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A novel way to understand and communicate the burden of AntiPsycHotic prescribing for adults across specialist Intellectual Disability services in England and Wales: the APHID feasibility study protocol
Get PDF© 2025 Stanyard, Neilens, Allgar, Bailey, Musicha, Purandare, Perera, Roy, Sawhney, Watkins, Jaydeokar, Lennard, Mitchell, McGowan, Laugharne, Tromans and Shankar. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.Background: The stopping overmedication of people with a learning disability, autism, or both (STOMP) programme was launched in 2016 in response to concerns about the over-prescribing of medication in people with intellectual disability. The programmes focus has been on the withdrawal of antipsychotic treatment for the individual person than the service or dosage optimisation. It could be that cumulative service level antipsychotic treatment converted and presented as chlorpromazine units could allow for comparison of services on how antipsychotic treatment is being utilised and allow for comparing of practices between services in different regions. The aim of this feasibility study is to explore if cumulative service scores of antipsychotic treatment burden could define prescribing patterns across different specialist intellectual disability services in England and Wales, focused on those on ≥2 antipsychotic treatments. There is no evidence to use ≥2 antipsychotic treatments for any individual. Methods: The study is a feasibility cross-sectional study investigating service antipsychotic treatment cumulative burden at seven annual time points, 2017–2023. De-identified data for adult patients with intellectual disability under the care of specialist intellectual disability services in receipt of ≥2 oral and/or long-acting IM (intramuscular) injectable (depot) antipsychotic treatments are included. Demographic and clinical data will be collated, in addition to information on the prescribed antipsychotic treatments. The data will be evaluated for data completeness and will be inputted into the Statistical Process Control tool. Outcomes will be measured using a combination of methods including descriptive analysis (including mean, standard deviation and percentage values), and a mixed effects regression model, to determine changes in chlorpromazine equivalent dose values over time. Results: Seven England and Wales National Health Service intellectual disability services are recruiting up to 490 people. There were recognised challenges in identifying the relevant eligible cohort across services and administering a common set of outcome measures. Discussion: This study is intended to inform decisions to design a wider registry that would involve antipsychotic treatment prescribing data for patients across multiple sites nationwide. Developing a de-identified database using routinely collected data, without the requirement for informed consent, comes with unique benefits and challenges. Registry reference: NCT06238089 (www.clinicaltrials.gov).The Baily Thomas Charitable Fund (reference TRUST/VC/AC/SG6328-9580
A qualitative exploration of the practice learning experiences of third‐year nursing students: challenges and opportunities
Get PDFCopyright © 2025 Elizabeth Mueke Kiilu et al. Nursing Research and Practice published by John Wiley & Sons Ltd.Aim: This study investigated the practice‐based learning experiences of third‐year nursing students under the Nursing and Midwifery Council (NMC) Future Nurse Standards (2018). The study identified enablers and barriers to proficiency achievement and explored how these experiences inform their preparation for roles as registered nurses and future practice supervisors.
Background: The study focused on nursing students who began their undergraduate programs in September 2020, the first cohort under the NMC Future Nurse Standards (2018). Conducted during the COVID‐19 pandemic, the research explored clinical practice learning experiences across three higher education institutions in England, highlighting the challenges in meeting required proficiencies.
Design: A qualitative approach was used, underpinned by hermeneutic phenomenology. Focus group discussions with 17 final‐year nursing students were undertaken.
Methods: Thematic analysis was employed to explore shared experiences of practice‐based learning. Ethical approval was obtained, and data saturation ensured robust findings.
Results: Five themes emerged: the physical and emotional impact of practice learning, lack of confidence in the process of assessment due to inconsistency, being prepared for practice, the impact of the practice supervisor/assessor, and what might help. Students described the process of achieving proficiencies as exhausting and emotionally draining, with assessment inconsistencies and limited supervisor engagement contributing to stress, isolation, and reduced learning opportunities.
Conclusion: While students navigated the pandemic’s impact on education, practice supervisors/assessors were seen as pivotal yet overstretched or insufficiently prepared. Findings highlight the need for standardized assessments, improved supervisor training, and tailored preplacement support to enhance practice‐based learning and better prepare students for registration and future supervisory responsibilities.unfunde
From data-compliance to model-introspection: Challenges in AV rule compliance monitoring
No full text© 2025 IEEE. Personal use of this material is permitted. Permission from IEEE must be obtained for all other uses, in any current or future media, including reprinting/republishing this material for advertising or promotional purposes, creating new collective works, for resale or redistribution to servers or lists, or reuse of any copyrighted component of this work in other works.Autonomous vehicles (AVs) are expected to comply with traffic laws, ensure safety, and provide transparent explanations of their decisions. Achieving these goals requires monitoring architectures that pro- cess large volumes of sensor, control, and contextual data. While real-time perception and decision-making are functionally indispensable, storing and using this data for auditing or improvement raises unresolved legal and technical challenges.
