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An ethnographic study of multidisciplinary collaboration: the role of psychological safety at a high secure forensic inpatient hospital in Germany
Get PDFThis author accepted manuscript is deposited under a Creative Commons Attribution Non-commercial 4.0 International (CC BY-NC) licence. This means that anyone may distribute, adapt, and build upon the work for non-commercial purposes, subject to full attribution. If you wish to use this manuscript for commercial purposes, please contact [email protected]: This study aims to provide an in-depth understanding of staff perspectives of enablers and barriers to multidisciplinary team (MDT) collaboration and the role of psychological safety (PS) within a high secure forensic inpatient hospital. Design/methodology/approach: A qualitative ethnographic design was adopted. Data were sourced for thematic analysis from 10 observations of treatment meetings, 13 in-depth interviews, and informal conversations among 49 professionals belonging to seven professions, between March 2017 and June 2018. Findings: Four central themes were discovered: a shared approach to care, informal relationships, leadership–power–hierarchy, and PS – influenced by all and influencing all. The absence of a shared approach to care, informal relationships, inclusive leadership, construction of meetings, perceived equality between professions, and feelings of belonging and value to the MDT exert the greatest influence on PS and MDT collaboration. Practical implications: Leaders and knowledgeable staff are advised to: - adopt an inclusive leadership style, - give meeting ownership and chairing to professions low in the hierarchy – design a multidisciplinary concept of treatment with informal relationships, and establish clear roles/responsibilities that enhance equality, value, and belonging to promote PS and diminish perceived power distance between professions. Originality/value: MDT collaboration that aims to socially construct knowledge and share information about patients through communication in meetings is not possible without first consciously creating a safe organisational culture and local context that enables staff to overcome the perceived power distance between professions.Unfunde
Lead-free piezoelectric ceramics with ultralow mechanical quality factor
Get PDF© 2025 The Authors. Published by Elsevier Ltd.The mechanical quality factor (Qm) is a key parameter in the applications of piezoelectric ceramics. For force sensors and acoustic transducers, low Qm allows a broadened frequency range for signal reception. Currently, the most popular low-Qm materials are lead-based ferroelectric ceramics, such as PbNb2O6. However, restrictive regulations on Pb-containing components have prompted the search for alternative lead-free piezoelectrics. Some studies on low-Qm lead-free ceramics have been reported, but without clarifying its origin. Here, lead-free piezoceramics with a nominal composition K0.475Na0.475Bi0.025Ag0.025Nb0.95Hf0.05O3 (KNN-BAH) were developed by a partial substitution of K and Na at A-sites with Bi and Ag, and the Nb at B-sites with Hf in K0.50Na0.50NbO3 (KNN). The KNN-BAH ceramics sintered at 1080°C and 1120°C showed Qm values of about 27.2 and 57.1, respectively, which are among the lowest values reported for lead-free piezoelectric ceramics. The ultralow Qm is attributed to the bi-phasic structure and enhanced domain wall motion.This work was supported by Mexico CONACYT and CIMAV Scholarships (No 789276), Grant Agency of the Slovak Academy of Sciences (VEGA Grant No. 2/0034/23), the Royal Society grant (NAF\R1\201126), and China Scholarship Council (No. 202006040021 and No. 202106370015)
Milstein scheme for a stochastic semilinear subdiffusion equation driven by fractionally integrated multiplicative noise
Get PDF© 2025 by the authors. Licensee MDPI, Basel, Switzerland.This paper investigates the strong convergence of a Milstein scheme for a stochastic semilinear subdiffusion equation driven by fractionally integrated multiplicative noise. The existence and uniqueness of the mild solution are established via the Banach fixed point theorem. Temporal and spatial regularity properties of the mild solution are derived using the semigroup approach. For spatial discretization, the standard Galerkin finite element method is employed, while the Grünwald–Letnikov method is used for time discretization. The Milstein scheme is utilized to approximate the multiplicative noise. For sufficiently smooth noise, the proposed scheme achieves the temporal strong convergence order of O(τα), α∈(0,1). Numerical experiments are presented to verify that the computational results are consistent with the theoretical predictions.This research was funded by the Fund Program for the Scientific Activities of Selected Returned Overseas Professionals in Shanxi Province (Grant No. 20240037), the Research Project Supported by Shanxi Scholarship Council of China (Grant No. 2024-139), the Lvliang High Tech Research and Development Program (Grant No. 2023GXYF14), and the Shanxi Provincial Art Science Planning Project (Grant No. 24BA106)
Assessing the impact of stratification of admission need and intensive support on inpatient admissions for people with intellectual disabilities
Get PDFThis author accepted manuscript is deposited under a Creative Commons Attribution Non-commercial 4.0 International (CC BY-NC) licence. This means that anyone may distribute, adapt, and build upon the work for non-commercial purposes, subject to full attribution. If you wish to use this manuscript for commercial purposes, please contact [email protected]: This study aims to understand the impact on number of admissions to inpatient services for people with intellectual disability, following the implementation of the Dynamic Support Database-Clinical Support Tool (DSD-CST) and formation of intensive support functions (ISFs). Type of mental health admission was reviewed, and number of admissions avoided ascertained.
