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Adult social care nursing: A hybrid concept analysis.
Full text linkObjectiveThe concept of adult social care nursing is poorly articulated in the literature. This study explores and defines adult social care nursing by examining its antecedents, attributes, and consequences. By clarifying this concept, the research aims to enhance understanding among policymakers, educators, service providers, and the public, fostering greater recognition of social care nurses' roles, workplaces, and contributions.DesignA qualitative hybrid concept analysis model was used. This approach combined theoretical examination with empirical inquiry to develop a comprehensive understanding of the concept. The study was structured in four phases: concept identification, literature review, empirical data collection, and integrative analysis.Data sourcesA comprehensive literature search was conducted using CINHAL, Medline, APA PsycInfo, Wiley Online, OVID, and The King's Fund library. Grey literature was explored through the Department of Health and Social Care's adult social care collection, expert consultation, and reference handpicking.ParticipantsNineteen participants took part via four focus groups, two 2:1 interviews, and one 1:1 interview. Eighteen participants were registered nurses, and one participant was a registered social worker with experience of working with nurses.MethodsUsing a hybrid concept analysis approach, the study progressed through multiple phases. A preliminary exploration (Phase 1) provided an initial conceptual framework, which was refined through a literature review (Phase 2). Empirical fieldwork (Phase 3) involved focus groups and interviews, thematic content analysis was utilised to identify key attributes, followed by integrative analysis to synthesise findings and refine the conceptual model. The study was not registered in a trial registry given it is a qualitative study.ResultsThis study identified that adult social care nursing is present when people have a combination of health and social care needs that require registered nurses' care. Attributes include a career of choice, independent and autonomous nursing, with professional and business skill development including advanced practice. This supports social care nurses in their goal to be dynamic change agents who empower people to be active participants in their own care, with improved quality of life, being able to live well with their health needs in a social context.ConclusionThis paper proposes an initial definition of nursing within adult social care, which serves as a foundation for further discussion and development. It highlights nurses' vital role, diverse skill set, and equal partnership in the social care landscape, reinforcing their significant contributions to integrated, person-centred care across diverse settings.Social media abstractDefining adult social care nursing: A dynamic field where registered nurses manage complex needs, and drive person-centred, evidence-based care across diverse settings
A digital platform with activity tracking for energy management support in long COVID: a randomised controlled trial
Full text linkIn a 6-month pragmatic randomised controlled trial (RCT; ISRCTN16033549), we compared a just-in-time intervention to support energy management in adults with long COVID (LC) to standard care. Participants received either the ‘Pace Me’ app and a wearable activity tracker (intervention) or an app only with data entry screens (control). The intervention group received just-in-time messages on energy management when they reached 50%, 75%, and 100% of their daily ‘activity allowance’. The primary outcome was post-exertional malaise (PEM) measured by the DePaul Symptom Questionnaire-PEM (DSQ-PEM). Of 369 participants assessed for eligibility, 250 participants were randomised 1:1, and 77 controls and 84 intervention participants were included in the final per-protocol analysis. There was no time by group interaction for the DSQ-PEM. The intervention group value was 48 (95% CI 44-53) at baseline and 46 (95% CI 41-51) post-intervention (arbitrary units). The control group value was 47 (95% CI 42-52) at baseline and 44 (95% CI 39-49) at follow-up (interaction effect p = 0.614, η²p = 0.002; trivial). No individual question exhibited an interaction effect (p > 0.05). Although the intervention had minimal effect compared to control, the substantial recovery rates previously reported in LC, coupled with our wide inclusion criteria may have masked intervention effects. Therefore, future studies should consider this energy management framework in conditions without such recovery rates, such as CFS
Ethical and bioethical issues in physical therapy: A systematic scoping review
Full text linkImportance Ethical and bioethical issues are central to the identity and practice of physical therapy. A comprehensive overview of how these issues are addressed in the literature is essential for advancing education, clinical practice, and professional reflection. Objective The objective was to systematically map ethical and bioethical issues in the physical therapy literature, describe the methodologies employed, and identify key gaps to inform education, practice, and policy. Data Sources Medline (via PubMed), Embase, Cochrane Central, CINAHL, PsycINFO, PEDro, grey literature sources, and academic library resources were searched from inception to October 2024. The review protocol was prospectively published on medRxiv. Study Selection Studies addressing ethical or bioethical issues in physical therapy were included, encompassing both normative and descriptive (empirical) approaches. After screening titles, abstracts, and full texts, 