Data protection regulations—such as the GDPR—mandate that personal data processing be limited to what is strictly necessary for specified purposes (Art. 5(1)(b), (c), and (e)). Yet, in practice, what counts as “necessary” remains ambiguous. This tension gives rise to the data-justification gap: the lack of systematic methods to determine which logged data is both sufficient to support compliance assessments and minimal under data protection constraints.
At the same time, aligning formalized rules with their legal intent poses a separate but interrelated challenge—the alignment problem. Legal norms are often ambiguous or context-dependent, and existing monitoring frameworks rarely guarantee that formal specifications faithfully reflect legal meaning.
This paper outlines a research agenda for bridging these gaps. We propose an integrated approach com- bining formal methods, legal reasoning, and runtime monitoring to develop data-justification frameworks. Such frameworks would enable developers to generate interpretable rule formalizations, synthesize minimally sufficient monitors, and justify data collection in a transparent and legally defensible manner.German Aerospace Center: 10.13039/50110000294
Investigation of corporate sustainability performance data and developing an innovation-oriented novel analysis method with multi-criteria decision making approach
Get PDF© 2025 by the authors. Licensee MDPI, Basel, Switzerland.This study addresses the growing importance of integrating innovation into corporate sustainability strategies by examining the financial and environmental performance of ten firms listed on the Borsa Istanbul Sustainability Index over a five-year period. The main objective is to develop and test a novel, data-driven analytical framework that reduces reliance on subjective expert judgments while providing actionable insights for sustainability-oriented decision-making. Within this framework, the entropy method from the Multi-Criteria Decision Making (MCDM) approach is first applied to calculate the objective weights of sustainability criteria, ensuring that the analysis is grounded in real performance data. Building on these weights, an innovative reverse Decision-Making Trial and Evaluation Laboratory (DEMATEL) model, implemented through a custom artificial neural network-based software, is introduced to estimate direct influence matrices and reveal the causal relationships among criteria. This methodological advance makes it possible to explore how environmental and financial factors interact with R&D expenditures and to simulate their systemic interdependencies. The findings demonstrate that R&D serves as a central driver of both environmental and financial sustainability, highlighting its dual role in fostering corporate innovation and long-term resilience. By positioning R&D as both an enabler and outcome of sustainability dynamics, the proposed framework contributes a novel tool for aligning innovation with strategic sustainability goals, offering broader implications for corporate managers, policymakers, and researchers.Unfunde
The circular blue economy in Egypt: opportunities for regional cooperation and integration with Mediterranean countries for sustainable development
Get PDFCopyright © 2025 by author(s). Publishing rights by UAB Sustainability for Regions. This work is licensed under the Creative Commons Attribution International License (CC BY).This study examines the possibility of the Circular Blue Economy in Egypt to support sustainable development and the usage of its renewable resources, focusing on possibilities for regional collaboration, particularly in the Mediterranean region. The study's methodology was an analysis of missing policies, identifying key actors, and an expert survey to identify future collaborations and opportunities, which included 20 experts from diverse sectors. Current policies in Egypt (e.g., Egypt Vision 2030) and the Mediterranean region were analyzed against the Sustainable Development Goals (SDG 14) and regional initiatives such as BLUEMED and SwitchMed, highlighting shortcomings in cooperation, investment, and environmental measures. The main parties, including the Egyptian government, the Union for the Mediterranean (UfM), the private sector, and local communities, were grouped according to their level of interest and influence. Findings indicate that Egypt's strategic location and extensive coastline are suited to drive regional efforts in maritime tourism, aquaculture, and maritime transport. Yet, problems, including marine litter and underfunding, continue. Experts also support the creation of regional cooperation platforms and joint pollution monitoring systems. The paper concludes with policy recommendations to integrate circular economy concepts into government strategies, strengthen collaboration across the region, and establish a collaborative and innovation-based ocean governance model. The paper presents new ideas to support regional integration and suggests additional studies on sustainable financing mechanisms.Unfunde
Policy options in accelerating circular economy adoption in the Gulf countries
Get PDFCopyright © 2025 by author(s). Publishing rights by UAB Sustainability for Regions This work is licensed under the Creative Commons Attribution International License (CC BY).The transition to a circular economy is a pivotal step for the Gulf Cooperation Council (GCC) countries, given the growing environmental challenges, scarce resources, and the urgent need to diversify economies away from hydrocarbon dependence. This paper presents a comprehensive analysis of policies to accelerate the adoption of the circular economy in the Gulf countries based on a multi-dimensional analytical framework encompassing Social, Technological, Economic, Environmental, and Political (STEEP) aspects. Drawing on consultations with regional experts and specialized researchers, numerous case studies, and global best practices. The study reviews a set of proposed policies to accelerate investment in the circular economy in the Gulf countries. These include various tools such as investment in clean technology, strong political support, and the establishment of circular funds. It also reviews the challenges and outcomes of recycling, stimulates legislation, and reduces traditional consumption patterns. The study also presents a "causal loop diagram" (CLD) highlighting the dynamic interactions and feedback influencing the transition to a circular economy. The findings emphasize the importance of aligning regulatory policies, providing financial incentives, developing circular infrastructure, and enhancing community awareness. The study concludes by proposing six actionable policy options constituting a roadmap tailored specifically to the Gulf context, contributing to integrating circular economy principles into national development strategies. It contributes to the sustainable development literature by proposing realistic and effective policies that enable Gulf countries to lead in circular innovation and low-carbon growth. It further contributes to the growing discourse on sustainable development by offering actionable, context-sensitive policy recommendations for fostering a resilient and circular Gulf economy.This research was supported by project VALZEO Co-funded by the Horizon 2020 Framework Programme of the European Union - Marie Skłodowska-Curie action
