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Acceptability and barriers to implementation of the EULAR recommendations for the role of the nurse in the management of chronic inflammatory arthritis: A mixed-methods study with nurses and rheumatologists in Japan
No full textAimEULAR recommendations for the role of nurses in managing chronic inflammatory arthritis were updated in 2018. This study aimed to: (i) assess the level of agreement and implementation of these recommendations among nurses and rheumatologists, and (ii) identify barriers to the implementation of these recommendations in clinical practice in Japan.MethodNurses and doctors in rheumatology care in Japan were asked to complete a survey on (1) levels of agreement and implementation of each recommendation (0–10: 0 “not at all” and 10 “yes, entirely”), as well as (2) reasons for disagreeing and/or barriers to implementation. Quantitative and qualitative data were first analyzed separately then paired side by side for comparison and identification of similar categories within and across the eight recommendations.ResultsThere were 309 complete responses (215 nurses and 94 doctors). Both nurses and doctors showed high levels of acceptability with a median of 10 for all recommendations. Implementation levels were significantly lower, indicating the discrepancy between acceptance and implementation in both groups. Ten categories were extracted from a total of 1300 comments, illustrating perceived barriers. The most common categories were lack of time, knowledge, and resistance to role expansion in the nursing division.ConclusionThis study highlights the gap between acceptance of the recommendations in Japan and their implementation in practice. Despite strong agreement, challenges like time constraints, knowledge gaps, and systemic barriers hinder implementation. Overcoming these requires interprofessional collaboration and nurturing a supportive environment for rheumatology nursing role development
From intent to impact: Reflections and recommendations for EDI across the agri-food sector
No full textEquity, diversity and inclusion (EDI) are increasingly positioned as essential to effective agri-food systems transformation, yet evidence on how EDI commitments translate into practice over the lifecycle of large research networks remains limited. This report presents findings from a developmental evaluation of the Agri-food for Net Zero Network+ (AFN Network+), a UKRI-funded initiative involving over 3,000 members across research, policy, industry and civil society. Drawing on 24 semi-structured interviews and a network-wide survey (n=94), the study examines how EDI evolved from proposal-stage intentions to operational practice over three years.Using an analytical framework that combines four phases of network development (pre-development, take-off, acceleration and stabilisation) with justice-based dimensions of redistribution, recognition, representation and power dynamics, the report identifies patterns of progress, constraint and unintended consequence. Findings show that while the AFN Network+ made substantive advances - particularly in redistributing resources, supporting early-career professionals, valuing diverse forms of knowledge and designing inclusive events - early design choices, informal cultures and concentrated decision-making power continued to limit who influenced strategic direction. EDI became increasingly embedded in leadership culture over time, yet its visibility and impact were unevenly experienced across the wider membership.The report concludes that moving from EDI intent to impact requires more than rhetorical commitment. It demands operational clarity from the outset, dedicated resourcing, transparent pathways to leadership, and mechanisms that translate participation into influence. Practical recommendations are offered for UKRI as a funder and for future network leads, alongside an adaptable EDI planning and evaluation dashboard. Together, these insights provide a transferable blueprint for embedding justice-oriented EDI across collaborative agri-food research and innovation programmes
Listening to voices across cultures: Non-pharmacological approaches to coping with sleep problems in dementia among ethnically diverse older adults in the UK
No full textBackgroundSleep disturbances are a common yet often overlooked challenge for people living with dementia and their caregivers, significantly affecting daily functioning and well-being. Existing interventions frequently prioritise pharmacological treatments, which may not align with the cultural values and preferences of ethnically diverse communities. This study explored how older adults with mild dementia and their caregivers from white British, Caribbean, Chinese, and South Asian backgrounds in the UK understand and manage sleep difficulties using culturally meaningful, non-pharmacological strategies.MethodsA qualitative, cross-cultural design was adopted using focus group discussions with 12 dementia dyads (older adults and their caregivers) recruited from community organisations in a city in Southern England. Four focus groups were conducted using a topic guide to elicit participants’ lived experiences and culturally informed coping practices. Transcripts were analysed using reflexive thematic analysis with NVivo 14, generating four overarching themes that captured shared and culturally specific perspectives.ResultsAnalysis revealed four key themes: (i) Sleep as a holistic and relational experience, (ii) The importance of routine, ritual, and physical engagement, (iii) Emotional calm and non-drug coping with night-time worry, and (iv) Cultural fit and practical accessibility shape participation. Participants viewed sleep through a holistic lens, closely linked to emotional, spiritual, and relational harmony. Gentle, non-invasive approaches such as calming evening rituals, light physical activity, spiritual reflection, and mindfulness-like practices were described as culturally rooted and preferable to medication. Participants valued familiar routines, trusted facilitators, and flexible, community-based delivery. Practical barriers, such as time constraints and caregiving demands, were highlighted alongside a strong desire for co-designed, culturally adaptive interventions.ConclusionsThis study underscores the potential of culturally grounded, mind-body approaches to address sleep disturbances in dementia care. By aligning interventions with communities’ daily routines, spiritual beliefs, and emotional needs, non-pharmacological strategies can improve acceptability and relevance. Critically, these findings show that ethnicity and cultural background should not be overlooked in research and intervention design, as they shape how people experience and manage sleep. Community-embedded, participatory models can foster trust, sustain engagement, and ultimately support better sleep and well-being for people living with dementia and their caregivers
