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The ‘Walking/Wheeling With’ Framework: Establishing Walking/Wheeling with Children as a Mobility Justice Issue
No full textAdopting a mobility justice lens, this review paper brings together the often-fragmented literature on walking and wheeling with children and develops a ‘Walking/Wheeling With’ framework to understand and address the infrastructural, social, and cultural barriers that constrain these mobilities, and celebrate the many benefits they bring at the individual, family, community and planetary levels. Rooted in the everyday realities of caregiving mobilities, and adopting a disability-conscious lens, this framework emphasises that the removal of barriers to mobility enhances inclusion for all. Drawing from history, geography, disability studies, environmental planning, social policy, mental health, physical activity, and early childhood studies, we argue for a more cohesive, inclusive, and cross-sectoral research and policy agenda that recognises walking or wheeling with children as a site of both challenge and possibility. Ultimately, the ‘Walking/Wheeling With’ framework demands from researchers and policy makers alike that they systematically consider family/caring mobilities in relation to broader questions of access, inclusion, and movement in contemporary society. In practice, this might mean decentering speed and car-commuting while centering physical safety, slowness, health, civic engagement, environmental justice and inclusivity
Quantifying Internal and External Training Loads in Professional Ballet Dancers: The Role of Session Type and Sex
Get PDFPurpose : To (1) quantify the internal and external training-load (TL) demands of professional ballet dancers and (2) explore the influence of session type and sex on TL. Methods : Twenty-nine professional ballet dancers (men = 14, women = 15) were monitored over 2 weeks. Internal TL data were measured using heart rate (HR) –derived training impulse (TRIMP) and external TL using PlayerLoad (PL). TL data from 303 sessions were categorized and analyzed according to session type (rehearsal, class, and conditioning) and sex. Results : Dancers averaged ∼4.62 h/d (∼26.1 h/wk) comprising daily (PL: 539 arbitrary units [AU], HR TRIMP: 314 AU) and weekly (PL: 2608 AU, HR TRIMP: 1503 AU) TL. Rehearsals had the longest duration (197 [66] min) but lowest load per minute. Conditioning produced the highest PL (140.1 AU; 95% CI, 120.2–160.0), while class elicited the greatest HR TRIMP (89.4 AU; 95% CI, 72.1–106.7). Session type significantly influenced TL ( P = .004, η 2 = .68), with small to moderate differences between rehearsal and conditioning (PL effect size = 0.38, TRIMP effect size = 0.49). No significant differences were observed by sex (PL, P = .57; TRIMP, P = .18). Conclusions : Conditioning sessions produced the greatest TL response and should play a key role in professional ballet dancers’ schedules. Although TL did not significantly differ by sex, the study suggests that a uniform training model may not meet individual dancer needs. These findings support the implementation of personalized monitoring and periodized scheduling strategies to optimize both artistic and physical performance in professional ballet
‘Do existential touchstones really cool?’ An exploration of therapists’ experiencing of significant personal loss and how this informs their ‘way of being’ with a client
Get PDFThis paper reports on a study that explored how person-centered therapists affected by significant personal losses experience existential touchstones, and how these experiences inform their way of being with clients. Using a heuristic inquiry approach, alongside my own heuristic journey, semi-structured interviews were conducted with three person-centered therapists and analyzed thematically. The findings both support and challenge the limited existing literature on therapist grief, suggesting that grief is a unique and identity-shaping experience that can also foster personal growth. Lived loss reshapes therapists’ subjective experiencing within therapeutic encounters. Participants described how their own experiences of loss, when supported by grief education and supervision, deepened their empathy, strengthened relational connections, and enhanced their therapeutic practice. The study highlights how personal grief, when acknowledged and integrated, can become a transformative resource in therapy, underscoring the value of experiential understanding in the development of therapeutic presence and practice
Poor players? The role of short-lived newspapers in re-evaluating success and failure in the nineteenth-century periodical press
No full textUncoupling TGFβ1 signalling from collagen protein synthesis in Dupuytren's disease
