The project focused on the Río Cruces Wetland in Chile’s Los Ríos Region, a Nature Sanctuary covering more than 6,000 hectares and recognized as the country’s first Ramsar Site. Black-necked swans, spot-flanked gallinules, Southern lapwings, Austral thrushes and dozens of other species are associated with the wetland, which is visited by both resident birds and species that migrate during the year. The landscape has changed substantially over time.

The 1960 earthquake, pollution of the Cruces River, the decline of river navigation and urban expansion are among the events that altered both the ecosystem and the relationship between surrounding communities and their territory. Researchers from IEB, the University of Concepción and other organizations worked with residents of ten rural communities between 2019 and 2023. The project was an observational study and a knowledge co-production process in which local residents helped generate, interpret and share information.

Six residents from different communities were trained as biocultural monitors and took shared responsibility for coordinating activities with families, schools and other local residents. The change from a conventional researcher-led approach was prompted partly by the COVID-19 pandemic, but the research team said the participatory structure became a methodological strength. The central question was which birds could serve as indicators of biocultural memory and landscape transformation, while also documenting places and events that formed part of the wetland’s collective memory.

Participants recognized 87 species, or 73% of the bird species recorded by the Nature Sanctuary. The research team interpreted this result as evidence of substantial local knowledge about biodiversity. Community members also used birds to identify less visible changes, including species that had disappeared from particular areas and others that had become more frequent in specific parts of the sanctuary.

The findings were based on local observations and memory within this community setting, rather than on a controlled comparison between different monitoring systems. One especially clear spatial result was the location of the 27 sites identified as having particular biocultural significance. Ninety-three percent were outside the sanctuary’s boundaries.

These places were associated with experiences through which local knowledge, biodiversity and everyday life intersected. The project recovered memories of traditional navigation along the Cruces River, which had been important for decades as a route for moving people and goods to local markets and Valdivia’s River Market. Boats also created opportunities to gather, exchange goods and knowledge, and socialize.

As roads and bridges were constructed, river travel gradually became less prominent, transforming relationships between communities and the territory. Other memories associated with the mapped sites included gathering mushrooms and medicinal plants, making handicrafts and preparing beverages. To recover place-based accounts, researchers and participants traveled by boat and walked through locations selected during the mapping process.

In describing the significance of birds, Cristóbal Pizarro, an IEB researcher and director of the Laboratory for Anthropocene Studies, said that birds allow people to recall events of profound significance. He pointed to the environmental disaster caused by pollution of the Cruces River, noting that the migration and mass die-off of black-necked swans had a deep impact on communities surrounding the area. The study also documented those who sustain local knowledge of the wetland.

Around 54 people and families participated, and researchers identified 19 individuals with particularly extensive knowledge of biodiversity and transformations in the territory. Those participants ranged in age from 20 to 85, and most were women. Their participation was closely connected to their role in caring for the territory and preserving knowledge that forms part of community memory.

Pizarro described the relationship between experienced knowledge holders and younger residents returning to the territory as part of a broader effort to strengthen intergenerational connections and recover knowledge that may otherwise be lost. Returning the information to participants was an important part of the process. The team created the documentary Voices of a Territory, which features participants’ testimonies and experiences, and presented it at the Gran Diálogo de la Memoria, or Great Memory Dialogue.

The gathering brought together residents from different communities, researchers, authorities and other stakeholders connected to the wetland, allowing recovered stories to circulate among the people whose experiences they documented. The project also produced the Manifesto for Dialogue on the Biocultural Memory of the Río Cruces Wetland Nature Sanctuary. Its seven principles address conserving and restoring the wetland and its biocultural heritage, strengthening local communities and passing knowledge to future generations.

Other initiatives also emerged from the work, including an annual Bird Festival that has drawn strong participation from local communities. The findings offer a case study of how a participatory observational method can connect biodiversity observations with community histories in a landscape affected by crisis. The results are specific to Río Cruces, where the project depended on sustained engagement, locally trained monitors and relationships with ten surrounding communities; they should not be treated as a general estimate for other wetlands.

Nevertheless, the authors say the approach could be adapted to other territories, including places affected by floods, droughts or situations where access is difficult. By documenting how residents used birds to identify ecological change while recording memories of navigation, pollution, cultural practices and daily encounters with nature, the study demonstrates how knowledge co-production can inform community monitoring and landscape conservation beyond a protected area’s legal perimeter.

Subject of Research: Biocultural memory, wetland birds and community conservation in Chile’s Río Cruces Wetland

Article Title: Research explores the valuable connection between birds, memory, and territory in Chile

Article References: Research explores the valuable connection between birds, memory, and territory in Chile. Original publication (Bibliographic details unavailable.)

Image Credits: AI Generated

DOI: Not provided

Keywords: Río Cruces Wetland, Chile, wetland birds, biocultural memory, community monitoring, knowledge co-production, participatory research, environmental history, wetland conservation, Ecology and Society, Research, explores

The stakes are far from abstract. Ableist attitudes among future physicians and dentists can shape clinical decisions, communication, and even whether disabled patients feel safe seeking treatment at all. They also influence how learners and professionals with disabilities are treated within the health system itself, affecting who gets admitted, who gets supported, and who quietly leaves the profession. The United Nations Convention on the Rights of Persons with Disabilities obliges signatory states, including Germany, to dismantle such barriers, yet until now there has been no brief, context-sensitive German tool to quantify these subtle attitudes in the very institutions that train the country’s clinicians.

What makes the new study distinctive is its methodology. Conducted between 2022 and 2024, the three-phase instrument-development project placed people with disabilities at the center of the process from the outset. Rather than treating disabled people as subjects to be measured, the researchers involved them directly as experts by experience in interpreting the construct, generating new items, and reviewing content alongside specialists in disability studies and clinical practice. This participatory approach reflects a growing consensus in disability studies that instruments about disabled people should not be built without them, and it likely explains why the final scale captures dimensions of ableism that purely academic item-writing might have missed.

The technical groundwork began with the original English Symbolic Ableism Scale, which the team subjected to forward-backward translation into German. But translation alone was not enough. The researchers complemented the translated items with de novo items generated through the participatory process, then used qualitative content analysis and content validity ratios to refine the pool. Content validity ratios quantify how many experts judge each item as essential, giving the team a numerical handle on which questions genuinely belonged. By the end of Phase 1, a 25-item pool was ready for field testing, blending classic items on denial of rights and interpersonal comfort with new material grounded in lived experience.

Phase 2 put that pool to the test in a general-population pilot sample of 210 participants. Item-level statistics from this pilot guided both conceptual and linguistic redevelopment, trimming and reworking the instrument into a 21-item pre-final version tailored for students. This iterative winnowing is standard practice in scale construction, but the Freiburg team added an unusually rigorous statistical apparatus in the final phase, in which 173 medical and dental students completed the pre-final version. Deciding how many factors underlie a set of questionnaire items is one of the most contested problems in psychometrics, and the researchers attacked it from several directions at once.

Factor retention was guided by parallel analysis, a technique that compares observed eigenvalues against those generated from random data, using both Pearson and polychoric correlations. The team also applied Velicer’s minimum average partial criterion, which identifies the point at which removing further components no longer meaningfully reduces the correlations among remaining items. A primary exploratory factor analysis using maximum-likelihood extraction with oblimin rotation, which allows the resulting factors to correlate, was then supplemented by a sensitivity analysis designed for ordinal data, employing polychoric correlations and minimum residual extraction. The convergence of these methods on the same solution strengthens confidence that the two-factor structure is not a statistical artifact.

The final scale retained just ten items organized into two complementary factors. The first, Denial of Rights and Structural Barriers, comprises six items and showed strong internal consistency, with Cronbach’s alpha of 0.81 and McDonald’s omega of 0.83. The second, Interpersonal Comfort, comprises four items with alpha of 0.70 and omega of 0.74, values acceptable for a brief subscale. The unrotated maximum-likelihood extraction accounted for 44.3 percent of total item variance, and critically, the ordinal-data sensitivity analysis reproduced every primary item-to-factor assignment, suggesting the structure is robust to the choice of statistical treatment. The two dimensions echo a classic insight from prejudice research: someone can endorse abstract principles of equality while still feeling uneasy in personal interactions with members of a stigmatized group.

