The new NICE guideline for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), published in October 2021, makes significant changes in treatment recommendations. It acknowledges the complexity of this chronic medical condition, which always impacts quality of life and can be profoundly disabling, recognising the prejudice and stigma that people with ME/CFS often experience in the absence of any specific diagnostic test. The guideline outlines steps for accurate diagnosis, recognising post-exertional malaise as a core symptom; importantly, ME/CFS can now be diagnosed after just 3 months in a bid to improve long-term health outcomes. It recommends the need for individual, tailored management by a multi-disciplinary team, ensuring that the wellbeing of the individual is paramount. The guideline makes clear that any programme based on fixed incremental increases in physical activity or exercise, for example graded exercise therapy (GET), should not be offered as a treatment for ME/CFS and emphasises that cognitive behavioural therapy (CBT) should only be offered as a supportive intervention. Because of the rigorous methodology required by NICE Committee review and the inclusion of the testimony of people with lived experience as committee members, this guideline will influence the future diagnosis and management of ME/CFS in the UK and beyond.

This study presents a designated Flipped Classroom (FC) mathematics environment that utilizes a unique online platform designed for Arab minority students in Israel. It investigates how studying in an FC affects conceptual understanding and motivation to study mathematics among Arab high school students. The study also explores the factors that contribute to effective learning in the FC environment. Participants were 75 Arab high school students in 10th and 11th grade who studied advanced mathematics. Each grade group was randomly divided into two subgroups: an FC group and a traditional classroom group (comparison group). Quantitative questionnaires given before and after the learning program served to measure students’ motivation and conceptual understanding of the derivative and integral topics. Additionally, a random sample of students who studied in the FC group and the teacher who taught all the groups were interviewed. The study describes the positive effect an FC environment has on students' conceptual understanding, particularly for 11th graders. The participants mostly appreciated how the FC resulted in less lecturing in class. The study contributes to the literature about FC among minorities and contributes to national and international efforts being made to reduce the gap in mathematics achievements between minorities and other sectors.

Port state control inspections implemented under the Paris Memorandum of Understanding (MoU) have become known as one of the best instruments for maritime administrations in European Union (EU) Member States to ensure that the ships docked in their ports comply with all maritime safety requirements. This paper focuses on the analysis of all inspections made between 2013 and 2018 in the top ten EU ports incorporated in the Paris MoU (17,880 inspections). The methodology consists of a multivariate statistical information system (STATIS) analysis using the inspected ship’s characteristics as explanatory variables. The variables used describe both the inspected ships (classification society, flag, age and gross tonnage) and the inspection (type of inspection and number of deficiencies), yielding a dataset with more than 600,000 elements in the data matrix. The most important results are that the classifications obtained match the performance lists published annually by the Paris MoU and the classification societies. Therefore, the approach is a potentially valid classification method and would then be useful to maritime authorities as an additional indicator of a ship’s risk profile to decide inspection priorities and as a tool to measure the evolution in the risk profile of flag over time.

In this paper, we propose a robust video understanding model for activity recognition by learning the actor’s pair-wise correlations and relational reasoning, exploiting spatial and temporal information. In order to measure the similarity between the pair appearances and construct an actor relations map, the Zero Mean Normalized Cross-Correlation (ZNCC) and the Zero Mean Sum of Absolute Differences(ZSAD) is proposed to allow the Graph Convolution Network (GCN) to learn how to distinguish group actions. We recommend that MNASNet be used as the backbone to retrieve features. Experiments show a 38.50% and 23.7% reduction in training time in the 2-stage training process along with a 1.52% improvement in accuracy against traditional methods.

Objectives: The purpose of this systematic review was to ascertain critical care nurses’ understanding and experiences of patient advocacy in adult critical care settings. The specific objectives were to identify how critical care nurses define patient advocacy, to explore the understanding and experiences of critical care nurses regarding patient advocacy, to explore critical care nurses’ role in patient advocacy, and to ascertain the barriers to encouraging advocacy in the critical care setting. Research design: Systematic literature search of CINAHL and Medline databases, Google Scholar, and Cochrane Database of Systematic Reviews, as well as grey literature search, was conducted. Search dates were restricted from January 2005 to 2015 in both CINAHL and Medline. Findings: 62 studies were identified, of which 6 qualitative research papers were included. Nurses gave varied definitions of patient advocacy, which were categorized into three themes: communication, protection, and doing. Nurses perceive advocacy as truly listening to patients and their families. Conclusion: For critical care nurses to be effective advocates, there must be support, collaboration, and improved working relationship between professional groups. Moreover, nurses must be empowered to be able to give power to patients and family.

