Wider Uptake Research Articles

Protocol for a scoping review of patient–clinician digital health interventions for the population with hip fracture

IntroductionPatient–clinician digital health interventions can potentially improve the care of patients with hip fracture transitioning from hospital to rehabilitation to home. Assisting older patients with a hip fracture and their...

The relationship between trust and attitudes towards the COVID-19 digital contact-tracing app in the UK.

During the COVID-19 pandemic, digital contact-tracing has been employed in many countries to monitor and manage the spread of the disease. However, to be effective such a system must be adopted by a substantial proportion of the population; therefore, public trust plays a key role. This paper examines the NHS COVID-19 smartphone app, the digital contact-tracing solution in the UK. A series of interviews were carried out prior to the app's release (n = 12) and a large scale survey examining attitudes towards the app (n = 1,001) was carried out after release. Extending previous work reporting high level attitudes towards the app, this paper shows that prevailing negative attitudes prior to release persisted, and affected the subsequent use of the app. They also show significant relationships between trust, app features, and the wider social and societal context. There is lower trust amongst non-users of the app and trust correlates to many other aspects of the app, a lack of trust could hinder adoption and effectiveness of digital contact-tracing. The design of technology requiring wide uptake, e.g., for public health, should embed considerations of the complexities of trust and the context in which the technology will be used.

A biopsychosocial model to understand racial disparities in the era of cancer immunotherapy

The approval and wide uptake of immune checkpoint inhibitors (ICIs) in oncology practice raise the concerns of possibly worsened racial disparities in cancer treatment due to biological and psychosocial reasons. We propose a multilevel biopsychosocial model to understand the opportunities and challenges to racial disparities in the era of cancer immunotherapy.

FAIR-IMPACT

In this poster we present the FAIR-IMPACT project, “Expanding FAIR solutions across EOSC”, which is funded by the European Commission Horizon Europe programme. The acronym FAIR stands for Findable, Accessible, Interoperable and Reusable. The project is coordinated by DANS and supported by 27 additional partners from 11 countries. FAIR-IMPACT will build on the successful practices, policies, tools and technical specifications arising from FAIRsFAIR other H2020 projects and initiatives, and from the FAIR and other relevant Working Groups of the former European Open Science Cloud (EOSC) Executive Board. The FAIR-IMPACT project is active between June 2022 and May 2025. Cascading grants will be available to support uptake of FAIR solutions and practices. The overall objective of FAIR-IMPACT is to realise a FAIR EOSC, that is an EOSC of FAIR data and services, by supporting the implementation of FAIR-enabling practices across scientific communities and research outputs at a European, national, and international level. Advancing findability, accessibility, interoperability and reusability (“FAIRness”) of data and other research objects are at the core of this project, which closely collaborates with the FAIRCORE4ESOC project (https://faircore4eosc.eu/ ). We will coordinate the implementation of frameworks and the alignment of FAIR data practices on metadata and persistent identifiers (PIDs) in order to achieve the wide uptake of and compliance with FAIR principles by national and European research data and metadata providers and repositories. In the poster we present our work on the implementation of the FAIR principles and practices. Among other things we aim at a coherent implementation of PIDs and more exact data citation, as services then are able to support better data quality with suitable PID solutions. A broader and more targeted use of PIDs, based on end-user needs, can support trust and risk management and requires collaboration among PID service providers and developing PID policies. Special attention will be paid to reproducibility and to sensitive data. As semantic artefacts are an important element in creating semantic interoperability, they are also regarded as digital objects with their own recommendations for FAIR implementation, as are software. Working together with the FAIRCORE4ESOC project, we can address things like kernel information profiles that are highly relevant for FAIR digital objects. The project will also focus on increasing data accessibility through enhancing interoperability on all levels, with specific steps taken to address recommendations outlined in the EOSC (The EOSC Interoperability Framework). Validation of core interoperability components through metadata mechanisms across scientific disciplines, fostering interoperability alignment with the nine European Data Spaces, and the DAMA framework (DAMA-DMBoK), i.e. the EOSC ecosystem, are of relevance. Metrics and FAIR assessment are also addressed in this project, that will extend and adapt the FAIRsFAIR data object assessment metrics and F-UJI tool to be more disciplinary-context aware and to include more discipline specific tests. The FAIR-IMPACT project will closely work with how the FAIR principles are implemented within the EOSC and how digital objects can be identified and managed.