Get PDFDupuytren's disease is a fibroproliferative disorder of the palmer fascia (PF) characterised by flexion contractures in the hand. Dupuytren's disease can be treated surgically, but disease recurrence rates are high, potentially due to continual production of matrisomal proteins. Here, metabolic labelling and proteomics identified differences in the new synthesis and composition of matrisomal proteins between Dupuytren's tissue and normal PF. Dupuytren's tissue actively synthesised type I collagen, fibronectin (FN1), matrix metalloproteinases-2 and -3 (MMP2, MMP3) and tissue inhibitor of metalloproteinases 2 (TIMP2). Both tissues actively synthesised insulin-like growth factor binding protein 7 (IGFBP7). Label-free analysis implicated the transforming growth factor-β (TGFβ) pathway in the matrisomal profile of Dupuytren's tissue. The effect of TGFβ isoforms on COL1 mRNA expression was first tested in cultured young and aged equine tenocytes. COL1A1 mRNA responded to treatment with all TGFβ isoforms and was more highly expressed in cells from aged samples. In aged human cells, COL1A1 and COL1A2 mRNA was higher in cells derived from Dupuytren's tissue than normal PF and in response to TGFβ1, but no changes in COL1A1 or COL1A2 CpG methylation were detected. TGFβ1 treatment only resulted in increased type I collagen protein accumulation in the media of Dupuytren's nodule cells. In three-dimensional cultures, COL1A1 mRNA was lower in normal PF than in Dupuytren's cells, but TGFβ1 treatment only increased type I collagen accumulation in the media of normal PF cultures, and TGFβ1 inhibition did not alter new collagen protein synthesis. TGFβ1 inhibition in Dupuytren's tissue explants did not alter the proportion of homotrimeric type I collagen, nor was this changed in skin or tendon of the tight-skin (TSK) mouse, a naturally occurring model of indirect TGFβ1 activation. Therefore, the role of TGFβ in Dupuytren's disease may be predominantly related to myofibroblast phenoconversion and contractility rather than directly altering collagen protein synthesis
Feeling safe, feeling connected: aesthetic and polyvagal approaches to dementia care
Get PDFThis perspective brings together authors from care aesthetics, dementia studies, mental health nursing, and clinical psychology to explore how aesthetics and Polyvagal Theory intersect in dementia care. Across these fields, there is growing recognition that wellbeing is shaped not only by clinical interventions but also by the subtle, embodied cues that create a sense of safety, connection, and belonging for patients. Concepts such as aesthetic care, in-the-moment practices, and everyday aesthetics emphasize how lived experience and wellbeing is grounded in the sensory and relational details of everyday life. In parallel, Polyvagal Theory provides a psychophysiological framework for understanding how people respond to such cues through the process of threat detection, co-regulation, and social engagement. By placing these perspectives side-by-side, we explore the currently untapped benefits of developing a cross disciplinary therapeutic toolkit for clinicians working with people living with dementia. Looking ahead, integrating aesthetics and Polyvagal-informed approaches could reshape dementia care into a practice that values safety, connection, and meaning as core clinical outcomes. Although further research is needed to translate this integrated model into practice, the work of the authorship in both research and clinical practice with people with dementia illustrate that such approaches are already ongoing and can bring tangible benefits for several stakeholders, including people living with dementia
Attention-Guided U-Net for Cell Nucleus Segmentation in Microscopy Images
No full textCell nuclei segmentation is a fundamental step in computational pathology and biomedical image analysis, enabling downstream tasks such as disease diagnosis and drug discovery. However, existing DL based approaches often rely on heavy encoders or complex multi-branch designs, leading to large parameter counts and limited practicality in clinical settings. We propose a lightweight encoder–decoder architecture that achieves improved segmentation performance with significantly reduced model complexity. Our custom residual encoder leverages dilated convolutions and Squeeze-and-Excitation (SE) modules to capture rich contextual features, while a Spatial Pyramid Pooling bottleneck enhances multi-scale representation. In the decoder, enhanced attention gates selectively refine skip connections, resulting in sharper boundaries and more robust segmentation under challenging conditions, such as overlapping or irregular nuclei. Extensive experiments on three diverse benchmarks, Blood Cell Segmentation (BCS), Data Science Bowl (DSB), and Nuclei Instance Segmentation (NuInsSeg), demonstrate that the proposed model consistently outperforms or matches State-of-the-art (SOTA) models while using fewer parameters. Specifically, it achieves Dice scores of 0.9817 on BCS, 0.9262 on DSB, and 86.45 on NuInsSeg, surpassing SOTA models in most cases despite much smaller computational footprint. These results establish the proposed model as an effective and practical solution for real-world biomedical segmentation pipelines, offering a favorable balance between accuracy and efficiency
Global learner feedback on CME-accredited e-learning modules in Paediatric Endocrinology and Diabetes: cross-sectional study
