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BackgroundPersonas, based on customer or population data, are widely used to inform design decisions in the commercial sector. The variety of methods available means that personas can be produced from projects of different types and scale. ObjectiveThis study aims to experiment with the use of personas that bring together data from a survey, household air measurements and electricity usage sensors, and an interview within a research and innovation project, with the aim of supporting eHealth and eWell-being product, process, and service development through broadening the engagement with and understanding of the data about the local community. MethodsThe project participants were social housing residents (adults only) living in central Cornwall, a rural unitary authority in the United Kingdom. A total of 329 households were recruited between September 2017 and November 2018, with 235 (71.4%) providing complete baseline survey data on demographics, socioeconomic position, household composition, home environment, technology ownership, pet ownership, smoking, social cohesion, volunteering, caring, mental well-being, physical and mental health–related quality of life, and activity. K-prototype cluster analysis was used to identify 8 clusters among the baseline survey responses. The sensor and interview data were subsequently analyzed by cluster and the insights from all 3 data sources were brought together to produce the personas, known as the Smartline Archetypes. ResultsThe Smartline Archetypes proved to be an engaging way of presenting data, accessible to a broader group of stakeholders than those who accessed the raw anonymized data, thereby providing a vehicle for greater research engagement, innovation, and impact. ConclusionsThrough the adoption of a tool widely used in practice, research projects could generate greater policy and practical impact, while also becoming more transparent and open to the public.

This article provides guidelines for assessing and managing bleeding risk before invasive procedures. It recommends individualized assessment and decision-making based on the specific procedure and patient characteristics. The article discusses the management of anticoagulant and antiplatelet therapy, the limitations of routine coagulation testing, and the potential use of global haemostatic and platelet function testing to predict bleeding risk. It also addresses the use of plasma products and platelet transfusions in the ICU, emphasizing the lack of evidence supporting their prophylactic use. The article highlights the importance of operator and procedural factors in reducing the risk of complications during procedures. [Extracted from the article]

In the mid‐southern United States, rice (Oryza sativa L.) is flooded primarily to suppress weed germination and growth. Two experiments were conducted to determine whether herbicide performance in conventional or Clearfield rice weed control programs was affected by intermittent flooding. The effects of flooding and herbicide program on barnyardgrass [Echinochloa crus‐galli (L.) P. Beauv] control, rice grain yield, and water applied were investigated at the Delta Research and Extension Center in Stoneville, MS, on Sharkey clay (very fine, smectitic, thermic Chromic Epiaquert). For herbicides commonly applied in conventional (clomazone, quinclorac, pendimethalin, thiobencarb, fenoxaprop‐ethyl, cyhalofop‐butyl, and bisypriboac sodium) or Clearfield rice weed control programs (imazethapyr plus bispyribac‐sodium followed by imazethapyr, imazamox or bispyribac‐sodium), intermittent flooding had no adverse effect on barnyardgrass control relative to a continuous flood. Moreover, initiating irrigation when the perched water table drops to 8 inches below the soil surface had no effect on rice grain yield and reduced water applied by 51%. Mid‐southern US rice producers can capture the water‐saving benefits of intermittent flooding while having no adverse effects on herbicide activity or crop productivity in conventional and Clearfield systems. Core Ideas: Barnyardgrass control did not differ between intermittently and continuously flooded systems.Initiating irrigation when perched water table drops 8 inches below soil surface had no effect on rice grain yield.Intermittent flooding reduced water applied 51% compared to continuous flooding. [ABSTRACT FROM AUTHOR]

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As with many OECD countries, graduating medical students have been choosing specialist careers at a greater rate than ever before. Generalism in the form of family (general practice) and more generalist medical specialties have been trending down resulting in distributional geographic challenges. With the advent of COVID-19 in March 2020, medical schools and in particular the Joint Medical Program situated in a regional and rural area in NSW Australia had the unique opportunity to rethink the penultimate year curriculum when the previous rapid rotation model through numerous medical specialities became untenable. The need to vision a new practical pragmatic curriculum spurred a rapid revaluation of assessment, placement length and model with a pivot to an “embedded senior student placement” agnostic of discipline and supported by a competency-based learning portfolio. This article explores the barriers and enablers and identifies the potential elements of this type of placement which can be adapted to community and smaller rural sites. The positive student and supervisor experience also enabled an employment model to be woven into the students learning and ensured on hand medical student workforce for hospitals throughout the rural footprint. The capacity of these placements to celebrate variation in experience and support students to learn on the job have now caused a revision of the penultimate year with expectation of gains in students’ satisfaction and in employability. It has also opened up options to deliver and increase the inherent value of generalist placements with likely long term workforce benefit. [ABSTRACT FROM AUTHOR]