Exploratory regression analyses offered intriguing, if preliminary, correlates. Lower scores on Denial of Rights and Structural Barriers were associated with female gender, enrollment in medicine rather than dentistry, and friendship with a person with disabilities. Lower Interpersonal Comfort scores were associated with medical study and with such friendship. The friendship finding is particularly interesting, because sustained personal contact has long been identified in social psychology as one of the most reliable reducers of prejudice, and the pattern here is consistent with that literature. The authors are careful, however, to frame these regressions as hypothesis-generating rather than confirmatory, given the modest sample size and single-site design.

Indeed, the team is unusually candid about the limits of the evidence. The findings provide initial exploratory support for the scale’s structure and internal consistency in a single-site student sample, but independent multisite confirmation is required before the SAS-G can be deployed to evaluate interventions or compare groups or countries. Evidence of temporal stability, meaning that scores remain consistent over time in the absence of real change, is still lacking, as are data on responsiveness to change and measurement invariance, the property that a scale measures the same construct across different populations. These are exactly the psychometric milestones that separate a promising research instrument from one suitable for high-stakes program evaluation.

Even so, the arrival of the SAS-G marks a meaningful step for German-speaking health professions education. A ten-item questionnaire that can be completed in minutes gives educators, researchers, and curriculum designers a practical tool to benchmark attitudes, track the effects of disability-awareness training, and open honest conversations about how ableism operates in clinical culture. Its participatory pedigree may prove as important as its statistics: by building the scale with disabled people rather than merely about them, the Freiburg team has modeled the kind of inclusion the instrument is designed to promote. As medical and dental faculties across Germany and beyond grapple with their obligations under the CRPD, the SAS-G offers a way to measure how far there is still to go, and whether the steps being taken are actually working.

Subject of Research: Development and psychometric evaluation of a German-language scale measuring symbolic ableism in health professions education

Article Title: Symbolic ableism in health professions education: development and initial psychometric evaluation of the German symbolic ableism scale

Article References: Hillebrecht, A.-L., Hausdorf, D., Warth, R. V. D., Jeung-Maarse, H., Fabry, G., Linde, P., Auerbacher, M., Spies, B. C., & Reissmann, D. R. (2026). Symbolic ableism in health professions education: development and initial psychometric evaluation of the German symbolic ableism scale. BMC Medical Education. https://doi.org/10.1186/s12909-026-10636-6

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10636-6

Keywords: symbolic ableism, health professions education, psychometrics, scale development, disability studies, medical students, dental students, exploratory factor analysis, participatory research, prejudice measurement, Germany, questionnaire validation

Schwab-Farrell, an assistant professor in UC’s College of Allied Health Sciences, brings an unusual dual expertise to the question. She specializes in physical therapy and experimental psychology, and her past work has centered on rigorously designed studies that collect precise data about how people with disability move, including the movement capabilities of stroke survivors. Over several years of running such studies, she noticed a troubling pattern. Participants seemed engaged while immersed in virtual reality environments or tracked by motion capture systems, but the enthusiasm did not last. They would leave the laboratory without feeling that they understood more about their own disability, or without seeing how the carefully controlled measurements collected in the session would practically help other people living with disability.

That observation coincided with Schwab-Farrell’s deepening engagement with disability studies literature, a field that seeks to prioritize the voices of people with disability rather than treating them as passive subjects. The combination proved transformative for how she thought about her own role. She has described gradually coming to understand that if she truly wanted to be an impactful disability researcher, she needed not only to study disability but also to make sure that disabled voices were an active part of the research being created. The scientific impact and merit of a study matter in an academic context, she has noted, but impactful research should also matter to the people whose lives are directly affected by its outcomes. Through this reflection, she identified a gap in her own work: she had brought her research expertise to her studies, but the pragmatic lived experience of people with disabilities had been missing.

To address that missing component, Schwab-Farrell and her colleagues designed a two-year project aimed at building a study from scratch with co-researchers who have had a stroke. The first-year discovery phase involved four iterative focus groups with five individuals, each of whom had participated in an average of eight prior stroke research studies at the University of Cincinnati. That depth of prior experience was deliberate. The team wanted the group to draw on a wide variety of research experiences so they could articulate desired study features, and so that a broad range of stroke-related disability would be represented in the findings. The goal was to get a handle on what people with stroke value in research, their likes and dislikes, before designing anything new.

The most striking finding, according to Schwab-Farrell, was that participants value peer relationships and would like to see those relationships more deeply integrated into study designs. After a stroke, relationships change, and people with stroke build a new support network. For those involved in research experiences, researchers become part of that network. This reframes the researcher-participant dynamic in a technically important way: rather than a one-directional exchange in which data flows from patient to laboratory, the interaction becomes a sustained social relationship with emotional and practical significance for the participant. Study designs that ignore this dimension may be missing one of the very features that makes participation meaningful and keeps stroke survivors engaged over time.

The participant experts also emphasized the value of being fully informed participants. That means knowing the potential benefits of a study, understanding its relevance, and seeing how the work could help other people down the road. In practical terms, this suggests that informed consent processes in rehabilitation research should go beyond legal disclosure and actively communicate the real-world translation of the data being collected. Participants in the focus groups wanted to visualize the downstream impact of their contribution, a desire that Schwab-Farrell’s earlier motion capture and virtual reality studies had failed to satisfy despite their technical sophistication.

A third theme concerned the orientation of the studies themselves. Individuals with stroke appreciated capacity-oriented studies, meaning research that emphasizes what people with stroke can do rather than focusing exclusively on deficits. Schwab-Farrell has said she thinks it is important for researchers to address this and find ways that success can occur in studies, or ways that de-emphasize individual deficits. This finding carries technical implications for outcome selection in physical and occupational therapy research. Measures framed around residual impairment can implicitly define success as the recovery of pre-stroke function, while capacity-oriented framing allows participants to demonstrate achievement within their current abilities, potentially improving engagement, retention, and the psychological experience of taking part.

The project is now moving into its next phase. Schwab-Farrell and her team of academic and stroke community researchers are using the first-year findings to design a physical or occupational therapy study that is meaningful and relevant to participants. The group held its first co-design workshop recently, with a second workshop scheduled for later in October to determine the research question. Schwab-Farrell has said the team already has some great ideas floating around and that she is excited to see what the group comes up with. This iterative structure, in which focus group findings directly shape the design of a subsequent intervention study, is an example of participatory research methodology in action rather than consultative engagement after the fact.

On a larger scale, Schwab-Farrell argues the findings can be applied by any stroke or disability researchers looking to make their studies more collaborative. In her view, collaboration should be more than consultative and more than checking a box; it should genuinely involve people with disability in all aspects of study design and production, from the development of a research question all the way to dissemination and translation. That principle, if adopted widely, would change the standard workflow of rehabilitation science. Community co-researchers would sit at the table when hypotheses are formed, when outcome measures are chosen, when protocols are piloted, and when results are communicated back to the disability community.

The study, titled ‘Some of Them Were Created by People Who Have Never Had a Stroke’: Understanding Desired Physical and Occupational Therapy Research Study Features for People With Chronic Stroke, was published in Health Expectations on 8 October 2026, and the authors declare no conflicts of interest. For a field in which stroke survivors are often recruited repeatedly for movement analyses, therapy trials, and technology evaluations, the message from this discovery phase is clear. The people who volunteer for stroke research want to form relationships, understand the real-world impact of their participation, and take part in studies that recognize their capabilities. Building those features into research design, Schwab-Farrell’s team suggests, is not a courtesy but a prerequisite for studies that genuinely matter to the people whose lives they aim to improve.

Subject of Research: Patient priorities and co-design in stroke rehabilitation research

Article Title: University of Cincinnati study finds patients participating in stroke research value forming relationships and visualizing real-world impact

Article References: University of Cincinnati study finds patients participating in stroke research value forming relationships and visualizing real-world impact. Original publication (Bibliographic details unavailable.)

Image Credits: AI Generated

DOI: Not provided

Keywords: stroke, stroke rehabilitation, disability research, participatory research, co-design, patient engagement, physical therapy, occupational therapy, Health Expectations, University of Cincinnati, shared decision-making, peer relationships

The article, authored by Tiffany J. Grant of the University of Cincinnati Libraries, proposes the Racism–Resilience Response Framework, or R3F. Its central claim is provocative: most implementation frameworks overlook racism-mediated resilience, treating racism as a background risk factor rather than a multilevel implementation determinant. Interventions, the paper argues, are never introduced into neutral environments. They land in dynamic systems shaped by structural racism, institutional disinvestment, organizational constraint, mistrust, and community-generated resilience. In these settings, implementation is an iterative process shaped by interacting forces across levels and over time—not the linear pipeline that traditional frameworks imply.

