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Written Briefing Paper for the Committee for the Executive Office. Inquiry (Mother and Baby Institutions, Magdalene Laundries and Workhouses) and Redress Scheme Bill
No full textSupporting young children’s participation in child welfare. European perspectives
No full textHow do we better involve young children in the decision-making of their own social care? This book, developed from the Erasmus Plus-funded PANDA project, explores the development of knowledge and resources to educate and support social workers in their collaboration with children aged 12 and under
Optimisation of levofloxacin-loaded electrospun fibres for diabetic wound treatment
No full textFoot ulcers are a common and serious diabetes complication, significantly affecting patients’ quality of life. Chronic diabetic wounds are difficult to treat and often resist conventional therapies. Recently, materials developed through emerging techniques have gained attention for use in wound care and tissue regeneration. This study explores the development of nanofibres through electrospinning to create therapeutic patches for diabetic foot ulcers. Electrospinning allows control over fibres composition, orientation, and diameter, offering advantages such as simplicity and adaptability. Key process parameters, including flow rate, applied voltage, and polymer concentration, were optimized to produce defect-free fibres. The antibiotic levofloxacin was encapsulated in the fibres to assess its controlled release profile. Additionally, blends of chitosan and polycaprolactone (PCL) in various solvent systems were studied to enhance fibre characteristics. The combination leverages the elasticity, mechanical strength, biocompatibility, and versatility of PCL. The resulting composite fibres had an optimal diameter of 400 nm. Drug release analysis showed an initial peak-crucial for antibacterial efficacy-followed by a slower, sustained release phase. This biphasic release is beneficial in preventing infection while supporting prolonged therapeutic action. The findings demonstrate that a carefully designed formulation strategy can optimize fibres performance, making electrospun nanofibers patch a promising tool in the treatment of diabetic foot ulcers.<br/
Insights from clinicians on reconnecting with survivors of critical illness: An international qualitative investigation
No full textBackground: Over the last two decades multiple interventions have been implemented to support critical care survivors, each with limited success in improving quality of life and clinical outcomes. There has been limited evaluation of longitudinal critical illness recovery care, including any corresponding impact on the healthcare system or clinicians. The objective of this analysis was to explore the experience of clinicians reconnecting with survivors of critical illness and the subsequent impact that this reconnection was perceived to have within the healthcare system. Methods: We conducted an international qualitative investigation using in-depth semi-structured interviews with clinicians from varied settings, including the UK National Health Service, USA Veteran Affairs, and USA Safety Net Hospitals. Clinicians represented different professional disciplines, specialities, and experience. Interviews were analysed using Framework Analysis. Results: Nineteen clinicians were interviewed. Of those interviewed, 16 (84 %) were female, and the majority worked in critical care settings (n = 10, 53 %). In total, 16 healthcare system settings were represented across the interviews. Following the identification of how reconnection with survivors was operationalised, six themes were identified, and categorised into two domains. The first domain was the Impact of reconnection for clinicians and included: mitigation against emotional exhaustion; workplace meaning; and value placed on staff. The second domain was the Impact on the critical care system and care delivery and included humanisation of care delivery; richer insights to underpin decision-making; and the provision of data to drive improvements in care. Conclusions: This multi-centre international investigation suggests that there are potentially benefits for clinician wellbeing as well as the delivery of care within the critical care setting from reconnection between survivors of critical illness and clinicians. Clinical Implications: This research has explored the experience of reconnection between critical care survivors and clinicians from a clinician perspective. It has shown potential benefits for clinician wellbeing as well as the delivery of care within the critical care setting. Reconnection and how it could be incorporated into critical care services should be considered in future research.</p
Designing an academic development programme to support the embedding of Education for Sustainable Development (ESD) in the curriculum
No full textBridging the gap: Efficacy of combined therapies for cognitive, behavioral, and functional outcomes in Alzheimer's disease – results from a systematic review and network meta-analysis
