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Operationalising Sufficiency in an Organisational Context:A Systematic Literature Review
No full textEfficiency-led sustainability is important but often fails to deliver absolute reductions in resource use, leaving organisations exposed to rebound effects. What remains underexplored is how sufficiency, the strategic limitation of consumption and resource use, is operationalised within organisational contexts. We address this gap through a systematic review of 70 peer-reviewed studies, using the Structure-Conduct-Performance (SCP) framework to connect enabling conditions, organisational practices and sustainability performance. We identify eight thematic clusters reflecting how sufficiency is enacted across domains such as governance and policy, organisational practices, social norms and infrastructural systems. Building on these, we develop a typology of five strategic types through which organisations operationalise sufficiency. This paper (1) adds a system-level perspective that bridges structural, strategic and performance domains; (2) extends the SCP framework as a theory-building lens to expose misalignments that hinder sufficiency transitions; and (3) highlights tensions that challenge dominant assumptions in sustainability-oriented organisational strategy
Could master protocols be adapted for effectiveness-implementation hybrid studies?
No full textBackgroundMaster protocols leverage a common trial infrastructure for launching multiple sub-studies. Translational research aims to progress scientific discoveries toward public health impact, which depends on establishing an intervention's efficacy, effectiveness in real-world conditions, and successful strategies for implementation. While master protocols have been designed to improve the efficiency of clinical trials as sub-studies addressing a particular disease, their application with effectiveness-implementation hybrid studies is yet to be explored. The aim of this study was to develop recommendations for adapting mater protocol methods for effectiveness-implementation research.MethodsA method of consultation with translational research networks was undertaken between January and December 2024. Consideration was given to the requirements for service providers to engage in translational research, and how master protocols could support effectiveness-implementation hybrid sub-studies. The underlying rationale for potential adaptations is provided with reference to implementation frameworks, discussion of advantages and disadvantages, and summary recommendations.ResultsRecommendations are proposed on establishing common trial infrastructure, aims and hypotheses, data collection, control groups, adaptive elements, and eligibility criteria. By leveraging cross-sectoral partnerships, co-producing research and dissemination, and incorporating adaptive elements, master protocols may offer a promising approach for accelerating progress along the translational research pipeline.ConclusionsThe adaptation of master protocols for hybrid sub-studies could enable evidence-based interventions to be more effectively implemented in routine care settings. The feasibility of master protocols for effectiveness-implementation research is yet to be tested, and further development in this area is needed to trial the proposed methodology
Enhancing home care nursing in the Netherlands:how can organisations facilitate the improvement of needs assessments in home care nursing? A focus group study
No full textBackgroundHome care nursing plays an essential role in the current and future societal challenges. In the Netherlands, home care nurses autonomously determine the type, cost and duration of nursing care at home. There are no guidelines for performing this needs assessment and organisations can implement the needs assessment according to their preferences. Recent research indicates variation in the assessed care of comparable patients. Also, there are various problems in the needs assessment process, mostly on organisational level. Organisations play a crucial role in the improvement of the needs assessment. However, it remains unclear how organizations address the challenges encountered during the needs assessment process and what specific difficulties they face. The aim of this study is to explore the challenges that organisations encounter in the process of the needs assessment and what approaches they handle to optimise the process of the needs assessment.MethodsThis study had a qualitative explorative design. Four focus group interviews were conducted with professionals including managers, policy- and quality officers, and home care nurses from different organisations who are involved in improvement processes regarding the needs assessment in Dutch home care organisations. The focus group interviews were audio-recorded and transcribed. Data were analysed using a thematic approach.Results38 participants from 22 