School of Health Sciences
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Item Feasibility, Safety, and Intensity of Frame Running for people with Multiple Sclerosis with Moderate-to-Severe Walking Impairments(Taylor & Francis, 2026) McEwan, Gary; Andreopoulou, Georgia; Koufaki, Pelagia; Bulley, Catherine; Jagadamma, Kavi; Stansfield, Ben; van der Linden, MariettaPurpose: Physical activity is a key symptom management strategy for people with Multiple Sclerosis (pwMS). Yet, pwMS with advanced disability remain less active than the general population, possibly reflecting the dearth of adapted exercise opportunities for this population. This study therefore aimed to evaluate the feasibility of Frame Running, an adapted physical activity, for pwMS with moderate-to-severe walking impairments, its physiological demands, and the feasibility of conducting a definitive trial. Methods: A single-arm, pre-post design was employed, with physical function and self-reported outcomes assessed before and after a 12-week Frame Running programme. Feasibility outcomes included consent and retention rates, adherence, and safety. A one-year follow-up evaluated continued community-based Frame Running participation. Heart rate (HR), steps, cadence, and distance covered during training were recorded. Results: Twenty individuals registered interest, of whom 10 (all with progressive MS; Patient Determined Disease Steps score: 4–6) consented. Consent, retention, and adherence rates were 50.0%, 70.0%, and 86.9%, respectively. Six participants continued attending weekly training sessions one year later. Three participants reported eleven non-serious adverse events. Sessions elicited mean and peak HRs of 64.7±6.7% HRmax and 84.6±9.6% HRmax, respectively. Participants covered 1801±941 m per session, accumulating more steps at cadences ≥100 steps/min on training than non-training days (1756 vs. 767 steps). Conclusion: Frame Running appeared, for those who chose to participate, to present a feasible and safe community-based exercise option for pwMS with substantial mobility impairments, enabling participation in moderate-to-vigorous intensity exercise. Larger controlled trials are warranted to evaluate efficacy and address participation barriers.Item Research capacity strengthening in fragile and shock-prone settings: Insights from a research consortium(Elsevier BV, 2026-02-14) Khalil, Joanna; Bertone, Maria Paola; Ghanshyam Gautam; Mansour, Wesam; Idriss, Ayesha; La, Thazin; Fouad, Fouad; Raven, JoannaIntroduction Research capacity strengthening (RCS) is acknowledged as a critical element for improving health systems through contextually-embedded research findings and recommendations. However, RCS remains a critical gap in the field of Health Policy and Systems Research (HPSR), especially in fragile and shock-prone settings facing unique challenges that further constrain research capacity. The ReBUILD for Resilience (ReBUILD) consortium, operating in Lebanon, Myanmar, Nepal, and Sierra Leone, sought to strengthen HPSR capacity across individual, organizational, and community levels. This paper reflects on the RCS approaches of the ReBUILD consortium, analyzing strategies and lessons learned. Methods A mixed-methods approach was applied including surveys, discussions, progress reports, and meeting minutes. Data was collected iteratively at different stages of the RCS design and implementation. Results Based on needs and assets assessment, the RCS strategy was embedded in the consortium’s operations and adapted to local needs. Southern partners and early career researchers increasingly led initiatives, while mentorship and practical learning were emphasized. Efforts focused on strengthening individual skills and knowledge and expanded to the organizational level. Community members were trained and actively contributed to research design and implementation. Gender, equity and safeguarding were systematically integrated. The consortium’s work led to increased research outputs, policy influence, and improved local processes. Conclusions Findings from ReBUILD’s RCS approach demonstrate that context-specific, values-driven, and multi-level strategies can effectively strengthen resilient research ecosystems in fragile and shock-prone settings. This study proposes an adapted conceptual framework for RCS that emphasizes flexibility, equity, and shared leadership as key to sustainable research capacity development.Item Discretion at the margins: An observational study of community pharmacists' adaptive practices in supporting migrant and ethnic minority health(Elsevier BV, 2026-02-05) Sente, Charlotte; Foulon, Veerle; Kielmann, KarinaBackground Migrants and ethnic minorities (MEM) often face health challenges and structural and social barriers in accessing primary care. Pharmacists, as accessible healthcare professionals with expertise in medication management can address some of these barriers, however, their roles in serving MEM remain underexplored. Objectives This study explored the adaptive communication and care practices of community pharmacists in responding to MEM clients in Flanders, Belgium. Methods We conducted 42 h of non-participant observation and short reflective consultations with pharmacy staff of seven community pharmacies in two cities during February and March 2025. Field notes were structured using a semi-structured topic guide covering duration and content of pharmacist-client interactions; modes of communication; and delivery of pharmaceutical care. Framework analysis was used to code and categorize field notes according to micro-, meso-, and macro-level factors identified as influencing interactions between pharmacy staff and MEM clients. Results Community pharmacy staff bridge healthcare gaps for MEM clients through multiple strategies, shaped by the dual logics of retail and healthcare. They were observed to accommodate diverse languages and proficiency levels; support medication and health (systems) literacy; address socio-economic challenges; and show sensitivity towards