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Family caregivers' experiences of long-term care residents living with dementia during the COVID-19 pandemic: An international grounded theory study
Full text linkAims: Caution around the COVID-19 pandemic resulted in visitation restrictions to prevent the spread of the virus among vulnerable older persons living in long-term care (LTC), which posed a threat to individual well-being and family togetherness across the globe. The purpose of this study was to explore family caregiver's experience of having a person who is living with dementia residing in a long-term care facility during the COVID-19 pandemic.
Design: Qualitative descriptive study using constructivist grounded theory (GT) methodology.
Methods: The study was carried out in five countries: the United States, Switzerland, Hong Kong (China), United Kingdom and Japan. Data were collected between June 2021 and August 2022. In-depth understanding and initial theorising about experiences and social interactions between family members, residents and long-term care staff across cultural contexts, strategies from constructive GT were used. Data were collected through 15 semi-structured, in-depth interviews with 16 family members. Analysis included individual and team-based coding, memo-writing, constant comparison and category generation.
Results: Due to visit restrictions, families faced upsetting situations of exclusion. The caregiver participants experienced inequality, felt isolated and witnessed residents' despair and helplessness. Analysis revealed four subthemes to the basic social process of ‘negotiating for access to maintain relational continuity’: (1) Feeling excluded, isolated and upset; (2) facing depersonalising situations; (3) navigating challenging interactions; and (4) living with (post-) pandemic circumstances.
Conclusion: This study highlights the suffering experienced by family caregivers and their loved ones living with dementia in long-term care during COVID-19, demonstrating the key role that relationships play in family care. During similar public health crises, policies and infection prevention measures that depict family and close caregivers as visitors whose access needs to be regulated need to be altered into policies that enable a culture of partnership and inclusion acknowledging the importance of social interactions for health and well-being
Cyber-physical system security for manufacturing industry 4.0 using LSTM-CNN parallel orchestration
Full text linkInteroperability among different machines, systems, and humans connected via the Internet of Things (IoT) has blessed Industry 4.0 with numerous advantages over the years. However, these benefits have unleashed risks of cyber attacks on internet-connected manufacturing units such as autonomous intelligent computer-controlled cutting (ICNC) machines. These are used in different manufacturing industries to ensure high precision and faster production. Over the Internet these machines receive product designs and instructions of how to produce them. Intrusions through malicious code embedded in the design can hamper precision and cause production delays, resulting in significant revenue loss. This paper presents an innovative cyber-physical system (CPS) security mechanism, using a long short-term memory (LSTM) network and a convolutional neural network (CNN) coordinated by a parallel orchestration (PLO) algorithm. It detects intrusions from both image and text data with 90.85% and 91.66% accuracy, respectively. Applying the proposed methodology in a simulated manufacturing industry shows an average yearly successful intrusion reduction from 184 to 15, saving an average of $30,474 in revenue. Its innovative concept, the distinctive mechanism of the PLO algorithm, and applying it in a simulated manufacturing industry make the proposed security system superior to comparable approaches
How to harness education fellows to optimise clinical placement capacity
No full textThere is a global need to increase our medical workforce to meet the demands of changing population demography and increased complex comorbidity. Recruitment to medicine, nursing and other healthcare professions must significantly increase [1]; however, clinical placement saturation is becoming a rate-limiting step to substantial increase in student numbers. This article will consider how clinical placement providers can deploy education fellows (EFs) to innovatively create capacity whilst enhancing undergraduate clinical placement quality. Clinical teaching fellows are increasingly becoming pivotal players in supporting delivery of undergraduate clinical education and promoting student experience. Unlike clinical teaching fellows, EFs do not have clinical commitments and can reliably coordinate, create and deliver diverse undergraduate learning, mentoring and assessment activity, alleviating senior clinical staff of competing educational responsibilities. We propose that integrated EF-led innovation can facilitate more consistent, high-quality placement learning whilst growing placement capacity, without compromising patient care. This article focuses on educational interventions within hospital clinical placements for students from a range of healthcare disciplines including medicine, nursing and allied healthcare professions. The change in workforce requirements and consequent need for a greater undergraduate capacity should catalyse wider discussion around the structure of healthcare education and philosophies of placement development. The authors' experience is in medical education; however, the principles are widely applicable to all healthcare professions for whom experiential placement learning is a necessary training component. Reimagining and restructuring of placement experiences will support healthcare faculty, universities and regulators in supporting sustainable health workforce expansion and equitable healthcare access for all
Integration of Refugees and Asylum Seekers in Europe: A Scoping Review of Interventions
No full textIntegration of refugees and asylum seekers into the local communities within host countries is a pivotal aspect of rebuilding this population’s lives with dignity. However, establishing and maintaining effective integration programmes remain challenging for resettlement countries and their partners in Europe. This scoping review aims to identify and characterize existing integration interventions in Europe and evaluate their implementation strategies and effectiveness. We systematically searched PubMed, Scopus, CINAHL, and ASSIA databases from inception to 15 March 2024 for relevant articles. We also searched grey literature for additional relevant articles. The scoping review was conducted to identify original research articles on integration interventions targeting any of the four integration outcomes of health and social care, work, housing, and education among refugees and asylum seekers. We conducted a narrative synthesis of our findings. The literature search generated 1237 studies, of which 16 articles met the inclusion criteria. The interventions, predominantly from Sweden and the UK, were diverse and conducted among different categories of refugees and asylum seekers and various settings, including community-based and school-based settings. They were delivered by local authorities and non-profits, with some involving volunteer refugees and asylum seekers. Interventions led to improvements in education (n = 3), health and social care (n = 10), work (n = 3), and housing (n = 2). The review findings show that a variety of interventions in diverse settings have been implemented in Europe to promote integration among refugees and asylum seekers, and the majority register positive outcomes. Investment in integration programmes for immigrants is a crucial step toward the improvement of various social and health outcomes
Planetary health as a troubling concept for the ecological university: unification, revolution or utopia?