108 studies met the inclusion criteria. Data Extraction and Synthesis Data were extracted using a modified Joanna Briggs Institute standardized form. A narrative synthesis was conducted to map ethical themes and characterize methodological approaches across studies. Main Outcome(s) and Measure(s) Identification and mapping of ethical and bioethical themes and characterization of research methodologies applied. Results A total of 15,464 records were identified; 3223 duplicates were removed. Of 12,241 titles and abstracts screened, 385 full texts were assessed, and 108 studies were included. Major themes included ethical reasoning (n = 33), ethical reasoning and education (n = 19), ethical theories (n = 12), care relationships (n = 15), justice and equity (n = 8), perception of ethical issues (n = 13), and codes of ethics (n = 8). Key challenges involved physical touch, informed consent, professional boundaries, and moral distress. Structural barriers, cultural contexts, and disparities in ethics education were recurring concerns. Ethical reasoning was often situational and intuitive, whereas formal codes were frequently perceived as disconnected from clinical practice. Conclusions and Relevance Ethical complexities in physical therapy arise from its embodied, relational, and context-sensitive nature. The literature reveals variability in how ethics is taught and applied across settings and highlights underexplored areas, including oncology, end-of-life care, digital health and artificial intelligence, and equity, diversity, and inclusion. Findings emphasize the need to strengthen ethics education, reinforce the application of existing codes of ethics, and provide organizational supports for ethical deliberation. This descriptive synthesis provides a foundation for future research and can inform curricular development, clinical practice, and policy initiatives in physical therapy ethics
Ambulatory Tasks and Journeys: A Framework for Free-Living Behaviour
Full text linkBackground: Standard accelerometer summaries obscure meaningful differences in how people move while upright. We introduce an operational two-class Ambulatory Behaviour Framework that separates Ambulatory Tasks—periods of standing and short continuous stepping bouts (<1 min) that are indicative of activity in a single locus—from Ambulatory Journeys—long continuous stepping bouts (≥1 min) that are indicative of movement between locations. Methods: We analysed thigh-worn activPAL3 data from 3545 participants in the age-46 sweep of the 1970 British Cohort Study (24,815 valid monitor-days). Event-based algorithms grouped upright events and classified them as an Ambulatory Task or Journey; linear models examined associations with sitting time and differences by sex and BMI. Results: Mean upright time averaged 6.50 h day−1; Ambulatory Tasks dominated (5.91 h; 90.6% of upright exposure), whereas Ambulatory Journeys contributed 0.61 h (9.4%). Each additional hour of Ambulatory Tasks corresponded to 0.61 h less sitting (β = −0.61 h; 95% CI: −0.63 to −0.61), while an extra hour of Ambulatory Journeys displaced only 0.04 h of sitting (β = −0.04 h; 95% CI: −0.044 to −0.039). Women accumulated significantly more time in Ambulatory Tasks and less sitting time than men. Both upright behaviours declined with increasing BMI. Conclusions: Ambulatory Tasks substantially replace sitting time, whereas Ambulatory Journeys leave sitting essentially unchanged. Interventions to displace sitting should concentrate on fostering frequent, brief, context-embedded tasks throughout the day. This novel framework yields interpretable, sensor-agnostic metrics to target behaviour change and standardise reporting of free-living mobility
Molecular Modeling of Arsenic Species Adsorption on Clay Minerals and in the Presence of Organic Matter
Full text linkArsenic (As) contamination of soils is a critical environmental and geochemical concern, with its mobility and bioavailability largely controlled by molecular-scale interactions with soil minerals. This study investigates the adsorption behavior of arsenate [As(V)] and arsenious acid [As(III)] on major clay minerals to elucidate fundamental controls on As retention in soil and sediment systems. Molecular modeling approaches were employed to investigate these interactions. Density functional theory (DFT) calculations were performed on cluster models of illite, chlorite, montmorillonite, and kaolinite to evaluate adsorption configurations and binding energies of arsenate and arsenious acid. In addition, semiempirical (PM6) and classical force-field (UFF) methods were used to examine the influence of vermicompost-derived organic matter on arsenate-mineral interactions. Multiple adsorption configurations, including atop atom, bridge, threefold filled, and threefold hollow sites, were evaluated, and binding energies were calculated with correction for basis set superposition error. The results indicate that threefold hollow sites are the most favorable, with As(V) binding energies of 60-65 kcal mol −1 on illite, chlorite, and montmorillonite, reaching 75 kcal mol −1 on kaolinite at a surface distance of 2.7 Å. In contrast, As(III) shows weaker and energetically flatter adsorption, with binding energies of 28-54 kcal mol −1 and larger equilibrium distances of 3.2-4.0 Å. Modeling of vermicompost addition suggests a substantial reduction in arsenate binding on most clay minerals, except illite, indicating competitive or disruptive interactions at mineral surfaces. These findings provide quantitative, atomistic insight into mineral-and amendment-specific controls on As stabilization and mobility in soil and sediment systems
The impact of digital learning in the context of nursing pedagogy.