Low-cost Na2S-EG-MTPB deep eutectic solvents absorb SO2 effectively at a high temperature in flue gas

Deep eutectic solvents (DESs) cannot absorb SO2 at high temperatures, due to the lower solubility of the toxic gas in DESs at high temperatures, limiting their wider uptake in industrial applications. To address this knowledge gap, we added Na2S to a series of DESs to improve SO2 adsorption capacity at elevated operating temperatures in this work. The experimental results show that the newly designed Na2S-EG-MTPB DESs can adsorb SO2 effectively up to 90 °C. Solid products resulted from the interaction of SO2 and Na2S-EG-MTPB DES is mainly elemental sulfur (S8) and sodium sulfite (Na2SO3). DESs can be reused for SO2 absorption for at least five times by adding additional Na2S. Therefore, Na2S-EG-MTPB DESs have great potential as substitutes for existing SO2 absorbents due to their excellent high temperature resistance, high SO2 absorption capacity and low cost.

Demonstration of the New IPNI (International Plant Names Index) Registration System

Registration systems have long been in place for names of plant cultivars, fungi, prokaryotes and animals, and more recently for algae (Müller et al. 2022). Yet, despite previous attempts, nothing has become established for vascular plants. The newly released International Plant Names Index (IPNI) registration system aims to address this. We will be demonstrating that this new system can be used to register vascular plant names that are new to science, in addition to names that have been validly published but are not yet in IPNI (The Royal Botanic Gardens, Kew et al. 2022). We will show the different options that are available and explain how we validate the data and ensure its integrity. The demonstration will also focus on the standards we use, and how these are maintained. The new registration system will allow resources to be used more efficiently and give scientists more control over how and when the names they publish are entered into IPNI and made available for users worldwide. Without registration, indexers must manually check scientific publications from around the world (both hard copy and online) to find newly published names. Registration will release time for indexers to spend on improving data quality, resolving nomenclatural issues, adding missing names, and ensuring IPNI complies with existing and future data standards. The current project is working to ensure that the registration system has a wide uptake to maximise these benefits.

Life Cycle Environmental Impacts of Wastewater-Derived Phosphorus Products: An Agricultural End-User Perspective.

Recovering phosphorus from wastewater in more concentrated forms has potential to sustainably recirculate phosphorus from cities to agriculture. The environmental sustainability of wastewater-based phosphorus recovery processes or wastewater-derived phosphorus products can be evaluated using life cycle assessment (LCA). Many LCA studies used a process perspective to account for the impacts of integrating phosphorus recovery processes at wastewater treatment plants, while some used a product perspective to assess the impacts of producing wastewater-derived phosphorus products. We demonstrated the application of an end-user perspective by assessing life cycle environmental impacts of substituting half of the conventional phosphorus rock-based fertilizers used in three crop production systems with wastewater-derived phosphorus products from six recovery pathways (RPs). The consequential LCA results show that the substitution reduces global warming potential, eutrophication potential, ecotoxicity potential, and acidification potential of the assessed crop production systems in most RPs and scenarios. The end-user perspective introduced in this study can (i) complement with the process perspective and the product perspective to give a more holistic picture of environmental impacts along the “circular economy value chains” of wastewater-based resource recovery, (ii) enable systemwide assessment of wide uptake of wastewater-derived products, and (iii) draw attention to understanding the long-term environmental impacts of using wastewater-derived products.

A Design Approach to Optimise Secure Remote Three-Dimensional (3D) Printing: A Proof-of-Concept Study towards Advancement in Telemedicine.

