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Associations between diabetes and depressive symptoms across European countries
No full textBackground
We examined the potential role of several macro- and micro-sociodemographic factors in moderating the longitudinal bi-directional association between depressive symptom severity and diabetes across European countries. This submission summarizes the results of two empirical studies and workshop-based group discussions with people living with diabetes.
Methods
We analyzed data from three prospective cohort studies - the English Longitudinal Study on Ageing, the Irish Longitudinal study on Ageing, and the Survey on Health, Ageing and Retirement in Europe. We examined possible country-level and individual-level sociodemographic factors of diabetes, including healthcare quality and expenditure, wealth inequalities, and health behaviors, as moderators of the relationship between newly developed diabetes and depressive symptoms. Lived experience of diabetes reports were collected via two public workshops in Ireland.
Results
Depressive symptoms were a risk factor for diabetes (HR = 1.14, 95% CI [1.10;1.18]), and vice versa (HR = 1.48, 95% CI [1.37;1.61]), and the hazard ratios were stable across European geographical regions. All sociodemographic factors significantly (all p's .01). Workshop reports demonstrated that some people with diabetes in Ireland experience a significant psychological burden because of their condition, about which they felt their healthcare practitioners should be better informed.
Conclusions
The relationship between depressive symptoms and diabetes was consistent, regardless of most individual- or country-level factors. Because of this, international policies on managing depression-diabetes comorbidity might be applicable across European countries. In Ireland, healthcare practitioners should be better informed about the characteristics of daily living with diabetes.
Key messages
• The relationship between diabetes and depressive symptoms is stable across Europe, suggesting the same robust underlying mechanism of their mutual interaction.
• Healthcare practitioners and public health decision makers in Ireland should be more aware of the challenges to mental health which are associated with diabetes diagnosis
Kripke semantics for MTL
No full textWe provide a generalisation of Kripke semantics for Monoidal TNorm Logic (MTL), and prove adequacy of the same. In doing so, we exploit constructions found in [3], extending insights from [7, 14, 15, 16] to MTL, a fuzzy logic lacking divisibility. This continues our programme of extracting generalisations of Kripke semantics from algebraic semantics for fuzzy logics
Queering disasters, climate change and humanitarian crises: an introduction
No full textThe introduction provides a guide for navigating the edited collection. It outlines the book’s organisation, structure and key themes; the relationships between empirical studies and first-hand, personal accounts; and a summary of each chapter and vignette. It concludes with some reflections on how the collection might be used to further the development of queer-inclusive disaster research, policies, programmes and services
The countermovement rebound jump assessment: validity, reliability, associations with athletic performance and sensitivity to change
Get PDFJumping is a common action in competitive sports, requiring precise coordination of the lower limbs. Among the various jump types, the countermovement jump (CMJ) and drop jump (DJ) are widely used to assess athletic performance. However, evaluating both slow and fast stretch-shortening cycle (SSC) capabilities through separate CMJ and DJ tests can be time-consuming if undertaking multiple trials for each test, and logistically challenging. To address this, the countermovement rebound jump (CMRJ), which combines characteristics of both the CMJ and DJ, has been proposed as a potential alternative. Despite its promise, the between-session reliability, and practical utility of the CMRJ remain underexplored, limiting its adoption as a comprehensive jump performance assessment tool. The primary aim of this thesis was to investigate the CMRJ as a valid, reliable, and practical alternative for assessing jump performance. Specifically, this thesis sought to: (i) review the literature relating to fast SSC mechanisms in rebound jumping and different methods that have been used to calculate jump height during CMJ and DJ tests; (ii) examine the between-session validity and reliability of the CMRJ in measuring kinetic and strategy-based metrics compared to the CMJ and DJ; (iii) evaluate the influence of external verbal cueing on CMRJ performance metrics; (iv) explore the associations between CMRJ outcomes with independent measures of athletic performance, including sprint speed, change-of-direction (COD) ability, and maximal force production; (v) and determine the sensitivity of CMRJ metrics to detect neuromuscular fatigue induced by a controlled repeated sprint intervention. The findings of this thesis provide novel insights into the applicability of the CMRJ as a streamlined and efficient tool for monitoring athletic performance, offering practical guidance for its use in both research and applied settings.
