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Artificial Intelligence (AI) is rapidly transforming the landscape of academic law libraries worldwide, offering new opportunities for enhancing legal research, information management, and user engagement. This article examines emerging trends in AI applications within academic law libraries, focusing on global developments alongside the unique challenges and opportunities faced in the Caribbean context. Key areas of exploration include AI-powered legal research tools, natural language processing (NLP) applications, and the ethical considerations surrounding AI integration. Drawing from insights presented at the CARALL Conference in July 2024, this article provides a comparative analysis of global best practices and proposes strategic recommendations for Caribbean academic law libraries to harness the potential of AI while addressing regional gaps in technological infrastructure and AI literacy.
Objectives/Goals: We developed an educational online module to equip researchers with knowledge, skills, and resources for conducting community-engaged research, aiming to foster meaningful collaboration between academia and communities. Methods/Study Population: A working group was formed, including three research faculty, four staff members, and four community partners who have partnered with researchers on community engaged projects. The working group first identified three objectives for the module and outlined what should be covered for each objective. The working group identified existing resources, texts, and videos that would address the objectives and worked in small groups to create additional content for the module. A smaller subgroup then took this content, organized it, and worked with the Office of Online Education to put the content into an interactive online format. Results/Anticipated Results: The three objectives identified for the online module are 1) Describe community engaged research, the purpose it serves, and why researchers do it; 2) Identify how to seek and collaboratively engage with a community partner; and 3) Identify and connect with resources for conducting community engaged research in Indiana. Each objective contains text, interactive figures and images, links to external resources or further reading, and videos of researchers and community partners talking about their own experiences and lessons learned. Each objective also includes activities and prompts for the learner to complete to apply the module content to the work they want to do. Discussion/Significance of Impact: Community engagement ensures research addresses real-world needs, builds trust, and includes diverse perspectives. Many researchers lack best practices to do this ethically. This module teaches skills needed to foster trust through transparency, respect, and by incorporating community voices.
We conduct the first modern econometric analysis of the historical deaf population in the United States by incorporating deafness into a model of human capital. We find that the deaf population invested less in observable educational and physical human capital. Lower literacy, employment, and occupational scores also suggest that unobserved human capital investments were not substantial enough to improve productivity to the level of the hearing population. States that subsidized schools for the deaf provided deaf people with improved social capital and access to intangible goods that they pursued at the cost of higher economic achievement. Finally, we argue that substantial lifecycle differences between the hearing and deaf populations have implications for unbiased school attendance and employment rate estimation.
This paper reports a series of experiments designed to evaluate how the advertised participation payment impacts participation rates in laboratory experiments. Our initial goal was to generate variation in the participation rate as a means to control for selection bias when evaluating treatment effects in common laboratory experiments. Initially, we varied the advertised participation payment to 1734 people from to using standard email recruitment procedures, but found no statistical evidence this impacted the participation rate. A second study increased the advertised payment up to . Here, we find marginally significant statistical evidence that the advertised participation payment affects the participation rate when payments are large. To combat skepticism of our results, we also conducted a third study in which verbal offers were made. Here, we found no statistically significant increase in participation rates when the participation payment increased from to . Finally, we conducted an experiment similar to the first one at a separate university. We found no statistically significant increase in participation rates when the participation payment increased from to . The combined results from our four experiments suggest moderate variation in the advertised participation payment from standard levels has little impact on participation rates in typical laboratory experiments. Rather, generating useful variation in participation rates likely requires much larger participation payments and/or larger potential subject pools than are common in laboratory experiments.
Advance Choice Documents (ACDs) have been recommended for inclusion in new mental health legislation for England and Wales based on evidence they reduce compulsory psychiatric admission, with particular benefit for Black people. As Black people disproportionately experience compulsory psychiatric admission in the UK, our aim was to explore potential barriers and enablers to effective ACD implementation for Black people with previous experience of compulsory admission.
