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“Nothing for us without us”: a mixed methods study examining the acceptability, feasibility, and impact of involving guardians of children with acute lymphoblastic leukemia in Tanzania as public contributors
No full textIntroductionIn low- and middle-income countries (LMICs) such as Tanzania, non-adherence and treatment abandonment are major factors contributing to low childhood cancer survival rates. Providing guardians with reminders and information via an SMS intervention may increase adherence and reduce treatment abandonment. The purpose of the GuardiansCan project is to reduce guardians' abandonment of children's maintenance therapy for acute lymphoblastic lymphoma (ALL) in Tanzania, thereby increasing ALL survival rates in the country by developing and evaluating an SMS intervention. We report initial results from phase one of a mixed-method examination of public contribution activities in the GuardiansCan project. We aimed to: recruit guardians of children treated for ALL to a Guardian Advisory Board (GAB) to contribute to the design and conduct of Study II within the GuardiansCan project (Study II) and the wider GuardiansCan project; and examine the acceptability, feasibility, and impact of GAB members' contribution from the perspective of GAB members and public contribution coordinators (coordinators).MethodsWe adopted a convergent parallel mixed-methods design, using impact logs and semi-structured interviews, with data integrated at the point of analysis. During four workshops, GAB members provided suggestions and recommendations, which were recorded in impact logs. GAB members and coordinators were interviewed about the acceptability, feasibility, and impact of GAB members' contributions.ResultsNine guardians were recruited. GAB members made 63 suggestions and recommendations, of which 50 (79%) were implemented. Semi-structured interviews resulted in seven categories: Meaning and value, Motivation and willingness to volunteer, Suggestions and areas for improvement, Barriers and challenges, Facilitators, Personal impact, and Research impact.ConclusionFindings suggest GAB members' contribution was acceptable and feasible, and had an impact on both the research and GAB members themselves. Findings can inform how to meaningfully involve public contributors in LMICs.</p
Combined benefits of multi-hazard early warnings on human mobility resilience to tropical cyclones
No full textMulti-hazard early-warning systems (MHEWS) are critical for mitigating extreme weather impacts and enhancing disaster resilience. However, quantitative empirical evidence on how different types of early warnings individually and collectively trigger preventive actions and influence resilience remains limited. Here, using location-based human mobility data aggregated from over 1.1 billion mobile devices across Chinese cities, we quantified daily intracity human mobility responses to 21,126 early warning signals during 19 tropical cyclones (TCs) from 2021 to 2023. To represent disaster resilience under MHEWS protection, we developed a protected resilience index that integrates both the magnitude of mobility changes and recovery durations. We found that, compared with city-level TC warnings alone, combined multi-level, multi-hazard warnings resulted in a 52.4 % reduction in mobility during TC exposure days, thereby increasing avoided direct population exposure by around 57.1 %. Each additional warning type further shortened recovery times, collectively reducing recovery durations by at least 55.6 %, with larger effects observed for stronger TCs. Under MHEWS protection, protected resilience remained statistically similar between moderate-intensity TCs (34 kt and 50 kt) but declined significantly under severe (≥64 kt) conditions. Although absolute reductions in exposure were greater in high-frequency, coastal, and wealthier cities, relative improvements from MHEWS were more pronounced in less frequently affected, inland, and socioeconomically disadvantaged areas. Consequently, MHEWS significantly narrowed resilience disparities among cities facing equivalent hazard exposures. This study introduces a scalable, behaviour-based framework for quantifying early-warning effectiveness, highlighting the essential role of integrated multi-level and multi-hazard warnings in disaster preparedness across cities amid escalating climate risks.</p
Managing care challenges related to lack of awareness in the person with dementia. Stakeholder consultation 2025
No full textThis is the supplementary information for the report "Managing care challenges related to lack of awareness in the person with dementia: Report of a stakeholder consultation".The supplementary information includes:1. Responses to structured questions2. Text matrices for free text responses 3. Additional survey responses reported separatelyThe report is available in ORE at https://hdl.handle.net/10779/exe.31136854</p
Maximizing the Benefits of Desalinated Seawater Supply for Agricultural Sustainability
No full textDesalination is increasingly recognised as an essential component of water management in arid and semi-arid coastal regions, including central and northern Chile where conventional freshwater resources are severely constrained. While desalinated water has traditionally served municipal and industrial sectors, its potential role in agriculture remains underexplored. This thesis assesses the feasibility of using desalinated seawater for irrigation through a set of integrated investigations spanning infrastructural, agronomic, economic, and institutional dimensions. A case study of the Copiapó Valley in Chile’s Atacama Region provides an empirical anchor for evaluating both the opportunities and limitations of this emerging practice.
