoring and fair mortgage lending: article two

Credit scoring systems ; Mortgages

Prevalence of drooling, swallowing, and feeding problems in cerebral palsy across the lifespan: a systematic review and meta‐analyses

Aim: To determine the prevalence of drooling, swallowing, and feeding problems in persons with cerebral palsy (CP) across the lifespan. Method: A systematic review was conducted using five different databases (AMED, CINAHL, Embase, MEDLINE, and PubMed). The selection process was completed by two independent researchers and the methodological quality of included studies was assessed using the STROBE and AXIS guidelines. Meta-analyses were conducted to determine pooled prevalence estimates of drooling, swallowing, and feeding problems with stratified group analyses by type of assessment and Gross Motor Function Classification System level. Results: A total of 42 studies were included. Substantial variations in selected outcome measures and variables were observed, and data on adults were limited. Pooled prevalence estimates determined by meta-analyses were as high as 44.0% (95% confidence interval [CI] 35.6–52.7) for drooling, 50.4% (95% CI 36.0–64.8) for swallowing problems, and 53.5% (95% CI 40.7–65.9) for feeding problems. Group analyses for type of assessments were non-significant; however, more severely impaired functioning in CP was associated with concomitant problems of increased drooling, swallowing, and feeding. Interpretation: Drooling, swallowing, and feeding problems are very common in people with CP. Consequently, they experience increased risks of malnutrition and dehydration, aspiration pneumonia, and poor quality of life. What this paper adds: Drooling, swallowing, and feeding problems are very common in persons with cerebral palsy (CP). The prevalence of drooling, swallowing, and feeding problems is 44.0%, 50.4%, and 53.5% respectively. There are limited data on the prevalence of drooling, swallowing, and feeding problems in adults. Higher Gross Motor Function Classification System levels are associated with higher prevalence of drooling, swallowing, and feeding problems. There is increased risk for malnutrition, dehydration, aspiration pneumonia, and poor quality of life in CP

What do We Know About Entrepreneurial Finance and its Relationship with Growth?

This article explores what we do (and do not) know about entrepreneurial finance and its relationship with growth. Broadly, there is a need for research to go beyond traditional supply side/market failure issues to better understand the role of entrepreneurial cognition, objectives, ownership types and firm life-cycle stages in financing/investment decisions. We show that little is known about the pivotal relationship between access to external finance and growth due to limitations in current approaches to testing financial constraints. Instead, we propose that the relationship between funding gaps and business performance as a direct and nuanced approach to identifying financial constraints in different entrepreneurial finance markets requires scrutiny. There is also a necessity for research to disentangle cognitive from financial constraints and to better understand the role of financiers in enabling growth. In particular, there is a need to explore the relationship between non-bank sources of finance and growth, shorn of inherent survival and selection bias. We outline an agenda for future research to address gaps in our understanding

“When We’re on the Ice, All We Have is Our Inuit Qaujimajatuqangit”: Mobilizing Inuit Knowledge as a Sea Ice Safety Adaptation Strategy in Mittimatalik, Nunavut

Increased variability in weather and sea ice conditions due to climate change has led to high rates of injury, trauma, and death for Inuit travelling on the sea ice. Contributing to these high rates are the ongoing effects of colonial policies that diminish and disrupt the intergenerational transfer of sea ice Inuit Qaujimajatuqangit (IQ). Despite these challenges, place-based experiential IQ continues to be the most important information source for safe travel on the sea ice. This paper presents an Inuit-led, coproduced, cross-cultural research project in which Inuit youth documented and mobilized sea ice IQ in Mittimatalik (Pond Inlet), Nunavut for safe community sea ice travel. We outline the Inuit youth training to facilitate the terminology and participatory mapping workshops and to document this IQ. We also discuss the IQ that was most important to share, and the mapping and artistic methods used to mobilize this IQ into a booklet, maps, and posters. Inuktitut sea ice terms are the foundation to enable youth with the skills to learn about sea ice IQ with experienced hunters. IQ enables Inuit to interpret and synthesize information from weather forecasts, earth observations, and community-based monitoring to apply to local conditions. Seasonal IQ maps of safe and hazardous sea ice conditions provide travel planning information at spatial and temporal scales that supplemental information sources cannot address. The IQ products mobilize preparedness, situational awareness, navigation, and interpretation skills so Inuit youth can become more self-reliant, as access to technology is not always possible once out on the sea ice.    La fluctuation accrue des conditions météorologiques et de l’état de la glace de mer découlant du changement climatique se traduit par des taux plus élevés de blessures, de traumatismes et de décès chez les Inuits se déplaçant sur la glace de mer. À cela s’ajoutent les effets permanents des politiques coloniales qui amenuisent et perturbent le transfert intergénérationnel de l’Inuit Qaujimajatuqangit (IQ) au sujet de la glace de mer. Malgré ces défis, l’IQ tiré de l’expérience sur les lieux continue de représenter la source d’information la plus importante pour favoriser des déplacements sécuritaires sur la glace de mer. Cet article présente un projet de recherche interculturel dirigé et co-réalisé par des Inuits dans le cadre duquel de jeunes Inuits ont documenté et mobilisé l’IQ sur la glace de mer à Mittimatalik (inlet Pond), au Nunavut, en vue de déplacements communautaires sécuritaires sur la glace de mer. Nous mettons l’accent sur la formation reçue par les jeunes Inuits visant à faciliter les ateliers de terminologie et de cartographie participative ainsi qu’à documenter l’IQ en question. Nous discutons également de l’IQ le plus important à partager de même que de la cartographie et des méthodes artistiques utilisées pour mobiliser l’IQ dans un cahier, sur des cartes et sur des affiches. Les termes inuktituts propres à la glace de mer servent de fondement pour doter les jeunes des connaissances nécessaires pour apprendre l’IQ de la glace de mer avec les chasseurs d’expérience. L’IQ permet aux Inuits d’interpréter et de synthétiser l’information en provenance des prévisions météorologiques, des observations de la terre et de la surveillance communautaire afin de l’appliquer aux conditions locales. Les cartes saisonnières de l’IQ illustrant les conditions sécuritaires et les conditions dangereuses de la glace de mer fournissent de l’information pour la planification des déplacements à l’échelle spatiale et temporelle que des sources supplémentaires ne pourraient fournir. Les produits de l’IQ permettent de mobiliser les compétences en préparation, en connaissance de la situation, en navigation et en interprétation pour que les jeunes Inuits puissent devenir plus autonomes, car l’accès à la technologie n’est pas toujours possible lorsqu’ils se trouvent sur la glace de mer.