Cortical visual prostheses often use penetrating electrode arrays to deliver microstimulation to the visual cortex. To optimize electrode placement within the cortex, the neural responses to microstimulation at different cortical depths must first be understood. We investigated how the neural responses evoked by microstimulation in cortex varied with cortical depth, of both stimulation and response. A 32-channel single shank electrode array was inserted into the primary visual cortex of anaesthetized rats, such that it spanned all cortical layers. Microstimulation with currents up to 14 μA (single biphasic pulse, 200 μs per phase) was applied at depths spanning 1600 μm, while simultaneously recording neural activity on all channels within a response window 2.25–11 ms. Stimulation elicited elevated neuronal firing rates at all depths of cortex. Compared to deep sites, superficial stimulation sites responded with higher firing rates at a given current and had lower thresholds. The laminar spread of evoked activity across cortical depth depended on stimulation depth, in line with anatomical models. Stimulation in the superficial layers of visual cortex evokes local neural activity with the lowest thresholds, and stimulation in the deep layers evoked the most activity across the cortical column. In conjunction with perceptual reports, these data suggest that the optimal electrode placement for cortical microstimulation prostheses has electrodes positioned in layers 2/3, and at the top of layer 5. • Lamina superficial to layer 4 respond to microstimulation most readily. • All lamina reach a maximum response no later than 9 μA. • Extremely small microstimulation charges (<4 μA) in the superficial lamina results in primarily local neural activation. • Similar microstimulation in the input and deep lamina results in broader activation with a smaller response. [ABSTRACT FROM AUTHOR]

Continuous cultivation of dry seeded rice in addition to adverse environmental factors make the rice soils deficient of nitrogen more than any other essential nutrient. The study was conducted under greenhouse conditions in pots by varying soil N during seedling growth. Six cultivars with diverse genetic background, CL152, R4100412, Antonio, Bowman, Nipponbare, and Rex, were seeded in 6 × 12 inch PVC pots filled with 3:1 (sand: soil) as the rooting medium. All plants were irrigated with full-strength Hoagland nutrient solution, delivered three times for 28 days after sowing. Then, half the plants in each cultivar were supplied with 100% of control nutrient solution minus N for another 4 weeks. Agronomic, physiological and root parameters measurements recorded at optimum interval. Cumulative indices were calculated by summing each response index value as a ratio of treatment by control values. Cultivars were classified based on total cumulative N stress response index (TCNSRI), the sum of all the traits measured, into different groups based on mean and standard error. The reductions in most of the measured traits were less in CL152 and R4100412 than other rice cultivars to soil N stress. Based on total cumulative N stress response indices, the cultivars were classified. The cultivar R41004122 was identified as tolerant, CL152 as intermediate, and Antonio, Bowman, Nipponbare and Rex were sensitive to soil N stress. The identified soil N stress tolerant and intermediately tolerant cultivars will be useful to breeders to develop new genotypes and farmers to select cultivars best suited for dry seeded rice. [ABSTRACT FROM AUTHOR]

This paper describes a novel approach to explore how regulators, working with patients and practitioners, may contribute to supporting person‐centred care and processes of shared decision making in implementing professional standards and reducing harms. Osteopathic patients report high levels of patient care. However, areas of consultations less likely to be rated as high included "fully understanding your concerns," "helping you to take control," and "making a plan of action with you," suggestive of a paternalistic approach to care and a barrier to the effective implementation of standards. This programme explored how to support patients and practitioners to make more explicit what is important to support consultations with better communication in accordance with standards. A series of workshops took place involving approximately 80 participants, which explored and identified practitioner and patient values; these were themed to develop a common framework and tested using case studies. Aspects of what enables or presents a barrier to a positive consultation were further explored with real patient narratives, and a range of resources were subsequently developed, which may support patients and practitioners to make explicit what is important to them in a consultation. A series of approaches and tools were then developed for piloting including patient curriculum vitae; patient goal planner; patient animation to support preparation for an appointment; infographic: a patient poster or leaflet; practitioner reflective tool; and an audio recording to increase awareness and understanding of values‐based practice. In conclusion, a range of approaches may help to support patients and practitioners to make explicit what is important to them in a consultation. The next phase of our programme will use a range of methods including cluster sampling, pre‐testing and post‐testing with the Consultation and Relational Empathy (CARE) measure tool, and interviews and focus groups with users and practitioners to demonstrate impact. [ABSTRACT FROM AUTHOR]