The technical case for this reframing rests on a substantial body of evidence about how racism structures the implementation landscape. Structural racism refers to processes embedded in laws, policies, and institutional practices that advantage racial groups deemed superior while oppressing groups viewed as inferior. Public health research has often and incorrectly used race as a proxy for racism, despite race having neither a biological origin nor inherent health effects. The paper traces how federal policies enforcing racial residential segregation—particularly redlining, the lawful systematic withholding of low-interest home mortgages from predominantly Black neighborhoods during the Jim Crow era—codified racial exclusion in housing and concentrated poverty through limited resource allocation, educational access, and employment opportunities.

The downstream health consequences are measurable. A 2023 study of 213 counties in 37 states found that historically redlined areas are still disproportionately inhabited by racial minorities and rank consistently worse across all Social Determinants of Health domains. An earlier economic analysis found that a one standard deviation reduction in segregation eliminates approximately one-third of the difference between Black and White individuals in most outcomes. A 2018 study linked racial residential segregation to lower survival rates among Black Americans aged 35 to 75, concluding that eliminating segregation and equalizing socioeconomic status would essentially eliminate the survival gap. Segregated neighborhoods also experience hospital closures, fewer primary care providers and pharmacies, and longer travel times to high-quality facilities—structural barriers that determine whether even well-designed interventions can achieve reach and sustainability.

Racism also operates at organizational and interpersonal levels. Organizations serving minoritized communities tend to be less resourced and more constrained in their ability to implement interventions successfully. At the clinical encounter, discriminatory interactions, stereotype-driven decision-making, and internal mistrust shape how patients experience and engage with new practices. The paper situates this within a long history of explicit medical racism, including the Tuskegee Study of Untreated Syphilis in the Negro Male and the non-consensual use of Henrietta Lacks’ cells, compounded by contemporary implicit bias and medical training that has historically conflated race with biology. Together, these experiences foster deep mistrust in the medical system and significantly alter how people engage with it.

Here the framework makes its most distinctive conceptual move: mistrust is reframed not as irrationality but as a learned response to repeated experiences of racism and exclusion—and, paradoxically, as an empowering mechanism that drives the development of powerful resilience strategies. From the Jim Crow era through the COVID-19 pandemic, communities of color have consistently shifted power away from formal government institutions toward local, community-rooted systems of care, leadership, and survival. These responses often produced results that were faster, more culturally grounded, and more equitable than official public health efforts. The paper catalogs these adaptive strategies: community-based organizations that employ members of the communities they serve and have earned trust through longstanding engagement or shared lived experience; trusted messengers who bring the authority and familiarity needed to achieve uptake of health messages; mutual aid and informal care networks; faith-based institutions; and grassroots advocacy. Collectively, these function as parallel public health infrastructures that shape how, when, and where communities engage with health information and services.

The COVID-19 pandemic offered vivid demonstrations. Marginalized communities used community-based organizations and trusted messengers to combat misinformation, encourage vaccine uptake, and provide highly effective outreach, education, and vaccination efforts. Evidence from community-based participatory research during the pandemic led to community-reported improvements in access to testing and information in African American, Native American, and Latinx communities, and informed equity-focused federal policy recommendations. One recent study found that multisector partnerships leveraged community-level data to address language, transportation, and literacy barriers, leading to the successful vaccination of 5,000 community members. Long-term simulation estimates suggest sustained multisector partnerships could prevent 880 premature deaths and save approximately 125.7 million dollars in medical costs over 20 years.

Technically, R3F is built as a modified, equity-centered extension of the Health Equity Implementation Framework, which was designed to identify factors related to uptake, healthcare disparities, and improved outcomes in marginalized communities but leaves racism largely implied rather than directly specified. Grant integrates Ellis’s Community Resilience model—which defines community resilience as the sustained ability of community systems to prepare for, withstand, and recover from acute shocks while addressing the chronic adverse effects of structural racism—and Public Health 3.0, which emphasizes cross-sector collaboration to address root causes of disease. Under the outer context, R3F details how housing, education, policing, and healthcare access-based structural racism drive inequitable conditions. Within the inner context, racism influences trust levels and healthcare system engagement. At the patient-provider level, historical and ongoing medical harm creates heightened mistrust alongside adaptive, culturally grounded coping strategies, including reliance on trusted messengers and protective skepticism toward institutions with histories of racialized harm. At the societal level, R3F asserts that racism is an all-encompassing root determinant on which all other determinants rest.

The framework operationalizes these concepts through a four-step participatory process. Step one, team formation and framing, assembles a multisector governance team of implementation scientists, clinicians, health system leaders, and community stakeholders—including faith-based leaders, mutual aid groups, and community-based organization leaders—as co-designers with genuine decision-making authority. Step two, multilevel assessment and mapping, uses geospatial analyses, policy review, census indicators, interviews, surveys, and focus groups to characterize formal and informal community-generated health infrastructures, synthesizing the data into a determinant map showing how racism impacts outcomes and how resilience systems support engagement. Step three, determinant mapping and strategy design, co-designs equity-centered strategies—modifying eligibility criteria, decentralizing service delivery, formalizing partnerships with community organizations, and building the capacity of trusted messengers—while deliberately avoiding the replication of inequities by supporting and compensating under-resourced community organizations rather than burdening them. Step four, equity-focused evaluation, disaggregates traditional implementation outcomes by race, ethnicity, and neighborhood, and measures shifts in trust, perceived discrimination, and community-defined indicators of success.

Crucially, R3F rejects the linear deployment model. Community governance structures with genuine decision-making authority guide ongoing oversight, interpretation of quantitative and qualitative data, and adaptation of strategies in response to newly identified racism-related barriers and resilience-related opportunities. The participatory emphasis is grounded in a stark finding: a recent assessment of active implementation science grants found that only 3 percent included community engagement through a partnership model, considered the highest level of engagement. The paper acknowledges substantial challenges—measuring structural racism and resilience remains difficult, mistrust is operationalized in various ways across validated measures, and authentic partnerships take time, staffing, funding, and expertise many teams lack. It also cautions that the framework, while illustrated with examples rooted in Black communities’ experiences, requires sensitive consideration of local histories, power dynamics, and community priorities when applied to other racialized groups, since no community is alike. Empirical testing is still needed. But the author argues these challenges do not diminish the framework’s value; they emphasize why an approach like R3F is needed to guide more thoughtful, responsive, and equitable implementation efforts—making equity not an aspirational goal but a core operational tenet of implementation design.

Subject of Research: Equity-focused implementation science framework integrating structural racism and community resilience

Article Title: Racism as context and resilience as infrastructure: the racism–resilience response framework for equity-focused implementation

Article References: Grant, T. J. (2026). Racism as context and resilience as infrastructure: the racism–resilience response framework for equity-focused implementation. Frontiers in Health Services, 6, Article 1955240. https://doi.org/10.3389/frhs.2026.1955240

Image Credits: AI Generated

DOI: 10.3389/frhs.2026.1955240

Keywords: implementation science, health equity, structural racism, community resilience, R3F, medical mistrust, Health Equity Implementation Framework, Public Health 3.0, community-based organizations, trusted messengers, evidence-based interventions, participatory research

The research team, led by Lukas Wohofsky and colleagues at Carinthia University of Applied Sciences, grounded the project in the Open Innovation in Science framework, a transdisciplinary approach that opens research directions to contributions from outside traditional academic circles. Rather than prescribing solutions, the researchers structured the process so that participants themselves decided what to develop. This design choice reflects a broader shift in how autism is understood. Older classifications such as Kanner or Asperger autism and labels like high- or low-functioning have fallen out of favor within the autism community, replaced by a neurodiversity perspective that views human minds and brains as naturally diverse rather than divided into normal and disordered.