The research first reframes desalination within a climate–water–energy–food (CWEF) nexus perspective, developing a multidimensional framework for analysing irrigation with desalinated water as a strategic rather than purely reactive option. Using a water distribution optimization model, the thesis explores how shared desalination infrastructure between the mining and agricultural sectors could reduce costs and environmental impacts. The results indicate that coordinated planning can lower the marginal cost of desalinated water by up to 58%, although practical adoption depends on sectoral incentives and governance capacity.
The thesis then introduces a demand-side optimisation framework that leverages desalinated water’s independence from hydro-climatic variability. This framework couples AquaCrop-OSPy with a novel self-tuning multi-layer (STML) algorithm. The method identifies optimal planting windows and deficit irrigation strategies that enhance water use efficiency and crop profitability. Applied to tomato production in the Copiapó Valley, the approach demonstrates that strategically aligning planting schedules with climatic conditions can generate meaningful agronomic gains, and under certain circumstances, approach economic viability.
A synthesis chapter integrates these findings to examine the conditions under which desalinated-water irrigation may be feasible in practice. Key considerations include infrastructure constraints, technology adoption, crop selection, coordination between sectors, and institutional readiness. While the Atacama Region provides a highly specific context, several components of the methodology, particularly the optimisation framework, the STML algorithm, and the nexus-based analytical approach, are transferable to other water-stressed regions with appropriate local adaptation.
Overall, the thesis positions desalinated seawater as a potentially viable component of climate-resilient agriculture when embedded within coordinated planning, cross-sectoral investment, and adaptive governance. The research contributes methodological innovation, regional insight, and a transferrable analytical foundation for future work at the intersection of water security and agricultural sustainability.</p
Decreased muscle protein breakdown the day after eccentric exercise improves net protein balance but is unaffected by protein-polyphenol intervention.
No full textProtein and polyphenol ingestion can improve recovery from muscle-damaging eccentric exercise, but the contribution of muscle protein breakdown (MPB) is unknown. We characterised postabsorptive MPB, muscle protein synthesis (MPS) and net balance (MPNB) the day after eccentric exercise, and investigated whether this was manipulated by ingesting protein-polyphenol. Twenty-five recreationally active participants (age 23 ± 5 y, BMI 24 ± 3 kg m− 2 ) were randomised to consume either 25 g protein and 650 mg pomegranate extract (PP; n = 12), or maltodextrin placebo (PLA; n = 13), prior to and immediately after 300 maximal, unilateral, eccentric, knee extensor contractions. The following day, participants received L-[ring2 H5]-phenylalanine and L-[15N]-phenylalanine infusions to determine MPS, MPB, and MPNB. Blood samples and muscle biopsies from the control (CON) and eccentric (ECC) legs were collected throughout. Muscle isokinetic function was determined before eccentric exercise and after the final biopsy. Muscle function decreased in ECC after eccentric exercise (P < 0.001), but was unaffected by intervention. MPB was lower in ECC versus CON (PLA: 0.071 ± 0.049 vs. 0.119 ± 0.046 %⋅h− 1 ; PP: 0.083 ± 0.050 vs. 0.109 ± 0.057 %⋅h− 1 ; P < 0.01), but unaffected by intervention. MPS did not differ between legs in PLA (0.092 ± 0.040 vs. 0.092 ± 0.023 %⋅h− 1 ), but was greater in ECC vs. CON of PP (0.141 ± 0.067 vs. 0.097 ± 0.037 %⋅h− 1 ; interaction P < 0.01). Although MPNB was greater in ECC vs. CON (P < 0.01) this was unaffected by intervention. We show for the first time that maximal, high-volume, eccentric exercise reduces MPB the following day, generating positive MPNB. Protein-polyphenol ingestion did not influence MPB and MPNB, suggesting that strategies to accelerate recovery need not focus on ameliorating MPB and act through alternative mechanisms.</p
Towards Sustainable Electronics: Optimizing Automated Smartphone Disassembly Performance via Simulation Metamodeling
