Practical Lessons Research Articles

Assessing racial bias in healthcare predictive models: Practical lessons from an empirical evaluation of 30-day hospital readmission models

ObjectiveDespite increased availability of methodologies to identify algorithmic bias, the operationalization of bias evaluation for healthcare predictive models is still limited. Therefore, this study proposes a process for bias evaluation through an empirical assessment of common hospital readmission models. The process includes selecting bias measures, interpretation, determining disparity impact and potential mitigations. MethodsThis retrospective analysis evaluated racial bias of four common models predicting 30-day unplanned readmission (i.e., LACE Index, HOSPITAL Score, and the CMS readmission measure applied as is and retrained). The models were assessed using 2.4 million adult inpatient discharges in Maryland from 2016 to 2019. Fairness metrics that are model-agnostic, easy to compute, and interpretable were implemented and apprised to select the most appropriate bias measures. The impact of changing model’s risk thresholds on these measures was further assessed to guide the selection of optimal thresholds to control and mitigate bias. ResultsFour bias measures were selected for the predictive task: zero-one-loss difference, false negative rate (FNR) parity, false positive rate (FPR) parity, and generalized entropy index. Based on these measures, the HOSPITAL score and the retrained CMS measure demonstrated the lowest racial bias. White patients showed a higher FNR while Black patients resulted in a higher FPR and zero-one-loss. As the models’ risk threshold changed, trade-offs between models’ fairness and overall performance were observed, and the assessment showed all models’ default thresholds were reasonable for balancing accuracy and bias. ConclusionsThis study proposes an Applied Framework to Assess Fairness of Predictive Models (AFAFPM) and demonstrates the process using 30-day hospital readmission model as the example. It suggests the feasibility of applying algorithmic bias assessment to determine optimized risk thresholds so that predictive models can be used more equitably and accurately. It is evident that a combination of qualitative and quantitative methods and a multidisciplinary team are necessary to identify, understand and respond to algorithm bias in real-world healthcare settings. Users should also apply multiple bias measures to ensure a more comprehensive, tailored, and balanced view. The results of bias measures, however, must be interpreted with caution and consider the larger operational, clinical, and policy context.

EXPLORING DIVERGENT QUESTIONS AND COLD CALLING IN A CLASS DISCUSSION

Effective communication is crucial in education as it plays a pivotal role in fostering student engagement and participation in the classroom. Students encounter numerous challenges when engaging with teachers, particularly in English classes. They must exert greater focus and be more proactive in the learning process to comprehend the information, which hinders their ability to remain engaged and actively participate. Researchers aim to explore questioning strategies and cold-calling techniques to enhance students' comprehension, increase their engagement in the learning process, and create avenues for them to articulate their viewpoints using cold-calling approaches facilitated by the teacher. This study aims to analyze how students react to the combination of the questioning method and cold calling in a collaborative setting. The study employed the qualitative descriptive method as its research approach and design. The research findings demonstrated that integrating the questioning method and cold calling was not beneficial in facilitating the development of practical lessons. It was evident from the shift in class dynamics observed after the study. Conversely, cold calling continues to pressure students, causing them to lose concentration on class issues. Implementing questioning and cold-calling strategies in the classroom yields distinct effects. There were two opposing situations in which students attempted to maintain their focus to respond to the teacher's questions while also experiencing anxiety simultaneously.

Session 13. Oral Presentation for: Practical lessons from implementing a top-down, drone-based methane emissions quantification technology into global oil and gas operations

Session 13. Oral Presentation for: Practical lessons from implementing a top-down, drone-based methane emissions quantification technology into global oil and gas operations

Instructional Videos for Students in Dental Medicine: Rules of Design and Correlations with Their Habits as Internet Consumers.