The neurodiversity paradigm, coined by researchers on the autism spectrum in the late 1990s, argues that neurological differences such as autism, ADHD, and dyslexia should not by definition be treated as disorders but as expressions of natural human variation, comparable to differences in ethnicity, gender, or culture. This marks a fundamental departure from the traditional medical model of disability, which often frames neurological differences as deficits. Instead of adapting autistic people to a supposed norm, the neurodiversity approach calls for reshaping social structures so that everyone can participate equally regardless of neurological traits. According to a systematic review cited by the authors, approximately one percent of the world’s population is on the autism spectrum, making the stakes of such structural change enormous.

Participatory research, in which community members collaborate with researchers throughout the scientific process, offers a natural vehicle for this paradigm. Yet it carries well-documented risks. The authors highlight tokenism, the practice of including affected individuals merely symbolically without real influence, as one of the most pressing concerns. Emotional overload can also arise when participants face unclear roles or overwhelming demands. A further complication is the reliance on neurotypical mediation, in which neurodivergent perspectives must be translated by third parties into academically acceptable language, potentially undermining the very goal of genuine participation. Classic models such as Arnstein’s ladder of participation place much autism research at its lower rungs, where tokenism flourishes.

To avoid these pitfalls, the project drew on Cornwall’s Continuum of Participation, a more flexible framework that does not assign normative value to specific levels of involvement. Instead, it allows participation to range from information-sharing to full empowerment depending on participants’ needs and preferences. This adaptability proved crucial for autistic contributors, for whom participation is often highly situational, shaped by fluctuating energy levels, masking behaviors, and constant self-regulation in response to neurotypical expectations. By enabling researchers to adjust roles and responsibilities dynamically, the model reduces the risk of tokenism and supports ethically sound collaboration.

The project unfolded in five phases. First, a survey on daily-life challenges was distributed through autism organizations, clinicians, and practitioners across Carinthia. Fifty-five people completed it, including fifteen autistic respondents, eight informal caregivers, and eighteen formal caregivers. Respondents rated twelve areas of daily life on a ten-point scale from pleasant to stressful, with an overall average of 7.1, indicating substantial strain. Social contacts emerged as the most stressful domain at 7.9, followed by public transport at 7.7 and education at 7.5. Across all areas, the three most frequently cited challenges were crowds, sensory overload, and a lack of awareness among neurotypical people in both child and adult settings.

The survey results fed into participatory kickoff events, held both in person and online to lower barriers to entry, where preliminary findings were discussed and potential contributors recruited. An online questionnaire then asked interested participants to rate fourteen candidate topics and provide information on location, travel willingness, and time resources. From this, six working groups formed around the domains of Working Life, Education, Public Authority Contacts, Shopping, Healthcare System, and Information, Networking, and Exchange. In total, forty people joined a group at least temporarily, with twenty-eight remaining active at the project’s end. Twenty-nine percent of the active citizen scientists were themselves on the autism spectrum. The groups met every two to four weeks for roughly eight months, mostly in person in three Carinthian cities, and were guided by the Dragon Dreaming method, a four-phase project design process of dreaming, planning, doing, and celebrating that requires no prior research experience.

The outcomes were strikingly concrete. The Education group developed a training program with the Caritas School for Social Care Professions, compiled into a booklet offering practical guidance for supporting autistic pupils, covering sensory sensitivity, classroom organization, lesson design, and examination accommodations. The Healthcare System group surveyed community experiences with health professionals and produced a guide to autism-inclusive providers in the region, aiming to transform stressful visits to dentists or therapists into manageable experiences. The Information, Networking, and Exchange group assembled 396 toolboxes containing informational and sensory materials, including items like fidget spinners and stretchable cords, distributed to schools, kindergartens, and healthcare organizations throughout Carinthia. The Shopping group piloted a peer-shopping assistance service in which autistic companions accompanied peers who found stores overwhelming, a concept now handed to a local NGO for further development. The Public Authority Contacts group printed and distributed more than 500 awareness brochures to government agencies, police, and emergency services, while the Working Life group produced flyers for employers and job-search guides for autistic job seekers.

Project evaluation confirmed the value of the approach. Twenty-five participants completed a reflection questionnaire based on the Open Innovation in Science impact tools of the Ludwig Boltzmann Gesellschaft. All respondents agreed or strongly agreed that they had done something meaningful through their participation, twenty of twenty-five agreed or strongly agreed that the project improved the situation of those affected, and the overwhelming majority expressed satisfaction with both the results and their degree of co-determination. These findings align with a growing body of literature, including work by Pellicano and colleagues and the co-production reflections of Stark and colleagues, showing that when autistic people hold significant decision-making power, research agendas and outcomes better reflect community priorities and lived experience.

The authors are candid about the project’s limitations. The initial decision to hold in-person meetings may have excluded potential participants who preferred virtual or asynchronous involvement, and communication challenges arose during early ideation stages. Group composition, driven by practical considerations of interest and geography, produced an uneven distribution of autistic members across groups, with one group composed entirely of autistic individuals and others containing none. The Dragon Dreaming method, while accessible, has seen little use in scientific research, which limits the comprehensibility of results. Still, the authors argue that the benefits of community-driven research outweigh these difficulties. They recommend broadening geographic reach, enabling virtual and asynchronous participation, refining communication strategies, and conducting long-term follow-ups. As a context-specific example from a region where participatory autism research remains rare, the Carinthia project offers a compelling demonstration that the people closest to the challenges of autism are often best positioned to design the solutions, provided research institutions are willing to share genuine power.

Subject of Research: Participatory research with autistic citizen scientists to develop autism-inclusive environments in everyday life

Article Title: Development of Autism-Inclusive Approaches for Everyday Life in a Participatory Process: From Challenges to Resolutions

Article References: Wohofsky, L., Küffner, C., Fink, S. H., Sulopuisto, O., Orter-Jerney, R., Seifert, N., & Krainer, D. (2026). Development of Autism-Inclusive Approaches for Everyday Life in a Participatory Process: From Challenges to Resolutions. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-026-07570-3

Image Credits: AI Generated

DOI: 10.1007/s10803-026-07570-3

Keywords: autism, participatory research, citizen science, neurodiversity, Open Innovation in Science, autism-inclusive environments, Carinthia, Dragon Dreaming, daily living challenges, community-based research, healthcare access, education inclusion

The study, published in Frontiers in Global Women’s Health, used a narrative inquiry design embedded within a larger participatory action research project. Each of the eleven participants took part in two in-depth interviews lasting up to two and a half hours, followed by three sequential focus groups held between February and May 2025. Rather than fragmenting the women’s accounts into codes and categories, the team applied Riessman’s thematic and structural narrative analysis, treating the stories as wholes. They paid attention not only to what was said but to how it was told: the sequencing, repetitions, interruptions, and omissions that revealed how the women made sense of their lives. The researchers then wove the material into composite narratives, first-person accounts built from multiple participants’ verbatim words, a strategy chosen to protect anonymity for women escaping abusive partners or hiding their housing insecurity from their own families.

The health burden the women carried was staggering. Every single participant met the criteria for multimorbidity, meaning two or more co-existing chronic conditions, a profile associated with reduced function, increased health service use, and premature death. Their conditions spanned diabetes, heart failure, cancer, chronic pain, arthritis, memory problems, depression, anxiety, and post-traumatic stress disorder, with many health problems attributed to or worsened by past intimate partner violence, which ten of the eleven women reported. Long-term homelessness is known to accelerate aging, with people experiencing homelessness presenting health profiles comparable to housed individuals ten to twenty years older. That is why age 50 is widely accepted as the threshold for older in homelessness research, and why women aged 55 and older now constitute the majority of visibly homeless women in Canada.

From the analysis, two storylines emerged. The first, which the researchers named Hurry up and Wait, captures the cruel rhythm of bureaucratic systems that appear to offer help while simultaneously disempowering the people they serve. Women described shelters as unsafe and unstable yet nearly impossible to exit. One woman recounted bed bugs, lice, and the risk of being barred from the shelter entirely if staff suspected she was photographing conditions on her phone. Another described how a case manager required her to phone every two weeks to keep her place on a waitlist for accessible subsidized housing, and how a full voice mailbox could cost her that spot. Mandatory workshops on resume writing and nutrition were repeated regardless of need, and one facilitator’s joking tone during a session on intimate partner violence left participants distressed.