Transitional justice and the restorative approach to searching for victims of enforced disappearance in Colombia: Moving mountains to find them, the case of La Escombrera
No full textThis article examines the restorative approach adopted within Colombia’s transitional justice framework, focusing on the Special Jurisdiction for Peace (JEP) and its response to enforced disappearances reported by the Movement of Victims of State Crimes (MOVICE) and other human rights organizations. Drawing on a critical analysis of the adoption of the precautionary measures ordered by the Section on Absence of Recognition of Truth and Responsibility for Acts and Conduct (SAR) of the JEP in the case of La Escombrera, the article explores how restorative justice principles were incorporated into judicial proceedings, participatory practices and reparative orders aimed at safeguarding suspected burial sites containing the remains of the disappeared. The active involvement of victims and their organizations has been central to this process, as their persistent advocacy has led to the implementation of precautionary measures and the recognition of their rights, in particular the guarantee of the right to search. The analysis reveals how these measures prompted a comprehensive state response, following decades of inefficient and inadequate responses from the state. However, the article also highlights ongoing challenges, such as limited resources, institutional resistance and difficulties in coordinating institutions, as well as issues with the participation and inclusion of victims. It concludes that although the JEP’s restorative approach is a significant development, meaningful progress is driven by the continued engagement and leadership of victims. Sustained political will and institutional commitment are essential to supporting this long-term process and ensuring that the victims’ rights remain at the centre of Colombia’s search for justice
Mycelium as a computational medium: A framework for growth modeling towards reservoir computing
Get PDFMycelium, the intricate vegetative network of fungi, has emerged as a promising candidate within the realm of engineered living materials (ELMs). While its intriguing structural and electrical properties highlight its potential, mycelium growth is highly sensitive to environmental conditions. To bridge this gap, a robust framework was developed to both model mycelium growth and explore its computational capabilities. This framework uses a cellular automata (CA) approach, enhanced with reaction-diffusion (RD) processes, to simulate mycelium growth under diverse environmental conditions. This configuration, combined with tunable parameters, enables the identification and validation of optimal growth patterns, supported by an algorithm designed to extract key features of hyphae–the fundamental building blocks of the mycelial network. Subsequently, the small-world properties of the modeled mycelium networks were investigated, revealing high clustering coefficients and short path lengths, characteristics that make them well-suited for reservoir computing (RC). To demonstrate their computational capabilities, mycelium-inspired RC architectures were evaluated on the MNIST dataset classification task, achieving an accuracy of up to 97.09%, highlighting the effectiveness of biologically inspired models. As a result, this framework establishes a comprehensive test-bench for mycelium modeling, growth, and computational exploration, paving the way for innovative applications in bio-inspired computing
Ethnic diversity in UK bioscience: Structural biases and recommendations for action
Get PDFScientific research is more innovative and impactful when scientists are drawn from diverse backgrounds. However, the scientific community does not reflect the demographics of wider society. Global Majority communities remain underrepresented within science, particularly within senior leadership roles. Here we explore ethnic diversity within UK academic biosciences, using publicly available staff and student demographic data from the UK Higher Education Statistics Authority. We use the Simpson index as a quantitative measure of diversity within the biosciences and construct linear mixed effect models to identify significant predictors of both student and staff ethnic diversity. For staff, there were significant negative effects on diversity for those in teaching-only roles, and lower diversity amongst higher paid and professorial or senior management staff. For students there are significant negative effects on diversity for part-time students and for postgraduate research students, with PhD students significantly less diverse than undergraduates. There was also considerable variation in diversity by biology subdiscipline, with higher ethnic diversity amongst biomedical sciences and biomolecular subdisciplines, while very low ethnic diversity was found within zoology, plant science and ecology. A correlation was found between the ethnic diversity of bioscience subdisciplines and the diversity of institutions offering those subdisciplines. Based on these findings, we provide evidence-based recommendations for action at various levels, including teaching teams, research groups, bioscience departments and professional bodies. We call upon the sector to take decisive steps to enhance outcomes and experiences for Global Majority staff and students, ultimately diversifying the academic pipeline to the direct benefit of UK bioscience
