Central Pillars Research Articles

A Toolkit to facilitate the implementation of an Integrated Care Network for People living with Parkinson: A Codesign Approach

Background: In response to the critical health care situation faced by People living with Parkinson’s (PwP), a group of experts decided to develop and implement a care model (iCARE-PD project) for addressing the complex care needs in Parkinson’s disease (PD). As part of this multidisciplinary and international project, a codesign approach was implemented to identify the central pillars of the care model, namely: home-based care delivery; integrated care; self-management support and technology-enabled care. For the success of this patient-centered model in a varied social, cultural and economic landscape, we need to develop a tool that facilitates the implementation of an integrated care network across different social contexts. 
 Purpose & Method: The codesign approach, implemented in this study, consisted of four linked steps that were coordinated among 5 countries: (1) Preparation (2) Capture patients’ experiences by using narrative interviews and understand the patients’ trajectory; (3) Design scenarios for an integrated care delivery network with patients, care partners (CP), and health care providers (HCP) and (4) Co-produce solutions by identifying key requirements for designing a roadmap and toolkit to facilitate the implementation of an integrated care network in various social contexts. As part of the iCARE-PD project, this communication presents the findings of the final phase of the codesign approach which brought together researchers, clinicians, nurses and patient advisors in May 2022 for a workshop aimed at collectively co-defining the key elements to be included in an integrated care toolkit. Scenarios identifying key components for designing an integrated care network for PD were created by PwP, CP and HCP during previous workshops. Based on these scenarios designed previously, a workshop was conducted and recorded in order to produce a roadmap and toolkit that takes into consideration the unique challenges faced by PwP in each country, and the need for an integrated care delivery network that can be personalized and malleable to evolving and changing needs over time. 
 Results: We will present the results of the thematic analysis of the transcript of the workshop. In order to improve person centeredness, tailor and personalize care and propose a holistic approach of PD in integrated care, a roadmap including three features needs to be integrated into a toolkit: (a) Identify ‘boundary spanners’ such as key individuals people or tools to support patient-centered care, (b) select mediators to connect various actors in the networks and create informational and technological infrastructure to facilitate access to tailored information and resources and, (c) create and share tools, data and resources to improve communication processes and coordination of care. Each of the design features involves various practical solutions shared and co-created during the workshop that could be useful to develop an integrated care toolkit. 

An epistemology for democratic citizen science.

More than ever, humanity relies on robust scientific knowledge of the world and our place within it. Unfortunately, our contemporary view of science is still suffused with outdated ideas about scientific knowledge production based on a naive kind of realism. These ideas persist among members of the public and scientists alike. They contribute to an ultra-competitive system of academic research, which sacrifices long-term productivity through an excessive obsession with short-term efficiency. Efforts to diversify this system come from a movement called democratic citizen science, which can serve as a model for scientific inquiry in general. Democratic citizen science requires an alternative theory of knowledge with a focus on the role that diversity plays in the process of discovery. Here, we present such an epistemology, based on three central philosophical pillars: perspectival realism, a naturalistic process-based epistemology, and deliberative social practices. They broaden our focus from immediate research outcomes towards cognitive and social processes which facilitate sustainable long-term productivity and scientific innovation. This marks a shift from an industrial to an ecological vision of how scientific research should be done, and how it should be assessed. At the core of this vision are research communities that are diverse, representative, and democratic.

Diethylcarbamazine elicits Ca2+ signals through TRP-2 channels that are potentiated by emodepside in Brugia malayi muscles.