The composite narrative of Marilyn, assembled from several women’s experiences, illustrates how these constraints compound. After a stroke at 54 ended her work and driving, she cycled through an emergency shelter, a hostile relative’s home, and her daughter’s apartment, all while facing rents above $1,200 against income support of less than $1,000 a month. A missing credit history, destroyed by an ex-partner’s fraudulent cards, and mobility limitations that ruled out staircases closed off even the cheapest options. Full disability benefits, which might have changed the math, required yet more medical documentation, expensive taxi rides, and waits of more than a year to see a neurologist. Seniors housing with elevators and lower rents sat just out of reach behind an age-65 eligibility threshold. Her summary was blunt: stuck everywhere.

The second storyline, Making lemonade, documents what the women did inside these constraints. They formed bonds in shelters that outlasted re-housing, talking daily and providing emotional support across the city. They searched for housing together, attended each other’s medical appointments, and exchanged tips on navigating resources. One participant, a recognized artist, offered to teach craftwork in the shelter; another used her computer skills to file housing applications not only for herself but for other residents. Women advocated at building meetings in transitional housing, set boundaries against drug smoke and violence, and used humor strategically, greeting shelter staff behind the glass with a cheerful line that, as one woman recalled, made her smile for the first time.

It is this relational labor that the researchers propose as a previously unrecognized form of social capital. Social capital, in the sociological sense, refers to the resources people derive from their networks and relationships, and it has been mapped in homelessness research across three domains: interpersonal relationships, access to formalized services, and the exchange of emotional, practical, and informational support. The Calgary women built bonding relationships with socially similar peers and bridging relationships with service providers who treated them with dignity. They worked to repair family ties, maintained fierce identities as mothers and grandmothers, and drew on cultural teachings about looking out for one another. In the language of urban geography, they functioned as people as infrastructure, informal networks of cooperation that patched over the fragmentation and under-resourcing of formal systems.

The researchers are careful to note the limits of this finding. Mutual aid, however productive, cannot substitute for housing and healthcare, and other scholars have cautioned that homelessness itself undermines the reciprocity and autonomy that sustain social capital. The structural barriers the study documents are formidable: affordable housing stock that has declined since federal withdrawal from housing provision in the 1980s and 1990s, income supports so low that some women continued working low-wage jobs despite serious illness, and specialist care waits that rippled outward, blocking disability income, transportation passes, and housing waitlists that all demanded medical proof. Age-based eligibility criteria excluding adults under 65 from seniors’ housing left a gap that the study’s participants, most aged 57 to 64, fell straight through.

The study’s methods deserve attention in their own right. The work grew out of the Exchange, a collective of older adults with lived experience of late-life homelessness who co-direct research aimed at improving services. Recruitment used snowball sampling through shelters, transitional housing, and an elder abuse shelter, and the team employed a trauma-informed approach throughout, providing transportation, food, honoraria, and process consent revisited at every encounter. The authors acknowledge limitations: the sample was intentionally small, and Black, Indigenous, and people of color, as well as LGBTQ and Two-Spirit participants, were underrepresented relative to their prevalence in the homeless population, a gap the researchers attribute partly to recruitment pathways that reproduce the same structural barriers the study examines.

The implications reach from clinic to legislature. For health providers, the findings underscore the gendered nature of late-life homelessness and the value of trusting, person-centered primary care relationships, which ten of the eleven women had established. For homelessness organizations, the study argues for relational continuity and manageable caseloads to counter the burnout and turnover that erode the few supportive connections women found. For policymakers, the message is that older women’s lived expertise must inform system design, and that trauma-informed, age- and ability-specific services are likely to yield high returns while preventing the institutionalization the women themselves identified as their greatest fear. Behind the policy language, though, is the study’s central, quietly radical observation: the women it followed were never simply waiting to be helped. They were helping, every day, in ways no system counted.

Subject of Research: Experiences of aging, health, and homelessness among older women and their mutual support networks

Article Title: Help me, and I'll help myself (and others). A narrative inquiry into older women's experiences of health and homelessness

Article References: Nixon, L., Boyling, E., Mierau, E., Hughes, R., Ugburo-Shanomi, J., & Kelly, M. (2026). Help me, and I'll help myself (and others). A narrative inquiry into older women's experiences of health and homelessness. Frontiers in Global Women's Health, 7, Article 1740814. https://doi.org/10.3389/fgwh.2026.1740814

Image Credits: AI Generated

DOI: 10.3389/fgwh.2026.1740814

Keywords: homelessness, older women, aging, social capital, narrative inquiry, health equity, shelters, housing policy, caregiving, structural stigma, participatory research, Canada

The review, led by Soutongnoma Safiata Kaboré and colleagues, set out to answer a deceptively simple question: to what extent does AI research in health actually contribute to inclusive technologies for people with disabilities? To find out, the team searched four major biomedical and scientific databases, MEDLINE, Embase, Web of Science, and CINAHL, for studies published over a ten-year window. They followed the five-stage scoping review methodology developed by Arksey and O’Malley and adhered to the PRISMA-ScR reporting guidelines, a framework designed to make systematic reviews transparent and reproducible. The initial search pulled up 4,233 references; after screening, eligibility checks, and inclusion decisions, 93 studies remained.

The geography of the included research tells its own story. Nearly three-quarters of the studies came from just two regions: North America accounted for 45.2 percent of the corpus and Europe for 26.9 percent. That concentration matters, the authors argue, because disability is not distributed evenly across the globe, and the technological priorities of high-income research ecosystems may not map onto the needs of communities where access to assistive devices, rehabilitation services, and even basic healthcare infrastructure is far more limited. An AI-powered prosthetic control system developed and tested in a North American lab, however sophisticated, says little about what is feasible or useful in settings where such devices never reach the clinic.

What the studies did cover was broad. The AI applications identified in the review targeted five major categories of disability: motor, sensory, cognitive, communication-related, and psychosocial. The dominant use cases clustered around three functions: prediction and diagnosis, assistive technologies, and personalized care. In practice, that means machine learning models trained to detect conditions earlier, smart systems designed to help people navigate their environments or communicate, and adaptive tools that tailor interventions to individual users. These are precisely the areas where AI’s pattern-recognition strengths align with the day-to-day challenges of living with a disability, which makes the field’s equity gaps all the more striking.

The review’s central finding lies in the gap between rhetoric and action. Roughly 60 percent of the included studies referenced equity in some form, whether in their framing, their limitations sections, or their discussions of future work. Yet when the researchers looked for concrete measures, adapting tools for vulnerable groups, ensuring diversity in training datasets, or accounting for the specific constraints faced by disabled users, only 12 studies, or 12.9 percent, had implemented anything of the sort. The rest treated equity as a talking point rather than an engineering requirement. In machine learning terms, this is the difference between acknowledging that a model may perform poorly on underrepresented populations and actually auditing its performance across those populations, rebalancing the training data, or redesigning the interface for users with different sensory or motor capabilities.

Even more revealing is the participation gap. Only six studies, 6.5 percent of the total, actively involved people with disabilities through co-design or user validation. Co-design, in the participatory design tradition, means that end users are not merely test subjects at the end of a development pipeline but collaborators who shape requirements, prototypes, and evaluation criteria from the start. User validation, a weaker but still meaningful form of involvement, at least puts the finished tool in front of the people it is meant to serve before deployment. That 93.5 percent of AI health studies aimed at disability did neither suggests that the field is still operating on an outdated model in which experts build for users rather than with them, a model that disability advocates have spent decades pushing back against.

The technical roots of this exclusion are well understood, even if the remedies remain underused. Algorithmic bias arises when training data fail to represent the diversity of the population a model will serve; a speech recognition system trained primarily on non-disabled speakers, for example, may struggle with the atypical speech patterns associated with some communication disabilities, effectively locking those users out of voice-based interfaces. Non-representative datasets compound the problem at every stage, from feature engineering to performance evaluation, because a model can only be as inclusive as the evidence it learns from. And when people with disabilities are absent from the design process, the resulting applications often encode assumptions, about dexterity, vision, cognition, or communication, that simply do not hold for the users they claim to target.