Methods:
Six stakeholder workshops and one consensus workshop were held with: Black service users who had previously been involuntarily admitted, carers/supporters of Black service users, and mental health staff. Thematic analysis was conducted on workshop transcripts.
Results:
Participants were service users (n = 13), carers/supporters (n = 7), service users and carers/supporters (n = 3), and staff (n = 18). Thematic analysis identified themes of ‘training’, ‘completion’, ‘access’, and ‘use’ concerning ACD implementation. Stakeholders highlighted the importance of understanding the racialised experience of Black service users for effective ACD implementation. Strong communication between and amongst stakeholders and helpful systems for access were also emphasised. Stakeholders also recommended joint training and independent facilitation of ACDs to address Black service user-staff power imbalances.
Conclusions:
Known enablers and barriers to ACD implementation are important when considering ACDs for Black people, as is explicitly engaging with their experiences holistically, including racialised historical and individual experiences that underline some treatment preferences. Independent facilitation and shifts in service user-staff power dynamics present as key to realising the potential of ACDs to empower Black service users in relation to their care, and in turn to potentially reduce coercive care.
Hallucinations are common and distressing symptoms in Parkinson’s disease (PD). Treatment response in clinical trials is measured using validated questionnaires, including the Scale for Assessment of Positive Symptoms-Hallucinations (SAPS-H) and University of Miami PD Hallucinations Questionnaire (UM-PDHQ). The minimum clinically important difference (MCID) has not been determined for either scale. This study aimed to estimate a range of MCIDs for SAPS-H and UM-PDHQ using both consensus-based and statistical approaches.
Methods
A Delphi survey was used to seek opinions of researchers, clinicians, and people with lived experience. We defined consensus as agreement ≥75%. Statistical approaches used blinded data from the first 100 PD participants in the Trial for Ondansetron as Parkinson’s Hallucinations Treatment (TOP HAT, NCT04167813). The distribution-based approach defined the MCID as 0.5 of the standard deviation of change in scores from baseline at 12 weeks. The anchor-based approach defined the MCID as the average change in scores corresponding to a 1-point improvement in clinical global impression-severity scale (CGI-S).
Results
Fifty-one researchers and clinicians contributed to three rounds of the Delphi survey and reached consensus that the MCID was 2 points on both scales. Sixteen experts with lived experience reached the same consensus. Distribution-defined MCIDs were 2.6 points for SAPS-H and 1.3 points for UM-PDHQ, whereas anchor-based MCIDs were 2.1 and 1.3 points, respectively.
Conclusions
We used triangulation from multiple methodologies to derive the range of MCID estimates for the two rating scales, which was between 2 and 2.7 points for SAPS-H and 1.3 and 2 points for UM-PDHQ.
Longitudinal studies can provide insights into how family members negotiate the caring role and carer identity over time. The analyses of the longitudinal, qualitative interviews on ‘living well’ with dementia from the IDEAL cohort study aimed to identify the shifting, embedded narratives of family members of people with dementia as they negotiated the caring role and carer identity over time. Twenty semi-structured, qualitative interviews were conducted with family members of people with dementia and 14 were repeated one year later; these interviews were analysed using cross-sectional and longitudinal thematic and structural narrative analyses. Longitudinal, interrelated themes, including the care needs and decline of the person with dementia, relationship change and variable service support, framed the narrative types of family members. Six shifting narratives, apparent as dominant and secondary narrative types, characterized negotiating the caring role over time: absent/normalizing, active role adoption / carer identity, resistance, acceptance and resignation, hypervigilance/submergence and role entrapment, and foreshadowed future. The presence or absence of a carer identity was also evident from interviewees’ accounts, although, even where family members were overburdened by the caring role, they did not necessarily express a carer identity. Rather than considering transition into a carer identity, hearing different narratives within the caring role is important to understand how family members experience caring, whether they see themselves as ‘carers’, and when and how they need support. Timely and continued post-diagnostic support, where different caring narratives are recognized, is needed, as well as international initiatives for carer identification.