To better understand the underlying mechanisms of the SSC in jumping (particularly the fast SSC utilised during rebounding movements), a narrative review was conducted as part of this thesis. Findings from the narrative review highlighted the importance of selecting jump testing protocols that are familiar to the cohort of athletes being assessed, as this ensures that the testing outcomes accurately reflect the SSC function being assessed. Additionally, the selection of outcome metrics should prioritise quality over quantity, focusing on measures that effectively capture both the movement strategy and physical capabilities practitioners aim to evaluate through rebound jumping tests.
Jump height is one of the key metrics commonly used by practitioners to assess jump performance. However, the definition of jump height and the methods used to calculate it vary widely across the literature. To address this inconsistency, a systematic review was conducted using SPORTDiscus, Medline, CINAHL, and PubMed to identify the calculation methods employed to measure jump height during CMJ and DJ tests. A total of 21 studies were included for analysis, and five different calculation methods were compared: (i) flight time, (ii) impulse-momentum, (iii) double integration, (iv) jump-and-reach, and (v) three-dimensional (3D) motion capture systems. The results indicated that the choice of calculation method is largely influenced by the availability of equipment and the operational definition of jump height.
The primary objective of study 1a was to examine the between-session reliability of strategy-based metrics collected from the CMRJ compared to the CMJ and DJ. The secondary aim was to compare the differences in jump height, reactive strength index modified (RSImod), and reactive strength index (RSI) computed using four different jump height calculation methods. Results revealed that time to take-off (TTTO) in the CMJ was significantly longer than in the first jump of CMRJ (CMRJ1) across both sessions (effect size [ES] ≤ 0.49, p ≤ 0.027). Among all measured metrics, leg stiffness (Kleg) was not reliable, as indicated by a poor coefficient of variation (CV ≥ 15.29%) and wide 95% confidence intervals (CI). The longer TTTO alongside poor absolute reliability in Kleg suggested a potential change in jump strategy when subjects performed unfamiliar jump tasks. Thus, practitioners are advised to ensure sufficient habituation trials (≥ 6 repetitions for athletes with CMRJ test experience; ≥ 9 repetitions for athletes new to CMRJ test) are conducted before incorporating the CMRJ into routine testing. Furthermore, jump height, RSImod, and RSI did not differ significantly between calculation method (p ≥ 0.254). Building on the findings of study 1a, study 1b evaluated the validity and reliability of kinetic metrics measured during the CMRJ, CMJ, and DJ. Significant differences were observed in negative and positive hip and knee work, as well as positive ankle contributions during the CMRJ compared to the CMJ and DJ (p ≤ 0.048), with ES data indicating small differences (≤ 0.71) based on Hedges criteria. No significant differences were found in other kinetic variables across the three jump types (p ≥ 0.086). Joint work and joint contribution strategies remained consistent across jump types, with the ankle and knee joints contributing most to total positive work, particularly in the DJ and the second jump of the CMRJ (CMRJ2). Collectively for these two empirical investigations, findings suggest that the CMRJ is largely a viable alternative to the CMJ and DJ tests, providing practitioners with valuable insights into movement characteristics and training recommendations.
Athletes may adopt varying movement strategies during the CMRJ test, which can lead to suboptimal performance. Given the limited research on the CMRJ, it remains unclear how athletes can be encouraged to maximise explosive strength, reactive strength or both simultaneously. Study 2 examined the impact of external verbal cues on CMRJ performance across both strategy-based and kinetic metrics. As the use of external cues may initially alter movement strategies, it is important to consider that introducing new cueing conditions could require additional time for athletes to habituate. The combined cue, designed to maximise rapid force production and reactive strength, significantly reduced contact time and increased Kleg compared to the height cue, which focused solely on maximising jump height (p ≤ 0.038). Furthermore, the combined cue increased jump height compared to the velocity cue, which aimed to minimise contact time (p ≤ 0.005). For kinetic metrics, the combined cue enhanced positive ankle contributions compared to the height cue (p = 0.020) and increased positive hip and negative knee joint work compared to the velocity cue during the CMRJ2 (p ≤ 0.040). These findings suggest that practitioners can utilise specific verbal cues to tailor specific performance outcomes: the height cue to maximise jump height, the velocity cue to minimise contact times, and the combined cue to optimise RSImod and RSI.