Full text linkTo examine the impact of digital technologies on nursing education, focusing on student digital literacy, generational learning preferences and pedagogical adaptations. Digital technologies are transforming nursing education, particularly for Generation Z learners who favour interactive, media-rich and flexible learning environments. These preferences challenge traditional teaching methods and require integration of digital tools to support engagement, skill development and individualised learning. A narrative review METHODS: A comprehensive search was conducted in British Nursing Index (BNI), CINAHL, PubMed and Google Scholar for English-language articles published between 2014-2024. Keywords included "digital learning," "nursing pedagogy," "digital technology," and "digital literacy." Eight articles meeting the inclusion criteria were selected for thematic analysis. Three overarching themes emerged: (1) Digital literacy, highlighting variability in students' and educators' digital skills and confidence; (2) Generational characteristics and learner needs, demonstrating Generation Z preferences for technology-enhanced, self-paced and interactive learning; (3) Evolving pedagogies in nursing education, showing integration of Learning Management Systems, virtual simulations and blended learning to enhance engagement and accessibility. Digital technologies are reshaping nursing education by enabling interactive and flexible learning. Nurse educators must address gaps in digital literacy, align teaching strategies with Generation Z learning preferences and integrate blended and immersive approaches to foster engagement, competency development and inclusive learning environments. [Abstract copyright: Copyright © 2025 The Authors. Published by Elsevier Ltd.. All rights reserved.
Towards a Housebuilding Paradigm: A Systems Theory Approach to Supply Chain Reconfiguration
Full text linkHousebuilding is often conflated with the construction sector, yet this research identifies that is it is fundamentally different in its purpose and organisation, and in fact should operate as its own distinct sector and research field. While construction encompasses a wide range of diverse, bespoke projects, residential housebuilding faces the different challenge of delivering at scale, requiring both high volume and consistent output. Project-based structures, while offering diversification, inherently limit the sector’s ability to achieve the scale and consistency needed to meet growing housing demand. Despite this, the housebuilding sector largely continues to operate through these discrete, project-based systems, prioritising short-term flexibility over repeatability further constraining efforts to achieve standardisation and efficiency.Drawing on systems thinking, the study identifies production theories, in particular, mass customisation as a more appropriate model for future housebuilding, allowing the sector to balance efficiency with the ability to tailor homes to diverse user and market needs. Achieving this, requires a fundamental reconfiguration of supply chain structures and practices. Current supply chain, characterised by the project management approach with short-term contractual arrangements and limited integration, are not conducive to the collaborative and long-term environments necessary for a transition to mass customisation. The paper therefore highlights the need to reconceptualise the supply chain design in volume driven housebuilding, underpinned by systems thinking, as a critical enabler for addressing housing demand. By investigating the transition from project-centric fragmentation towards long-term, integrated networks capable of supporting scalable delivery, the study contributes to ongoing debates around industrialisation in housebuilding. The research contributes to these debates by framing housebuilding as a distinct system, advancing mass customisation as a guiding paradigm, and identifying interdependent supply chain processes that can support scalable housing delivery. Realising this vision therefore requires reconfiguring the embedded supply chain practices in the sector. As such this study offers a new framework to support researchers and practitioners to shift from transient, transactional project supply chains to long-term, integrated networks capable of supporting standardisation, knowledge transfer, and collaborative innovation necessary for mass customisatio
Structure, Mutation, Functional Domain Roles and Medical Implications of Glycerol Kinase.
Full text linkGlycerol kinase (GK) is a key part of glycerol metabolism. It connects the metabolic pathways for lipids and carbohydrates by phosphorylating glycerol to glycerol-3-phosphate in an ATP-dependent reaction. This is essential for maintaining carbohydrate homeostasis, plasma glycerol withdrawal, and the utilization of glycerol by different tissues. Together, these processes impact glucose uptake and lipid metabolism. This review discusses the structure of GK, highlights the implications of mutations in the primary sequence, and provides insights on the roles of the various functional domains in the GK-catalyzed reaction. It also discussed the roles of GK in glycerol metabolism, energy production, and its connections with various cellular pathways and disease conditions. The proper regulation of GK activity is crucial, reflecting its critical role in various important cellular processes. Therefore, its regulation has been analyzed from the gene level to posttranslational modification and has implications for GK-linked disease. Separately, the critical role of this enzyme in some disease-causing organisms made it a promising target for inhibitor development. We here explore the current state of GK inhibitor research and discuss strategies for their development. Challenges in GK inhibitor research are identified, and approaches such as high-throughput screening, structure-based drug design, and computational modelling for discovering novel inhibitors are reviewed. Finally, the review highlights critical areas for further research, including the role of GK in synthetic biology and tumour development, among others. [Abstract copyright: © 2026. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
The effects of aerobic and resistance training across eight cancer types: a systematic review.