Telemedicine is defined as the delivery of healthcare services at a distance using electronic means. The incorporation of 3D printing in the telemedicine cycle could result in pharmacists designing and manufacturing personalised medicines based on the electronic prescription received. Even with the advantages of telemedicine, numerous barriers to the uptake hinder the wider uptake. Of particular concern is the cyber risk associated with the remote digital transfer of the computer-aided design (CAD) file (acting as the electronic prescription) to the 3D printer and the reproducibility of the resultant printed medicinal products. This proof-of-concept study aimed to explore the application of secure remote 3D printing of model solid dosage forms using the patented technology, DEFEND3D, which is designed to enhance cybersecurity and intellectual property (IP) protection. The size, shape, and colour of the remote 3D-printed model medicinal products were also evaluated to ensure the end-product quality was user-focused. Thermoplastic polyurethane (TPU) and poly(lactic) acid (PLA) were chosen as model polymers due to their flexibility in preventing breakage printing and ease of printing with fused deposition modelling (FDM). Our work confirmed the potential of secure remote 3D (FDM) printing of prototype solid dosage forms resulting in products with good reproducibility, resolution, and quality towards advancements in telemedicine and digital pharmacies. The limitation of the work presented here was the use of model polymers and not pharmaceutically relevant polymers. Further work could be conducted using the same designs chosen in this study with pharmaceutically relevant polymers used in hot-melt extrusion (HME) with shown suitability for FDM 3D printing. However, it should be noted that any challenges that may occur with pharmaceutically relevant polymers are likely to be related to the polymer’s printability and printer choice as opposed to the ability of the CAD file to be transferred to the printer remotely.

Advances in the Application and Utility of Subseasonal-to-Seasonal Predictions

Abstract The subseasonal-to-seasonal (S2S) predictive time scale, encompassing lead times ranging from 2 weeks to a season, is at the frontier of forecasting science. Forecasts on this time scale provide opportunities for enhanced application-focused capabilities to complement existing weather and climate services and products. There is, however, a “knowledge–value” gap, where a lack of evidence and awareness of the potential socioeconomic benefits of S2S forecasts limits their wider uptake. To address this gap, here we present the first global community effort at summarizing relevant applications of S2S forecasts to guide further decision-making and support the continued development of S2S forecasts and related services. Focusing on 12 sectoral case studies spanning public health, agriculture, water resource management, renewable energy and utilities, and emergency management and response, we draw on recent advancements to explore their application and utility. These case studies mark a significant step forward in moving from potential to actual S2S forecasting applications. We show that by placing user needs at the forefront of S2S forecast development—demonstrating both skill and utility across sectors—this dialogue can be used to help promote and accelerate the awareness, value, and cogeneration of S2S forecasts. We also highlight that while S2S forecasts are increasingly gaining interest among users, incorporating probabilistic S2S forecasts into existing decision-making operations is not trivial. Nevertheless, S2S forecasting represents a significant opportunity to generate useful, usable, and actionable forecast applications for and with users that will increasingly unlock the potential of this forecasting time scale.

Implementation of shared decision-making and patient-centered care in France: Towards a wider uptake in 2022

We present the evolution of patient-centered care (PCC) and shared decision-making (SDM) in France since 2017, highlighting advantages and drawbacks of their implementation at the macro level. We then focus on several key policy and legislative milestones that are aimed to develop PCC and SDM. These milestones underline the importance of patient movements to support and fund the development of research and practice in the field. We shall conclude by presenting the growing research agenda and selected key topics. These key topics notably include the increase in both patient and healthcare professional trainings on PCC and SDM provided by healthcare users’ and patients’ representatives.PCC and SDM continue to be central preoccupations at the macro level, supported by public health policies and patients/healthcare users’ actions. This overview, however, suggests that although implementation initiatives have increased since 2017, implementation remains scarce in routine clinical practice. Funding, not only for research projects, but for the implementation of PCC and SDM in real-life settings (e-decision aids, clinical guidelines integrating PCC/SDM, human resources dedicated to PCC/SDM, etc.) are needed to promote sustained adoption. More systematic training for both healthcare professionals and patients is also warranted for a true acculturation to occur.