Study 3 built upon the findings of previous studies by exploring the relationship between CMRJ performance and various independent measures of athletic performance, including the isometric mid-thigh pull (IMTP), 20-m linear sprint, and 505 COD speed tests. Significant positive relationships were observed between IMTP peak force and force at 300 milliseconds (ms) with the CMRJ1 height (r = 0.54 to 0.55, p ≤ 0.002). Additionally, inverse relationships were identified between RSImod and RSI with 20-m sprint total and split times (r = -0.55 to -0.66, p ≤ 0.001). The 10-m and total sprint times were also significantly correlated with the CMRJ1 height (r = -0.54, p = 0.003), suggesting greater rapid vertical force production and reactive strength are associated with faster sprint performance. Finally, significant inverse relationships were observed between CMRJ metrics (two jump height values and RSImod) and 505 speed times on both sides (r = -0.51 to -0.68, p ≤ 0.006). These results highlight the value of CMRJ performance metrics as indicators of lower-limb rapid force production ability.
The final experimental chapter (Study 6) investigated the impact of a controlled repeated sprint protocol on CMRJ performance measures, with retests conducted after each sprint set and at varying recovery time points (e.g., 0.5-hours, 1-hour, and-24 hours). These time points were chosen to provide a holistic approach as to the acute effects of fatigue and the subsequent recovery dynamics, offering demonstrations of how CMRJ performance evolves over a period of time when jump data was likely to be most affected. Results revealed significant reductions in CMRJ heights (in both jumps), RSImod, and RSI immediately following the sprints (ES = 0.27 to 1.78, p ≤ 0.040), indicating acute decrements in fast and slow SSC performance. In contrast, strategy-based metrics such as Kleg and contact time remained stable (p ≥ 0.079), suggesting limited sensitivity to fatigue. These findings highlight that while strategy-based metrics can provide valuable insights into individual athlete responses, outcome metrics remain the most practical and actionable measures for field-based monitoring and direct application.
In conclusion, the findings of this thesis provide a comprehensive understanding of CMRJ performance and offer practical insights for coaches, scientists, and practitioners in the field of sports performance. The results indicate that the CMRJ test produces comparable kinetic and strategy-based metrics to the CMJ and DJ tests, establishing its validity as an alternative jump performance assessment tool. Additionally, the influence of external verbal cues on jump strategies was evident, emphasising the need to select specific cues to optimise targeted CMRJ performance. This thesis also demonstrated significant relationships between CMRJ performance and other athletic performance metrics, such as IMTP strength, sprinting speed, and COD ability, underscoring the relevance of CMRJ metrics as proxy measures for an athlete’s overall performance capabilities. Furthermore, when using CMRJ test metrics to assess neuromuscular fatigue, outcome metrics were shown to be more reliable and actionable than strategy-based metrics. The inclusion of controlled fatigue interventions confirmed the robustness of CMRJ metrics across varying levels of fatigue, supporting their utility in both refreshed and fatigued states. Overall, these findings highlight the CMRJ as a reliable and versatile test that effectively assesses various aspects of athletic performance, including neuromuscular coordination, explosive power, and reactive strength. The CMRJ test, therefore, represents a valuable tool for practitioners seeking comprehensive insights into an athlete’s jump performance and broader physical capabilities
Assessing the technical feasibility of ethical artificial beings
No full textDigital systems are continuously gaining capabilities, are envisioned as the solution to some of the societal problems and therefore, associated with bigger decision-making responsibilities (for example as autonomous cars). Humans placed in those situations of responsibility face sometimes tough decisions, which they resolve on a daily basis guided by safeguards acquired through education or imposed by professional codes of conduct. With the latest wave of artificial systems demonstrating higher linguistic capabilities, society is starting to ascribe to them some sort of human-like existence, some sort of "Artificial Being". One concern is that these artificial beings, with increasing decision making power in daily-life events may not have a sense of moral duties towards other beings as good as society expects. In this work we look at past considerations of this societal challenge and examine what may take to transfer some sense of moral understanding to artificial beings, which ethical principles we can consider transferring into them. As a result, we identify some technical concepts which seem relevant to embed a level of moral capability in artificial beings. We see this not as a final solution, rather the beginning of a necessary branch of technology
Digital culture change