Background and Objectives The socioeconomics working group of the European ME/CFS Research Network (EUROMENE) has conducted a review of the literature pertaining to GPs’ knowledge and understanding of ME/CFS. Materials and Methods A MEDLINE search was carried out. The papers identified were reviewed following the Synthesis Without Meta-analysis (SWiM) methodology, and were classified according to the focus of the enquiry (patients, GPs, database and medical record studies, evaluation of a training programme, and overview papers), and whether they were quantitative or qualitative in nature. Results 33 papers were identified in the MEDLINE search. The quantitative surveys of GPs demonstrated that a third to a half of all GPs did not accept ME/CFS as a genuine clinical entity and, even when they did, they lacked confidence in diagnosing or managing it. Patient surveys indicated that a similar proportion of patients was dissatisfied with the primary medical care they had received. These findings were consistent with the findings of the qualitative studies that were examined, and have changed little over several decades. Conclusions Lack of knowledge and understanding of ME/CFS among GPs is widespread, and the resultant diagnostic delays constitute a risk factor for severe and prolonged disease. Failure to diagnose ME/CFS renders problematic attempts to determine its prevalence, and hence its economic impact.

Affective computing in general and human activity and intention analysis in particular, is a rapidly growing field of research. Head pose and emotion changes, present serious challenges when applied to player’s training and ludology experience in serious games or analysis of customer satisfaction regarding broadcast and web services or monitoring a driver’s attention. Given the increasing prominence and utility of depth sensors, it is now feasible to perform large-scale collection of three-dimensional (3D) data for subsequent analysis. Discriminative random regression forests was selected in order to rapidly and accurately estimate head pose changes in unconstrained environment. In order to complete the secondary process of recognising four universal dominant facial expressions (happiness, anger, sadness and surprise), emotion recognition via facial expressions (ERFE) was adopted. After that, a lightweight data exchange format (JavaScript Object Notation-JSON) is employed, in order to manipulate the data extracted from the two aforementioned settings. Motivated by the need of generating comprehensible visual representations from different sets of data, in this paper we introduce a system capable of monitoring human activity through head pose and emotion changes, utilising an affordable 3D sensing technology (Microsoft Kinect sensor).

Publicly-funded scientists have a responsibility to engage with the public on scientific information, but are lacking a standardized framework and assessment strategy to do it well. The PEPS (Public Engagement Practices for Scientists) Method is an outcomes-centered framework employing standardized pedagogical methods with quantifiable outcomes. This approach reveals that scientists often have unrealistic expectations for achieving affective learning outcomes (i.e. changing views from anti- to pro-vaccine) by solely cognitive learning strategies (i.e. supplying data). The PEPS Method can serve as a roadmap for standardized science communication assessments, complementing existing science communication training programs for the next generation of scientists.

People must have particular personality traits and social resources, also known as health literacy, in order to access, comprehend, and use information to make decisions about their health. Patients' ability to engage in complex disease management and self-care is strongly related to their level of health literacy. It can help us stay healthy by preventing illness and effectively managing existing illnesses. People with low health literacy (LHL) may find it difficult to manage their condition and prevent illness, which may lead to increased use of healthcare services. Furthermore, LHL is associated with increased hospitalizations, increased use of emergency care, decreased use of preventative services, and a worsened ability to understand labels and health messages, a worsened state of health, higher mortality, and more expensive medical care.

Backward electromagnetic waves are extraordinary waves with contra-directed phase velocity and energy flux. Unusual properties of the coherent nonlinear optical coupling of the phase-matched ordinary and backward electromagnetic waves with contra-directed energy fluxes are described which enable greatly-enhanced frequency and propagation direction conversion, parametrical amplification, as well as control of shape of the light pulses. Extraordinary transient processes that emerge in such metamaterials in pulsed regimes are described. The results of the numerical simulation of particular plasmonic metamaterials with hyperbolic dispersion are presented, which prove the possibility to match phases of such coupled guided ordinary and backward electromagnetic waves. Particular properties of the outlined processes in the proposed metamaterial are demonstrated through numerical simulations. Potential applications include ultra-miniature amplifiers, frequency changing reflectors, modulators, pulse shapers, and remotely actuated sensors.