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Dementia in-patient units (DIU) are mental health wards that care for people living with dementia (PLWD) whose symptoms are causing severe distress or potential risk. DIUs look after some of the most vulnerable and unwell people in society, yet they are environments that are underresearched: a recent systematic review revealed only 36 articles worldwide relating to DIUs. To better understand research priorities in DIUs, we undertook a two-round online Delphi survey of PLWD with experience of DIUs, their carers and professionals who work in DIUs.
Results
Ten research priorities were described and ranked. The top three were how to use non-pharmacological techniques to manage non-cognitive symptoms of dementia, supporting families and better understanding of how to discharge PLWD safely and healthily.
Clinical implications
This is the first Delphi consensus to describe DIU research priorities. This paper will help researchers focus on the areas that matter most to people who use DIUs.
Aiming at the error estimation problem of a radar detection system when the variation law of system error is unknown, an improved Gaussian mean-shift radar dynamic error registration algorithm (IGMSR) is proposed. The algorithm can effectively adapt to the variation of system error when the variation law of system error is unknown. The IGMSR algorithm uses the mean-shift method to contribute different characteristics to the estimation results of different sample points, and constructs weight coefficients according to the deviation of sample points from the mean and sampling time. The simulation results show that more than 90% of the constant system errors can be eliminated; for the systematic error with slow change, more than 80% of the bias can be eliminated in real time, while a previous method of Zhu and Wang (2018) can only eliminate 60% of the systematic error and require the change law to be known. This method overcomes the influence of random error and abnormal point, and the estimation results are more robust.
The International Regulations for the Prevention of Collisions at Sea (IRPCS) provide a comprehensive set of instructions for watchkeeping officers to follow and prevent collisions at sea. This study compares how six newly qualified deck officers and six Master Mariners, who were all trained at the same college, applied the IRPCS. Individual, semi-structured interviews were used to uncover how the 12 participants applied and interpreted the rules for three authentic scenarios. Phenomenography was used to capture the qualitatively different means by which participants interpreted the IRPCS. For basic collision avoidance situations, the results indicated little difference between the cohorts' ability to interpret and apply the IRPCS. However, when the scenarios became more complicated, Master Mariners outperformed newly qualified deck officers. In these cases, Master Mariners displayed a greater capacity to assess the overall situation, whereas newly qualified deck officers tended to simplify by focusing on a single rule. These findings indicate that training needs to focus on developing situational awareness; and training scenarios need to incorporate multiple vessels in authentic scenarios to enhance newly qualified deck officers' capacities to interpret the IRPCS.
I discuss a certain kind of emotionally charged negative reaction to defences of non-monogamous love, which I call collective-identity reactions. Expanding on work by Audrey Yap and Jonathan Ichikawa, who consider defensive reactions grounded in individual identity, I argue that collective-identity reactions are characteristically associated with claims about who we are, and motivated by a sense that the relevant we is in some way under threat. Looking into which we might be threatened by defences of non-monogamy, and why, reveals that this apparently personal subject matter is in fact entangled with global political issues like capitalism and American cultural imperialism. I conclude with some thoughts about ameliorative strategies for situations structurally similar to this one.
In light of a recent surge of interest in time across a range of disciplines, a case has been made that New Testament studies has experienced a “temporal turn.” This claim raises an important question about how one understands the relation of recent developments to earlier, long-held debates about time among New Testament scholars. This question is answered here by revisiting the “salvation history” debate between Oscar Cullmann and Rudolf Bultmann, with the help of Paul Ricoeur’s analysis in Time and Narrative and in the context of recent trends in work on “temporalities.” This article argues that, although in many respects recent work on time offers fresh language to describe the kinds of time at stake for New Testament scholarship, it is also true that attending to the earlier debates shows how parts of the temporal turn are in fact a return to questions long considered.
Currently, the Affordable Care Act helps to provide inexpensive preventive care services to adolescents (10–19 years old) by preventing insurance companies from implementing cost-sharing measures. Some of these services can fall under the realm of mental health preventive care such as anxiety and depression testing. The lack of cost to a patient and their family encourages doctors to offer these services to their young patients. Furthermore, this Affordable Care Act provision - fosters doctor-patient communication because it normalizes mental health services as part of well-being. However, Braidwood Management Inc. v. Becerra threatens to have far reaching implications for preventive care policy and to disrupt health communication efforts to promote positive mental health. This Article uses structuration theory and a conceptual framework of adolescent development to examine the potential ramifications of cost-sharing on adolescent health. The implications of this change in cost-sharing include constraining doctors’ communication behavior in primary care settings and stunting healthy adolescent development. Ultimately, if the Braidwood decision is upheld, it may pose a challenge to a doctor’s ability to communicate with their young patient about mental health.
Transhumanists claim that futuristic technologies will permit you to live indefinitely as a nonbiological ‘posthuman’ with a radically improved quality of life. Philosophers have pointed out that whether some radically enhanced posthuman is really you depends on perplexing issues about the nature of personal identity. In this paper, I present an especially pressing version of the personal-identity challenge to transhumanism, based on the ideas of Derek Parfit. Parfit distinguishes two main views of personal identity, an intuitive, nonreductive view and a revisionary, reductive view. I argue that the standard rationale for wanting to become a posthuman makes sense only if the intuitive view is correct, but that the standard rationale for thinking that it is possible to become a posthuman makes sense only if the revisionary view is correct. Following this, I explain why the obvious responses are unsatisfactory or imply the need to rethink transhumanism in ways that make it much less radical and less appealing.
The relationship between scholarship and adjudication has attracted considerable attention in recent years, especially in those areas where significant academic expertise has been developed and academic scrutiny of decisions is common. Yet the role of scholars and scholarship in the context of the adjudicatory practices of the European Court of Human Rights (ECtHR) has remained palpably under-investigated. This article begins to fill this gap in the literature by carrying out the first large-scale empirical study of the use of scholarship by the ECtHR. The authors rely on a purpose-built dataset comprising all the citations made by the Grand Chamber of the Court in judgments and separate opinions appended to it. The study finds that the Court's majority uses scholarship for the purposes of reviewing facts and interpreting international and domestic law but does so rarely. The majority of the ECtHR does not use scholarship to interpret the European Convention on Human Rights or for persuasive purposes, unlike the individual Judges in their separate opinions. Indeed, individual Judges refer to scholarship more often, for more varied and arguably different purposes. This use, however, is inconsistent in terms of both frequency and the types of sources referred to.
Constitutional courts operate under a framework of formal and informal rules. While formal rules have been extensively studied, our understanding of informal rules remains limited. Courts often rely on internal practices, traditions and unwritten customs developed over time, posing a significant challenge due to their hidden nature. Numerous constitutional courts lack detailed voting protocols in their statutes and internal regulations, leaving essential aspects to the court's discretion, such as, inter alia, the voting order, deliberation style, outcome versus issue voting and tie-breaking protocols. By employing a case study of strategic breaching of informal voting protocols in the Mexican Supreme Court, this article highlights the complexity of enforcing informal voting rules given that external actors may be unaware of them, along with other factors. Even when informal rules are broadly known, certain circumstances may diminish the efficacy of informal sanctions addressing their breach. Thus, key judicial players, such as chief justices or judge-rapporteurs, may take advantage of the informal rules of voting protocols to advance their policy preferences.