U-control – a universal platform for control system design with inversion/cancellation of nonlinearity, dynamic and coupling through model-based to model-free procedures
Get PDFThis paper presents the key components in the Universal(U)-control framework for designing dynamic control systems from model-based to model-free paradigms, in which the pillars include U-control system configuration, open-loop dynamic inversion, closed-loop dynamic inversion, general model-free cancellation of nonlinear-dynamic-coupling effect, model-free-sliding-mode control (MFSMC) and model-free composite nonlinear feedback (CNF) control. This paper is devoted to delivering intuitive and easy-to-understand explanations for the involved approaches with a series of schematic diagrams. Readers can refer to the corresponding publications for more details on the theoretical analyses. In addition, some showcase examples are provided in this paper to facilitate the understanding of certain important concepts
Cognitive Multisensory Rehabilitation, a novel approach for Complex Regional Pain Syndrome: Case series
Get PDFEffective treatment for Complex Regional Pain Syndrome (CRPS), a chronic pain condition, is challenging. Cognitive Multisensory Rehabilitation (CMR) is a cognitive and sensorimotor treatment approach aimed at restoring function that targets cognitive, somatosensory, and multisensory functions through sensory discrimination tasks. We aimed to apply CMR to treat CRPS within our clinical practice. Clinically, we have found promising results in reducing pain and other common features of CRPS, such as Body Perception Disturbances (BPD). In this clinical case series, four CRPS patients who participated in a two-week interdisciplinary CRPS rehabilitation program at the National Complex Regional Pain Syndrome Service in Bath, UK received CMR as part of their treatment. A combination of self-reported measures and clinical outcomes were collected pre and post-rehabilitation program. Functional improvements and a reduction on BPD were observed in all clinical cases. We demonstrate how CMR may improve several CRPS-related features that often hinder rehabilitation in people living with CRPS. Research involving larger cohorts are necessary to provide empirical evidence of the application of CMR in treating CRPS
Clinical and patient-reported outcomes in women offered oncoplastic breast conserving surgery as an alternative to mastectomy in the ANTHEM multicentre, prospective cohort study
Get PDFABSTRACTBackground: Oncoplastic breast conserving surgery (OPBCS) may be a better option than mastectomy, but high-quality comparative evidence is lacking. The ANTHEM study (ISRCTN18238549) aimed to explore clinical and patient-reported outcomes in a multicentre cohort of women offered OPBCS as an alternative to mastectomy +/- immediate breast reconstruction (IBR).Methods: Women aged >18 with invasive breast cancer or DCIS who were offered OPBCS to avoid mastectomy were recruited prospectively. Demographic, operative, oncological and 3- and 12-month complication data were collected. The proportion of women choosing OPBCS and the proportion in whom breast conservation was successful were calculated.Participants completed the validated BREAST-Q at baseline, 3- and 12-months post-operatively. Questionnaires were scored according to the developers’ instructions and scores compared across timepoints in each group.Results: 362 women from 32 breast units participated of whom 294 (81.2%) chose OPBCS. Of the OPBCS patients in whom post-operative margin status was reported, 210/255 (82.4%) had clear margins at initial surgery and only 10 (3.9%) required completion mastectomy. Major complications were significantly more likely after IBR. Women having a successful therapeutic mammaplasty reported significant improvements in ‘Satisfaction with Breasts’ and ‘Psychosocial Well-being’ scores from baseline to 3- and 12-but both OPBCS group reported significant decreases in baseline ‘Physical Well-being’ at 3 and 12-months.Conclusions: OPBCS allowed over 95% of women to avoid mastectomy with lower complication rates than IBR and improved patient-reported outcomes, especially after therapeutic mammaplasty. OPBCS should be offered as an alternative to mastectomy in all women in whom it is technically feasible
Towards sustainability balance in water-food-land nexus global development
No full textThe significant differences between quality of life and resource use characterise a sustainability imbalance in current global development. Evidence shows that infrastructure development, environmental capacity, and resource dependence are three driving factors. These three factors should be investigated to reduce the imbalance in future development, so that people in all countries can live a better life supported by adequate resources, without causing significant environmental degradation over the globe. This study conceptualises and quantifies the three driving factors in the water-food-land nexus based on the global social-environmental datasets. The three factors are aggregated into a sustainability imbalance index as a national-scale indicator. Then we investigate statistical correlations among the factors to uncover their interdependencies as driving mechanisms. Results indicate that achieving a sustainability balance at a global scale needs to significantly narrow the infrastructure development gap, with countries’ resource dependence informed by their environmental capacity. We propose ‘responsible’, ‘moderate’, ‘ambitious’, and ‘flexible’ development pathways towards the sustainability balance and discuss their practical implementation constraints. Our results highlight the importance of coordinating the key development drivers, which should be supported by systems-level information. Implementing the pathways needs more enhanced global collaborations towards a brighter future for people and our precious planet