Structuring sustainable knowledge brokering in street level organisations

Abstract Background: The idea and need for knowledge mobilization (KM) have gained traction in research and practice, but the long-term sustainability of KM practices remains challenging. Recent research suggests shifting from sustainability as an end-goal to ‘sustaining’ as actors’ work to keep knowledge translation practices productive. However, little is known about sustaining work, especially in street-level public welfare organizations.Aims and Objectives: This paper explores a) how organizational systems for sustainable KM can be built in street-level organizations, and b) how knowledge brokers in these organizations support the development of such structures.Methods: We draw on ongoing research collaboration between researchers and five Danish municipal public employment services. Data includes extensive qualitative data from interviews, fieldwork, observations, and mutual learning platforms with managers, professionals, knowledge brokers, and researchers. Data are analysed using concepts of translating, contexting, and institutionalizing KM.Findings: We identify three axes of a sustaining KM infrastructure: a horizontal axis focused on mobilizing knowledge at the professional level; a vertical axis focused on mobilizing knowledge between organizational levels; and an extra-organizational axis focused on mobilizing knowledge between the organization and the outside world, specifically research.Discussion and Conclusion: This paper highlights sustaining KM as ongoing and multifaceted work, emphasizing the role of street-level organization knowledge brokers. Their embeddedness in professional practice enables them to translate, context, and institutionalize KM. By outlining three axes of sustaining infrastructure, we suggest a framework for further research on sustaining in organizational practices.Background: The idea and need for knowledge mobilisation (KM) have gained traction in research and practice, but the long-term sustainability of KM practices remains challenging. Recent research suggests shifting from sustainability as an end-goal to ‘sustaining’ as actors’ work to keep knowledge translation practices productive. However, little is known about sustaining work, especially in street-level public welfare organisations.Aims and Objectives: This paper explores a) how organisational systems for sustainable KM can be built in street-level organizations, and b) how knowledge brokers in these organisations support the development of such structures.Methods: We draw on ongoing research collaboration between researchers and five Danish municipal public employment services. Data includes extensive qualitative data from interviews, fieldwork and observations. Data are analysed using concepts of translating, contexting, and institutionalizing KM.Findings: We identify three axes of a sustaining KM infrastructure: a horizontal axis focused on mobilizing knowledge at the professional level; a vertical axis focused on mobilizing knowledge between organisational levels; and an extra-organisational axis focused on mobilizing knowledge between the organisation and the outside world, specifically research.Discussion and Conclusion: This paper highlights sustaining KM as ongoing and multifaceted work, emphasising the role of street-level organisation knowledge brokers. Their embeddedness in professional practice enables them to translate, context, and institutionalise KM. By outlining three axes of sustaining infrastructure, we suggest a framework for further research on sustaining in organisational practices.<br/

Negative outcomes occur early among geriatric patients with early signs of dysphagia in an acute care setting

Objectives: This study aimed to investigate the clinical outcomes associated with early signs of dysphagia (SD) in geriatric patients in an acute care setting. Methods: In this prospective observational study with 18 mo follow-up, geriatric patients were screened for early signs of dysphagia in an acute care setting. Included patients were grouped based on swallowing function—SD or normal swallowing (NS). Follow-up data were retrieved from medical records on 332 patients with complete screening from baseline to 18 mo after admission. Results: Among participants, 52.0% were male, median age was 79 (25th percentile 73.0; 75th percentile 85.0) y and median BMI was 26.1 (22.4;29.8) kg/m 2. Patients with early SD had higher mortality (41.3%) compared with NS (23.3%) (P &lt; 0.001). Both mortality and readmissions occurred within the first 90 d after screening compared with after 90 d. Using multiple hazard regression analyses, risk factors for mortality were identified as increasing age, SD, nutritional risk, low performance status, increasing number of comorbidities, and inflammation markers (P &lt; 0.05). Furthermore, low performance status, a high number of comorbidities, and low hemoglobin were risk factors for readmissions within the 18 mo follow-up period (P &lt; 0.05). Conclusions: Early SD were associated with mortality after 18 mo, but readmissions were mostly pronounced within 90 d. Early dysphagia screening in older patients in general is relevant in the acute care setting as part of nursing care activities.</p