Filarial nematode infections are a major health concern in several countries. Lymphatic filariasis is caused by Wuchereria bancrofti and Brugia spp. affecting over 120 million people. Heavy infections can lead to elephantiasis, which has serious effects on individuals' lives. Although current anthelmintics are effective at killing microfilariae in the bloodstream, they have little to no effect against adult parasites found in the lymphatic system. The anthelmintic diethylcarbamazine is one of the central pillars of lymphatic filariasis control. Recent studies have reported that diethylcarbamazine can open transient receptor potential (TRP) channels in the muscles of adult female Brugia malayi, leading to contraction and paralysis. Diethylcarbamazine has synergistic effects in combination with emodepside on Brugia, inhibiting motility: emodepside is an anthelmintic that has effects on filarial nematodes and is under trial for the treatment of river blindness. Here, we have studied the effects of diethylcarbamazine on single Brugia muscle cells by measuring the change in Ca2+ fluorescence in the muscle using Ca2+-imaging techniques. Diethylcarbamazine interacts with the transient receptor potential channel, C classification (TRPC) ortholog receptor TRP-2 to promote Ca2+ entry into the Brugia muscle cells, which can activate Slopoke (SLO-1) Ca2+-activated K+ channels, the putative target of emodepside. A combination of diethylcarbamazine and emodepside leads to a bigger Ca2+ signal than when either compound is applied alone. Our study shows that diethylcarbamazine targets TRP channels to promote Ca2+ entry that is increased by emodepside activation of SLO-1 K+ channels.

The impact of an online physics lab on university students' self-efficacy and understanding of thermal concepts during COVID-19 pandemic

COVID-19 has caused widespread disruption, necessitating tough decisions for global economy and services, including one of the central social pillars, education. As in the rest of the world, Greek universities transformed and adapted their educational services to continue to operate during the pandemic. This article presents how a series of a physics laboratory work for thermal concepts was conducted to evaluate its effectiveness on students’ understanding and its impact on their self-efficacy beliefs. The results showed that the post-test performance on students’ understanding of thermal concepts and their self-efficacy beliefs levels toward physics teaching were higher than pre-test performance but still moderate. A critical challenge was to maintain the experiential consistency with the in-person laboratory classes of all the previous academic years and the promotion of group work of students.

Envisioning 6G Outlook and Technical Enablers

6G research has been extensively conducted by individual organizations as well as pre-competitive joint research initiatives. One of the joint initiatives is the Hexa-X European 6G flagship project. This paper shares the up-to-date deliverables through which Hexa-X is envisioning the 6G era. The Hexa-X deliverables presented in this paper encompas the overall 6G vision, use cases and technical enablers. The latest deliverables on tenets of 6G architectural design and central pillars of technical enablers are presented. In conclusion, the authors encourage joint research and PoC collaboration with Japanese industry, academia and research initiatives for the potential technical enablers presented in this paper, aimed at global harmonization towards 6G standards.

Beyond data transactions: a framework for meaningfully informed data donation

AbstractAs we navigate physical (e.g., supermarket) and digital (e.g., social media) systems, we generate personal data about our behavior. Researchers and designers increasingly rely on this data and appeal to several approaches to collect it. One of these is data donation, which encourages people to voluntarily transfer their (personal) data collected by external parties to a specific cause. One of the central pillars of data donation is informed consent, meaning people should be adequately informed about what and how their data will be used. However, can we be adequately informed when it comes to donating our data when many times we don’t even know it is being collected and, even more so, what exactly is being collected? In this paper, we investigate how to foster (personal) data literacy and increase donors’ understanding of their data. We introduce a Research through Design approach where we define a data donation journey in the context of speech records, data collected by Google Assistant. Based on the data donation experiences of 22 donors, we propose a data donation framework that understands and approaches data donation as an encompassing process with mutual benefit for donors and researchers. Our framework supports a donation process that dynamically and iteratively engages donors in exploring and understanding their data and invites them to (re)evaluate and (re)assess their participation. Through this process, donors increase their data literacy and are empowered to give meaningfully informed consent.

Blind spots in IPE: contract law and the structural embedding of transnational capitalism

This paper focuses on the ‘blind spots in IPE’ recently addressed in related Special Issues of Review of International Political Economy and New Political Economy. It identifies a blind spot of law in IPE, tracing the problem to a blind spot in the discipline of international relations (IR) generated by tendencies in dominant theories to consider international law to be super-structural, epiphenomenal, and not worthy of political analysis, and to associations of international law with idealism. The analysis notes an inverse blind spot in international law (IL), wherein legal scholars tend to regard IL as autonomous of politics and the political economy of ‘who gets what, when, how’. These blind spots contribute to the neglect of how legal forms function to mystify the political economy of IL, thereby advancing transnational capitalism and inequality. The empirical focus is on transnational contract law, dispute settlement, and value and production chain contracting. These laws function as Capital’s law and central pillars of the transnational politico-legal order by reaching deep inside states to restructure domestic spheres according to new constitutionalism and the demands of transnational capital. Drawing on critical political economy, the paper develops a historical materialist analysis to denaturalize and demystify Capital’s law. This is a necessary move for scholars interested in the progressive and emancipatory potential of IL.