Get PDFDigital culture change is not a one-size-fits-all approach but rather a dynamic way to engage people and technology within a transformative framework that enhances stakeholder learning within higher education (HE) and organisational effectiveness. The Covid-19 pandemic underscored the need for flexible digital strategies, highlighting challenges related to digital inequity and the limitations of uniform transformation models. To drive a meaningful approach to change, senior leadership at the University for the Creative Arts (UCA) created a Digital Enabling Strategy to support decision-making, efficiency and stronger connections for delivery and academic success. Creating the strategy included commissioning institutional research guided by Jisc, a digital technology agency, and a strategic leadership review to replace previous Information Technology (IT) planning. This staged approach involved engaging the broader community of academics, students, professional and technical staff as stakeholders in change. Key principles that surfaced from the research included creating a more collaborative digital culture, strengthening existing technology structures, fostering leadership for change, and resisting regression to outdated models. The leadership review supported implementing an enabling three-level framework (centralised, distributed, and distinctive) that could tap into the institution’s unique value propositions for both campus and online experiences. It is encouraging that the institution has, through this process, been able to reassess core creative and business aspirations through a digital lens, identifying opportunities for innovation and mixed modes of participation, planning and engagement. By embracing an enabling strategy that set out to appraise and reset digital readiness in a small specialist higher education institution, distributed leadership can now build a digital culture that is inclusive yet adaptive and robust enough for competitive change
Pre-clinical feasibility and translational challenges of cytokine-loaded dissolvable microneedles for cutaneous immunotherapy
No full textBackground
Cytokines such as IFN-γ, TNF-α and IL-10 are central to tumour immune regulation, but systemic delivery is limited by short half-life and toxicity. Cutaneous malignancies such as melanoma, squamous cell carcinoma and basal cell carcinoma represent attractive targets for local immunotherapy. Dissolvable microneedles (MNs) could provide minimally invasive intradermal immunotherapy in cutaneous malignancies by enhancing immune activation while reducing systemic exposure. The aim of this study was to evaluate the feasibility and stability of cytokine incorporation into dissolvable MNs as a potential immuno-oncology drug delivery strategy.
Methods
Sugar-based MNs were fabricated by vacuum-assisted casting incorporating IFN-γ, TNF-α and IL-10. Mechanical strength and skin insertion were verified using excised porcine skin tissue. Cytokine recovery was assessed by ELISA immediately post-fabrication and after storage at room temperature and 45 °C for 1 week, 1 month and 2 months. Standards confirmed assay validity. Release behaviour was monitored during dissolution in aqueous media.
Results
MNs exhibited sharp geometry, reliable stratum corneum penetration, and sustained dissolution with release extending over 5 days. However, cytokine recovery was consistently below the ELISA detection limit (<LOD) across all formulations, both immediately after fabrication and following storage under all conditions tested. Standards retained activity, confirming instability was introduced during MN processing.
Conclusions
Although dissolvable MNs provided adequate mechanical performance and enabled sustained release over 5 days, cytokine incorporation resulted in complete loss of detectable protein. This pre-clinical feasibility study identifies stability as the major barrier to advancing cytokine-based immuno-oncology. Overcoming this challenge will require formulation optimisation such as stabilising excipients, improved drying processes, and alternative matrices before progressing to in vivo models and clinical translation of MN-mediated cytokine delivery in cutaneous cancer immunotherapy
Erfolgsfaktoren für die Implementierung eines digitalen betrieblichen Gesundheitsmanagements in österreichischen Klein- und Mittelunternehmen – Eine empirische Analyse
No full textThe increasing digitalisation of modern life presents healthcare systems with both new opportunities and challenges. Especially in the corporate context, there is a growing tendency for workplace health promotion initiatives to adopt digitalised processes. Despite the widespread recognition of digital corporate health management as the future of corporate health management and the growing relevance of digital health applications in workplace settings, the implementation of digital health solutions at the organisational level remains a significant challenge. The current state of practice demonstrates a lack of scientific foundation regarding the precise strategies and success factors that are required to integrate digital health applications into an organisation's workflows. Given that 99.6% of all Austrian businesses are small and medium-sized enterprises, this dissertation aims to identify the key factors that contribute to the successful implementation of a digital corporate health management, with a particular focus on the peculiarities of small and medium-sized enterprises. Based on these findings, explicit recommendations are put forth to facilitate the future adoption