socio-cultural dynamics of care-seeking. Reflecting pharmacists' personal and professional motivations, these adaptive practices are shaped by meso-level factors such as staff composition, pharmacy layout, and social norms, as well as pharmacy-level discretionary actions within the Belgian health system and migration policy contexts. Conclusions While well positioned to guide MEM clients through a fragmented health system, community pharmacists require systemic policy support to serve diverse population needs effectively.Item Short-Term Effects of Manual Therapy Combined with Functional Magnetic Stimulation in Individuals with Lumbar Disk Herniation with Radiculopathy: A Randomized Clinical Trial(MDPI AG, 2026-01-24) Lytras, Dimitrios; Iakovidis, Paris; Kasimis, Konstantinos; Georgoulas, Vasileios; Algiounidis, Ioannis; Kamparoudi, Georgia Maria; Tsigaras, Georgios; Tarfali, Georgia; Vergidou, Georgia; Sidiropoulos, Nikolaos; Zerva, Eleftheria; Kallistratos, IliasBackground and Objectives: Lumbar disk herniation with radiculopathy (LDHR) is a prevalent neuromusculoskeletal condition characterized by nociceptive and neuropathic pain components. Manual therapy (MT) is commonly used in its management, whereas Functional Magnetic Stimulation (FMS) represents an emerging modality with limited evidence in radiculopathy. The aim of this study was to examine the short-term effects of combining MT with FMS compared with MT alone on pain intensity, neuropathic pain features, neural mechanosensitivity, and functional disability in individuals with chronic LDHR. Materials and Methods: Forty adults with MRI-confirmed unilateral LDHR were randomly allocated to an MT + FMS group or an MT-only group. Both groups received ten treatment sessions over three weeks. Outcomes included lumbar and leg pain intensity (NPRS), functional disability (RMDQ), neuropathic pain symptoms (S-LANSS), and straight leg raise (SLR) range of motion. Measurements were obtained at baseline and at week 3. Group and time effects were examined using a two-way mixed ANOVA with significance set at p < 0.05. Results: Significant group × time interactions were observed for all outcomes (p < 0.01), indicating greater improvements in the MT + FMS group. Reductions in lumbar and leg pain, disability, and S-LANSS scores exceeded established MCID thresholds, while SLR gains surpassed published MDC values, reflecting both statistical and clinical relevance. Only the MT + FMS group improved below the neuropathic pain diagnostic cutoff (S-LANSS < 12). Conclusions: The findings of this trial suggest that incorporating FMS into a manual therapy program may provide additional short-term clinical benefits for individuals with chronic LDHR. Further research with larger samples, longer follow-up periods, and mechanistic assessments is needed to confirm these preliminary results and to better understand the underlying mechanisms.Item Mapping resilience in conflict and recovery: A systems analysis of the health sector in Ethiopia’s Tigray region (2020-2025)(Elsevier BV, 2026-01-29) Tequare, Mengistu Hagazi; Bou-Orm, Ibrahim; Gebreslassie, Fana; Witter, Sophie; Bertone, Maria PaolaThis study explores the resilience of the health system in Tigray (Ethiopia) in the period during and following the most recent conflict (2020-2025). The aim is to gain an understanding of the dynamic ways in which the health system has responded to the crisis and early recovery, highlighting elements of its resilience, including the resilience strategies (adaptation, absorption and transformation), resilience capacities (i.e., underlying broader capacities that the health system must have in place in order to deploy specific approaches) and resilience pathways. The study is grounded in a resilience framework and adopts a systems thinking approach, drawing on data from a documentary review, key informant interviews and focus groups in Tigray. The findings illustrate the impact of the war on elements of the health system, and the resilience strategies adopted within each element to sustain some extent the health system functionality during the conflict as well as the (longer-term) health system recovery. Based on the findings, a Causal Loop Diagram is developed, which helps to identify key emerging resilience capacities (the motivation, dedication and individual coping strategies of health workers; community trust in healthcare providers; and the regional health authority’s leadership), highlighting causal, balancing or reinforcing loops and pathways between elements, and critically exploring how resilience strategies, capacities and pathways connect and interrelate, sustaining some elements of the health system, preventing collapse and potentially supporting a return to a fully functioning healthcare system. Findings provide evidence that could support the reconstruction and recovery efforts in Tigray, and might inform recovery planning in other settings post-conflict.Item The Material Culture of Art Therapy: Less Is More(Informa UK Limited, 2026-01-20) Whitaker, Pamela; McDermid-Thomas, AdrienneThis is a viewpoint shared by two art psychotherapy educators in the United Kingdom reducing their reliance on bought art materials within their professional training programs. They propose a reimagining and reuse of manufactured materials with an appreciation of regenerative practices. The material culture of art therapy typically endorses an accumulation of material resources rather than a reduced repertoire of choice. A new materialist pedagogy for art therapy recognizes the agency of materials and their volition and active participation within art therapy practice and education. The purpose of this shared commentary is to propose a new perspective on art therapy materials with an aim to reduce single-use consumption.Item E.10. Sumud As Informal and Non-formal Educational Practice in Everyday Life in Palestine(Associazione "Per Scuola Democratica", 2026) Shqair, Manal; Alowda, Shatha; Soliman, Mahmoud; Giatsi Clausen, Maria; Scandrett, EurigAcross decades of settler