Pottery Kilns of the end 17 – early 18 Century From the Town of Reshetylivka (Poltava Region)

The purpose of the paper is to reconstruct the process of firing pottery in the Hetmanate for the Early modern time, for example the materials from the rescue archaeological researches of two pottery kilns, carried out in 2006 in the former centurion town of Reshetylivka, Poltava regiment.
 The scientific novelty lies in that for the first time it is considered and described in detail of these pottery kilns construction, the characteristic feature of which was the use of kiln boxtype tiles to strengthen these thermo-technical facilities. For strengthening of the pottery kilns were used boxtype tiles. Such constructive specification sometimes was use in pottery kilns construction of Cossack Hetmanate pottery centers, but the peculiarity of these kilns is compilation of kiln’s central pillars completely of tiles. Was held the analysis of found in their filling materials, in particular, kitchenware, tiles (‘kahli’), candlesticks and other items.
 Conclusions. Found pottery kilns were built by one potter at his own estate in late 17 – early 18 centuries. Their forms of the kilns are typical for pottery kilns widespread on the territory of Ukraine at that time. All of tiles according to the place in a stove are divided into wall, corner and cornice. All of them are boxtype, rectangular with a small walls. According to the decor, the wall's boxytipe tiles are divided into seven types: with heraldic image of a two-headed eagle; with the heraldic image of the fight between the griffon and the lion; with rectangular center net with encircled thin branches; with crosses; with plant-geometric ornament; with the crossed stems of six three-petal ‘lilies’; with volute-styled elements. The analysis of the tiles’ decor showed that among the Reshetylivka’s tiles a special proficiency and high décor relief is peculiar for a part of tiles with crosses. Sometimes these are tiles with similar patterns, which show the durability of life of certain décor types.
 For long enough in Hetmanate were popular ‘carpet’ tiles with rhombic patterns, ‘tiles with crosses’ and tiles with volutes. Having entered into fashion at the beginning of 18 century such tiles were used practically during all the century on a wide territory. The majority of found in Reshetylivka tiles are similar to the findings from Poltava and are also correlated with the corresponding plots and decor of products of Middle Naddniprjanshchyna (Middle Dnieper territory). The analysis of the kitchenware (pots) showed that in Reshetylivka was produced smoked ceramics decorated with texturized ornament (mainly performed by graving with a stick (‘rytuvannia’) and stamping with roller). In 18 century became popular products decorated with painted ornament, which had replaced the previous ones in the assortment of potters. Judging from the characteristic features of kitchenware the abovementioned pottery kilns can be attributed to Poltava pottery region.

A shared novelty-seeking basis for creativity and curiosity.

Curiosity and creativity are central pillars of human growth and invention. Although they have been studied extensively in isolation, the relationship between them has not yet been established. We propose that both curiosity and creativity emanate from the same mechanism of novelty seeking. We first present a synthesis showing that curiosity and creativity are affected similarly by a number of key cognitive faculties such as memory, cognitive control, attention, and reward. We then review empirical evidence from neuroscience research, indicating that the same brain regions are involved in both curiosity and creativity, focusing on the interplay between three major brain networks: the default mode network, the salience network, and the executive control network. After substantiating the link between curiosity and creativity, we propose a novelty-seeking model (NSM) that underlies them and suggests that the manifestation of the NSM is governed by one's state of mind.