Design/methodology/approach: A cohort retrospective study was conducted, using secondary data from three community learning disability teams in Northwest England. Routine secondary data from 2013 to 2023 was used.
Findings: The DSD-CST and ISF model was successful in reducing admissions. Following implementation of the model in 2018, there was a decrease in the number of admissions for all ward types and the length of admission decreased. The DSD-CST data showed the number of people identified as being at risk of admission increased between 2019 and 2023; however, the number of admissions decreased.
Originality/value: As far as authors are aware, this is the only paper offering an evaluation of the combination of ISFs and risk of admission stratification, and the impact this has on admissions to inpatient services for people with an intellectual disability. It evidences a successful model to support the NHS agenda of supporting people in the community where possible.Unfunde
Impact of dietary patterns on skeletal health: A systematic review and meta-analysis of bone mineral density, fracture, bone turnover markers, and nutritional status
Get PDF© 2025 by the authors. Licensee MDPI, Basel, Switzerland.Background/Objectives: Dietary patterns play a crucial role in musculoskeletal health; however, the effects of different diets on bone mineral density (BMD), fracture risk, and bone metabolism remain inconsistent across studies. This systematic review and meta-analysis aimed to evaluate the impact of Mediterranean, calorie restriction, high-protein, low-carbohydrate, and ketogenic diets on skeletal outcomes in adults. Methods: A comprehensive search of PubMed/MEDLINE, CENTRAL, and Web of Science was conducted for studies published between January 2000 and June 2025. Eligible randomised controlled trials (RCTs) and cohort studies involving adults (≥18 years) and reporting outcomes related to BMD, fractures, bone turnover markers, and vitamin D or calcium status were included. Risk of bias was assessed using the Cochrane’s Risk of Bias tool for RCTs and the Joanna Briggs Institute checklist for observational studies. Random-effects meta-analyses were performed for outcomes reported by ≥3 comparable studies, presenting standardised mean differences (SMDs) for BMD and hazard ratios (HRs) for fractures. Results: Thirty studies met inclusion criteria, comprising 14 RCTs and 16 observational studies with over 500,000 participants. Pooled analyses showed no significant differences in BMD at the femoral neck (SMD = 0.12, 95% CI −0.80 to 1.04), lumbar spine (SMD = 0.04, 95% CI: −1.12 to 1.03), total hip (SMD = −0.07, 95% CI −0.36 to 0.21), or whole body (SMD = 0.03, 95% CI −0.07 to 0.14) across diet categories. However, adherence to a Mediterranean diet was associated with a significantly reduced hazard of hip and overall fractures (pooled HR = 0.95, 95% CI 0.93–0.96). Calorie restriction consistently increased bone resorption markers, whereas Mediterranean and high-protein diets showed neutral or modestly favourable effects. Vitamin D and calcium status were minimally affected across interventions. Conclusions: While dietary patterns exert diverse effects on skeletal health, consistent evidence supports Mediterranean-style diets as protective against fractures. Calorie restriction may elevate bone turnover, whereas ketogenic and high-protein diets show mixed effects on bone. However, across all analyses, high heterogeneity was observed. Further high-quality RCTs are warranted to clarify these relationships and inform dietary guidance for bone health.Unfunde
A story-in-the-making: An intertextual exploration of a multivoiced narrative
Get PDFThe following study will explore the stories which are not told – that is, it will scrutinize the process of intertextual emergence of an ultimately open story: one which has neither discernible authorship nor agenda and which remains in-the-making rather than strives to achieve closure. The paper will discuss the process in which multifaceted and multidirectional organizational stories are created, in which plots and characters exchange and ‘ending’ is defied. This lack of closure is perceived here as a breeding ground for networked meanings, which, if allowed to remain interdependent and plural, eschew the danger of a new organizational story becoming universal carrier of inflexibly established contents. Since the unifying semantic organizational frameworks (e.g. ‘success story’) may be construed as impostors attempting to ascribe both authorship and agency to a nonagentical and non-authored ‘untold story’, this study proposes one way in which multidirectedness and plurality of the story may be preserved.Unfunde
The BERA Guide to Decolonising the Curriculum Equity and Inclusion in Educational Research and Practice
No full textLed by international educationalists across all phases of education, The BERA Guide to Decolonising the Curriculum is a powerful evocation, direction, and call to action for epistemological equity in knowledge production, teaching, and ...N/
A figurational examination of the working lives of backroom staff in men’s professional football clubs in the United Kingdom
