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The roles and experiences of informal caregivers in non-malignant respiratory disease at the end of life: A thematic synthesis of qualitative studies
No full textObjectives The aim of this review was to identify, review and synthesise primary qualitative literature to answer the question ‘what are the roles and experiences of informal caregivers providing care to a person with non-malignant respiratory disease at end of life from the perspectives of the caregiver and recipient of care?’ Methods This qualitative systematic review was undertaken using thematic synthesis (Thomas and Harden 2008). Electronic databases (British Nursing Database, Cumulative Index to Nursing and Allied Health Literature Plus, Medline, PsycInfo, ProQuest Sociology, Allied and Complementary Medicine Database (AMED)) covering nursing, medicine and social sciences were systematically searched from inception to October 2024. Studies were included if they reported data on the experiences and roles of caregivers in non-malignant respiratory disease at end of life, from the perspective of the caregiver or the person with non-malignant respiratory disease. Twenty-two papers met the eligibility criteria and were included in the review. Quality assessment was undertaken using the JBI Critical Appraisal Checklist for Qualitative Research. Results Thematic synthesis of the data generated five analytical themes: Caregivers experience shifting identity and new roles; Adaptation is necessary to cope with loss and change; Caregivers need more information and co-ordinated care services; Emotional effects of caregiving; and Future uncertainty and facing death. The findings illustrated the complexity of the caregiving role and highlight unmet needs during the end of life stage. Significance of Results This evidence synthesis highlights the significant contribution caregivers make in the lives and deaths of those with non-malignant respiratory disease. Challenges of caregiving in this context increase the stress of caregivers, including unpredictable disease progression and difficult symptoms such as breathlessness. There are persistent inequalities between malignant and non-malignant care pathways. Caregivers would welcome more recognition and information from healthcare professionals to support their role.
Strategic enablers of sustainability in the Indian medical device supply chain: An ISM-DEMATEL approach
No full textPurpose This research aims to identify enablers of sustainability in the medical device supply chain. Design/methodology/approach A medical device manufacturing firm located in western India was selected for the study. An analysis using ISM DEMATEl was condcted. Findings The paper identified 14 enablers in the implementation of a sustainable supply chain in medical device firms. Resource and capacity management, along with supplier relationship management, are the are the two most influential enablers that affect the long-term sustainability of the medical device supply chain. Practical implications To enhance supply chain sustainability, management needs to ensure higher funds and resources to adopt modern technologies, new machines, and equipment. Originality/value The findings provide a theoretical framework for sustainability strategies in the supply chain of medical device manufacturers
Air pollution and environmental justice: A systematic literature review on methodological approaches
Get PDFAir pollution is the greatest environmental risk to human health, according to the WHO and other international entities like the UN Human Rights Council and EEA. However, not everyone is equally affected by air pollution, depending on exposure and vulnerability. The objective of this systematic literature review is to investigate whether and how concepts related to environmental inequalities or justice have been considered when assessing health impacts of air pollution, identify possible gaps in knowledge, and offer suggestions for future research. A total of 99 articles are assessed considering framework, study region, time scale, data and indicators used and finally, the method applied (statistical, numerical or survey). Results show that EJ studies took place in 21 different countries, led by the United States of America (53%), followed by Canada (6%) and China (5%). In terms of temporal coverage, more than 50% of the studies were published in the last 5 years and are mainly focused on long-term studies. As regards proxy data, most of the studies focused on PM2.5, but only 50% explicitly include health or exposure data. All studies evaluated EJ questions related to socio-economic status (SES) or race/ethnicity. The socio-economic indicators mostly used are associated with income (99%), followed by population characterization and housing. The most common method used was statistical analysis (71%), with 14% applying surveys and 15% using modelling for scenario approaches. These results point out that there is space for other case studies in Europe among other regions of the world, with more robust statistical models based on advanced mixed methods to deal with such multivariable research. At small geographic units, studies supported by survey information would be recommended to include both individual and contextual socio-economic indicators. A limited number of studies deal with social perceptions and citizen engagement. Future research is suggested. It should be noticed that this literature review only looks for occurrences of "environmental justice" related to air pollution/quality
Processes of sharing and relating of women with Multiple Sclerosis through a group psychological intervention: A longitudinal qualitative study