Family and friends (family carers) provide substantial support to those with mental ill health, often affecting their own well-being. Subsequently, family carers have their own recovery journeys. Research highlights numerous benefits of attending Recovery Colleges, but whether these apply for family carers remains unexplored.
Aims
We aimed to explore family carers’ experiences of attending Recovery Colleges across England, to understand current provision and how this might better include and support family carers.
Method
Together with lived experience researchers, this qualitative focus group study used collaborative thematic analysis of online focus groups and interviews with family carers and Recovery College staff from across England.
Results
We generated six superordinate themes: ‘The “carer” identity is not clearcut’, ‘Recovery ethos applies to family carers too’, ‘Power of lived experience’, ‘Educational focus is appealing’, ‘Family carers deserve recognition and provision’ and ‘Reaching out and fitting around family carers’. Attending Recovery Colleges developed family carers understandings and gave them skills to navigate services and support themselves and others, which furthered their own recovery journeys. Shared learning spaces were helpful, but participants felt these were not always oriented to include family carers. Our findings revealed ways Recovery Colleges could increase their relevance and accessibility to family carers.
Conclusions
The unique characteristics of Recovery Colleges suited the recovery needs of family carers. However, more resources are needed to develop this potential and reach more family carers. Family carer co-researchers enriched our findings, and discussions with the Recovery College community furthered our recommendations for practice.
Sodium-glucose cotransporter-2 inhibitors reduce cardiovascular outcomes in patients with congestive heart failure and a biventricular circulation. Congestive heart failure in Fontan univentricular circulation is distinctly different. Experience with sodium-glucose cotransporter-2 inhibitors in this group has not yet been well described.
Objectives:
This work describes safety and tolerability of sodium-glucose cotransporter-2 inhibitors in patients with Fontan circulation.
Methods:
Single-centre review of patients with Fontan circulation prescribed a sodium-glucose cotransporter-2 inhibitors for congestive heart failure. Primary outcome was tolerability or need for discontinuation. Secondary outcomes were changes in New York Heart Association class, congestive heart failure hospitalisation, ventricular function, exercise performance, and laboratory values.
Results:
We identified 25 patients with Fontan circulation prescribed an sodium-glucose cotransporter-2 inhibitors, most with a systemic right ventricle. Over a third of subjects had at least moderately reduced baseline ventricular function. Baseline catheterisation showed a mean Fontan pressure of 17.1 ± 3.7 mmHg and pulmonary capillary wedge pressure 11.7 ± 3.2 mmHg at rest; 59% had occult diastolic dysfunction with abnormal pulmonary capillary wedge pressure elevation following volume expansion. Most were on congestive heart failure medications and/or a pulmonary vasodilator prior to sodium-glucose cotransporter-2 inhibitors addition, and three had a congestive heart failure hospitalisation within the previous year. All reported good medication tolerance except one patient was nonadherent to medications and two discontinued sodium-glucose cotransporter-2 inhibitors for perceived side effects. There were no significant differences in secondary outcomes. There was, however, a downward trend of serum brain natriuretic peptide (n = 13) and improved peak VO2 (n = 6), though neither statistically significant (p > 0.05).
Conclusion:
This series, the largest published to date, suggests that sodium-glucose cotransporter-2 inhibitors are safe and tolerable congestive heart failure therapy in Fontan circulation. Further research is warranted to explore therapy in this unique population.
Relatively little is known about mental healthcare-related harm, with patient safety incidents (PSIs) in community-based services particularly poorly understood. We aimed to characterize PSIs, contributory factors, and reporter-identified solutions within community-based mental health services for working-age adults.