No full textBackroom staff have various important roles in supporting professional footballers and first team managers. Over time, the number of support staff in football clubs has grown, as the game has become increasingly professionalised and commodified to ensure athletes are provided the most effective support. Yet, what we know about their working lives is limited. Given the growth in academic research related to those who backroom staff support, who could not do the job without them, it is also important to explore their working lives. Therefore, this study examines the working lives of backroom staff in the first team at men’s professional football clubs in the United Kingdom. Semi-structured interviews were conducted with 51 backroom staff, exploring their football background, employment within the industry, aspects of their working day and relationships with key stakeholders. The study tested a figurational sociological perspective for its adequacy to make sense of their experiences. Working in men’s professional football involved accepting challenges, such as excessive working hours, work-life imbalances, job insecurity, relocation, workplace transitions and familial sacrifices, which participants felt meant the role was more akin to a lifestyle choice. Many were motivated to work in football due to their love of the game, contributing to their perseverance through the challenges experienced. Alongside their emotional motivations, constant job insecurity and a saturated job market meant staff felt they had to accept the sacrifices until they started questioning the long-term sustainability of a career in football. The relationship with the first team manager impacted participants’ current roles and future job opportunities. Backroom staff were split into the manager’s staff, referred to as the inner circle, and club staff. The inner circle was seen as a double-edged sword, as it appeared to come with greater influence and responsibility within their roles. However, such roles came with greater job insecurity during managerial change. The inner circle represents the importance of interdependent relationships in understanding the structure and functioning of football clubs as workplaces. Backroom staff developed close, personal relationships with players. Some backroom staff offered a ‘safe-haven’ to players to speak about personal issues, who would not speak to teammates or the manager about these issues through concerns of stigmatisation and risking their place in the team. Participants explained the balance they had to strike between having personal relationships to support players and ensuring their professional position would not be compromised. This provides greater insight into relationships and workplace dynamics characterised by unequal power balances. Overall, this study has provided insight into the working lives of backroom staff and developed a greater understanding of these workplaces from the unique perspective of those perceived to be lower down the organisational hierarchy
What are the roots of the nation’s poor health and widening health inequalities? Rethinking economic growth for a fairer and healthier future
Get PDF© The Author(s) 2024.Health inequalities are differences in health between groups in society. Despite them being preventable they persist on a grand scale. At the beginning of 2024, the Institute of Health Equity revealed in their report titled: Health Inequalities, Lives Cut Short, that health inequalities caused 1 million early deaths in England over the past decade. While the number of studies on the prevalence of health inequalities in the UK has burgeoned, limited emphasis has been given to exploring the factors contributing to these (widening) health inequalities. In this commentary article I will describe how the Government's relentless pursuit of economic growth and their failure to implement the necessary regulatory policies to mitigate against the insecurity and health effects neoliberal free market capitalism (referred to as capitalism herein) causes in pursuit of innovation, productivity and growth (economic dynamism) is one key driver underpinning this social injustice. I contend that if the priority really is to tackle health inequalities and ensure health for all then there is an imperative need to move beyond regulation alone to mitigate the worst effects of capitalist production; the goal of the economy has to change to fully restore the balance between economic growth and public health.Unfunde
Strong convergence for efficient full discretization of the stochastic Allen-Cahn equation with multiplicative noise
Get PDF© 2025 The Authors. Published by Elsevier B.V.In this paper, we study the strong convergence of the full discretization based on a semi-implicit tamed approach in time and the finite element method with truncated noise in space for the stochastic Allen-Cahn equation driven by multiplicative noise. The proposed fully discrete scheme is efficient thanks to its low computational complexity and mean-square unconditional stability. The low regularity of the solution due to the multiplicative infinite-dimensional driving noise and the non-global Lipschitz difficulty intruduced by the cubic nonlinear drift term make the strong convergence analysis of the fully discrete solution considerably complicated. By constructing an appropriate auxiliary procedure, the full discretization error can be cleverly decomposed, and the spatio-temporal strong convergence order is successfully derived under certain weak assumptions. Numerical experiments are finally reported to validate the theoretical result.Financial support was provided by the Research Fund of Jianghan University under Grant No. 2024JCYJ0
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