In search of alternative futures:Co-designing a situated futuring game with an indigenous San community

Mainstream design futuring methods regrettably direct the practice of designing and envisioning futures towards a narrow set of possibilities shaped by a prevailing worldview. This tendency limits the exploration of a wider and more diverse range of futures. To address this limitation, alternative perspectives of the future are needed. Therefore, in this article, we present the co-design of a design futuring game, /Xoa-!khaia, with an indigenous San community in Southern Africa. The game, as a situated tool for Community-based Futuring, aims to facilitate new visions of the future by broadening and grounding technology possibilities within the local context. We illustrate how its co-design contributes to a transition from and contentation with the status quo, opening up alternative trajectories that leverage indigenous values and practices.</p

Numerical investigation of sorption-enhanced ammonia synthesis for hydrogen storage: CFD modeling, experimental validation, and scale-up

Ammonia (NH3) is increasingly recognized as a clean hydrogen (H2) carrier due to its high H2 content, carbon neutrality, and ease of storage and transport. Realizing its potential as an energy vector requires synthesis technologies that operate under mild conditions and are compatible with water electrolysis. This study develops a comprehensive computational fluid dynamics (CFD) model of sorption-enhanced NH3 synthesis with alternating catalyst and sorbent layers, validated against experimental data, to elucidate the in-situ sorption effects. The model is subsequently employed to scale up the process and to optimize the operation conditions of a pilot-scale reactor. Results indicate a 66.8% increase in H2 conversion with a six-layer configuration, while a 60-layer pilot reactor achieves over 90% conversion and 99.5% NH3 capture in single-pass operation. These findings demonstrate the scalability and potential of sorption-enhanced NH3 synthesis, providing a moderate and efficient pathway for H2 storage and transport.</p

The effect of implementing colon capsule endoscopy in colorectal cancer screening on participation and sociodemographic inequalities:A parallel group randomised controlled trial

OBJECTIVES: Significant sociodemographic inequalities in participation in colorectal cancer (CRC) screening programmes across the globe are evident. We aimed to investigate the effect of introducing colon capsule endoscopy (CCE) as a filter test in faecal immunochemical test (FIT)-based CRC screening on overall FIT participation and social inequalities in FIT participation.STUDY DESIGN: We conducted a randomised controlled trial, randomising 368,452 individuals.METHODS: Both groups received an invitation to submit a FIT sample, which elicited a follow-up investigation if ≥ 20 μg haemoglobin/g faeces was detected. The control group followed the standard screening pathway and was referred for follow-up colonoscopy. The intervention group were free to choose between colonoscopy and colon capsule endoscopy.RESULTS: The overall FIT participation proportion was significantly lower in the intervention group (63.4 %), compared to the control group (64.9 %). All sociodemographic subgroups in the intervention group had lower participation proportions than their control group counterpart, with an average of 1.4 (range 0.3-2.7) percentage points lower participation. The odds of non-participation, divided by sociodemographic characteristics, were not significantly different between interventions and controls for any subgroup, except for those aged 55-59 in which the odds ratios for non-participation was 1.59 (1.54-1.65) in the control group and 1.48 (1.43-1.53) in the intervention group, comparing them to those aged above 70.CONCLUSIONS: Introducing a free choice between colon capsule endoscopy and colonoscopy if FIT positive did not increase FIT participation in CRC screening. Further, it did not affect the pattern of social inequalities in FIT uptake.</p

Direct connection between secondary relaxation mode and fracture toughness in alkali-aluminosilicate glasses