First Results from Fermi GBM Earth Occultation Monitoring: Observations of Soft Gamma-Ray Sources Above 100 keV

The NaI and BGO detectors on the Gamma-ray Burst Monitor (GBM) on Fermi are now being used for long-term monitoring of the hard X-ray/low energy gamma-ray sky. Using the Earth occultation technique as demonstrated previously by the BATSE instrument on the Compton Gamma-Ray Observatory, GBM can be used to produce multiband light curves and spectra for known sources and transient outbursts in the 8 keV to 1 MeV energy range with its NaI detectors and up to 40 MeV with its BGO detectors. Over 85% of the sky is viewed every orbit, and the precession of the Fermi orbit allows the entire sky to be viewed every ~26 days with sensitivity exceeding that of BATSE at energies below ~25 keV and above ~1.5 MeV. We briefly describe the technique and present preliminary results using the NaI detectors after the first two years of observations at energies above 100 keV. Eight sources are detected with a significance greater than 7 sigma: the Crab, Cyg X-1, SWIFT J1753.5-0127, 1E 1740-29, Cen A, GRS 1915+105, and the transient sources XTE J1752-223 and GX 339-4. Two of the sources, the Crab and Cyg X-1, have also been detected above 300 keV.Comment: 13 pages, 9 figures, submitted to Ap

Species prioritization for monitoring and management in regional multiple species conservation plans.

Successful conservation plans are not solely achieved by acquiring optimally designed reserves. Ongoing monitoring and management of the biodiversity in those reserves is an equally important, but often neglected or poorly executed, part of the conservation process. In this paper we address one of the first and most important steps in designing a monitoring program - deciding what to monitor. We present a strategy for prioritizing species for monitoring and management in multispecies conservation plans. We use existing assessments of threatened status, and the degree and spatial and temporal extent of known threats to link the prioritization of species to the overarching goals and objectives of the conservation plan. We consider both broad and localized spatial scales to capture the regional conservation context and the practicalities of local management and monitoring constraints. Spatial scales that are commensurate with available data are selected. We demonstrate the utility of this strategy through application to a set of 85 plants and animals in an established multispecies conservation plan in San Diego County, California, USA. We use the prioritization to identify the most prominent risk factors and the habitats associated with the most threats to species. The protocol highlighted priorities that had not previously been identified and were not necessarily intuitive without systematic application of the criteria; many high-priority species have received no monitoring attention to date, and lower-priority species have. We recommend that in the absence of clear focal species, monitoring threats in highly impacted habitats may be a way to circumvent the need to monitor all the targeted species

Cardiovascular disease in transgendered people: A review of the literature and discussion of risk.

This review examines the impact of gender affirming hormone therapy used in the transgendered and non-binary populations on cardiovascular outcomes and surrogate markers of cardiovascular health. Current evidence suggests that hormonal therapy for transgendered women decreases or is neutral regarding myocardial infarction risk. There is an increased incidence of venous thromboembolism (VTE), but newer studies suggest that the risk is significantly lower than previously described. For transgendered men, there appears to be an adverse effect on lipid parameters but this does not translate into an increased risk of cardiovascular disease above that of general male population. In all transgendered people, risk factor interventions such as smoking cessation, weight management and treatment of co-morbid conditions are important in optimising cardiovascular health. The effect of gender affirming hormonal therapy in transgendered people is difficult to interpret due to the variety of hormone regimens used, the relative brevity of the periods of observation and the influence of confounding factors such as the historical use of less physiological, oestrogens such as conjugated equine oestrogen and ethinylestradiol which are more pro-thrombotic than the 17β oestradiol that is used in modern practice