Why does this matter beyond the research community? People with disabilities make up 16 percent of the global population, and AI, deployed well, could enhance their autonomy, access, and quality of life in transformative ways. Predictive models could catch secondary complications before they escalate. Assistive technologies powered by computer vision or natural language processing could open up environments, physical and digital, that were previously inaccessible. Personalized care systems could adapt rehabilitation and support to individual needs rather than forcing users through one-size-fits-all protocols. The review affirms that this potential is real. But it also shows that potential is being squandered when the tools are built without the populations they are meant to serve, because exclusion at the design stage tends to reproduce exclusion at the point of use.

The authors frame the way forward in terms of socially responsive innovation. Realizing AI’s promise for people with disabilities, they conclude, will require moving beyond technical optimization, the pursuit of ever-better accuracy scores on benchmark datasets, toward inclusive design, participatory methods, and equity-driven frameworks aligned with responsible AI development and use. In concrete terms, that means treating sample diversity as a methodological requirement rather than an afterthought, building co-design into research budgets and timelines, and evaluating AI applications not only on how well they perform but on who benefits and who is burdened. It also means recognizing that equity considerations belong in the earliest stages of a project, when requirements are defined and datasets are assembled, because retrofitting inclusivity onto a finished algorithm is far harder than building it in from the beginning.

The review arrives at a moment when AI in healthcare is scaling faster than the safeguards around it. As health systems around the world begin integrating AI tools into diagnosis, care planning, and patient communication, the question of who those tools serve is no longer academic. A field in which fewer than 7 percent of studies involve the end users they target, and in which concrete equity measures appear in fewer than 13 percent, has a long road ahead. But the authors see the decade of research they surveyed not as a record of failure so much as a map of opportunity: the technical foundations are being laid, the methods for participatory and equitable design exist, and the remaining task is to connect the two. For the 1.3 billion people with disabilities worldwide, that connection cannot come soon enough.

Subject of Research: The contribution of artificial intelligence research to inclusive health applications for people with disabilities

Article Title: Contribution of artificial intelligence research to the development of inclusive applications for people with disabilities: A scoping review (2015–2025)

Article References: Kaboré, S. S., Bayani, A., Ewane, L. P. E., dos Anjos, D. S. O., Nikiéma, J. N., & Mac-Seing, M. (2026). Contribution of artificial intelligence research to the development of inclusive applications for people with disabilities: A scoping review (2015–2025). PLOS Digital Health, 5(10), e0001749. https://doi.org/10.1371/journal.pdig.0001749

Image Credits: AI Generated

DOI: 10.1371/journal.pdig.0001749

Keywords: artificial intelligence, disability, digital health, health equity, assistive technology, algorithmic bias, inclusive design, participatory research, scoping review, machine learning, co-design, accessibility

The study, published in BMC Public Health by Rathi Ramji and Therese Sterner of Malmö University, is remarkable not only for what it found but for how it found it. It forms part of a larger program called Kids in Action for Health Equity, or KAHEQ, which runs in three leisure time centers in the Malmö districts of Lindängen, Rosengård and Helenholm. These are neighborhoods that reports by Save the Children have flagged for concentrated child poverty, characterized by unemployment, overcrowded housing, limited leisure opportunities and safety concerns linked to criminality. Many families there have migrated from the Middle East or Eastern Europe, and language barriers can make accessing services and social participation harder.

What sets the study apart methodologically is that the children were not merely consulted. They were co-researchers. Over twelve months, from June 2023 to June 2024, the researchers met weekly with the children in a participatory action research design, building on community-based participatory research principles pioneered by Kurt Lewin and grounded in Amartya Sen’s capability approach, which treats children as active agents with their own goals rather than passive subjects of adult decisions. The children received identity cards reading Child Co-Researcher, visited the university to see the adult researchers’ workplace, wrote their own code of conduct with consequences gentler than school punishments, and, crucially, took ownership of the analysis itself.

The technique at the heart of the project was photovoice, a method developed by Caroline Wang and Mary Ann Burris in which participants photograph aspects of their lives and interpret the images through group dialogue. But here the children reshaped it into something new, which the authors call Participant Led Collaborative Photovoice, or PLCP. Instead of discussing individual photographs, the children worked in small groups to build collages, wrote presentation scripts together, and presented their collages to their peers. The audience groups then acted as co-researchers, asking probing questions and creating insight cards on post-it notes that summarized keywords from the discussions. The presenting group could correct or refine these cards on a whiteboard, keeping the interpretations child-led every step of the way.

From this material, three themes crystallized, and the children themselves clustered the insight cards and negotiated the labels. The first was feeling safe and supported. The children described security as dynamic and relational: it grew out of calm, emotionally available adults who listen rather than judge, and out of reliable access to material resources. One ten-year-old girl explained, You feel safe knowing that you have an adult to talk to. And that makes us feel good. Another girl, aged eleven, was blunt about the alternative: If adults yell, it doesn’t feel good. It feels better when you get to talk about things instead of just being yelled at. The researchers note that this sensitivity to tone resonates with attachment theory, which holds that responsive adults provide the secure base children need to explore the world with confidence.

The material side of that theme may raise eyebrows in a country that offers free child health services, education and social services until age eighteen. The children emphasized surplus food, clean public spaces, functioning dustbins, clean toilets, and sports equipment as foundations of wellbeing rather than luxuries. Food, they said, was not just about quelling hunger but about the freedom to eat as much as they wanted, which produced a feeling of security. One ten-year-old boy put it plainly: We need to be able to eat as much as we want. Then we feel safe and feel good. Another twelve-year-old explained that without balls and other equipment, recess becomes boring and we do not feel good. The authors interpret this focus as possible awareness of poverty-related constraints at home, where financial strain and crowded housing make such access uncertain, even as prior research links food security and equipment access to measurable improvements in health outcomes.

The second theme, belonging and being included, captured a distinctly social understanding of wellbeing. The children framed fairness and equality as rights, not privileges, insisting that respect should not depend on gender, religion, language, appearance or economic background. Everyone is equally valuable, boys and girls, one ten-year-old girl said. You feel good when you don’t feel judged, even if you’re different. For children navigating multiple cultural contexts, the researchers suggest, this emphasis may reflect lived experience of exclusion or discrimination. The children also described happiness as a collective journey rather than an individual state, expressed through shared games, dancing, drawing and music with friends. And they singled out having a voice: being genuinely involved in decisions, through democratic voting and polling, made them feel important. We get to be part of making decisions, an eleven-year-old boy said. If you say something and it is taken seriously, it means a lot, then you feel important.

The third theme, growing and developing as a person, linked wellbeing to learning and transformation. The children described learning new skills beyond school, from dance and music to horseback riding, and spoke of the confidence that comes from thinking independently and trying things they had never done before. When you get to think for yourself, come up with ideas, and do different things, it makes you feel smart, you can feel yourself growing, one ten-year-old girl reflected. Others framed it in moral terms: It is not just about having fun, but also about becoming a better person. We have learned how to behave and how to be a good friend. The authors connect this to Vygotsky’s sociocultural theory, in which play creates a unique space for children to take on new roles and act beyond their usual level of competence, and they suggest that for families with limited financial resources, community-based leisure centers may be the only arena where such developmental opportunities exist.

The researchers were careful about the power dynamics inherent in adult-child research. Every session opened and ended with open reflections in which children could voice discomfort, note whether adults had taken too much space, or say whether they felt unheard. Adults were never allowed to outnumber children at any session, so that adult voices could not dominate the democratic decision-making. Activity leaders, themselves often born and raised in the same neighborhoods and several of them former attendees of the centers, served as trusted bridges between the researchers and the children, functioning much like the cultural brokers described in earlier literature. Concerns were followed up in weekly planning meetings, and trust was treated as a dynamic process to be renegotiated continuously rather than a box checked once.

The implications stretch well beyond Malmö. As wellbeing becomes increasingly recognized as a social determinant of health, the study shows that children’s own definitions can diverge sharply from the assumptions baked into assessment tools and policy frameworks designed by adults. Several conditions the children named as defining are typically invisible in wellbeing surveys precisely because more privileged settings take them for granted. The findings, the authors argue, underscore the need for interventions and policies that address structural and environmental barriers rather than applying a one-size-fits-all model of the kind Michael Marmot has criticized for ignoring social gradients in health. They also align with the World Health Organization’s recommendation to invest early in children’s wellbeing to reduce health inequalities. The children, having co-analyzed their own data, presented the final themes to their parents and the centers’ leadership, and the results will feed into the ongoing development of a culturally aligned survey tool to measure wellbeing among children in similar contexts. In a field where children are often asked for their opinions but rarely given real influence, that may be the study’s quietest and most radical finding: the kids did not just define wellbeing. They demonstrated it.