different home care organisations participated in the study. Three main themes emerged: (1) Problems in the process of the needs assessment, (2) Best practices in organisations, and (3) Professionals' improvement ideas. Organisations experience challenges especially due to a lack of a shared vision and different perspectives on the needs assessment. Many different approaches were seen between organisations that could influence practice variation, e.g. short-term assessments, intake routes or various roles and functions, such as senior home care nurses, ambassadors, or dual management.ConclusionsTo optimise the needs assessment process, a clear and shared vision is needed among all involved organisations, health care professional and health insurers. Furthermore, more scientific evidence on interventions and strategic approaches in home care nursing are essential to provide organisations with guidance in improvement processes towards a better needs assessment. Third, home care organisations, other health care professionals, and health insurers must collaborate to create a more uniform process of the needs assessment
Patterns of practice of image guided particle therapy for brain tumours:A site specific multi-institutional survey of the European particle therapy network
No full textPurpose: To investigate the current practice patterns in image-guided proton therapy (IGPT) for brain tumours. Methods: A multi-institutional survey was distributed to European particle therapy centres to analyse the current practice of IGPT for neuro-oncology. The survey was subsequently used for driving a DELPHI consensus analysis aiming at defining the minimum requirements and the optimal workflow. Results: Seven centres participated in the survey on proton therapy for brain tumours. All reported access to pencil beam scanning and rotating gantries; one also used passive scattering. Supine positioning with standard immobilisation tools was common, while prone and paediatric-specific methods were rare. Multimodal imaging with CT and MRI was standard; PET use was limited and SPECT absent. Rigid registration between imaging modalities was widely used, though MR imaging in treatment position was uncommon. Verification practices varied. Six centres joined the DELPHI consensus, reaching agreement on minimum requirements for immobilisation, imaging for treatment planning, image registration and pre-treatment setup. Disagreement remained on robustness criteria, imaging frequency, and dose tracking, highlighting the need for unified clinical guidelines and workflow optimisation. Conclusion: There is generally agreement across European proton centres, but variability remained in key components of treatment planning, verification and workflow optimisation, including the frequency and modality of control imaging, plan robustness criteria, and treatment position imaging protocols. These differences reflect both local resource availability and the absence of harmonised guidelines. The minimal requirements for image guidance in brain proton therapy achieved good consensus level and will be very useful for new centres
Embedded 3D Printing of Graphene Oxide-Containing, Chemically Crosslinkable Poly(Ethylene Glycol) Inks
No full textThe incorporation of graphene-based materials into hydrogels enhances their mechanical, electroconductive, and antimicrobial properties, offering significant potential for biomedical applications. However, 3D printing graphene-containing inks may present challenges because of their unsuitable shape retention or the fact that the concentration of the graphene component can hinder photocrosslinking. This study explores embedded 3D printing to process a chemically crosslinkable poly(ethylene glycol) ink with a high (4% w/v) graphene oxide concentration (PEG/GO). Given the PEG/GO ink's insufficient shape retention and slow crosslinking, various support baths are screened, with the microparticulate bath of the crystal self-healing embedding bioprinting (CLADDING) method proving most effective. The interstitial solution of the CLADDING bath influences the mechanical properties of printed PEG/GO constructs. Multilayered PEG/GO cylindrical constructs with <500 μm filament width and up to 4.5 mm height (30 layers) are fabricated, presenting better tensile properties when printed within CLADDING in calcium chloride (vs. baths in crosslinking initiators). The surface of PEG/GO constructs is anti-adhesive toward human foreskin fibroblasts, and their extracts are cytocompatible. Hence, embedded 3D printing emerges as an innovative strategy to surpass limitations of shaping graphene-containing hydrogels into complex geometries, broadening the biomanufacturing possibilities for diverse biomedical applications requiring kPa-range mechanical properties.</p
Should We Consider Sacral Nerve Stimulation as a Treatment for Neurogenic Lower Urinary Tract Dysfunction? ICI-RS 2025