Methods
We obtained data on PSIs reported within English services from the National Reporting and Learning System. Of retrieved reports, we sampled all incidents reportedly involving ‘Death’, ‘Severe harm’, or ‘Moderate harm’, and random samples of a proportion of ‘Low harm’ or ‘No harm’ incidents. PSIs and contributory factors were classified through qualitative content analysis using existing frameworks. Frequencies and proportions of incident types were computed, and reporter-identified solutions were inductively categorized.
Results
Of 1825 sampled reports, 1443 were eligible and classified into nine categories. Harmful outcomes, wherein service influence was unclear, were widely observed, with self-harm the modal concern amongst ‘No harm’ (15.0%), ‘Low harm’ (62.8%), and ‘Moderate harm’ (37.6%) categories. Attempted suicides (51.7%) and suicides (52.1%) were the most frequently reported events under ‘Severe harm’ or ‘Death’ outcomes, respectively. Incidents common to most healthcare settings were identified (e.g. medication errors), alongside specialty-specific incidents (e.g. Mental Health Act administration errors). Contributory factors were wide-ranging, with situational failures (e.g. team function failures) and local working conditions (e.g. unmanageable workload) widely reported. Solution categories included service user-directed actions and policy introduction or reinforcement.
Conclusions
Study findings provide novel insights into incidents, contributory factors, and reported solutions within community-based mental healthcare. Targets for safety improvement are outlined, aimed at strengthening system-based prevention of incidents.
Klebsiella pneumoniae are opportunistic pathogens which can cause mastitis in dairy cattle. K. pneumoniae mastitis often has a poor cure rate and can lead to the development of chronic infection, which has an impact on both health and production. However, there are few studies which aim to fully characterize K. pneumoniae by whole-genome sequencing from bovine mastitis cases. Here, K. pneumoniae isolates associated with mastitis in dairy cattle were identified using matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS) and whole-genome sequencing. Furthermore, whole-genome sequence data were used for phylogenetic analyses and both virulence and antimicrobial resistance (AMR) prediction, in parallel with phenotypic AMR testing. Forty-two isolates identified as K. pneumoniae were subject to whole-genome sequencing, with 31 multi-locus sequence types being observed, suggesting the source of these isolates was likely environmental. Isolates were examined for key virulence determinants encoding acquired siderophores, colibactin, and hypermucoidy. The majority of these were absent, except for ybST (encoding yersiniabactin) which was present in six isolates. Across the dataset, there were notable levels of phenotypic AMR against streptomycin (26.2%) and tetracycline (19%), and intermediate susceptibility to cephalexin (26.2%) and neomycin (21.4%). Of importance was the detection of two ESBL-producing isolates, which demonstrated multi-drug resistance to amoxicillin-clavulanic acid, streptomycin, tetracycline, cefotaxime, cephalexin, and cefquinome.
For several years stigma researchers in India have relied on Western instruments or semi-structured stigma scales in their studies. However, these scales have not been rigorously translated and adapted to the local cultural framework. In the current study, we describe the cultural adaptation of six stigma scales with the purpose of using it in the native language (Kannada) based on translation steps of forward translation, expert review and synthesis, cultural equivalence, back translation and cognitive interview processes.
Several items were modified in the target language at each stage of the cultural adaptation process as mentioned in the above steps across all scales. Cultural explanations for the same have been provided. Concepts such as “community forest” and “baby sitting" was replaced with equivalent native synonyms. We introduced native cultural and family values such as “joint family system” and modified the item of housing concept in one of the tools. The concept of “privacy” in the Indian rural context was observed to be familial than individual-based and modification of corresponding items according to the native context of “privacy”. Finally, items from each scale were modified but retained without affecting the meaning and the core construct.
In 2022, a group of health technology assessment (HTA) bodies from Australia, Canada, and the UK announced a collaboration to identify solutions to common challenges. This collaboration was later expanded to include agencies from New Zealand and Quebec, Canada. Since one possible activity of the consortium is joint assessments, we compared the methodologies of the agencies on 11 topics to assess the feasibility of this.
