Disruptions in Aesthetic Medicine: A Global Analysis of GLP-1 Agonists Using Punctuated Equilibrium Framework

Introduction The adoption of GLP-1 receptor agonists, such as semaglutide, has significantly improved obesity and type 2 diabetes management. However, their unintended side effects, particularly facial volume loss termed “Ozempic face,” have disrupted aesthetic medicine. This intersection between metabolic health and aesthetics raises ethical dilemmas and growing dependency on corrective interventions such as dermal fillers. Methods A mixed-methods approach was employed, incorporating content analysis, social media sentiment analysis, and social network modelling. Data were collected from 15 peer-reviewed studies, clinical reports, and 3.79 million social media posts across global regions. Sentiment analysis identified public perceptions, while network analysis examined influencer dominance in promoting aesthetic solutions. Results Findings revealed a 40% increase in filler consultations attributed to GLP-1-related aesthetic concerns. Sentiment analysis showed that 72% of high-engagement content was driven by influencers normalising fillers as necessary adjuncts to GLP-1 therapies. Ethical concerns were prominent, particularly in regions like Asia and South America, where commercial narratives dominate. In contrast, North America and Europe demonstrated a more balanced approach, prioritising informed patient care under regulatory frameworks. Conclusion GLP-1 therapies represent a transformative shift in metabolic care but introduce significant aesthetic, ethical, and psychological challenges. Social media amplifies commercial influences, often at the cost of evidence-based practice. Regulatory reforms, longitudinal studies, and enhanced patient education are critical to navigating this evolving landscape and ensuring patient well-being.</p

Poverty, mad dogs and culling: dogs and entitlement to poor relief in England, c. 1750-1834

During the old poor law, people were struck off relief lists for owning dogs. While authorities justified this by saying that they were curtailing the spread of rabies or helping the poor to budget better, it became an important, discretionary reason why people were viewed as entitled to poor relief or not. This aspect of welfare has received little attention from historians, but it formed a vital part of many peoples’ experiences of the poor law. People were attached to their dogs and were made to decide between killing them or accepting help that they desperately needed. In looking at this topic, this article advances our understanding of entitlement to poor relief, as well as the history of medicine and rabies, human-animal relations and societal views on the poor.</p

Expert Perspectives on Factors Shaping Metaverse Adoption for Cultural Heritage Experiences in Hospitality Industry within an Emerging Economy

Purpose –Although the Metaverse has been widely adopted in developed countries, there has not been any research investigating the implantation of this highly transformative technology in emerging economies and disadvantaged regions, such as Tunisia. This paper aims to critically explore the factors influencing the adoption of Metaverse for cultural heritage experience and discusses how will it disrupt the future of the hospitality and tourism industry. Design/methodology/approach – 44 semi-structured interviews were conducted in the Tunisian hospitality and tourism industry who provided their expert opinions during in-depth interviews. The interviews were then analysed using thematic analysis. Findings - The findings indicate that the Metaverse presents benefits, success factors and challenges for offering cultural heritage experiences in the hospitality and tourism industry and that its adoption in poor and less developed countries is nuanced. Social Implications - Leveraging the Metaverse for cultural enrichment can be a powerful tool for the socioeconomic development of underprivileged regions, provided that it is implemented inclusively to include underprivileged labour, whose work in the industry lies on the bottom of the economic pyramid. Practical Implications – The findings of the study help hospitality managers identify opportunities and challenges in Metaverse, fostering an understanding of the cultural environment and its socio-economic development as key requirements to enhance visitor experience via Metaverse tourism. Originality/value –This paper further explains the impacts of Metaverse on cultural heritage experience provided in the hospitality and tourism industry rooted in the previous literature relating to technology-enhanced experience.</p

‘You need to be built differently for a re-sit class’: further education English teachers’ views of the GCSE re-sit and its influence on their professionalism

This empirical study investigates teachers’ attitudes toward teaching the English GCSE re-sit qualification in post-compulsory education and its impact on their professionalism. It situates the work within the context of England’s 2011 English education reforms and ongoing concerns with the qualification. The study examines how 72 lecturers navigate challenges and develop professional agency. Findings reveal that institutions offering greater support tend to foster professional growth. Many educators experience frustration due to limited freedom to innovate, inadequate recognition, and lack of professional development. Yet, some practitioners report that teaching the re-sit enhances their professional skills. Open responses show that despite systemic constraints, further education teachers often demonstrate adaptability and retain some curriculum autonomy. The research highlights the value of their role, even when not fully supported by their institutions. It calls for systemic change to better support teacher agency, encourage collaboration, and redesign the qualification to meet contemporary literacy needs. The study contributes to debates on literacy education reform and teacher autonomy, recommending enhanced support and collective action among subject specialists to strengthen the effectiveness and satisfaction of teaching in this complex area.</p