No full textBackground:The European Society for Paediatric Endocrinology (ESPE) e-Learning website, www.espe-elearning.org, is a free, globally accessible online resource to enhance learning in pediatric endocrinology and diabetes. The content is created by world-leading experts in pediatric endocrinology and diabetes and is closely aligned with published international consensus guidelines. In August 2022, 30 hours of e-learning courses received accreditation from the European Accreditation Council for CME (EACCME®). These CME courses cover three categories: (1) Pediatric Endocrinology, (2) Pediatric Diabetes, and (3) Pediatric Endocrinology in Resource-Limited Settings.Objective:To assess learners' demographics and feedback from mandatory surveys after completion of CME e-learning courses, and identify areas for improvement.Methods:The ESPE e-learning committee created a mandatory survey for each CME e-learning module. The survey includes baseline demographics and feedback on the quality of the learning content, assessed using a five-level Likert scale. Data was extracted from the start of the CME modules in August 2022 until September 2025.Results:567 surveys were completed: 286 (50,4%) in the category Pediatric Endocrinology, 225 (39,7%) in the category Pediatric Diabetes ISPAD Guidelines, and 56 (9.9%) in the category Pediatric Endocrinology in Resource Limited Settings. There was global participation, with most learners practicing in Europe (n=333 (59%)), followed by Asia (n= 124 [22%]), Africa (n=53 [9%]), the Americas (n=45 [8%] North America, n=11 [2%] South America),and Oceania (n=1 [0%]). Most of the users indicated to be medical experts (37%), followed by fellows/residents (39%), medical students and nurses (5% and 6%, respectively); 10% of learners practice in resource-limited countries. Overall, the learning content was well received for all modules regarding accessibility, organization, level of interest, improvement of learner’s clinical practice, appropriateness of content and provision of feedback (median Likert score 4; IQR 1). Learners’ free-text feedback identified some areas of improvement, including reducing text-heavy content, providing more graphical content and more interactive case reports. Most learners' free text feedback consists of encouraging and thankful comments.Conclusions:The ESPE CME-accredited e-learning modules are well-received providing globally free CME education in pediatric endocrinology and diabetes. These findings support the continued development and promotion of open-access CME platforms improving global equity in specialist medical education and focusing on educational impact
Opioids and long-term pain management: nursing considerations
No full textEvidence suggests that opioids are no longer appropriate for long-term use in chronic non-malignant pain, due to lack of efficacy and risks to patients such as increasing tolerance and dependency, multiple physical side effects, mental health issues or even death from accidental overdose. This article considers the evidence on the appropriate use of opioids, and ways to safely implement and manage their long-term use. The author details best practice for nurses on subjects such asthe use of opioids in the treatment of various types of pain, the principles of opioid stewardship, optimising the effects of opioids, and the risk of tolerance, dependency and dose escalatio
AI in the Curator’s Loop: Designing Transparent and Trustworthy Metadata Displays under the EU AI Act
No full textMuseums are increasingly exploring how artificial intelligence could assist with largescale metadata enrichment, yet few have implemented such systems beyond small research pilots. Concerns about hallucinations, bias, transparency, and the erosion of curatorial authority have made many institutions cautious about operational use. This paper introduces Project SPOT, a research-led framework and AI-assisted tool developed to operate within the curator’s loop, ensuring that AI generated suggestions support rather than supersede and replace curatorial knowledge and judgement. SPOT identifies sub-objects within artefact images and produces candidate metadata that are subsequently reviewed, amended, or rejected by curators, maintaining clear human authorship throughout the process.Forthcoming transparency obligations under the EU AI Act add urgency to these discussions. The Act requires public disclosure when content has been generated or influenced by AI, raising new design questions for museums that wish to display AIassisted information online. Using SPOT as a case study, this paper examines strategies for integrating AI-generated, curator-verified data into artefact webpages while remaining compliant with the Act. It considers both interface-level and metadatalevel approaches for signalling AI involvement and analyses how these might affect user trust in institutions long regarded as sources of reliable knowledge.By framing AI as a transparent, curator-controlled partner in the creation of cultural data, the paper contributes to current debates on human–machine interaction, digital provenance, and the museum as an epistemic actor in the digital public sphere