No full textPurpose: Relationships are important for people with Multiple Sclerosis (MS). Social support contributes to well-being, and psychological group interventions show positive findings on quality of life, coping, and self-efficacy. The current article aims to report sharing and relating processes in an online group integrative psychological intervention named MyMS-Ally that contributed to positive change in five women with MS who participated in the study.Methods: This study followed the principles of Longitudinal Interpretative Phenomenological Analysis (LIPA). Five women living with MS participated in an 8-week online integrative psychological intervention group. Qualitative data were collected at three different time points: before the start of the intervention, post-intervention and at the 3-months follow-up. The findings presented here are part of a mixed-method feasibility and acceptability study for MyMS-Ally intervention.Results: The longitudinal group experiential theme ‘transitioning from concealing MS to embracing its relational effect’ was developed to capture the changes participants experienced in their relationships with people with and without MS following their engagement with the MyMS-Ally intervention. From the point of hiding their symptoms and needs, they became more open to communication in their relationships. The temporal changes of the five participants were grouped under the three time points.Discussion: The findings demonstrate the pathways participants went through towards sharing and relating with their MS and the group processes they found most impactful. Processes were deemed more important than the psychological techniques employed during the intervention. Implications for the development of group psychological interventions for people living with MS and their evaluations are also discussed
Integrated logistics and election performance: A systematic literature review
Get PDFElections are typically seen through the lens of political frameworks, overlooking the profound impact of logistics on election performance. Through a systematic literature review, this study explores the integral role of logistics in election performance. It highlights the links between logistics functionality performance and perceptions of electoral integrity. The findings reveal that as prerequisites, elections require specialised logistics systems integrated with inclusive I.T. and the human side to ensure dependability, increased visibility and security during the transportation and warehousing of sensitive electoral materials throughout election cycles. The findings identify distinct challenges faced by developed and developing countries, particularly concerning reverse logistics, warehousing, transport networks, distribution planning and technological infrastructure, suggesting the need for tailored logistics strategies based on national development status. Finally, the study emphasises the imperative involvement of logistics experts to ensure the effective integration of logistics functions within elections, oversight and the strategic development of an election logistics field
Reconceptualizing plastic pollution regulation in Nigeria, the U.S., and the U.K. from a corporate social responsibility (CSR) perspective
Get PDFPlastic pollution is an escalating crisis, yet Corporate Social Responsibility (CSR) remains largely voluntary in certain countries. In Nigeria, weak regulations and a lack of corporate accountability worsen the problem. While the United States and the United Kingdom have stronger sustainability initiatives, CSR in these countries is still not explicitly legally mandated, resulting in inconsistent corporate efforts. Despite growing advocacy for stricter environmental policies, businesses are not legally required to take responsibility for plastic waste. This article explores how CSR can go beyond voluntary commitments to become a structured, enforceable approach to addressing plastic pollution. By comparing CSR models in Nigeria, the United States, and the U.K., the article assesses best practices that could help Nigeria develop stronger corporate sustainability policies. Ultimately, it advocates for a clear CSR framework that holds businesses accountable and ensures they actively contribute to reducing plastic waste and safeguarding the environment
Omega-3 fatty acids in depression: A systematic review of human studies with supporting evidence from preclinical models
Get PDFBackground: Omega-3 polyunsaturated fatty acids (n-3 PUFAs) are essential for brain function and have been increasingly studied for their potential preventive and therapeutic roles in depression.Methods: A systematic review was conducted in accordance with PRISMA guidelines, focusing on recent human studies evaluating the effects of n-3 PUFA supplementation and Mediterranean dietary patterns on depression-related outcomes. Studies were identified through electronic databases and manual searches and critically appraised using the Joanna Briggs Institute Checklist for Randomized Controlled Trials. To contextualize human data, relevant preclinical animal studies were also reviewed.Results: The review identified mixed and context-dependent evidence for the efficacy of n-3 PUFAs in depression prevention among general populations. In contrast, more consistent therapeutic effects were observed in treatment studies, particularly when EPA-predominant formulations were used as adjunctive interventions. However, many studies lacked statistical power or did not achieve significance. Six preclinical studies demonstrated robust antidepressant and anxiolytic effects of EPA and DHA across models of nicotine withdrawal, chronic stress, aging, and neurotrophin deficiency. These effects were linked to anti-inflammatory, neuroprotective, and neurotrophic mechanisms.Conclusions: Omega-3 PUFAs—especially EPA—may offer modest yet clinically relevant benefits as adjunctive treatments for depression. While preventive efficacy remains unclear, preclinical data provide strong mechanistic support. Future large-scale, biomarker-informed human trials are warranted to clarify efficacy and optimize dosing strategies