Incorporating Ecosystem Services into Water Resources Management\u2014Tools, Policies, Promising Pathways

Ecosystems provide a range of services, including water purification, erosion prevention, and flood risk mitigation, that are important to water resource managers. But as a sector, water resources management has been slow to incorporate ecosystem protection and restoration, for a variety of reasons, although related concepts such as nature-based solutions and green infrastructure are gaining traction. We explain some of the existing challenges to wider uptake of the ecosystem services concept in water resources management and introduce some promising avenues for research and practice, elaborated in more detail through 12 papers, spanning five continents and a variety of contexts, which make up a Special Issue on “Incorporating Ecosystem Services into Water Resources Management”. Cross-cutting themes include (A) ecosystem services as a flexible concept to communicate with stakeholders; (B) participatory processes to involve stakeholders in research; (C) multiple values, and valuation methods, of water-related services; and (D) applications of decision-support tools. We conclude with a summary of research gaps and emphasize the importance of co-producing knowledge with decision makers and other stakeholders, in order to improve water resources management through the integration of ecosystem services.

281 Impact of Using Risk Communication Tools in Counselling Patients with Newly Diagnosed Non-Metastatic Prostate Cancer

Abstract Introduction There have been substantial advances in risk communication tools that help patients understand prognosis associated with prostate cancer and the benefit/gain from treatment. Over the last three years, two tools; Cambridge Prognostic Groups (CPG), and Predict Prostate (https://prostate.predict.nhs.uk), along with decision-making consultations with clinical nurse specialists (CNS) have been integrated into the new diagnosis pathway in our unit. Method Treatment decisions for patients with new non-metastatic prostate cancer were audited after (2019–2020) and before (2016–2017) new risk communication tools were implemented. Data were compared between the two time periods and also benchmarked against national level data from the National Prostate Cancer Audit (NPCA) (Parry et al 2020; PMID: 32460859). The main outcome measured was comparison of rates of over and under-treatment of disease. Results 168 and 95 patients were included in the 2019–2020 and 2016–2017 cohorts, respectively. Following implementation there was a reduction in over-treatment (use of radical surgery/radiotherapy) in patients with low risk/CPG1 (23% to 4%). These rates were also better than the national average from NPCA data (4% vs 11%). In parallel, there was an increase in use of radical treatment (reduced under-treatment) in high risk and very high-risk/CPG4-5 disease (84% vs 73%). Again, these rates were also superior to national level data from the NPCA (84% vs 76%). Conclusions Incorporating personalised risk-communication tools and dedicated CNS counselling in our unit has reduced over-treatment of early disease and under-treatment of advanced disease. Wider uptake could enhance risk-appropriate treatment of patients with a new prostate cancer diagnosis.

An Open Access Chamber Designed for the Acoustic Characterisation of Microbubbles

Microbubbles are used as contrast agents in clinical ultrasound for Left Ventricular Opacification (LVO) and perfusion imaging. They are also the subject of promising research in therapeutics as a drug delivery mechanism or for sonoporation and co-administration. For maximum efficacy in these applications, it is important to understand the acoustic characteristics of the administered microbubbles. Despite this, there is significant variation in the experimental procedures and equipment used to measure the acoustic properties of microbubble populations. A chamber was designed to facilitate acoustic characterisation experiments and was manufactured using additive manufacturing techniques. The design has been released to allow wider uptake in the research community. The efficacy of the chamber for acoustic characterisation has been explored with an experiment to measure the scattering of SonoVue® microbubbles at the fundamental frequency and second harmonic under interrogation from emissions in the frequency range of 1.6 to 6.4 MHz. The highest overall scattering values were measured at 1.6 MHz and decreased as the frequency increased, a result which is in agreement with previously published measurements. Statistical analysis of the acoustic scattering measurements have been performed and a significant difference, at the 5% significance level, was found between the samples containing contrast agent and the control sample containing only deionised water. These findings validate the proposed design for measuring the acoustic scattering characteristics of ultrasound contrast agents.