Southern African Development Community (SADC) member states participate in many regional and multilateral initiatives that aim to enhance collective maritime security. How these initiatives affect state behaviour, and how African states’ interests and values, in turn, shape the functioning of these initiatives remain underexplored in maritime security studies. In addition, the study investigated the significance of SADC-focused regionalism as a force for its member states as they develop and implement foreign policies concerning maritime security in the region.

Objectives: We aimed to develop and validate Kinyarwanda versions of Short-Form Leeds Dyspepsia Questionnaire (SF-LDQ) and Short-Form Nepean Dyspepsia Index (SF-NDI) to measure the frequency and severity of dyspepsia and associated quality-of-life impact in Rwanda. Setting: A single, tertiary care centre in Rwanda. Participants: 200 consecutive Kinyarwanda-speaking patients referred to endoscopy (100 patients) or medical outpatients (100 patients). Interventions: Kinyarwanda versions of the SF-LDQ and SF-NDI were developed from English versions by translation, with back translation, crosschecking and pilot testing. Study participants completed these questionnaires at enrolment (time 1), and then completed the surveys again with blinded phone interviewers 3 days later (time 2). 20 randomly selected participants, diagnosed with a peptic ulcer on index endoscopy, completed a third survey by phone at day 30 (time 3), after therapy. Primary outcome measures: Internal consistency at time 1 (by Cronbach's α) and test-retest reliability between time 1 and time 2 (Spearman's correlation coefficient) for translated SF-LDQ and SF-NDI; validity versus clinical diagnosis (by receiver operating characteristic (ROC) curve) and responsiveness to treatment for SF-LDQ (by change in mean score). All outcomes were measured as per protocol. Results: Cronbach's a of the translated SF-LDQ was 0.93, showing high internal consistency. Spearman's correlation coefficient comparing time 1 and time 2 was 0.978 (p<0.001), demonstrating high reliability. Cronbach's a for the translated SF-NDI was 0.92. A cut-off score of 16 on the SF-LDQ showed a sensitivity of 97% and a specificity of 71% for the diagnosis of dyspepsia, correctly classifying 89% of patients. In the responsiveness analysis, the mean SF-LDQ score was reduced from 20.1 prior to treatment to 13.9 after 30 days of treatment (p=0.003). Conclusions: The Kinyarwanda versions of the SFLDQ and SF-NDI were valid, reliable and responsive to treatment. [ABSTRACT FROM AUTHOR]

Administrators of sport organizations have increasingly become aware of the importance of management not only for the operation of their day to day affairs, but alsofor the successfully operation of their respective sport organizations. In the case of national sport federations, management techniques that implement good governance can ultimately lead to success not only in the boardroom but also on the playing field as well. The purpose of this paper is to examine the perception of good governance and management by National Sport Federations administrators in Cyprus. Specifically, the objective of this paper is to examine: 1) the perception of good governance and management in National Sports Federations, and 2) the challenges in introducing good governance and better management practices in the sport system of Cyprus. The results revealed a positive perception orientation towards the inclusion of good governance as a management practice by National Sport Federation administrators. The results also revealed a limited understanding as well as a skill set for the application of good governance and management practice. [ABSTRACT FROM AUTHOR]