Maternal diet-induced hypercholanemia alters gut microbiota and metabolome in adult female Western diet-fed offspring
Get PDFChildren of mothers with intrahepatic cholestasis of pregnancy (ICP) are more likely to develop metabolic disease later in life. Using a mouse model of gestational cholestasis, we previously found that 18-week-old offspring had metabolic alterations that were exacerbated in female offspring when challenged with a Western diet (WD). Microbiota changes are emerging as a potential mechanism for developmental programming, and the maternal gut microbiota is known to be altered in pregnancy and in ICP. We hypothesized that, in our model, the offspring gut microbiota is altered by maternal gestational disease, potentially impacting future offspring metabolic health. Female mice were fed a cholic acid (CA)-supplemented diet for 1 week preceding and throughout pregnancy to mimic gestational hypercholanemia. Female offspring were challenged with a WD from 12 to 18 weeks of age and cecal contents were collected for metataxonomics and metabolomic profiling. Maternal CA dietary supplementation was associated with markedly increased cecal sulfated bile acid species (up to 387-fold increase). Whilst WD-feeding of offspring was associated with a greater proportion of primary to secondary bile acids, and more tauro-conjugated bile acids than for offspring fed a normal diet, this adaptation to WD-feeding was not evident for those whose mothers were fed a CA-supplemented diet. Indeed, WD-fed offspring of CA-supplemented mothers had a >2-fold reduction in CA and dehydrocholic acid levels compared to those from NC-fed mothers. This corresponded with an altered profile of cecal microbiota, with clear separation of microbiotal profiles according to maternal diet in the WD-fed, but not NC-fed, offspring. This observational mouse study has shown that exposure to maternal hypercholanemia can significantly impact the effects of an obesogenic diet on offspring intestinal bile acid metabolism and gut microbiota, likely increasing their vulnerability to metabolic dysfunction when exposed to the “second hit” of an unhealthy postnatal environment
Downlink optimization for direct-to-satellite IoT with LEO satellites and LoRaWAN
Get PDFDirect-to-satellite communication systems for the Internet of Things, particularly those based on low-Earth-orbit satellite constellations, are emerging as a transformative solution to achieve global connectivity. However, ensuring efficient and reliable downlink communication from satellites to ground-based IoT devices remains a significant challenge due to intermittent satellite visibility, short contact durations, limited bandwidth, device energy constraints, and high network density. Unlike prior studies that primarily focus on uplink optimization, this work proposes a downlink-aware optimization framework that integrates satellite dynamics, LoRaWAN MAC constraints, and energy-aware scheduling. The framework accounts for physical-layer limitations, satellite visibility modeling, time-slot feasibility, and realistic system parameters consistent with LEO satellite operations. Simulations demonstrate that the proposed downlink-aware optimization framework improves the packet delivery ratio from 0.41 (achieved under random scheduling) to 0.96, while reducing the average energy consumption per successful transmission by approximately 55 %. These results highlight the efficiency of the proposed NSGA-II-based scheduling approach and provide an initial pattern that points toward potential scalability, compared to conventional non-optimized methods, demonstrating its promise for next-generation satellite-enabled IoT networks
Protocell computing on Aragonite substrates
Get PDFAragonite-proteinoid microstructures are an emerging type of biocomputing material. They mix inorganic calcium carbonate with self-assembled organic proteinoid networks. Scanning electron microscopy shows a range of structures. These include isolated microspheres and complex networks over 50 μm. They have dendritic shapes, with uneven nodes that create linear patterns resembling simple network topologies. Electrochemical testing shows a threshold response. This allows for all seven basic Boolean logic operations: AND, OR, NOT, NAND, NOR, XOR, and XNOR. It does this by classifying analog signals into binary states. This suggests a promising future for material-based computation. Frequency-dependent square wave voltammetry shows power-law scaling. It performs best in the 30–50 Hz range, which is important for biological use. This indicates adjustable electrochemical properties that are ideal for bioelectronic applications. The systems show autonomous oscillatory behavior for over 25 h. They maintain a steady ultralow frequency, like biological rhythms. This means they generate signals on their own, without any outside help. Impedance spectroscopy shows stable circuit features. There are strong links between resistive and capacitive parts. However, cyclic voltammetry shows that electrochemical degradation increases over time. These findings show that aragonite-proteinoid microstructures are well-suited for novel computing uses. They can help with things like autonomous sensing, neuromorphic devices, and biohybrid electronics. These microstructures use mineral-organic interfaces for processing information and generating signals. This approach connects synthetic materials to biological computing principles