Exploring future scenarios for strengthening science, technology, and innovation collaboration between Egypt and BRICS countries
Get PDFIn this study, the potential enhancement of science, technology, and innovation (STI) collaboration between Egypt and the BRICS countries (Brazil, Russia, India, China, South Africa) and new members (Egypt, Ethiopia, Iran, Saudi Arabia, UAE) is analyzed by scenario analysis until 2040. It highlights the significance of Egypt's recent BRICS membership in 2024 and its alignment with the country’s Vision 2030. The study identifies key drivers for STI collaboration, including government policies, economic and investment factors, technological capacity, and the private sector’s role. The paper employs a methodology combining literature reviews, expert inputs, and scenario writing to develop three future scenarios: strategic partnership (“Green Zone”), full integration (“BRICS Harmony”), and limited engagement (“Narrow Path”). These scenarios reflect varying degrees of cooperation, driven by economic, political, and technological factors. These scenarios envision varying degrees of cooperation based on economic, political, and technological factors, with a focus on creating a sustainable, innovation-driven economy in Egypt. The paper emphasizes the importance of building robust international partnerships, investing in technology, and developing research infrastructure to enable Egypt to maximize the benefits of its BRICS membership and strengthen its role in the global digital economy. Policy recommendations are offered to ensure long-term success, including enhancing public-private partnerships, fostering innovation, and aligning national policies with BRICS standards.N/
Editorial: People and pets: Good for each other?
Get PDFEditorial for special issue on relationships between people and their companion animals.unfundedAAM removed and archived and VoR uploaded to CR 29/07/202
‘Excuse me, I have a delivery’ The [re] construction of interview ‘space' in the Covid-19 pandemic
Get PDF© University of LeedsCovid-19 has transformed the qualitative interview process, as remote video methods have become mainstream, challenging the domination of face-to-face interviews. In the pandemic churn, researchers’ focus was on ensuring participants’ safety and care in the virtual interview environment. There was more limited consideration of what this ‘new normal’ meant for the researcher. This reflection draws on two qualitative research projects conducted during the 2020/2021 pandemic period in the UK. We propose that assumptions of ‘space’ in the qualitative interview process have been (re)constructed in remote interviews during Covid19. To be present virtually creates geographic freedoms of participant access, but subjective risks from interviewing in the virtual space. Context can no longer be understood through the shared experience of an interview space. There is a delineation of what is ‘public’ or ‘private’ as participants and researchers share their domestic spheres. Using ethnographic reflections, we explore the changing notions of geographic, public and private space in the Covid-19
interview.Unfunde
Observational study of the pre-service vulnerabilities, in-service exposures and post-service antecedents of suicide in veterans of the UK Armed Forces, 2007–2018
Get PDF© Author(s) (or their employer(s)) 2025. Re- use permitted under CC BY- NC. Published by BMJ Group.INTRODUCTION: Although there have been a number of epidemiological studies of suicide in veterans, there have been few in-depth studies of those who have died. Studies have not explored the relative contribution of pre-service, in-service and post-service factors. We aimed to investigate the adversities veterans face before they take their lives, their contact with support services that could be preventative and whether these differ in younger and older veterans.
METHODS: Using national databases of discharged personnel and suicide deaths, we identified deaths by suicide in personnel who left the UK Armed Forces (UKAF) between 2007 and 2018. We extracted information on the antecedents of suicide in a random sample of these deaths from official investigations, mostly coroners’ records.
RESULTS: In total, we obtained data for 145 individuals; 134 (92%) were male and 11 (8%) were female. Seven (5%) were from a minority ethnic group. The median age at death was 36 years (21–65 years). 18 (12%) veterans had experienced childhood adversity. Relatively few (10, 7%) experienced trauma relating to deployment on combat operations or had difficulty adjusting to civilian life (6, 4%). Most (140, 97%) veterans had been in contact with support services, particularly primary care (130, 90%), but undertreatment was common with only 10 (5%) veterans having received psychological intervention. Unemployment, alcohol and drug misuse, mental and physical ill health, workplace, housing and relationship problems were common antecedents.
CONCLUSIONS: Veterans experience a range of challenges after leaving the UKAF. Common antecedents to suicide, such as self-harm, suicidal ideation and drug misuse, are open to intervention. However, despite most veterans seeking help from a range of support services, few were receiving psychological intervention. Prevention should also focus on addressing the needs of veterans beyond mental ill health, like employment and housing.This work was jointly funded by the UK Ministry of Defence (MoD) (Grant/ Award Number: Not Applicable) and NHS England (Grant/Award Number: Not Applicable)
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