‘Holding Fast to the Heritage of Freedom’: the Grotian Moment(s) of the Universal Declaration of Human Rights and the Early United Nations (1941–1949)

Abstract As our contemporary international order seems to come apart at its seams in the trenches of Eastern Europe, many observers have sought solace in the promises made by the historical crucible in which this order was forged. It was, after all, in the aftermath of a previous global conflagration that a planetary constellation of statespeople attempted to create an architecture that would save ‘succeeding generations from the scourge of war’ under the aegis of the ‘United Nations Organization’ (uno). In hindsight, it is easy to look at the years that led to the creation of this international institution—and the proclamation of the Universal Declaration of Human Rights (udhr) of 1948, one of its central pillars—as a decisive ‘Grotian moment,’ insofar as it promised a new age for international ordering. And yet, the historical record shows that those contemporary to the making of the uno and the udhr were less certain about the ‘Grotianness’ of the moment they were living. In this sense, I argue that the plural legacies of the years 1941–1948 have been contested and disputed from the outset. In this contribution I think with, and perhaps against, the notion of ‘Grotian moments’ to interrogate how a narrative of the udhr as a watershed period for secularized individual rights came to eclipse another account of the udhr, which highlighted the centrality of collective welfare for the post-war settlement.

Genetic data are not always personal-disaggregating the identifiability and sensitivity of genetic data.

In both the EU and USA, genetic data are recognized as a special category of data that requires heightened privacy protection. Identifiability and sensitivity are central pillars of the regulatory framework in both jurisdictions: the privacy concerns stem from the assumption that genetic data are capable of identifying the individual and reveals sensitive information about them. But not all genetic data are identifiable and sensitive, nor are genetic data necessarily different from other types of big data in terms of these issues. This article argues that a more nuanced approach is needed to assess the threat to privacy interests posed by uses of genetic data. The privacy interests involved should be distinguished in terms of proposed use, the amount of data in question, and its uniqueness and informational content. When these factors are disaggregated, it is clear that both regulatory schemes could better achieve their goals by focusing more on the ways genetic data can be used rather than on their status as a special category of data.

NDAs: A Study in Rights, Wrongs, and Civil Recourse

Abstract According to John Goldberg and Ben Zipursky (“Goldursky”), there are two central pillars to tort law, pillars that are best explicated by civil recourse theory. Torts are legally recognized wrongs, and the power to seek redress is part of the Lockean bargain. Using the recent question of whether nondisclosure agreements (NDAs) should be permitted, this Article unearths an instability in the kind of normativity upon which Goldursky relies. Specifically, this paper explores how the unenforceability or bans on NDAs premised upon third party harms may presuppose the victim has a duty to rescue these third parties. I begin by revealing the underlying moral relationship at the heart of these potential duties. From there, I explore how these sorts of arguments cannot easily be voiced within the presuppositions of civil recourse theory. Finally, I consider the pressure points within civil recourse theory that could potentially take on board these moral considerations. My bottom line is simple: Whichever way one thinks about NDAs and the duty to rescue, a dilemma is created for Goldursky. There is simply a mismatch between the kind of arguments that one can make about why it would be (in)appropriate to limit the plaintiff’s cause of action and what the underlying content of tort law should be. Ultimately, the kind of normativity that they need to understand the Lockean bargain, as well as the content of and caveats thereto, may require more bite than positive morality.

Expectations of guideline developers on living guidelines

Guidelines are central pillars of high-quality care and care planning. The quality requirements for the development of guidelines and the associated effort are very high. Therefore, more efficient approaches are being forced. The opportunities and challenges in the introduction of a dynamic updating concept within the framework of the digitalization of guidelines were explored from the perspective of guideline developers in the field of psychiatry. This perspective should be included in the implementation. Between January and May 2022 across-sectional survey was conducted among guideline developers (N = 561, response 39%) based on aquestionnaire developed and tested in advance. Data were analyzed descriptively. A total of 60% were familiar with the concept of living guidelines. Alarge proportion endorsed adynamic updating (83%) and digitalization (88%) of guidelines; however, various challenges are associated with the concept of living guidelines: the risk of inflationary changes (34%), the need for continuity of all actors (53%), involvement of patient and family representatives (37%) and definition of criteria regarding the decision what to change (38%). The vast majority (85%) thought it necessary that guideline development should be followed by implementation projects. German guideline developers are very receptive regarding the implementation of living guidelines; however, they named numerous challenges, which need to be addressed in this approach.

