Nurses' implicit and explicit attitudes towards transgender people and the need for trans-affirming care

Background: The primary objective of this study is to investigate the implicit and explicit attitudes of healthcare professionals - in particular nurses - towards transgender people. This is especially important in light of recent calls for improved trans-affirming care provision by healthcare professionals to generate quality healthcare access and outcomes for transgender people. Methods: We use publicly available data from the transgender version of the Implicit Association Test from 2020 to 2022. We focus on differences between three subsets of participant: (1) non-healthcare professionals (N = 177,810), (2) non-nursing healthcare professionals (N = 22,443) and (3) nursing healthcare professionals (N = 11,996). We present the results of parametric statistical tests (t-tests) and an ordinary least squares regression, to analyse the robustness of our results when controlling for a host of sociodemographic characteristics. Results: We find that non-healthcare professionals have significantly lower implicit bias towards transgender people compared to healthcare professionals. Further, within healthcare professionals, we find nurses have significantly higher implicit bias towards transgender people compared to non-nurses. We show how implicit bias and explicit attitudes are highly correlated. Further, we provide evidence that healthcare professionals - but in particular nurses - conflate sex and gender identity. Conclusion: Whilst nurses continue to have higher levels of implicit and explicit bias towards transgender people there remains a need to globally establish additional enhanced trans-affirming care training provision for nursing and medical students

Development of an intelligent sensing technique for active control of railway vehicles with independently rotating wheels

This thesis continues the development of an intelligent sensing scheme; using practical techniques for estimating the vehicle variables and economic measurements, which are mounted away from any arduous environments. The independently rotating wheelset design (IRW) de-couples the wheels; losing the mechanical feedback inherent with the conventional solid axle. The issue with the IRW, however, is that the natural curving characteristic is lost as a result, and therefore it is necessary to provide steering to the wheelset, to avoid flange contact and guide the wheelset, which can be supplied using a yaw constraint: passively or actively. As primary feedback variables aren’t readily available to measure, and are costly to provide, the Kalman filter has been used to provide full state optimal estimation of the dynamic system. Involving random perturbations to return the necessary states required, the Kalman filter allows the controller and actuator to apply active steering to the IRW. This thesis applies the Kalman-Bucy filter to a closed loop system with a mechatronic vehicle. A simple P controller is used to provide a torque to the actuators. The novelty about this work is that the sensors are mounted to the vehicle body, avoiding the extreme climactic conditions that a sensor would usually see if mounted to the axle. Re-formulating the Kalman filter to include curvature and cant within the state space and output matrices has been assessed to see if the curving performance will be maintained or improved. Altering the amount of sensors used has also been assessed, to see how the curving performance is affected. This can coincide with assessing whether the system will work, should one or more of the sensors fail

Essays on reputation and information

The following thesis presents the results and analysis of three distinct experiments. The first features an experimental auction market designed to resemble eBay and other such peer-to-peer markets, including the presence of a reputation mechanism. The results presented suggest that the presence of a reputation mechanism will improve consumer welfare. Further, having a greater number of possible feedback ratings available leads to even further improvements in consumer welfare. The second features a repeated auction that also involves Bayesian uncertainty, about the `type’ of the seller. In addition, we present the predictions of a theoretical model that extends the existing sequential equilibrium literature into multi-player, market-based games. We find that reputational concerns remain an important consideration in such settings. The final experiment examines the role of within group heterogeneity (in the endowment and marginal return) in public goods games. The novel experimental designed allows for a full schema of relationships between the endowment and marginal return. The results presented suggest that there are significant behavioural differences depending on the relationship between the endowment and marginal return. When they are inverse, subject’s absolute contributions are not different. When the two are proportionally related, relative contributions are not different

ICS Testbed Tetris:Practical Building Blocks Towards a Cyber Security Resource

Cyber attacks on Critical National Infrastructure (CNI) can be hugely detrimental to society, notably via compromising Industrial Control Systems (ICS) that underpin core CNI functions. In order to explore in-depth ICS Cyber Security challenges, testbeds are an essential tool, avoiding the need to experiment exclusively on live systems. However, ICS testbed creation is a complex multidisciplinary challenge, with a plethora of conflicting requirements. This paper, based on over six years of ICS testbed research and development that spans multiple diverse applications, proposes a flexible high-level model that can be adopted to support ICS testbed development. This is complemented by a baseline set of practical implementation guidance incorporating related and emerging technologies. As a collective, the model and implementation guidance offers a go-to guide for a wide range of end-users. Furthermore, it provides a coherent foundational structure towards establishing an online "living" resource, which can be expanded over time through broader community engagement

Silent soft tissue pathology is common with a modern metal-on-metal hip arthroplasty: Early detection with routine metal artifact-reduction MRI scanning

Adverse reactions to metal debris have been reported to be a cause of pain in metal-on-metal hip arthroplasty. We assessed the incidence of both symptomatic and asymptomatic adverse reactions in a consecutive series of patients with a modern large-head metal-on-metal hip arthroplasty

Making environmental and health equal, diverse, and inclusive: Reflections from a Centre of Environment and Human Health (REACH)

The REACH Project has allowed the Centre to take initial stock of current and future research and training as well as the Centre culture through a lens of decolonisation and anti-racism. The Reflections from a Centre of Environment and Human Health (REACH) Project was funded under the Natural Environment Research Council (NERC) Making environment and health equal, diverse, and inclusive Programme

Invisible Disabilities in Education and Employment

More than 1 in 5 UK adults are disabled. Disabilities that are not immediately obvious are known as ‘invisible disabilities’, such as mental health conditions, neurodivergences and energy-limiting conditions.1 Evidence on this topic is limited as most research focuses on disability in general, or on a few specific conditions. Those with invisible disabilities may face challenges due to a lack of awareness and difficulty accessing support and services. Strategies aimed at increasing access and inclusion for adults with invisible disabilities in employment, and in higher and further education, could include: increasing awareness and understanding via training and reciprocal mentoring schemes; introducing ‘passports’ for transfer of adjustments to avoid repeated disclosure; inclusive design that considers sensory and informational barriers to access; maintaining online access to events and services post-pandemic; updating policy and guidance with examples of less recognised invisible disabilities; and promoting flexible working and learning arrangements. The 2021 National Disability Strategy set out the actions the Government would take to improve the lives of disabled people, including making workplaces more inclusive and accessible. However, the High Court ruled in 2022 that the strategy was “unlawful due to inadequate consultation”, which the Government has sought permission to appeal. Fourteen policies in the strategy are currently paused