From Biomechanics to Welfare: Integrative Advances in Equine Sports Medicine and Rehabilitation

Equine sports medicine continues to advance at pace, driven by innovations in technology, AI, biomechanics, exercise physiology, and clinical diagnostics [...]</p

Topographic Modeling of Equestrian Surfaces: An Innovative Perspective with Photogrammetric Aerial Survey

The topographic assessment of equestrian surfaces is essential for controlling the surface mechanical behavior and its biomechanical effects on horses. The use of Unmanned Aerial Vehicles (UAVs) emerges as a precise alternative to conventional topographic methods. This study aimed to apply the photogrammetric aerial survey method for the topographic modeling of equestrian surfaces. Thus, a survey was conducted using UAVs on five equestrian surfaces (I, II, III, IV, and V) with mechanical behavior measured through hardness, moisture, grip, depth, maximum drilling depth (MDP), and composition. The data were analyzed for normality using the Shapiro-Wilk test, homogeneity of variance using the F-test for two samples and Bartlett's test, with means compared by the Tukey test and paired T-test (P < 0.05). To quantify the effect of topography on the surface, Principal Component Analysis was used. The results demonstrate that there are differences (P < 0.05) in slope and morphology in the longitudinal and transverse measurement directions among the equestrian surfaces, as well as between the measurement directions. The observed differences result from construction processes, geographical characteristics, and soil composition. However, surface I exhibits functional slope and morphology indices for a non-constructed environment, while surface V demonstrates effective slope parameters for surfaces with a constructed base. Topography accounted for 17.86% of the total variation found. For future studies, it is recommended to investigate the effects of animal load, focusing on thehorse-hoof-surface interaction using the photogrammetric aerial survey method</p

A Comparison of Physical Characteristics in Different Brands and Staining Techniques in a Brand of Lissamine Green Strips

Backgrounds/Objectives: The aim of this study was to compare differences in the physical characteristics of lissamine green (LG) strips and the outcomes of using different staining techniques. Methods: Two separate complementary investigations were conducted. Physical study: Differences between four LG strips were evaluated in terms of material, dye concentration, and dye absorption. In vivo study: Bulbar conjunctival staining was compared for four application methods of I-DEW LG strips presented in a randomized order for twenty-two participants: (1) single application 5 s after wetting (also repeated using GreenGlo for comparison), (2) single application using two strips held together, 5 s after wetting, (3) two applications using a single LG strip 5 s after wetting, 1 minute apart, (4) the same as method 3, with a single fluorescein strip in between LG applications. White light imaging was performed immediately following application and after 30, 60, 90, and 300 s. Three masked practitioners independently evaluated the randomized staining images for spot count and staining intensity. Results: Physical study: Strip paper fibres demonstrated visible similarities, with no difference in saline absorption (p > 0.05). LG concentration increased as saline retention duration increased (F = 964.1, p 0.05); however, staining intensity was significantly higher following two applications of I-DEW, 1 min apart, compared to a single application (p = 0.042). Both spot count and staining intensity decreased with time (p </p

Higher Education Learning Experiences pre-, peri- and post-COVID-19: What will evolve, and what will survive?

This article reports the results of a mixed-methods research project at one UK university to explore student experiences before, during, and after the COVID-19 lockdowns. The research questions were ‘Which HE learning experiences will be retained?’ and ‘Which HE learning experiences will evolve?’. All final-year undergraduates in the 2021/22 academic year (n = ~3,000) were asked, via a survey and focus groups, to rate various formats of learning and teaching for their effectiveness for learning, building positive learning communities, and overall satisfaction. Students were also asked to list any features of their learning from before the pandemic that the University should reinstate, and any from during the pandemic that should be retained. Quantitative data were analysed using SPSS, and qualitative data were analysed using NVivo. Analysis suggests that prior to the lockdowns, students felt they had the full ‘university experience’ as they had anticipated. During lockdowns, students faced disorientation, isolation, and a lack of motivation, but appreciated not having to commute, and an improved work/life balance. After lockdown ended, students wanted to return to on-campus teaching, particularly for the social aspects, and to experience higher-quality teaching. Although large-group lectures on campus scored highly for both effectiveness and satisfaction, students wanted to retain recordings of live lectures for revision and unanticipated absences. Analysis by demographics indicated variations by gender, study mode (i.e. Part-Time/Full-time), learning difficulties, and caring responsibilities, emphasising the imperative to meet the differing learning needs of diverse student populations.</p