No full textAddressing the urgent challenge of electronic waste, this research investigates an optimization framework for automated smartphone recycling lines. We combine discrete event simulation with response surface metamodeling to analyze and improve the throughput of high-speed disassembly. This simulation model portrays the real disassembly procedure, from pre-processing (sorting and adhesive disabling) through AI-assisted X-ray structural analysis, precision weakness creation via press-cutting, to final component separation by impact. Experimental design explores six operational parameters, revealing that sorting and freezing speeds—particularly their synergistic interaction—exert dominant influence on the system output. The derived quadratic metamodel enables rapid, resource-efficient performance prediction without repeated simulation, which eventually leads to the identification of optimal configurations for maximum efficiency.</p
Mobility and strength training with and without protein supplements for pre-frail/frail older people with low protein intake: maximising mobility and strength training (MMoST) feasibility randomised controlled trial
No full textObjectives The first objective was to establish the feasibility of conducting a definitive trial to evaluate the effectiveness of mobility and strength training with or without protein supplements for pre-frail/frail older people with low protein intake. The second objective was to finalise outcome measures for a definitive trial. Design Multicentre feasibility randomised controlled trial. Setting and participants Four National Health Service (NHS) community trust physiotherapy departments. We recruited via clinical caseloads, an existing cohort study and community advertising. Participants were adults aged ≥60 years, frail or pre-frail, reporting walking difficulties or slow walking and low protein intake (</p
Self-Powered Wearable Sweat Monitoring using 2D WS2 Textile Integrated Triboelectric Nanogenerators for Future Personalized Healthcare
No full textThe growing global burden of chronic diseases such as diabetes, cardiovascular
disorders, and neurological conditions highlight the urgent need for continuous,
non-invasive health monitoring solutions. Sweat-based sensing has emerged as
a promising alternative to traditional diagnostic approaches, offering a rich source
of biomarkers including electrolytes, metabolites, and stress-related molecules
such as cortisol. However, conventional laboratory-based methods are
unsuitable for real-time monitoring, prompting the development of wearable
biosensors. This PhD thesis explores a novel class of self-powered wearable
biosensors using two-dimensional tungsten disulfide (2D WS2) integrated into
textile-based self-powered triboelectric nanogenerators (TENGs) devices.
The research introduces a novel fabrication approach for creating self powered biosensors by integrating 2D WS2 into textile substrates. 2D WS2 was
produced via liquid-phase exfoliation and deposited onto fabrics using three
methods: ultrasonic spray coating, drop casting, and immersion. Among these,
spray coating emerged as the optimal technique due to its superior film uniformity,
reproducibility, and mechanical robustness under flexural strain. This approach
enabled the creation of TENGs tailored for sweat sensing applications while
preserving the textile’s flexibility and wearability. The concept of "electronic
dyeing" was also introduced, wherein 2D WS2 imparts functional electronic
characteristics to textiles in a similar manner to how traditional dyes impart colour,
allowing scalable integration of sensing functionalities directly onto wearable
fabrics.
The 2D WS2-coated textiles were first evaluated for sweat sensing
performance using phosphate-buffered saline (PBS) to simulate physiological
sweat conditions. Devices were subjected to triboelectric testing under varying
humidity conditions and volumes of PBS to assess stability, output consistency,
and the impact of fluid exposure. The results revealed that polyester fabrics
coated with 2D WS2 and paired with polyethylene terephthalate (PET) as the
counter layer showed the most stable and reproducible performance.
Building upon the successful platform for model sweat sensing, the
research progressed to selectively detect uric acid, a key biomarker of metabolic
function and oxidative stress, using 2D WS2 -based TENGs. Uric acid
concentrations ranging from 10 µM to 20 mM were tested, encompassing both
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physiologically normal and pathologically elevated levels. The biosensor,
composed of a 2D WS2-coated textile paired with a PET counter layer,
demonstrated consistent, linear changes in triboelectric outputs including open circuit voltage, short-circuit current, and transferred charge across this range.
This work marks the first demonstration of a textile-based, energy-autonomous
device capable of detecting uric acid without requiring external power, offering a
low-maintenance, wearable solution for real-time metabolic health monitoring.