Beliefs around help-Seeking and Support for Dementia in the Australian Arabic Speaking Community.

The number of people with dementia in multicultural Australia is rapidly increasing. Despite its culturally diverse population, there is limited research about how people from ethnic minority groups understand and approach help-seeking and support for dementia. The aim of this study is to understand the perceptions of dementia symptoms, help-seeking and support in the Australian Arabic-speaking community. This study used a cross-sectional qualitative research design. Individual, semi-structured interviews using projective stimulus techniques were used. Participants were three Arabic-speaking people aged over 70 who were experiencing cognitive changes or dementia symptoms, six carers, and five health or social care practitioners experienced in working with Arab-Australians. Phone or video chat interviews were conducted in either Arabic or English. Interviews were audiotaped, translated when needed, transcribed verbatim and inductive thematic analysis was undertaken. Seven themes were identified. Participants described dementia as relating to symptoms of confusion and memory loss. Carers and older people believe that when older people are experiencing these cognitive symptoms, they must be cared for primarily by ensuring their happiness and comfort. Barriers to help-seeking and support included a lack of help-seeking due to cultural norms of family orientated care, families are unsure of where to seek help and fear of community judgement. Two ways to facilitate help-seeking and support were to build trust through culturally appropriate support and to educate the community. Family, trust and community were identified as central pillars of the Australian-Arabic-speaking community. There is a need to increase dementia literacy in this community particularly around help-seeking and decreasing stigma. Education should be promoted by trusted community members and religious leaders. As the first point of professional contact, general practitioners need to be upskilled to support Arabic-speaking Australians around dementia.

Self-Fashioning of a Hindu Political Sanyasi: Muscular Asceticism and Sectarian Freedom in Swami Satyadev Parivrajak’s Autobiography

This essay focuses on the autobiographical writings of Swami Satyadev ‘Parivrajak’ (1879–1961), a prolific Hindi writer, and a charismatic modern-day worldly political ascetic in the early twentieth-century north India. It discusses three central pillars of his ineradicably political autobiography: first, the performance of an exemplary celibate Hindu masculinity; second, the conceptualization of a segmented and exclusionary freedom, unencumbered by the presence of Muslims; and third, his deep antagonism towards Gandhi, and defence of his assassination. Taken together, his autobiography is a critical contribution to the intellectual history and genealogy of sectarian Hindi–Hindu literature, while also showcasing cultivated precursors of a modern, monolithic and militant Hindu nation.

Securitisation, humanitarian responses and the erosion of everyday rights of displaced Venezuelan women in Brazil

ABSTRACT This article explores the gendered securitisation of humanitarianism through the lens of Venezuelan women who have fled to Brazil, as part of the largest migration flow in South America. By the end of 2022, the number of displaced Venezuelans had grown to seven million, half of whom were women and girls. Alongside humanitarian programmes, measures of migration control, policing and deterrence are now routinely implemented. This article explores the interplay between securitised policies and humanitarian programmes in the everyday experience of rights of Venezuelan migrant women and girls. We ask: what happens when migrant women reach Brazil, a supposed place of safety? Do they experience rights restitution and protection, or do they continue to be subject to everyday gendered humiliations? Building on fieldwork in Boa Vista and Manaus in 2020–2022, we explore migrant women and girls’ experiences with shelter and healthcare, two central pillars of humanitarian programmes. Contributing directly to literatures on migration management, humanitarianism and control, this article focuses on ‘the receiving end’ of securitised humanitarian practices and deploys a gender lens to reveal how securitised humanitarianism reproduces disciplinary dynamics of governance and creates gendered risks and vulnerabilities that erode migrant women and girl’s rights and agency in everyday life.