colonial domination and apartheid, Palestinian communities have developed forms of everyday resistance that are deeply educational, and democratic. This panel explores sumud as a mode of embodied political agency, focusing particularly on, but not solely, women whose daily practices of care, labour, and community life become forms of resistance and citizenship under conditions of structural violence (Johansson & Vinthagen, 2020). Drawing on interdisciplinary perspectives from anthropology, feminist theory, Indigenous studies, Palestine studies, occupational science, public sociology, and lifelong education, the panel investigates how meaningful occupations as purposeful activity, livelihood and participation in community life, become sites of learning, resistance, and democratic possibility (Hocking, 2009). The panel is an opportunity to explore the contested space of the hegemonic common sense of the oppressor vs. the good sense of the oppressed in Gramsci's sense of "every relationship of hegemony is necessarily an educational relationship" (Gramsci, 1971). We invite contributions that address the role of informal education in the resistance of Palestinians bearing the brunt of Israeli violence. Papers may explore embodied and affective labour; sustaining land-based knowledge through oral narratives; intergenerational identity; the politics of everyday care, and how informal educational practices shape collective resilience. By highlighting sumud as both a pedagogical and political process that is enacted by Palestinian women and men as a form of informal politics, the panel aims to frame democratic education beyond institutional settings by focusing on informal and non-formal spaces to show how communities, under settler colonialism and apartheid, generate learning, meaning making, and resistance.Item E.02. Children as Political Actors: Rethinking School, Agency, and Democracy(Associazione "Per Scuola Democratica", 2026) Giatsi Clausen, Maria; Kustatscher, Marlies; Konstantoni, KristinaThis panel explores how children often act as political subjects within and beyond school, and how their participation, resistance, and everyday negotiations invite new ways of understanding democracy. Rather than viewing children as adults and citizens "in-waiting", we emphasize the diverse ways they already engage with power through dialogue, collective action and activism, subtle forms of resistance or subversiveness, and practices of meaning making. These actions challenge assumptions that political agency emerges only with maturity and reveal schools as contested spaces where democratic capacities are reproduced, constrained and, potentially, reimagined. Schools operate within hierarchical, surveillance-driven, and neoliberal structures that often privilege compliance and, at times, inequality. They also contain possibilities for agency, solidarity, and democratic expression. Children’s responses, ranging from everyday infrapolitics to activism, highlight capacity to interpret, contest, and reshape their social worlds. Moreover, participatory and dialogic approaches to learning can open spaces where intergenerational relations become more reciprocal, enabling children to articulate concerns and analyse conditions. The panel invites contributions that expand the democratic imaginary to include children as active co-participants in civic life. We welcome papers from education studies, childhood studies, sociology, political philosophy, anthropology, psychology, social policy, critical pedagogy, occupational science, and related interdisciplinary fields, drawing on theory, empirical research, or policy analysis. The panel aligns with the themes such as as Childhood, Citizenship & Social and Cultural Justice, Pedagogical Practices, Democratic Participation & School Governance, as it stresses children’s political agency and the democratisation of schooling.Item Children’s Resistance, Participation and the Scholē: Re-imagining Human Rights Education(International Association for Human Rights Education, 2026) Giatsi Clausen, MariaThis paper brings together empirical work with young children in participatory research and a critical theoretical analysis of formal schooling to argue for re-imagining human rights education (HRE) in a turbulent world. Drawing on participative research enquiry in early childhood and primary settings, the paper shows how children understand their UN rights to protection, provision and participation, yet experience these rights unevenly. While children frequently report that their participation rights are curtailed, adults often invoke protection rights to justify restrictions on children’s agency, questioning their credibility, or limiting their involvement in matters affecting them. This structural tension—between safeguarding children and enabling them to act as political subjects—emerges as a defining contradiction within contemporary schooling, in particular. These insights are placed alongside a critique of the modern school as an ideological state apparatus, where grading, surveillance and age-based organisation reproduce inequalities for both children and teachers. Using Havel’s notion of “ideological excuses” and Tesar’s theorisation of childhood subjectivities, the paper examines children’s strategic compliance, subtle resistance, and moments of solidarity with teachers, as well as the ambivalent outcomes of “counter-school” cultures. Against calls to depoliticise education, the paper argues for an openly politicised HRE that confronts the realities of domination, agency and intergenerational power. To expand the educational imaginary, the paper advances the ancient Greek concept of the Scholē as a resource for re-envisioning HRE as democratised, playful and non-commodified time for collective inquiry and action. Such spaces, within and beyond school, can nurture critical consciousness, strengthen intergenerational solidarity, and support the realisation of children’s rights—particularly their right to participate—in increasingly unequal societies.