Subject of Research: Participatory photovoice research on how migrant-background children in socioeconomically disadvantaged Swedish neighborhoods define wellbeing

Article Title: Understanding wellbeing together with children from migrant backgrounds living in socio-economically disadvantaged neighborhoods- A participatory photovoice study

Article References: Ramji, R., & Sterner, T. (2026). Understanding wellbeing together with children from migrant backgrounds living in socio-economically disadvantaged neighborhoods- A participatory photovoice study. BMC Public Health, 26(1), Article 2944. https://doi.org/10.1186/s12889-026-29910-9

Image Credits: AI Generated

DOI: 10.1186/s12889-026-29910-9

Keywords: child wellbeing, photovoice, participatory research, migrant children, health equity, social determinants of health, Malmö, community-based participatory research, leisure time centers, social inclusion, UNCRC, public health

Tef holds a singular position in Ethiopia’s agricultural economy. The self-pollinated warm-season cereal originated in Ethiopia and covers approximately 2.8 million hectares, the largest area among all cultivated crops in the country, contributing 17.57 percent to total grain production. Ethiopia produces over 95 percent of the world’s tef output, often reaching 4.8 million metric tons annually. The crop is valued for its exceptional nutritional profile, being gluten-free, rich in minerals and protein, and free from storage pests. Beyond the grain, tef straw is the most appreciated feed for cattle and is used to reinforce mud plaster for house walls and local grain storage facilities. The crop’s ecological resilience is equally remarkable, as it tolerates low moisture conditions and is often called a rescue crop because it can survive when earlier planted crops fail, making it a low-risk option for farmers facing erratic rainfall.

Despite this importance, tef productivity in the study areas remains very low due to several production constraints. Farmers face erratic distribution of rainfall, drought, diseases such as yellow rust, insect pests including shoot fly, and low adoption of improved tef production packages due to poor extension approaches. In Ethiopia, about 80 percent of the country’s 120 million population lives in rural areas where agriculture dominates the economy, providing 72.7 percent of employment opportunities and contributing 42 percent to the gross domestic product. Smallholder farmers account for 90 percent of the cultivated land, yet the sector is characterized by low productivity, traditional farming methods, and limited access to resources and markets. The Government of Ethiopia has established agricultural research institutes aimed at promoting demand-driven agricultural technologies to enhance production and alleviate food insecurity, and this demonstration initiative represents one such effort to bridge the gap between research and practice.

The study was conducted in the major tef-producing areas of eastern Amhara, with experimental sites purposively selected based on their high potential for tef production. Kobo District sits at approximately 1468 meters above sea level, Habru District at about 1825 meters, and Kalu District at 1492 meters. The areas experience a bimodal rainfall pattern with the main Kiremt season from June to September and the short Belg season from February to May. The researchers used the Farmer Research and Extension Group approach, a participatory research method in which researchers, extension workers, and groups of farmers collaboratively conduct research on selected topics based on farmers’ needs and interests directly in their fields. The experimental treatments included three management practices: the improved Mena tef variety with improved management, local tef varieties with improved management, and local tef varieties under traditional farmer management. Agronomic practices followed standard recommendations, with NPS fertilizer applied at 121 kilograms per hectare at planting and Urea at 100 kilograms per hectare in two splits.

Data collection was comprehensive, encompassing biological parameters such as grain yield, straw yield, plant height, and panicle length, economic data including market prices and input costs, and social data covering farmers’ perceptions and preferences. The researchers analyzed the data using analysis of variance through Gen Stat software, Duncan’s Multiple Range Test to compare means, partial budget analysis following CIMMYT guidelines to determine economic advantage, and pairwise ranking to analyze farmers’ preferences. Field days and field visits were organized at both the vegetative and maturity stages of the crop, during which host farmers and neighboring farmers participated in evaluating the performance of the tested technologies.

The analysis of variance results revealed no statistically significant differences in grain yield and biomass among treatments across all three districts, though numerical differences were noted. At Kobo, the Mena variety with improved management recorded the highest mean values for plant height at 119.0 centimeters, panicle length at 44.0 centimeters, biomass yield at 5.33 tons per hectare, and grain yield at 0.88 tons per hectare, with significant differences observed only for plant height. At Habru, the Mena variety showed significant differences in plant height and panicle length. At Kalu, Mena maintained its numerical advantage in grain yield at 1.36 tons per hectare and panicle length at 45.9 centimeters, although differences among treatments were not statistically significant. The coefficients of variation were relatively high in Kalu, particularly for grain yield at 38.8 percent, indicating notable variability among treatments and across locations due to pest or disease damage. These findings suggest that environmental conditions and pest or disease pressure play a crucial role in determining yield performance, even when improved varieties and management combinations can influence vegetative growth traits.

The partial budget analysis demonstrated clear economic differences among the tested treatments when evaluated using the marginal rate of return, an essential decision-making tool that measures the additional return obtained for each additional unit of cost incurred when shifting from a lower-cost to a higher-cost treatment. In Habru and Kalu districts, the improved Mena variety with recommended management produced positive marginal returns of 33.46 Birr and 1.34 Birr respectively, meaning each additional Birr invested in the improved package generated those amounts after covering additional input costs. According to CIMMYT guidelines, a marginal rate of return greater than 100 percent indicates strong economic feasibility, while below 50 percent suggests limited attractiveness. Therefore, the investment was profitable with a minimum rate of return in Habru and Kalu. However, in the Kobo district, the improved Mena variety with the full management package did not provide additional net benefit compared with the local Boset variety under farmers’ practice. This outcome may be attributed to the early maturity and high yield potential of the Boset variety under moisture-deficit conditions, which can reduce production risks and labor requirements while maintaining profitability.

Farmers’ preference analysis through pairwise ranking revealed strong and site-specific preferences for the improved Mena variety. In the Kobo district, 22 farmers participated in the selection process, and the improved Mena tef variety was the most preferred, based on panicle length, seed color, disease resistance, marketability, earliness, plant height, tiller number, and straw palatability for animal feed. The local Boset variety with improved management ranked second, while Boset under farmer practices ranked last. In the Kalu district, the final acceptability ranking showed that the Mena variety with improved management was the most preferred variety, followed by Bursa with improved management and Bursa with local management. The Mena variety’s top ranking reflects its superior performance in disease resistance, seed color, and grain size for market and consumption purposes, number of tillers, and panicle traits. However, in the Habru district, where 29 farmers participated, the local Magna variety with improved management ranked first, Mena with improved practices ranked second, and local Magna under farmer practices ranked last, suggesting that the local variety’s adaptation to specific agro-ecological conditions and cropping patterns continues to hold value in that location.

Farmers provided valuable feedback during field days, highlighting that the improved Mena tef variety possesses superior seed size and color suitable for both market and consumption, resistance to yellow rust disease, palatable straw for animal feed, and the ability to maintain green morphology even at the maturity stage. However, they expressed dissatisfaction with its loose panicle structure, which did not fully meet their preferences. In comparison, the local Magna variety in Habru, locally known as dalga tef, was appreciated for its semi-loose panicle, large seed size, high grain yield, shattering resistance, and green stalk retention. In Kalu, the local Bursa variety was praised for its white seed color, large seed size, tall plant height with compact panicles, and high productivity, though it was criticized for susceptibility to yellow rust, locally called mich, and non-palatable straw. In Kobo, the Boset variety was widely adopted due to its early maturity and high productivity, making it suitable for triple cropping systems during the Meher, irrigation, and Belg seasons, though farmers reported issues with grain shattering during unexpected rainfall at harvest.

Based on these findings, the researchers recommend scaling out the improved Mena variety with the recommended production package in Kobo and Kalu districts to create further demand, while in Habru, further adaptation trials and targeted extension support are recommended to optimize returns and align the variety with local farmer preferences. The study underscores the importance of integrating improved varieties with recommended production practices to achieve better agronomic and economic outcomes, and highlights that farmers’ preferences are strongly influenced by productivity, resilience, and market-related attributes. The superior ranking of the improved Mena variety in Kobo and Kalu demonstrates the combined advantage of genetically improved varieties and better crop management practices, while the continued value of local varieties in Habru emphasizes the need for location-specific recommendations. Continuous participatory evaluation and feedback integration should be maintained to ensure the promotion of varieties that meet both productivity and socio-economic needs of smallholder farmers in these risk-prone farming systems.