The final phase of the work addressed the detection of cortisol, a critical
biomarker for stress and fatigue. The biosensor was tested across cortisol
concentrations from 100 ng/mL to 1 mg/mL, capturing both normal and elevated
physiological levels. Output signals were recorded under controlled mechanical
actuation and simulated biomechanical motion to reflect realistic use scenarios.
The device demonstrated a peak response at 200 ng/mL, consistent with typical
human stress-induced cortisol levels, and maintained reliable performance even
at ultra-high concentrations.
Collectively, these findings establish a robust, wearable platform capable
of detecting multiple sweat biomarkers through scalable fabrication and self powered operation, aligning with the future vision of personalized, preventive
healthcare.</p
Kindergarteners’ engagement in mathematical thinking via the interactive reading of mathematical stories
No full textThe development of mathematical thinking is fundamental to the study of mathematics and should be the primary focus of mathematics education throughout all stages of education. As most kindergartens incorporate daily storytelling sessions, exploiting mathematical stories may be one strategy to encourage kindergarteners’ engagement in mathematical thinking. This small-scale teaching experiment was conceived within a constructivist paradigm and guided by Burton’s (1984) theoretical framework for mathematical thinking processes. It focuses on the expressed mathematical thinking processes that were evoked in pupils aged 5–7 through the interactive reading of a mathematics-focused story. We used a mathematical story designed around examples of the commutative property of addition and read interactively in a class of twenty-three pupils. A qualitative analysis of the video recording of the reading session showed that the kindergarteners engaged in mathematical thinking processes throughout the storytelling - although they encountered difficulties. This indicates that using carefully designed, illustrated stories with age-appropriate mathematical concepts facilitates young pupils’ engagement in mathematical thinking. The results also highlight the crucial role of specialization in assisting pupils’ progression to more advanced mathematical thinking processes, and the significance of maintaining a questioning atmosphere that leads pupils to engage in mathematical thinking. The teacher, the story, and the interactions it afforded among the teacher and pupils, were all crucial in guiding the pupils towards a mathematical way of thinking.</p
Stigma and Workplace Relationships: An Exploration across Individual and Structural Levels
No full textThe workplace is an important space in the lives of adults, who spend a significant amount of their time at work. Positive workplace relationships benefit both employees and institutions, while negative workplace relationships harm employees’ health and work-related outcomes. However, evidence suggests that there are likely to be disparities between employees from majority and minoritized social groups because of stigma. This thesis aims to explore how stigma influences employees’ workplace relationships through four studies, with a particular focus on the role of structural discrimination.
The studies reported in this thesis included multiple and diverse research methods to examine the impact of stigma on relational outcomes. Chapter 2 presents a systematic review of existing measures of structural stigma. We summarised existing measures into four categories, which varied in terms of their objectivity or subjectivity, the domains rated, the source of the rating, and the structure or level at which ratings were provided. Chapter 3 used semi-structured interviews to explore how racial and ethnic minority employees perceived and experienced racism, focusing primarily on how they understand structural racism and how racism influences their professional relationships. The results show that racial and ethnic minorities consider their work organizations to be structurally racist when it has poor demographic diversity, when they find evidence of unequal treatment and when they perceive the organization to provide little support to minority employees. The professional relationships of these employees were complex and often involved mainly same-race groups. Chapter 4 reports a cross-sectional study examining the disparities in workplace relationships between Black and White employees in the UK and the US. In both samples, Black employees reported less co-worker support, less connection with co-workers, and less satisfaction with co-workers than White employees. Black employees also reported more perceived structural workplace racism at their organization than did White employees, and this mediated the racial disparity in work relationships. Chapter 5 examined how gender discrimination influences female employees’ workplace relationship functioning by using data from the 6th European Working Conditions Survey (EWCS 2015). This study additionally examined if this relationship was moderated by two objective country-level indicators of structural stigma (Gender Equality Index, GEI; Women’s Workplace Equality Index, WWEI) and two organizational-level indicators (organizational support mechanisms and women’s representation). Gender discrimination negatively predicted women’s workplace relationship functioning. Organizational support mechanisms and country-level gender equality supported women’s workplace relationship functioning, and therefore also positive work outcomes.
Overall, the research reported in this thesis demonstrates that stigma influences employees’ workplace relationships. The findings suggest that governments and organizations should pay closer attention to employees’ workplace relationships and that they should promote these by reducing stigma and increase equality between majority and minoritized employees.</p