Monitoring COVID-19-Induced Gender Differences in Teleworking Rates Using Mobile Network Data

The COVID-19 pandemic has created a sudden need for a wider uptake of home-based telework as means of sustaining the production. Generally, teleworking arrangements impact directly worker’s efficiency and motivation. The direction of this impact, however, depends on the balance between positive effects of teleworking (e.g. increased flexibility and autonomy) and its downsides (e.g. blurring boundaries between private and work life). Moreover, these effects of teleworking can be amplified in case of vulnerable groups of workers, such as women. The first step in understanding the implications of teleworking on women is to have timely information on the extent of teleworking by age and gender. In the absence of timely official statistics, in this paper we propose a method for nowcasting the teleworking trends by age and gender for 20 Italian regions using mobile network operators (MNO) data. The method is developed and validated using MNO data together with the Italian quarterly Labour Force Survey. Our results confirm that the MNO data have the potential to be used as a tool for monitoring gender and age differences in teleworking patterns. This tool becomes even more important today as it could support the adequate gender mainstreaming in the ‘Next Generation EU’ recovery plan and help to manage related social impacts of COVID-19 through policymaking.

Nationwide evaluation of the advanced clinical practitioner role in England: a cross-sectional survey

Background and study objectiveIn response to growing pressures on healthcare systems, the advanced clinical practice (ACP) role has been implemented widely in the UK and internationally. In England, ACP is...

Barriers to expanding continuous cover forestry in Sweden for delivering multiple ecosystem services

Sweden has the largest forest cover in the European Union, and for decades, Sweden's forest industry has pursued intensive forest management through tree plantations and clear-cutting in order to maximize wood production. The Swedish forestry sector is increasingly under pressure to transition away from intensive clear-cut forest management, but other forest management models are still a niche in Sweden’s forest management and face barriers in their wider uptake. We use transition theory and the multi-level perspective framework to analyse the dynamics within the Swedish forestry sector, and investigate the barriers that actors practicing and promoting Continuous Cover Forestry in Sweden face. We identify culture, forestry education, industrial networks and timber markets as domains where there is a mismatch between Continuous Cover Forestry and the current clear-cut forest management. Our analysis shows that the limited uptake of Continuous Cover Forestry in Sweden has explanations that go far beyond the lack of knowledge and ecological limitations that it is often associated with. Thus, we conclude that research and policy-making need to account for these diverse explanations and address the power and social dimensions associated with competing forest management models for building multi-functional forest ecosystems in the future.

Cultivating Bioliteracy, Biodiscovery, Data Literacy, and Ecological Monitoring in Undergraduate Courses with iNaturalist

iNaturalist is a large and growing open-source online platform connecting a global community of users to the natural world and to each other. iNaturalist makes it simple for anyone to share observations, get identifications, and make identifications of any species. We demonstrate how iNaturalist can connect students to nature in undergraduate courses, simultaneously contributing to biodiversity knowledge. Our three case studies use iNaturalist to improve student bioliteracy (awareness and knowledge of biodiversity), to engage them in biodiscovery (discovering undocumented biodiversity occurrences, behaviors, and interactions), to introduce students to systematic ecological sampling (documenting biodiversity patterns and trends), and to improve their data literacy (by depositing and accessing open biodiversity data and by performing analyses). Included are examples from a variety of contexts—a required general science course, introductory courses for science majors, and more specialized electives. We discuss the rationale for iNaturalist inclusion, how iNaturalist inspires students and complements courses, and outputs of our students’ iNaturalist use. Introducing students to tools such as iNaturalist helps build the next generation of bioliterate and biocurious citizens and scientists, fluent in open collaborative research and learning. With wider uptake and coordination, iNaturalist has potential to connect undergraduate ecology courses to form a distributed virtual global biodiversity observatory.