Methods
We reviewed the methodological guidelines of the Canadian Agency for Drugs and Technologies in Health (CADTH), L’Institut national d’excellence en santé et services sociaux (INESSS), the National Institute for Health and Care Excellence (NICE), the Pharmaceutical Benefits Advisory Committee (PBAC), the Pharmaceutical Management Agency (Pharmac), and the Scottish Medicines Consortium (SMC). The topics considered were real-world evidence, consideration of health effects, economic reference case, survival analysis, surrogate endpoints, patient involvement, uncertainty, orphan pathways, clinical evidence requirements, carer perspective, and decision modifiers. We analyzed the level of alignment across the collaborating agencies using information from the guidelines, supplemented by published literature where necessary.
Results
Three topics exhibited high alignment: consideration of health effects, clinical evidence requirements and surrogate endpoints. The topics of orphan pathways and carer perspective had low alignment. The remaining topics had moderate alignment. Regarding orphan pathways, NICE and the SMC had separate processes for ultra-orphan drugs, CADTH and INESSS implicitly consider rarity, and PBAC and Pharmac do not appear to consider rarity. Since carer perspective is not commonly accepted in HTA, NICE was the only agency with relevant guidance on this topic. INESSS required the societal perspective as standard, while the PBAC and Pharmac explicitly excluded it. CADTH may consider carer perspective in some circumstances, whereas the SMC guidance was ambiguous.
Conclusions
While there is good alignment on most topics, there are several areas where agencies would need to resolve divergences in preferred methodology if joint assessments are going to be carried out in the future. All relevant stakeholders should be part of this process, including patient groups and industry.
This article addresses a critical gap in international research concerning digital literacies and empowerment among adults who are English as an additional language (EAL) learners. In the Australian context, where digital communication and services are embedded in all aspects of life and work, proficiency in digital literacies, including advanced technologies like generative artificial intelligence (AI), is vital for working and living in Australia. Despite the increasing prevalence and significance of generative AI platforms such as ChatGPT, there is a notable absence of dedicated programs to assist EAL learners in understanding and utilising generative AI, potentially impacting their employability and everyday life. This article presents findings from a larger study conducted within training providers, spanning adult educational institutions nationwide. Through analysis of data gathered from surveys and focus groups, the article investigates the knowledge and attitudes of students, educators, and leaders regarding integrating generative AI into the learning program for adult EAL learners. The results reveal a hesitance among educators, particularly concerning beginning language learners, in incorporating generative AI into educational programs. Conversely, many adult learners demonstrate enthusiasm for learning about its potential benefits despite having limited understanding. These disparities underscore the pressing need for comprehensive professional development for educators and program leaders. The findings also highlight the need to develop the AI literacy of learners to foster their understanding and digital empowerment. The article concludes by advocating for a systemic approach to include generative AI as an important part of learning programs with students often from adult migrant and refugee backgrounds.
An extension is described to a product testing model to account for misinformation among subjects. A misinformed subject is one who associates the taste of product A with product B and vice-versa; thus, the subject would tend to perform incorrectly on pick 1 of 2 tests. A likelihood ratio test for the presence of misinformation is described. The model is applied to a data set, and misinformation is found to exist. Biases due to model misspecificationand other implications for product testing are discussed.
This Element provides a fresh approach to the representation and experience of the French Disease, by reassessing a wide range of textual and visual sources through the lens of contemporary medical ideas. It analyses how knowledge about the Great Pox was transmitted to a literate and also a wider public through performance and the circulation of popular prints. Chronicles, satirical and moralistic poems and plays about prostitutes, along with autobiographical accounts, described symptoms and the experience of patients, reflecting how non-medical men and women understood the nature of this terrible new disease and its profound physical and psychological impact. The second major theme is how the French Disease was represented visually. Woodcuts and broadsheets showing the moral and physical decline of courtesans are analysed together with graphic medical illustrations of symptoms and their treatment together with images of the diseased body of St Job, patron saint of the French Disease.