We investigated the opinions of a sample of 551 students from four medical universities in Romania, in order to identify the students' preferred characteristics in instructional videos, both globally and comparatively on genders and age groups and also according to their general preferences for using internet services. We used univariate (hypothesis testing) and multivariate (two-step clustering) data analysis techniques and revealed three clusters of students, primarily determined by their perceptions of the visual appearance of the instructional videos. The structure of the clusters by gender and age group was relatively similar, but we recorded differences associated with the students' expressed preferences for certain internet services compared to others. The first identified cluster (35.4% of the cases) contains students who prefer instructional videos to contain images used only for aesthetic purposes and to fill the gaps; they use internet services mainly for communication. The second cluster of students (34.8%) prefers videos designed as practical lessons, using explanatory drawings and diagrams drawn at the same time as the explanations; they also use internet services mainly for communication. The last cluster of students (29.8%) prefer videos designed as PowerPoint presentations, with animated pictures, diagrams, and drawings; they are slightly younger than the others and use internet services mainly for information and communication, but also for domestic facilities. The students' preferences for certain features of instructional videos depend not only on gender and age but are also related to their developmental background and general opinions about modern technologies.

Stories from Edzell Lodge children’s home in the 1940s and 1950s: lessons for practice and research

‘Gnatola ma no kpon sia, eyenabe adelan to kpo mi sena’ (‘Until the lion has his or her own storyteller, the hunter will always have the best part of the story’) (Ghanian proverb, available at: http://thelionandthehunter.org/). Historically, both the discipline and profession of social work have been imagined and constructed by those who oversee social work services – ‘the hunters’, according to the aforementioned Ghanaian proverb. Thus, it has been predominantly white, middle-class, non-disabled, mainly female, Global North voices that have determined what social work looks like and how it is carried out across the world. However, this is changing. Today, many more ‘lions’ are telling their stories, as this article demonstrates. Through the curated narratives of Bob, Doug and Rose, as well as that of their storyteller/collaborator, Viv, we learn that growing up in care in Scotland in the 1940s and 1950s was ‘confused and confusing’ for the children at the heart of it. Contradictory discourses competed for dominance, and the children experienced unintended consequences from the ‘care’ they received. While not attempting to universalise on the basis of three people’s stories, we believe that they have much to teach social work.

Strategic opportunities for nature-based solutions: Lessons for policy and practice from cross-city comparisons

Nature-based solutions (NbS) can address urban infrastructure challenges exacerbated by climate change (e.g., flooding) and contribute to citizens’ quality of life, supporting both environmental and social policy goals. Despite those advantages, NbS can be a difficult ‘sell’ for policy makers in a wider context of social uncertainty and austerity. To support greater insight into the issues affecting market uptake, this scoping study draws on data from a EU Horizons project. The experience of government and business stakeholders in six cities (Liverpool, Valladolid, Izmir, Mantua, Ludwigsburg, and Medellin), serve as illustrative cases of market uptake from the NbS provider perspective. Drawing on interview, survey and secondary data, three strategic drivers (and barriers) of NbS investment emerged: Socio-cultural, financial and governance. At operational level, four types of NbS (Grand, customized, large scale and niche) and four types of strategic opportunities emerged: Tolerable (low cost: low benefit), Ruinous (high cost: low benefit), Best case (low cost: high benefit) and Aspirational (high cost: high benefit). On the supply side, funding and maintenance capabilities are the primary barriers to NbS implementation. On the demand side, insight into public perception of NbS is crucial. Drawing from this data, the three pillars of successful NbS projects are: (1) Relevant policy frameworks (global, national and municipal), (2) supporting mechanisms and resources for public-private partnerships and (3) engaging all stakeholders through targeted communications emphasizing all forms of value.

Methodological and practical guidance for designing and conducting online qualitative surveys in public health.