The implementation potential of a method to monitor empirically-supported children\u2019s mental health treatment through claims data

BackgroundThe delivery of evidence-supported treatments (EST) in children’s mental health could be a valuable measure for monitoring mental healthcare quality; however, efforts to monitor the use of EST in real world systems are hindered by the lack of pragmatic methods. This mixed methods study examined the implementation and agency response rate of a pragmatic, claims-based measure of EST designed to be applied as a universal quality measure for child psychotherapy encounters in a state Medicaid system.MethodsImplementation potential of the EST measure was assessed with healthcare leader rankings of the reporting method’s acceptability, appropriateness and feasibility (n = 53), and post-implementation ratings of EST rate accuracy. Ability of the healthcare system to monitor EST through claims was measured by examining the agency responsivity in using the claims-based measure across 98 Medicaid-contracted community mental health (CMH) agencies in Washington State.ResultsThe analysis found the reporting method had high implementation potential. The method was able to measure the use of an EST for 83% of children covered by Medicaid with 58% CMH agencies reporting > 0 ESTs in one quarter. Qualitative analyses revealed that the most significant barrier to reporting ESTs was the operability of electronic health record systems and agencies’ mixed views regarding the accuracy and benefits of reporting.ConclusionsMeasurement of child mental health ESTs through Medicaid claims reporting has acceptable implementation potential and promising real world responsiveness from CMH agencies in one state. Variation in reporting by agency site and low to moderate perceived value by agency leaders suggests the need for additional implementation supports for wider uptake.

Promoting Junior School Students’ Anti-bullying Beliefs with the CATZ Cross-age Teaching Zone Intervention

In tackling the widespread problem of bullying victimisation, researchers have acknowledged the value of focusing on changing bullying-related beliefs and using peer-based interventions. In three studies (N = 419, 237 intervention and 182 controls), we tested the effectiveness of the CATZ cross-age teaching programme by inviting small groups of 11-year-olds to incorporate information supporting positive beliefs (concerning non-physical forms of bullying, the value of disclosing being bullied to adults, and helping victims) into a lesson they devised for themselves and to deliver that to small groups of 9-year-olds. Specifically, we examined if the intervention would promote that (i) non-physical forms of bullying are unacceptable (study 1), (ii) disclosing bullying to adults and getting the right kind of help have value and importance (study 2), and (iii) victims can be assisted in safe ways (study 3). Self-reports of nine specific aspects of these beliefs were collected from CATZ tutors and age-matched controls prior to and following the intervention, and at five-week follow-up in one study, using both open and closed questions. Results indicated significant positive effects of CATZ on all nine outcome variables, with mostly medium and high effect sizes. These findings support the use of CATZ to foster positive anti-bullying beliefs, and issues related to its wider uptake are discussed.

Service system design of video conferencing visits with nurse assistance

Despite providing convenience and reducing the travel burden of patients, Video-Conferencing (VC) clinical visits have not enjoyed wide uptake by patients and care providers. It is desired that the medical problems addressed by VC visits can match a face-to-face encounter in scope and quality. Subsequently, VC visits with nurse assistance are emerging; however, the scalable and financially sustainable of such services are unclear. Therefore, we explore the implementability of VC visits with nursing services using a game-theoretic model, and investigate the impact of different pricing schemes (discriminative pricing based on patient characteristics vs. non-discriminative) on patients’ care choices between VC and in-person visits. Our results shed light on the “artificial congestion” created by a profit-driven medical institution that hurts patient welfare, and subsequently identify the conditions where the interest of the social planner and the medical institution are aligned. Our results highlight that, compared to a uniform price of VC visits which seems fair, discriminative pricing can be more beneficial for patients and the medical institution alike. This heightens the importance of insurance coverage of telehealth-related services to promote the adoption of telehealth by patients and care providers, and ultimately, improving care access and patient outcomes.