Oxide glasses are intrinsically brittle, lacking sufficient atomic-scale mechanisms that can relax mechanical stresses in the vicinity of a propagating crack. As a result, fracture is typically well-captured by considering local bond rupture at the crack tip. Here we demonstrate that barrier energies related to the low-temperature γ-relaxation mode in alkali-aluminosilicate glasses are inversely related to the fracture toughness measured via standardized three-point bending fracture experiments. This holds true for both a series with varying cations (Li, Na, K) and one with varying Li concentration. The structural rationale for this finding is gained via Raman spectroscopy. The findings suggest that a fundamental structural relaxation mode measured on bulk specimens can serve as an effective guideline for fracture toughness of oxide glasses. Data for additional silicate glasses support this conclusion.</p

Outpatient versus inpatient surgery for ankle fractures:A randomized controlled non-inferiority trial

BACKGROUND: Growing evidence supports a shift from inpatient to outpatient surgical treatment for ankle fractures. The primary aim of this study was to investigate the effect of inpatient versus outpatient surgery of ankle fractures on patient-reported outcome utilizing the Foot and Ankle Outcome Score (FAOS) at 12 weeks following surgery. Secondary aims were to report patients' satisfaction, adverse events, pain, physical function, and bone healing between inpatient and outpatient treatment.PATIENTS AND METHODS: The study design was a non-inferiority randomized controlled, non-blinded trial with a two-groups. Patients were randomized 1:1 to outpatient or inpatient surgical treatment. The primary outcome was the FAOS at 12 weeks. Secondary outcomes included patients' satisfaction, health-related quality of life, intensity of pain, bone union, and adverse events.RESULTS: A total of 44 patients were randomized to inpatient surgery and 42 patients to outpatient surgery. The final follow-up at 12 weeks following surgery was completed by 69 patients (80 %). The mean age of patients was 49.2 (SD 16.9), ranging from 18 to 80. Female sex represented 44 % of patients. The primary analysis revealed no statistically significant difference in FAOS subscale scores between inpatient and outpatient surgery at the 12-week follow-up Adjusted mean difference: Pain: -0.8 (95 % CI -10.7-9.0); Symptoms: 2.7 (95 % CI -6.9-12.5); ADL: -4.7 (95 % CI -13.6-4.3); Sport/Rec: 2.9 (95 % CI -15.2-9.3); and QOL: -0.7 (95 % CI -11.8-10.3). Comparable results were observed for secondary outcomes.CONCLUSION: This study showed no statistical nor clinically significant difference in FAOS subscale scores between inpatient and outpatient surgery for ankle fractures 12 weeks following surgery. Furthermore, patients' satisfaction and adverse events were comparable between inpatient and outpatient surgery 12 weeks following treatment. Results indicated that outpatient surgery for ankle fractures is highly feasible for selected patients and may be considered as routine for clinical practice.</p

Dansk handicapsociologi og det oversete syn – teoretiske potentialer og empiriske muligheder

Denne artikel tager udgangspunkt i iagttagelsen af en hidtil forholdsvis begrænset interesse inden for dansk sociologi for handicapforskning og i særdeleshed for studiet af synshandicap. Dette er interessant, ikke mindst set i lyset af udbredelsen og omfanget af forskellige former for handicap i befolkningen, herunder synshandicap, men også fordi studiet af handicap kan anses som en oplagt adgangsportal i forhold til forståelsen af mange andre sociologiske kerneområder. I artiklen gennemgås først et argument for betydningen af studiet af handicap og oplevelsen af synstab. I forlængelse heraf præsenteres kort forskellige traditioner og modeller inden for handicapforskningen, hvorefter vi vender os mod en række sociologiske perspektiver og deres anvendelighed i forhold til studiet og forståelsen af handicap/synshandicap. Artiklens argument for betydningen af et fokus på handicap og synshandicap eksemplificeres af et nyligt kvalitativt studie af senblindes oplevelser på arbejdsmarkedet og de udfordringer, der både på det individuelle og strukturelle plan er forbundet hermed. Artiklen ønsker at skabe et indledende afsæt for både teoretisk og empirisk at interessere sig for studiet af handicap generelt og synshandicap mere specifikt inden for en dansk sociologisk kontekst