Online qualitative surveys-those surveys that prioritise qualitative questions and interpretivist values-have rich potential for researchers, particularly in new or emerging areas of public health. However, there is limited discussion about the practical development and methodological implications of such surveys, particularly for public health researchers. This poses challenges for researchers, funders, ethics committees, and peer reviewers in assessing the rigour and robustness of such research, and in deciding the appropriateness of the method for answering different research questions. Drawing and extending on the work of other researchers, as well as our own experiences of conducting online qualitative surveys with young people and adults, we describe the processes associated with developing and implementing online qualitative surveys and writing up online qualitative survey data. We provide practical examples and lessons learned about question development, the importance of rigorous piloting strategies, use of novel techniques to prompt detailed responses from participants, and decisions that are made about data preparation and interpretation. We consider reviewer comments, and some ethical considerations of this type of qualitative research for both participants and researchers. We provide a range of practical strategies to improve trustworthiness in decision-making and data interpretation-including the importance of using theory. Rigorous online qualitative surveys that are grounded in qualitative interpretivist values offer a range of unique benefits for public health researchers, knowledge users, and research participants.

68 Human Biomonitoring (HBM) for emergency responders - Basic considerations, a practical approach and lessons learned

68 Human Biomonitoring (HBM) for emergency responders - Basic considerations, a practical approach and lessons learned

FURst Aid: Advancement opportunities from hybrid public outreach series

FURst Aid is a series of free, hybrid events for animal lovers. Attendees learn practical first aid and preventative care skills from a diverse pool of experts at the Oregon State University (OSU) Carlson College of Veterinary Medicine (CCVM) to help them look after their furry friends. This case study will cover how the FURst Aid series offers public outreach, engagement and service, as well as continuing education to professionals (including CCVM alumni). It will also elaborate some practical tips and lessons learned for offering a successful hybrid event series. Though produced by a small advancement team and on a tight budget, the series yields great results and reaches a wide spectrum of audiences. By offering all events free of charge, economic barriers to the public's participating in and receiving benefits from this service are greatly reduced. From an advancement perspective, the series has enabled the college as well as the OSU Foundation to engage with a strategically important community for marketing, alumni relations and fundraising efforts. Readers will learn how to tap into their own experts to engage their own core communities, and considerations to plan, advertise and deliver a hybrid event series.

Living labs as transformative incrementalism: lessons learned on the role of a university living lab in mobilising just sustainabilities on campus

ABSTRACT The Living Lab approach is an opportunity for diverse actors to co-create solutions to solve real-world issues. Simon Fraser University, situated on the unceded territories of the Musqueam, Squamish, Tsleil-Waututh, Katzie, Kwikwetlem, Qayqayt, Kwantlen, Semiahmoo and Tsawwassen peoples in British Columbia, Canada developed a Living Lab program to apply the university’s leading climate research expertise to solve its own infrastructure, operations and service challenges. Projects were led by “Living Lab Scholars,” graduate students who form teams with faculty and staff to co-design research to help the university meet its sustainability and equity goals. The scholars took part in experiential learning, received mentorship and financial support and were provided with the opportunity to apply their academic research skills to address four sustainability issues: (1) waste management, (2) sustainable transportation, (3) carbon footprint of streaming, and (4) food security. While being grounded in participatory action research and integrating justice, decolonisation, equity, diversity and inclusivity considerations into the process design, the limited resources, time scarcity and operational reality reflected that the reality of implementing the solutions resulted in varying degrees of transformational impact. This paper applies autoethnography to enable the participants to reflect upon how the university as a system can support advances in just sustainabilities and highlights practical lessons learned for future Living Lab practitioners who aim to mobilise their solutions on campus. Findings from the project highlight the role of the Living Lab in supporting “transformative incrementalism” and challenging the conventions of academic knowledge production.