Full text linkPatients with canceroften experience declines in quality of life (QoL), functional capacity, psychosocial health, and body composition, alongside cancer-related fatigue. Aerobic and resistance exercise interventions have shown potential in mitigating these effects. This review evaluated the impact of such interventions on QoL, fatigue, body composition, functional capacity, and psychosocial health across both thecommonly studied cancers such as breast, prostate, lung, and colorectal, as well as the less-studied types, includinglymphoma, ovarian, multiple myeloma and head and neck cancers. Systematic searches were conducted across PubMed, Cochrane, ScienceDirect, Scopus, and EBSCOhost, identified 25 randomised controlled trials (RCTs) from an initial 18,116 studies. The 25 RCTs wereassessed using the TESTEX scale and PRISMA guidelines. Aerobic and/or resistance training showed to provide beneficial improvements in a number of measuresduring and after cancer treatment across cancer types. Qulity oflife improved in 12 (of 13) trialsthatreported QoL., There was a reported reduction in cancer-related fatiguein 9 (out of 10 ) studies that reported this measure. Significant enhancements in lean body mass and fat mass, were found in 6 of 8 trialsthat reported body composition. Functional capacity improved in 7 of 12 trialsthat reported this variable. Psychosocial outcomes showed mixed results, with significant improvementsreported in 2 out of 7 trials that measured depression and anxiety. Moderate-intensity exercise, performed three times per week, demonstrated the most consistent benefits. Specific improvements from exercise were found in patients suffering from breast, prostate, lymphoma, multiple myeloma, colorectal, lung, and head and neck cancer. There was a notable lack of trials meeting the inclusion/exclusion criteria thatspecifically focused on ovarian cancerpatients. Structured aerobic and resistance exercise showed tosignificantly improve QoL, fatigue, body composition, and functional capacity in cancer patients. Integrating tailored exercise into cancer rehabilitation can enhance recovery. Future trials should aim to standardise outcome measures and improve adherence across diverse cancer populations. [Abstract copyright: © 2026. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Trauma -Informed Design in Practice
No full textExecutive SummaryA new way of understanding the role of buildingsTrauma-informed design is reshaping how we understand the purpose and impact of buildings. It begins with a clear idea: the environments we create influence how people feel and how they engage with learning, care and community life. When places support comfort and clarity, they help people participate more easily and with greater confidence. This benefits everyone, not only those with lived experience of trauma.The challenge many environments still presentAlthough awareness of trauma and sensory diversity is growing, many educational and public buildings still struggle to meet the full range of psychological needs. Harsh lighting, unexpected noise or confusing layouts can create stress or hesitation, particularly for those who already feel under pressure. These environmental factors can affect confidence and make everyday interactions more demanding than they need to be. It’s a reminder that the built environment plays a role in shaping people’s wellbeing and sense of belonging.A shared approach to trauma-informed designThis paper sets out a collaborative and evidence-informed approach to trauma-informed design. It draws on principles from trauma-informed care, supported by research and practice, to outline a practical method for shaping environments that feel predictable and supportive. The approach encourages careful attention to sensory experience, spatial clarity and opportunities for personal control. Co-design is central to this method. The process values lived experience and uses it to guide decisions from the earliest stages of briefing through to detailed design.Insights from the development of the Thrive Health and Wellbeing CentreThe work on the University of Salford’s Thrive Health and Wellbeing Centre offered a significant opportunity to explore trauma-informed design in a complex, multidisciplinary environment. Academics, clinicians, students, estates professionals, designers and community partners contributed to a shared understanding of what people needed from the space. Their insights shaped the core values that underpinned the brief. The resulting design demonstrates how trauma-informed principles can influence building organisation, circulation and sensory character, while still supporting the academic and clinical functions the building must deliver.Benefits that reach beyond traumaThe paper highlights the strong connection between trauma-informed and neuroinclusive design. Both approaches value environments that feel calm and easy to interpret, with the flexibility to support a range of sensory needs. Because of this, many of the benefits extend across the whole building community. Improvements in comfort, wayfinding and acoustics help people concentrate, move more easily and feel more at ease.Sustaining trauma-informed values in everyday practiceA trauma-informed environment depends not only on the physical space but also on how the building is managed and occupied. Day-to-day interactions, staff awareness and organisational practices are central to whether people feel supported. The paper outlines practical steps that can help embed these values, including training, consistent communication and adaptable operational processes.Creating places where people can thriveThe insights presented in this paper show that trauma-informed design is both achievable and relevant to a wide range of educational and public environments. When adopted early and carried through into daily practice, it helps create places that feel more supportive and inclusive. These outcomes align closely with the wider ambitions of universities and public institutions that want to improve user experience and wellbeing.The development of the Thrive Health and Wellbeing Centre demonstrates the value of institutions and designers working together around shared aims. By designing with psychological safety in mind, it is possible to create environments where people feel welcomed, respected and able to thrive
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