No full textAims To explore the boundary of clinical use of sacral nerve stimulation (SNS) in neurogenic lower urinary tract dysfunction (NLUTD), identifying barriers to approval and early-impact research questions.Methods This review is derived from a proposal discussion at the International Consultation on Incontinence-Research Society in Bristol in June 2025.Results Current evidence for predicting NLUTD symptom improvement or functional recovery after SNS remains mainly from small retrospective cohorts. Definitive trials are a research priority, accordingly. The influence of SNS on urodynamic parameters is uncertain due to the lack of studies with urodynamics as the primary endpoint. Additionally, there is no core outcome set for NLUTD treated with SNS. Use of closed-loop SNS in NLUTD to adjust stimulation parameters may improve outcome and device longevity. Hence, we need to elucidate how SNS modulates LUT control network over time and across disease stages. Optimal stimulation parameters need to be defined for patient populations, but also for individuals, with dynamic strategies for adjustment. Use of SNS in NLUTD needs to enable ongoing use of MRI scanning for neurological evaluation, especially in progressive conditions. An MR Conditional SNS device means it can be safely scanned in specific MR environments. Use of such a device needs to factor in the range of further electronic implants that might be used in complex medical conditions.Conclusions The application of SNS to NLUTD is likely to increase. A key aspiration is nuanced patient selection, using functional assessment and urodynamic findings. To translate SNS into standard clinical practice, interdisciplinary collaboration and robust clinical trials are essential
Mental Resilience
No full textThis chapter explores the concept of mental resilience among forensic social professionals. It highlights the unique challenges they face, such as experiencing incidents, tensions during client interactions and exposure to emotionally demanding narratives. These challenges can lead to symptoms like PTSD, burnout or secondary traumatization when the mental burden exceeds their capacity. The chapter identifies risk and protective factors influencing mental resilience at both personal and organizational levels. Recommendations are provided to enhance resilience, including clear policies on prevention and aftercare, promoting an open culture and offering regular training. The chapter underscores the importance of further research to better understand and support the mental resilience of forensic social professionals.
Imaging Perinatal Death
No full textPerinatal death, including stillbirth and neonatal death within 28 days after birth, is a devastating event. The definition of stillbirth varies across countries. The NHS, national health service (UK), defines stillbirth as a baby born dead after 24 completed weeks of pregnancy [1]. The CDC, center for disease control and prevention (USA), defines it as loss of a baby at or after 20 weeks of pregnancy [2]. According to the WHO, World Health Organization, a baby who dies after 28 weeks of pregnancy, but before or during birth, is classified as stillbirth [3]. Although rare and significantly decreasing in the last decades, the office for national statistics reports in 2020 a rate of 3.8 stillbirths per 1000 total births in England and Wales [4] and neonatal mortality rate (aged under 28 days) of 2.7 per 1000 births [5]. Investigation of the fetus after death is important, not only for quality control of prenatal examinations and determining the cause of death, but for mourning purposes of the parents and counseling and management of future pregnancies. Autopsy reveals additional abnormalities in 16–76% of cases compared to antemortem imaging [6–11]. Less invasive techniques, including postmortem MRI (PMMRI), are used as a replacement or addition to autopsy. In this chapter we explain the suggested radiological modality for additional postmortem examination in fetal and neonatal deaths and clinical aspects of the main imaging modality, PMMRI in perinatal deaths
Deep-Learning to predict outcome of CRT based on pulsed-wave Doppler, clinical biomarkers and pacemaker settings
No full textCardiac Resynchronization Therapy uses a biventricular pacemaker and is the recommended treatment for Heart Failure patients with Left Bundle Branch Block. The pacemaker settings are determined during the implantation procedure based on the patient's acute response and can be altered during follow-up exams months after implantation. Despite the careful follow-up, only 65-70% of eligible patients respond to this (expensive) therapy and better selection of candidates for CRT as well as optimization of the pacemaker settings for an elected patient are required. Therefore, we developed a deep learning (DL) algorithm on commonly acquired echocardiographic recordings during the standard care path to predict how a patient will likely respond to certain pacemaker settings after 6 months