Using co-design to modify an open-source rhythm game for upper limb rehabilitation after stroke

This thesis investigates whether an open-source rhythm-based music game, modified with off-the-shelf interfaces, can serve as a low-cost and accessible platform for upper limb rehabilitation after stroke. Existing research outlines the urgent need for strategies for long-term upper limb rehabilitation interventions, particularly due to low adherence to at-home rehabilitation programmes. This research introduces the design and adaptation of innovative prototypes that combine music and gaming technologies for upper limb rehabilitation after stroke. It also delineates the significant gaps that exist in exploring the potential for existing music-based rhythm games to be used in this context and recommends future research emphasis on this basis.The research uses a participant-centred co-design approach to tailor the intervention, investigating the use of musical preferences and bespoke compositions to enhance therapeutic outcomes, and the adaptability of the intervention to accommodate different levels of hemiparesis.This study had a mixed-methods approach. Quantitative data were collected through the game’s inbuilt scoring system, demonstrating its ability to track essential formative and summative assessment metrics such as gameplay frequency, number of repetitions, and stroke survivors' scorebased progress within the game. The co-design process enabled participants to develop qualitative feedback methodologies that contributed to an iterative process of design, testing, response, and refinement.Findings highlight that long-term co-design is essential in creating effective, personalised interventions and that stroke survivors' lived experience is fundamental to include in intervention design. The intervention has the potential to facilitate a wide range of upper limb rehabilitation exercises through ‘end of movement range’ switch placements, which alleviates the need for stroke survivors to hold gaming controllers. While games that used participants' musical preferences were motivating, a method of visual, auditory and movement synchrony was developed. This further enhanced the intervention by synchronising exercise components with immersive original music compositions, pitch-based or rhythmic phrases and in-game visuals, with the goal to improving exercise timing, precision and adherence.The free open-source software is highly adaptable and can facilitate isolated, assisted, and unassisted upper limb exercises. Future research can focus on refining the gaming levels, enhancing interface mounting and including tools essential for stroke rehabilitation, such as compensation detection and online therapist intervention.This research contributes to the field of stroke rehabilitation by demonstrating the importance of co-design in prototype development and participant adherence, the synchronisation of music, movement and visuals in gaming rehabilitation interventions, and the customisation of an open-source rhythm game for upper limb rehabilitation after a stroke.</p

Pain burden and sleep quality in community-dwelling adults aged ≥50 years in Ghana: potential psychosomatic mechanisms

Objectives: Pain has been related to adverse health outcomes in old age. However, evidence from low-income countries is limited, and the potential mediators are poorly understood. Therefore, the aim of this study was to analyze the association between pain burden (PB) and sleep problems (SP) among older adults in Ghana and explore potential psychosomatic mediators.Method: We analyzed data from the Aging, Health, and Health-seeking Behavior study administered to 1201 adults aged ≥50 years. PB was assessed using the pain subscale of the Medical Outcomes Study Short Form-36. SP was assessed using nighttime/daytime SP in the last 30 days. Multivariable OLS and mediation models evaluated the hypotheses.Results: Mean (SD) age was 66.14 (11.85) years, and 63.3% were women. After full adjustment, PB (versus no PB) was positively associated with SP in the overall sample (b = 0.227, 95% CI = 0.124 − 0.331) and women (b = 0.363, 95% CI = 0.233 − 0.492) but not in men. Moreover, the association was pronounced in the ≥65 year group (b = 0.317) than in the 50-64 year group (b = 0.216). Self-rated health (54.4%), immobility (23.4%), physical activity (12.2%), restlessness (12.1%), depression (6.4%), anxiety (6.3%), and social isolation (7.2%) mediated the PB-SP association.Conclusion: PB was positively associated with SP among older adults in Ghana. Bio-psychosomatic factors were identified as potential mediators in this association. Addressing these factors may improve sleep health in older adults with pain.</p