No full textThis paper contributes new insights into a topic of contemporary significance to higher education in general, and more particularly to this journal – that of the role and responsibility of the university in the context of socio-ecological crises. Specifically, it explores the (hitherto unexamined) relationships between the ideas of the ecological university and planetary health and the ways in which the latter might inform or ‘trouble’ the former. To provide a frame for this exploration, the Planetary Health Education Framework – developed to distil ‘the essence’ of planetary health in relation to values, knowledge and practices in higher education – is deployed. It is concluded that, while the relationship between the two concepts is (super)complex, the idea of the ecological university is supervenient on that of planetary health. Planetary health can be understood as a potentially unifying concept for the ecological university in its responding to three key planetary ‘failures’ (conceptual, knowledge and implementation). It is also a revolutionary concept, calling for an urgent transformation of major institutions, systems and frameworks at micro and mega-ecosystem levels. Most significantly, although both concepts contain utopian strains, with its foundation in ontological realism, planetary health offers a strong regulatory ideal for universities which seek to develop their ecological credentials
“It's OK for me to cry”: client and therapist perspectives on change processes in SPEAKS therapy for anorexia nervosa
Full text linkIntroduction and Aims
Existing therapies for Anorexia Nervosa (AN) have limited effectiveness, necessitating the development of novel therapies and interventions. Hypothesizing and targeting clear mechanisms of change within treatment offer potential opportunities to improve them. The SPEAKS program aimed to develop, trial, and evaluate a therapy which targets key emotional and social factors known to be relevant in the development and maintenance of AN. The aim of the present study is to explore therapist and client experiences of change processes during the SPEAKS intervention, and what supported or inhibited these.
Method
Semi-structured interviews were conducted with sixteen female clients (in age range of 18–49) and six therapists; topic guides explored perceptions of client change processes. Thematic analysis was conducted on the data by two researchers.
Results
Two themes and six sub-themes were developed from the data. These were: “the impact on the eating disorder,” “change processes” (“emotional change” and “changing the self”), and “facilitators of and barriers to change processes” (“therapeutic relationship,” “clients’ emotional engagement,” “online delivery,” and “therapist lacking flexibility”). “Emotional change” involved an enhanced capacity for clients to tune-in more, acknowledge, listen to, and express how they felt, and “Changing the self” represented a shift in how clients related to themselves, particularly the more vulnerable parts of themselves.
Discussion
The findings of the present study provide support for the hypothesized mechanisms of change inherent within the SPEAKS therapy approach. This supports the robustness and validity of the intervention and lends support for further investigation of its effectiveness.
Clinical Trial Registration
The study was registered according to the guidelines of the International Standard Randomized Controlled Trial Number Register (ISRCTN No. 11778891)
Catching up with commuter students: What do we know and what should we do to support them?
No full textRecognising, understanding and addressing the environmental, network and social impacts of the student commute to university in the UK
No full textThere are 2.8 million students in higher education (HE) at universities in the UK. Almost half of these – 47% (Kenyon, 2025) – are commuter students: ‘students who continue to live at home while studying, rather than moving into student accommodation’ (Kenyon, 2024a: 116).
Unlike residential students, commuter students continue to live at home, travelling to university for their lessons, or to access services, social networks and support.
This gives a substantial transport footprint.
The average student is timetabled to attend classes on three days a week, during term time. This equates to 1.3 million students commuting to attend taught sessions at university, three times a week, every week, equating to 3.9 million return journeys.
However, university students are largely invisible in transport planning. Local Transport Plans and development planning routinely exclude students from surveys, personas, strategies and models. The National Travel Survey (DfT, 2025) and the Census (ONS, Nd), which provide much of the data that we rely on to inform transport planning, present education data in aggregate, failing to disaggregate between primary, secondary and tertiary, so it is not possible for us to understand travel to university, or being a university student as an occupation.
This reflects a fundamental misunderstanding of the nature of participation in HE today, across society, government and the transport planning industry.
There are three key impacts of this for transport planners, policy makers and practitioners.
• The first is the network impact of this transport footprint, which we need to understand, account for and mitigate, considering service use and service provision.
• The second is the environmental impact, which we need to understand, account for and mitigate, if we are to achieve a net zero transport economy.
• The third is the exclusionary impact of a transport system in which a substantial number of users are invisible and, therefore, likely to be underserved, which we need to understand, account for and mitigate, if we are to achieve an inclusive transport system.
As such, this paper aims to raise awareness of commuter students, amongst the transport planning community, in order that the negative network, environmental and social impacts of these invisible commuters can be mitigated