No full textBackgroundEvidence regarding efficacy of combined pharmaco- and non-pharmacotherapies and their comparative effectiveness for Alzheimer's disease (AD) is limited.ObjectiveTo estimate the comparative efficacy of pharmacotherapies, non-pharmacotherapies, and combined therapies for improving cognitive, behavioral, and functional outcomes in patients with AD.MethodsRelevant studies were identified from Medline via PubMed and Scopus databases (March 2021–December 2022). Randomized-controlled trials were eligible if they assessed the efficacy of pharmacotherapies, non-pharmacotherapies, or combined therapies in patients aged 60 years or older, and measuring cognitive, behavioral, or functional outcomes. A network meta-analysis was conducted to estimate relative treatment effects, and interventions were ranked using surface under the cumulative ranking (SUCRA) curve. Confidence in the findings was evaluated using the Confidence in Network Meta-Analysis (CINeMA) framework.ResultsA total of 153 randomized-controlled trials were analyzed. Compared to placebo/usual care, donepezil plus cognitive therapy and rivastigmine plus cognitive rehabilitation significantly improved Mini-Mental State Examination scores. Behavioral outcomes were improved by rivastigmine plus cognitive stimulation, brain stimulation plus exercise, and occupational therapy. Functional status improved significantly with rivastigmine plus cognitive stimulation and exercise. Based on SUCRA ranking, rivastigmine plus cognitive rehabilitation ranked highest for cognitive improvement (92.8%), brain stimulation plus exercise ranked highest for the behavioral outcome (93.1%), and rivastigmine plus cognitive stimulation ranked highest for functional improvement (94.1%).ConclusionsDonepezil plus cognitive therapy and rivastigmine plus cognitive rehabilitation were the most effective treatments for improving cognitive outcomes. Rivastigmine plus cognitive stimulation ranked highest for both behavioral and functional outcomes, while exercise remains an important strategy for supporting daily functioning in patients with AD
Measuring childhood mind wandering and its effects in the classroom
No full textMind wandering, where attention drifts from the here-and-now to internal thoughts, is often linked to decreased educational performance. However, its impact on children remains largely unexplored. This study introduces and evaluates a method for measuring mind wandering in classroom environments. A sample of 126 8–9-year-olds participated in a listening activity where they periodically categorized their thoughts before completing immediate and delayed memory tests. Children reported being off-task in 45% of responses, 22% of which were mind wandering and 23% of which were thoughts about distractions. Our findings reveal that classroom mind wandering is common and can adversely affect immediate memory recall. The long-term implications of mind wandering in childhood are still uncertain, highlighting the need for further research. The results demonstrate the feasibility of assessing off-task thought in the classroom using thought probes that differentiate between distractions and mind wandering, which have distinct causes and may require tailored responses.<br/
Braided accountability in an autocratic age
No full textThis paper introduces braided accountability as a democratic response to authoritarian populism and the increasing juridification of governance. Drawing on Melvin Dubnick’s concept of accountability spaces and Richard Rorty’s pragmatism, it argues for a shift from rigid, formal mechanisms to inclusive, dynamic spaces of explanation and redescription. Using examples from business and human rights, the paper shows how accountability can amplify marginalised voices and strengthen democratic resilience through collaborative account-giving
Bridging the gap: Efficacy of combined therapies for cognitive, behavioral, and functional outcomes in Alzheimer's disease – results from a systematic review and network meta-analysis
No full textBackgroundEvidence regarding efficacy of combined pharmaco- and non-pharmacotherapies and their comparative effectiveness for Alzheimer's disease (AD) is limited.ObjectiveTo estimate the comparative efficacy of pharmacotherapies, non-pharmacotherapies, and combined therapies for improving cognitive, behavioral, and functional outcomes in patients with AD.MethodsRelevant studies were identified from Medline via PubMed and Scopus databases (March 2021–December 2022). Randomized-controlled trials were eligible if they assessed the efficacy of pharmacotherapies, non-pharmacotherapies, or combined therapies in patients aged 60 years or older, and measuring cognitive, behavioral, or functional outcomes. A network meta-analysis was conducted to estimate relative treatment effects, and interventions were ranked using surface under the cumulative ranking (SUCRA) curve. Confidence in the findings was evaluated using the Confidence in Network Meta-Analysis (CINeMA) framework.ResultsA total of 153 randomized-controlled trials were analyzed. Compared to placebo/usual care, donepezil plus cognitive therapy and rivastigmine plus cognitive rehabilitation significantly improved Mini-Mental State Examination scores. Behavioral outcomes were improved by rivastigmine plus cognitive stimulation, brain stimulation plus exercise, and occupational therapy. Functional status improved significantly with rivastigmine plus cognitive stimulation and exercise. Based on SUCRA ranking, rivastigmine plus cognitive rehabilitation ranked highest for cognitive improvement (92.8%), brain stimulation plus exercise ranked highest for the behavioral outcome (93.1%), and rivastigmine plus cognitive stimulation ranked highest for functional improvement (94.1%).ConclusionsDonepezil plus cognitive therapy and rivastigmine plus cognitive rehabilitation were the most effective treatments for improving cognitive outcomes. Rivastigmine plus cognitive stimulation ranked highest for both behavioral and functional outcomes, while exercise remains an important strategy for supporting daily functioning in patients with AD