THE SETAs AND S-SYSTEM SKILLS DEVELOPMENT IN SOUTH AFRICA AND BRAZIL: A TRANSFORMATIVE SOCIAL POLICY PERSPECTIVE

Relevance. The African Union declared 2024 the Year of Education, Educating an African Fit for the 21st Century and the Agenda 2063 aspiration seeks to catalyse an education and skills revolution for Africa’s industrialisation. This places Technical and Vocational Education and Training at the centre in skills development on the continent. As part of their endogenous initiatives at improving skills, knowledge and abilities desired for work and enhance industrial competitiveness South Africa and Brazil instituted the SETAs system and the S-System, respectively aimed at skills formation and human capital development. Aim. The two BRICS countries of South Africa and Brazil, through Acts of Parliament, institutionalised skills development programs which had seen them emerge as leading economies on their respective continents. What key lessons can be drawn for other African countries in their quest for industrialisation in the AU Year of the Year of Education to foster the relevant and competitive skills needed for the 21st century. Methods. The case studies of the S-system of Brazil and the SETAs system of South Africa are presented using a case study approach. Examining the SETAs and S-systems using a Transformative Social Policy framework, the paper adopts a case study approach seeks to answer the following questions: (1) what kind of institutional linkages and coordination between industry/business and skills/education training institutions need to be in place for adequate and appropriate human capital formation in Africa? (2) what are the appropriate funding mechanisms for human capital development suitable for African countries to adopt? (3) What coordination and facilitating role should be adopted by states in African countries to facilitate industry/training institutional linkages? Results and conclusions. Key finding indicates that while the SETAs in South Africa are widely recognised by employers and give holders a big advantage in securing employment, TVET-market coordination, regional coordination for area-specific industrialisation and appropriate skills funding mechanism are key for competitive skills development and provide practical and policy lessons for African governments.

Agrotechnology Students’ Acceptance on Agriculture Drones Spraying as Practical Tool in Class using the Knowledge, Attitude and Practice (KAP) Model

Agriculture drones are currently becoming a major mechanization for the agricultural industry. Drones have been specifically utilized to improve agricultural activities and hence require a specific skill set to operate effectively and efficiently in the field. Therefore, the future workforce in the agriculture industry is required to learn and accept this new technology. Nonetheless, integrating drone technology into the classroom presents obstacles for students and lecturers as well. Therefore, gaining a deeper comprehension of the numerous facets of drone technology integration in higher education, especially courses related to agrotechnology programs is critical. This quantitative survey used the Knowledge, Attitude, and Practice (KAP) paradigm to investigate agrotechnology students' acceptance of agriculture drones while reducing ambiguity using statistical analysis SPSS 26.0 and employed both descriptive and inferential analysis techniques. The KAP model was employed in a recent survey to ascertain the student's perspective regarding drones within their practical class. In order to gain a deeper understanding of students' knowledge, attitudes, and risk perceptions regarding agriculture drone applications, a closed-ended structured survey was designed. The survey was disseminated to selected University Malaysia Kelantan students specifically further study in agrotechnology and intensive training on handling and practical skill-set of agriculture drone spraying was provided to them. The response from the survey obtained showed that students had a good level of knowledge about the application of agriculture drones (mean score of 4.43), attitude toward the drone application (mean score of 4.56) and practice level of the students showed a mean score of 4.57. The findings from the study revealed that the practical lesson involving agriculture drone spraying had a positive benefit on the agrotechnology student’s skills for their future career endeavor.

The Impact of Large Language Models on Medical Education: Preparing for a Revolutionary Shift in Doctor Training

This article presents insights gained from utilizing Collaborative Autoethnography (CA), a qualitative research method, by two international faculty members who documented their experiences from a year-long participation in a Faculty Learning Community (FLC) at a midwestern university in the US. The FLC aimed to create a supportive environment where international faculty and graduate students could discuss their challenges, struggles, and joys related to their 'international-ness'. Through autoethnographic reflection, the study highlights how FLC participation helped mediate initial anxieties and dilemmas for one faculty member (Galina) and facilitated a productive reconceptualization of teaching for the other (Henny). The findings demonstrate the value of reflecting on personal experiences through autoethnography, allowing the participants to draw practical lessons that connect their FLC involvement to their individual teaching contexts and personal struggles in establishing a viable teacher identity. The article concludes with pedagogical recommendations on structuring future FLCs to better address the needs of international faculty.