Although intermittent flooding of rice ( Oryza sativa L.) has been shown to significantly reduce irrigation demand, farmer adoption is limited in the United States where continuous flooding remains standard practice. This limited extent of adoption stems in part from a number of scalability and agronomic concerns. This study used replicated trials established in farmer-managed fields to determine if intermittent flooding can be successfully adapted to commercial-scale rice production in Mississippi. When intermittent flooding was coupled with multiple-inlet rice irrigation (MIRI), the quantities and qualities of yields were maintained or increased for five commercial rice varieties and one hybrid, relative to continuously-flooded controls. Only CL151 exhibited a decrease in total head rice when milled, this after being subjected to five or more wetting and drying cycles over ≈80 day flood periods. Water use over three years averaged 32% less than comparable MIRI systems not using intermittent flooding. These results demonstrate that intermittent flooding can be successfully adapted by producers to commercial-scale and that 600 mm irrigation is an achievable goal for rice grown on clay soils in Mississippi. The positive yield responses of CL162 to intermittent flooding and pre-flood urea-nitrogen support research showing that rice benefits from carefully managed wetting- and drying-periods when used in conjunction with effective pest management. The success of these producers at adapting intermittent rice flooding to commercial scale can be attributed in part to their having comprehensive weed and disease management programs, proficiency in using MIRI, and reliable irrigation systems with ample well capacities that allowed rapid flood establishment. Even partial adoption of intermittent rice flooding can increase rainfall capture and reduce demand for irrigation. In turn, this could help to alleviate overdraft of the Mississippi River Valley Alluvial aquifer, a resource of national and international significance. [ABSTRACT FROM AUTHOR]

This article details how a council service established an integrated management system ( IMS) within a wider corporate framework. In this context, an IMS was used as a tool to improve (i) Performance, (ii) Quality, (iii) Environment, and (iv) Health and Safety Management. A key factor was that the IMS had to be appropriate for accreditation and integratible with an emerging corporate management framework. In this case study, the authors provided a literature review before considering the issues facing the management team in implementing the IMS. Next, the discussion reflected on how the IMS has delivered improvements before concluding with recommendations on how to implement an IMS within similar services. These points of learning may be relevant beyond local government. This article therefore provides a summary of action research and the steps taken to deliver an IMS within a broader context. [ABSTRACT FROM AUTHOR]

In responding to the demand for change and improvement, local government has applied a plethora of operations management-based methods, tools and techniques. This article explores how these methods, specifically in the form of performance management models, are used to improve alignment between central government policy and local government practice, an area which has thus far been neglected in the literature. Using multiple case studies from Environmental Waste Management Services, this research reports that models derived in the private sector are often directly ‘implanted’ into the public sector. This has challenged the efficacy of all performance management models. However, those organisations which used models most effectively did so by embedding (contextualisation) and extending (reconceptualisation) them beyond their original scope. Moreover, success with these models created a cumulative effect whereby other operations management approaches were probed, adapted and used. [ABSTRACT FROM PUBLISHER]

Purpose – The aim of this paper is to investigate the links and relationships between strategy and operations in local government improvement efforts under the umbrella of the Local Government Modernisation Agenda (LGMA) in England. More specifically, it explores the implementation of structured change methods and performance measurement and management initiatives that claim to have a linked strategic and operational focus through to stakeholder impact. Design/methodology/approach – This research adopts an interpretive multiple case approach (n=5), using in-depth semi-structured interviews and focus groups, as well as substantive archive information. Findings – The structured integration of strategic level policy-setting and its associated operational level activity in local authorities is often obscure and lacking in cohesiveness. Performance measurement and management at the strategic level is, for the most part, driven by emerging legislation and the need for compliance rather than improving service effectiveness. This has led to discontinuity, delays in implementing policy, and criticism of performance measures from service delivery staff. Practical implications – There is a need for improved integration across the strategic-operational divide, which requires improved understanding and translation approaches. Methods adopted from other sectors should be assessed critically and tailored to suit this need rather than adopting an off-the-shelf provision. Originality/value – There is a paucity of in-depth studies relating to performance measurement and management across the strategic-operational span in the public sector in general, and local government in particular. Increased understanding in this area is of critical importance in relation to implementing effectively the current and future modernisation and reform initiatives. [ABSTRACT FROM AUTHOR]

The article describes the case of a late steroid-refractory immunotherapy-induced colitis relapse in a 65-year-old man without the precipitant of further immunotherapy. Highlights include severe colitis of the entire colon with oedema according to colonoscopy, the challenge of gaining hospital formulary or Pharmaceutical Benefits Scheme (PBS) approval, and PBS approval of combination immunotherapy for melanoma and renal cell carcinoma.

The article discusses the "What Is Crime?" photography competition held by the Centre for Crime and Justice, an educational charity at Kings College London in England. It explains the three categories considered for the said competition, such as environment, finance and violence. It describes the context and theme of some photograph entries for the 2009 competition, as interpreted by the artist who took the picture. The winners of the photography awards are mentioned.