China’s Bifurcated Space Diplomacy and Institutional Density

Abstract This article compares two central pillars of China’s space programme and observes that Chinese space diplomacy is not uniform regarding international scientific co-operation either in its approaches or in results. In the case of the Chinese Space Station programme, the China National Space Administration went through existing United Nations (UN) channels and successfully attracted international partners. However, the International Lunar Research Station has avoided UN channels and used national and bilateral platforms. This bifurcation in approaches and results offers an intriguing puzzle concerning international co-operation: practices of institutionalised multilateral co-operation and areas of state-centric bilateral co-operation co-exist in this case and further complicate the issue of space diplomacy. To propose a potential explanation, it is argued here that a crucial intermediate variable — institutional density — requires further theorising, as it seems to influence strategic choices about space diplomacy, which may lead to success or failure.

Structure of outpatient urology care in Germany

Although urological specialist practices are central pillars of outpatient care, there is alack of current data on the care structure of these practices. Adescription of the structures in large cities versus rural areas as well as gender effects and generational differences is needed not only as abaseline measure for further studies. The survey includes data from the physician directory of the Stiftung Gesundheit as well as from the German Medical Association and the Federal Statistical Office. Colleagues were divided into subgroups. Based on the different subgroup sizes, statements about the care structure of outpatient urology in Germany can be made. While the majority of urologists in larger cities work in professional practice groups and care for fewer patients on average, in rural areas there is aparticularly high proportion of individual practices with more inhabitants to be cared for per urologist. Female urologists work more frequently in the context of inpatient care. When female urology specialists choose to establish themselves, they are more likely to do so in practice groups and in urban areas. In addition, there is ashift in gender distribution: the younger the age subgroup considered, the higher the proportion of female urologists among all colleagues. This study is the first to describe the current structure of outpatient urology care in Germany. Future trends are already emerging that will significantly influence our way of working and the care of patients in the coming years.

Where is the l(ove)? Excavating law and labour in The Redress of Law

AbstractIn his monograph The Redress of Law, Emilios Christodoulidis provides a sophisticated genealogical study of the emergence of total market thinking in Europe. With market constitutionalism having sidelined political constitutionalism, the potential of law to organise the political community is significantly restricted. By examining the commodification of labour, processes of bargaining, unemployment, and strikes, Christodoulidis demonstrates the destructive consequences of law in the service of market rationalities as well as its potential for strategic action to build collective identity in the EU (European Union).Yet, I argue that this book comes with two significant blind spots, namely a dated understanding of both law and labour. First of all, Christodoulidis’s systems theoretical understanding of law is neglecting the material conditions that law continuously re-produces in the course of globalization. Secondly, his vision of labour remains rather traditional, focused on unionised, white, and male workers. Both elements are central pillars of his analysis but do not reflect the current reality of the 21st century. In this Article, I challenge his conceptualization by situating his work in recent research on the role of law and labour regulation in global capitalism.

Approaching Apprenticeship in Nepal: Lessons from Dual-VET of Germany

Apprenticeship training is geared towards meeting the demands of labor market which also ensures self-esteem, employability and vocational career development for the individuals. Against this background, apprenticeship is seen as a successful model for grooming the labor force and reducing youth unemployment. In this paper, we map the current state-of-the-art of apprenticeship in Nepal against the dual system of VET in Germany. The central question in our reflection is how common ownership can be established through responsibility sharing in countries, where other governance principles apply and the governance models also differ from the German model. Hence, in the first step, we focus on the origins of vocational training in both countries. We show that the development of apprenticeship has been driven by social, political and industrial needs, thereby getting deeply rooted in society. We show that despite many challenges, dual training in Germany is an important educational pathway for young people to access the labor market and a backbone of the economy. This is different in Nepal, where despite the governance structures that have been created in the meantime, apprenticeship training is struggling for recognition among the leaders, and actors in the economy. We end up adopting the "six central pillars for successful quality apprenticeships" (i.e. meaningful social dialogue, robust regulatory framework, clear roles and responsibilities, equitable funding, strong labor market and inclusiveness) developed by the ILO (2017). We reflect on them with reference to the Nepali case and in the shadow of the German experiences. In our conclusion, we propose to add "consideration of the country context" as the seventh important pillar for qualitative apprenticeship to ensure sustainable development – free of external funding and support.