A new approach to entrepreneurship and regional development: key roles of purpose and well-being in the Swansea Bay City Region

PurposeThis paper critically evaluates regional development through the lens of well-being and purpose. The paper provides insight into the key roles that well-being and purpose play in regional development and the way in which various actors are engaged in this process. This paper focuses on the Swansea Bay City Region within Wales, a country at the forefront of well-being legislation.Design/methodology/approachThis paper analyses a case study of 4theRegion, a membership organisation that undertakes regional development activities underpinned by a social purpose and well-being across the Swansea Bay city region. 4theRegion has been selected due to (1) its unique business model; (2) its clear focus on well-being and purpose; and (3) the influence of its regional development actions bringing together various stakeholder groups under a common aim.FindingsThis paper extends existing debates on collaborative development approaches and underlines the unique emphasis on asset-based local development influenced by well-being, which seeks to engage with a variety of community stakeholders to derive “holistic flourishing”. This emphasises inclusive development activities across the region, through people, place, process and purpose, underpinned by well-being. The research also underlines debates about the subjectivity of well-being and how the impact of well-being legislation can be evaluated.Originality/valueThis research provides a new way of looking at regional development, through the lens of well-being and purpose and provides insight into the way in which various actors are engaged in this process. Implications of this research could influence policymaking in supporting regional development activities, as well as practical lessons for those involved in place-based development.

PROFESSIONAL MOTIVATION OF STUDENTS AS A FACTOR FOR INTEGRATING FUNDAMENTAL AND CLINICAL DISCIPLINES IN HIGHER MEDICAL EDUCATION

This article addresses the pressing issue of medical education: the integration of fundamental and clinical disciplines. Given the rapid pace of scientific and technological advancements, the professionalism of modern doctors largely relies on their natural and scientific training, which begins in the early stages of medical university education. Medical and biological physics play an important role in this training, but integrating them into medical education is challenging due to the complexity of the discipline's content, which students must grasp at the outset of their education, and the lack of understanding among first-year students about the connections between physics, mathematics, and medicine. The article discusses various approaches to teaching medical and biological physics, focusing on creating professional motivation among students to master fundamental sciences. It highlights the example of designing an X-ray computed tomography (CT) scanner as a means of motivating students to excel in their studies. The importance of leveraging students' prior knowledge from school textbooks on physics, biology, and chemistry to solve tasks fundamental to clinical practice is emphasized. Using the practical lesson topic “Physical foundations of X-ray diagnostics and X-ray therapy” as an example, the article demonstrates the need to focus on the properties of X-ray radiation relevant to medical applications, such as rheography, fluorography, and CT scans. Professional motivation is further enhanced through activities like participating in a biophysics scientific circle and visiting university clinics and training centers, where students can witness the practical application of their theoretical knowledge. The article underscores the importance of integrating fundamental and clinical disciplines while adhering to pedagogical principles such as scientific rigor, continuity, and consistency.

Mastering Participatory Living Labs

This paper presents the concept and implementation of participatory living labs in the context of the unIT-e² project, which aims to integrate electromobility into the energy system efficiently. The article focuses on two field trials involving private and corporate users of electric vehicles and charging infrastructure. The paper describes the theoretical foundations of participatory aspects in living labs and proposes a participation pyramid model to structure the different levels and methods of participation. The paper also reports on the practical experiences and lessons from applying the participation pyramid model in the context unIT-e². The paper offers general recommendations for future participatory living labs in the energy and mobility transition context, such as developing an interaction strategy before participant acquisition, ensuring early onboarding and continuous information provision, balancing online and offline events, and gathering and listening to participant feedback. The paper concludes that professional, proactive, and regular interaction with the participants is crucial for the success of living labs and the knowledge gained for civil society and science.