and operationalisation of digital corporate health management initiatives. The research involved a systematic literature review, which was complemented by 14 semi-structured interviews with experts from small and medium-sized enterprises in Austria. To analyse the interviews, Mayring's qualitative content analysis methodology and the software MAXQDA were employed. The results indicate that the implementation of a sustainable digital corporate health management is contingent on a number of crucial factors. These factors include the specific digital health applications, organisational structures, involved stakeholders, external frameworks, network effects, legitimacy proofs, systematic implementation processes, and a focus on current developments as well as future prospects in the corporate health sector. In this regard, a total of 24 action recommendations for practice and research have been proposed. This dissertation contributes to closing existing research gaps by providing the first theoretically and empirically based study on the digital corporate health management of small and medium-sized enterprises in Austria while offering practical guidance for future implementation enterprises
Regulatory ethics versus ethics of truth: exploring procedures and methodological outcomes of accountability systems in fieldwork research
No full textThis article critically examines principles and procedures of research ethics and academic accountability relevant to fieldwork research employing materialist critiques of post-modern though. Academic systems of governance based on accountability have been questioned on ethical grounds. This study calls into question the theoretical assumptions of mainstream ethics seeking an alternative approach. First, it delineates a genealogy of critical methods following the emancipatory epistemologies of Bourdieu, Gramsci and Burawoy. Then, ethnographic research in post-soviet workplaces is used to investigate moral issues in fieldwork. The accountability failures of academics involved in Russia’s 1990s mass privatization make post-Soviet Russia a significant testing ground for the moral practice of ethnography. Confronting an unethical world, the researcher must resort to stratagems which, in retrospect, appear to violate ethics procedures. We ask whether an alternative approach can be identified without surrendering to mere instrumentalism. Our research identifies a morality that responds to the social context of research with participation and commitment. Research ethics inspired by Badiou’s ethics of truth recognize reflexivity, engagement, and emancipation as central to research’s moral integrity as they are to its scientific validity. An approach that can guide the researcher across the murky politics of fieldwork ultimately demands loyalty to emancipation struggles and those involved in it
Green pharma supply chain: a review of existing practices and future directions
Get PDFPurpose
The pharmaceutical industry is facing significant pressure to tackle antimicrobial resistance (AMR). Other ecological, societal and regulatory pressures are also driving the industry to “go green”. While such a (green) transition could be possible through appropriate green practices’ implementation, the present understanding about it is superficial and vague. A key reason is the lack of green practices’-related studies on pharmaceuticals, which are also insufficiently comprehensive. This knowledge gap is sought to be addressed.
Design/methodology/approach
A systematic literature review (SLR) was conducted with 73 carefully selected articles, then subjected to thematic content analyses for synthesising the relevant themes and sub-themes.
Findings
Around 76 operational-level green practices covering all key stakeholders across the drug lifecycle were identified. It was revealed that designing drugs having accelerated environmental degradability is important to combat AMR. Also, redesigning existing drugs is environmentally more resource-intensive than developing new ones with significant cost-saving potential in solvent recycling and flexible manufacturing, both of which are not common at present. With regards to green-related barriers, stringent quality requirements on drugs (and therefore risks in making relevant green-oriented modifications) and time-consuming and costly regulatory approvals were found to be the key ones.
Practical implications
The operational green practices’ framework developed for individual pharmaceutical supply chain stakeholders could help practitioners in benchmarking, modifying and ultimately, adopting green practices. The findings could also assist policymakers in reframing existing regulations, such as Good Manufacturing Practices or GMP-related, to promote greener drug development.
Originality/value
This work is the first systematic attempt to identify and categorise operational-level green supply chain practices across stakeholders in the pharmaceutical sector.
Highlights
• Biodegradability of drugs is more important than environmental degradability.
• Flexible manufacturing process design (or quality by design) reduces resource wastage.
• Ecopharmacovigilance is effective in combating PIE and AMR-related issues.
• Upstream and downstream coordination is key to greening pharma operations.
• Costly and time-consuming regulatory approval is a key barrier to greening pharma processes