Subject of Research: Pre-extension demonstration of improved tef ( Eragrostis tef (Zucc.)) variety in mid and low land areas of eastern Amhara, Ethiopia

Article Title: Pre-extension demonstration of improved tef ( Eragrostis tef (Zucc.)) variety in mid and low land areas of eastern Amhara, Ethiopia

Article References: Haile, A., Siyum, N., Assefa, M., Mihret, T., & Bahta, M. (2026). Pre-extension demonstration of improved tef (Eragrostis tef (Zucc.)) variety in mid and low land areas of eastern Amhara, Ethiopia. Innovations in Agriculture, 9, Article e180602. https://doi.org/10.3897/ia.2026.180602

Image Credits: AI Generated

DOI: 10.3897/ia.2026.180602

Keywords: tef, Ethiopia, agriculture, crop variety, participatory research, food security, Pre-extension, demonstration, improved, Eragrostis, Zucc, variety

The central claim of the commentary is deceptively simple but institutionally disruptive. Participatory and co-produced approaches are now well established in migrant health research, supported by a proliferation of frameworks explaining how to conduct research with rather than on migrant communities. Yet, as Uribe Guajardo documents, real-world stories of co-creation remain inconsistently reported and tend to concentrate in the operational aspects of projects, such as recruitment and data collection, rather than in agenda-setting, analysis, leadership, dissemination, or decision-making. Research continues to be conducted predominantly on migrants rather than with migrants as equal partners in knowledge production. The paper argues that without changing who holds authority over knowledge, existing patterns of epistemic marginalisation will simply be reinforced.

Epistemic justice, a concept drawn from philosophy and increasingly applied in decolonial health scholarship, sits at the heart of the argument. In this framing, epistemic justice means enabling marginalised researchers and communities to think about and analyse their own experiences in ways that value and appropriately recognise those experiences, particularly when those interpretations clash with dominant, institutionally sanctioned discourses. Applied to public health, it requires challenging the traditional hierarchies that privilege academic and institutional expertise while marginalising lived expertise. Uribe Guajardo contends that migrants should be recognised not merely as research participants or beneficiaries, but as legitimate knowers whose knowledge is systematically incorporated into decision-making, and as leaders, agenda-setters, and producers of public health evidence.

The evidence for this argument comes from an evolving program of research spanning three domains: health and social care integration, public health emergency preparedness, and international collaborations with migrant communities, frontline workers, and researchers. In the earliest phase, the work focused on understanding and strengthening the systems that support migrants in Sydney, Australia, before shifting attention to who holds power within those systems. Studies of policy mechanisms for integrating health and social care for culturally and linguistically diverse communities identified how governance arrangements, partnerships, workforce models, and service coordination could support more integrated responses, while also exposing persistent fragmentation across sectors. Related work on data sharing found that information exchange between sectors remained limited, hampered by inadequate governance, funding structures, and organisational capacity to meet migrant communities’ needs.

These early findings pointed to a structural gap that goes beyond service delivery. Even where integration models made progress, community representatives, migrants themselves, were rarely formally embedded in the health or social care systems that shape research, policy, and practice affecting their lives. The research concluded that effective migrant responsiveness depends not only on how services are delivered, but on the policy infrastructures that enable organisations to work together through shared governance, including clearly embedded community decision-making, information flows, and resources. Meaningful and equitable integration of migrant voices in research, policy, and practice, the paper notes, remains low, and researchers have yet to challenge the system in sustainable ways.

A second strand of the commentary examines the relational infrastructure that underpins any genuine shift in power. Relationships and partnerships, both formal and informal, proved decisive throughout the research program, and never more so than during the COVID-19 pandemic. During the crisis, these networks were crucial in translating health and public information, facilitating access to health and social services, identifying emerging needs, and supporting communities through successive waves, including the Delta phase in Sydney’s diverse ethnic communities. Policymakers contributed insight into system-level priorities and constraints; service providers described the practical realities of implementation; and community-led organisations and migrant volunteers illuminated how policies and services are actually experienced on the ground. Bringing these perspectives together produced a more comprehensive understanding of the barriers and opportunities for equity than any single vantage point could offer.

Yet this relational work carries a cost that academic systems rarely acknowledge. Meaningful engagement with migrant representatives requires significant investments of time, trust, and relationship-building, and formal institutions must in turn develop trust in community-led organisations and individuals. Building partnerships across health, social care, and community sectors involved ongoing communication, repeated engagement, coordination of diverse interests, and a commitment to understanding stakeholder priorities beyond the immediate objectives of crises or funded projects. Uribe Guajardo is candid that this invisible labour sits outside traditional measures of academic productivity, even though it is essential for producing evidence that is relevant, actionable, and capable of supporting system-wide change. In her account, the partnerships became both a mechanism for generating evidence and an outcome in themselves, fostering connections that support ongoing collaboration and contribute to more integrated, responsive, and inclusive systems.

The commentary also offers a technical account of what co-production actually requires in migrant health research, and where it most often falls short. Positionality must be acknowledged first, followed by deliberate trust-building with communities and the creation of spaces that value lived experience while avoiding colonising narratives and frameworks. Co-production, the paper argues, often begins before co-production formally starts: engaging and getting to know migrant leaders before a grant application or project is developed allows researchers to leverage fully formed relationships rather than assembling community panels as an afterthought. Recognising communities as legitimate knowledge holders and contributors, including as authors on publications, creates a concrete shift towards epistemic justice. In Uribe Guajardo’s own program, forming formal governance structures in which migrant representatives formally drive the research, including through reimbursement, strengthened knowledge generation and helped ensure the research was not positioned for epistemic extraction, while giving back to the community in ways the community itself chose to define.

Importantly, the paper warns against a subtle failure mode: rejecting non-traditional narratives simply because they do not fit conventional research conventions. Instead, research approaches should prioritise and accommodate diverse forms of knowledge, including those grounded in lived experience, culture, and community practice, which may require challenging, adapting, or rejecting colonising frameworks that fail to align with the realities and priorities of participating communities. The commentary extends this logic to how success itself is measured. Existing governance and research systems frequently rely on institutionally determined indicators, such as academic outputs, that overlook what communities value. Shared governance, by contrast, creates space for communities to participate not only in identifying problems but in defining desired outcomes, including cultural expression, social connectedness, and self-determination.

The destination of this journey, Uribe Guajardo argues, is a model in which reciprocity and sustained engagement are not ancillary to governance but constitute governance itself. Relational infrastructure, encompassing long-term partnership building, shared accountability, and ongoing investment in community relationships, is a critical yet frequently undervalued component of shared governance; without it, participation risks becoming symbolic rather than transformative. She also cautions against framing migrants solely through narratives of vulnerability and disadvantage: while attention to structural inequities remains essential, shared governance requires simultaneous recognition of migrant agency, creativity, resilience, resistance, and leadership. The commentary distils the conceptual ladder that the field must climb: collaboration concerns relationships and partnerships, co-production concerns meaningful contributions to research and practice, epistemic justice concerns the recognition of migrants as legitimate knowers, and governance concerns authority, power, and decision-making. Viewed this way, the next evolution of migrant health research lies not in strengthening participation or co-production alone, but in advancing institutionally embedded models of migrant-centred governance, with these processes reported as outcomes of the research itself. The result, the paper suggests, would be public health research, policy, and practice that are more equitable, accountable, and responsive to the communities they claim to serve.

Subject of Research: Epistemic justice and migrant-centred governance in public health research

Article Title: Leading by example: a migrant health researcher’s journey from participation to epistemic justice and migrant-centred governance in public health research

Article References: Uribe Guajardo, M. G. (2026). Leading by example: a migrant health researcher’s journey from participation to epistemic justice and migrant-centred governance in public health research. International Journal for Equity in Health, 25(1), Article 245. https://doi.org/10.1186/s12939-026-03055-y

Image Credits: AI Generated

DOI: 10.1186/s12939-026-03055-y

Keywords: migrant health, epistemic justice, co-production, participatory research, public health, health equity, shared governance, community engagement, health and social care integration, decolonising research, COVID-19, research leadership