Teaching Folk Medical Concepts from the Epic of Manas Using the INSERT Method

Article discusses the problems of developing critical thinking and creative thinking of students when teaching the Epic of Manas in special vocational schools. To pay attention to building connections between previous knowledge in order to understand new ones. To develop students' thinking skills so that they can critically look at and evaluate information received. At the same time, students learn to communicate with each other in a special way using the table. Students should not be given ready-made knowledge in the classroom. Method INSERT for developing the critical thinking was chosen, and methodological instructions for practical lesson were organized, method and results were presented on a scientific basis. This experience is recommended for all teachers of the Epic of Manas. Almost approved. Specific steps of how the INSERT method implements reading comprehension, analytical and interpretive understanding based on the read text in developing students’ critical thinking were shown. To increase students’ interest in the Epic of Manas, as well as to substantiate various topics, specific examples from the epic can be considered. One critical thinking strategy that can help students work with text on a given topic is the INSERT method. This method is implemented on the basis of marked reading of the text, activates reading comprehension, critical thinking, helps analyze objections, be able to argue one’s views, understand the meanings in the epic, increase vocabulary, be able to form one’s own opinion, and develop creative thinking. It is necessary to awaken students' interest in education through the teachers’ skills. This is a question that sets a goal for the student in various ways and points the way to its implementation.

Gradually tapering off antipsychotics: lessons for practice from case studies and neurobiological principles.

There has been an increasing focus on deprescribing in psychiatry recently, particularly of antipsychotic medication, with recognition that not all patients with psychotic disorders require lifelong medication. We summarize some empirical and theoretical papers, and examine case studies to provide instruction on this topic. Recent studies have found that slower tapering (over months or longer) of antipsychotics is associated with a lower relapse rate than quicker tapering (weeks). Case studies presented suggest that the process of reduction is associated with the precipitation or exacerbation of psychotic symptoms and that a slower process of reduction may minimize this effect. This may be because faster reductions cause greater disruption of homeostatic equilibria, provoking psychotic symptoms either as direct withdrawal symptoms or consequences of nonpsychotic withdrawal symptoms (e.g. insomnia) - although not all patients will experience withdrawal symptoms. This suggests that smaller dose reductions, especially at lower doses, made very gradually, may minimize the risk of psychotic symptoms. Slower tapering of antipsychotics may provide time for adaptations made to the presence of the medications to resolve, thus reducing the disruption to homeostatic equilibrium caused by dose reduction, potentially reducing the risk of relapse. Exacerbation of psychotic symptoms on antipsychotic reduction may not represent evidence of the need for a higher dose of antipsychotic on a long-term basis but may indicate the need for more gradual reduction. Gradual reduction of antipsychotics, especially after long-term use in clinical practice is prudent.

Conflict mitigation as a means of climate change adaptation: Lessons for policy and development practice

In this article, we examine the ways conflict can drive climate change vulnerability and, in turn, argue that conflict mitigation can act as a means of climate change adaptation. We identify three key ways in which conflict mitigation enhances adaptation opportunities: (a) addressing conflict dynamics increases opportunities to address climate risks; (b) grounded analysis of conflict dynamics often reveals high-value opportunities for climate change-oriented programs as well as potential maladaptations to be avoided; and (c) conflict mitigation interventions which rely heavily on governance can be leveraged in climate change adaptation efforts. This has multiple implications for global climate change policy, especially when one considers key climate security outcomes emanating from international policy discussions such as COP 28. We conclude this article by identifying three under-examined—and practical—lines of inquiry that would address key knowledge gaps in how to fortify climate resilience in conflict-affected regions.

Collaborative Action Research As an Approach to School Improvement to Develop Inclusive Education in Pakistan

ABSTRACT Education in Pakistan continues to be underfunded and only one in three children complete primary education. Children with special needs face further barriers to access good quality education, with an estimated less than one in ten disabled children attending any school. In this situation, mainstream schools struggle to provide an inclusive education environment. Given these multiple challenges, Collaborative Action Research (CAR) was used to attempt to improve educational services, by facilitating teachers, school management, and families and parents to work together to promote inclusion. A research team consisting of occupational therapists and teachers worked with five local primary schools, using the Action Research cycles of plan-act-observe-reflect to develop practical strategies, materials, and inclusive lesson plans to facilitate the participation of all children in all school-based occupations. Support from school management as well as interdisciplinary collaboration were crucial factors for implementing Action Research and the innovations resulting from this process. Resulting strategies were found to benefit all children in class, leading to enhanced engagement and attainment of children with special needs as well as their peers. Both occupational therapists and teachers discovered the value of interprofessional collaboration through this process. A Resource Guide has been produced and is freely available.