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Overactive bladder medications and risk of emergency hospital admissions with delirium in adults without dementia: Self-controlled case series
Get PDFAims: We examined whether anticholinergic overactive bladder (OAB) medications are associated with emergency hospital admissions with delirium in adults without dementia. Setting: England’s primary care linked to inpatient records. Methods: The source population comprised 215 293 adults initiating anticholinergic OAB medications (e.g. oxybutynin, solifenacin and tolterodine) during July 2010–December 2019 when aged ≥50 years, without dementia, severe mental illness or <12 months registration. We conducted self-controlled case-series including 1831 men and 1954 women with emergency hospital admissions with delirium. Incidence rate ratios (IRR) were estimated in risk periods during 6 months before and 12 months after initiating OAB medications, adjusted for time-varying age, separately in men and women. Results: The risk of delirium admissions was elevated for the first 1–30 days of prescriptions [IRR 1.54 (95% CI 1.30–1.82) for men, 1.44 (1.22–1.70) for women] and whilst reducing over time for women [1.10 (0.94–1.29) for 91–365 days of prescriptions], it remained elevated for men [1.38 (1.17–1.64)]. There was some evidence of greater delirium IRRs in older men and men initiating higher dosages. In secondary analysis of 502 adults initiating mirabegron (non-anticholinergic beta-3 receptor agonist), the delirium IRRs during the first 1–30 and 31–90 days of prescriptions were 1.15 (0.76–1.75) and 0.72 (0.47–1.09). Conclusion: We observed increased hospital admission rates with delirium for adults without dementia whilst prescribed OAB anticholinergics, but not whilst prescribed mirabegron. Delirium risk remained raised for longer for men and was greater in older men. Alternative management options for OAB in older people should be considered before prescribing anticholinergic medications
Prevalence and dynamics of antimicrobial resistance in pioneer and developing Arctic soils
Get PDFAntimicrobial resistance (AMR) in soil is an ancient phenomenon with widespread spatial presence in terrestrial ecosystems. However, the natural processes shaping the temporal dissemination of AMR in soils are not well understood. We aimed to determine whether, how, and why AMR varies with soil age in recently deglaciated pioneer and developing Arctic soils using a space-for-time approach. Specifically, we assess how the magnitude and spread of AMR changes with soil development stages, including antibiotic resistance genes (ARGs), mobile genetic elements (MGEs), and antibiotic-resistant bacteria (ARB). We showed that ARGs, MGEs, and ARB are present, and exhibit a non-uniform distribution in the developing soils. Their abundance generally increases with soil age but at different rates overall and across different glacier forefields. Our analyses suggest a strong positive relationship between soil age and ARGs and ARB, which we attribute to increased competition between microbes in older soils. We also observed a strong negative relationship between soil age and ARG diversity mediated by soil organic matter – suggesting facilitation due to the alleviation of nutrient limitation. These contrasting results suggest that both competition and facilitation can regulate AMR spread through time in the Arctic, but competition might be the stronger determinant of AMR spread
An analysis of the effect of employee tenure on WACC
Get PDFNo international accounting policy exists to mandate that firms must report employee/workforce-level human capital information on a structured basis. Thus, the link between employee/workforce human capital and firm risk is not demonstrated in the literature. South Korea is a rare instance where human capital information, such as employee tenure is disclosed on Annual Reports as a rule. Therefore, we invoke resource-based theory, a human resource policy assertion, and a business ethics/sustainability inference to show whether capital providers differentiate between firms that are able/unable to retain employees, thus adjusting WACC accordingly. Using OLS regression analysis, from 2011-2020, empirical results show that firms with the ability to retain employees enjoy economically significantly lower levels of WACC. The results infer that equity/debt providers associate workforce tenure and firm risk/returns expectations. Empirical results also show that capital providers are nuanced when impounding employment information into risk/return assessments, based on incrementally different associations for investment-grade/non-investment-grade firms. The study contributes to the literature by providing evidence that management should develop strategies to retain employees to enjoy economic advantages. Because structured employee/workforce human capital information is rare internationally, the study has important practical implications for legislators, management, employees and the public
Integrating environmental justice into child-sensitive social protection: The environmental roots of intergenerational poverty in Amazonia
Get PDFChild-sensitive social protection (CSSP) is heralded as an investment in future human capital, based on the premise that changing poor families’ behaviours can interrupt cycles of poverty reproduction. However, funding for CSSP may come from extractive activities with high environmental costs for the same families that social programmes aim to support. Reflecting on this contradiction in Peruvian Amazonia, the study explores the tensions between State and parental understandings of impoverishment in an Indigenous village impacted by oil extraction. The findings are twofold: (i) although families are sceptical of CSSP’s potential to enhance children’s prospects, they embrace it as a form of compensation for resource dispossession. (ii) CSSP may fail to lift children out of poverty if it overlooks how environmental degradation engenders intergenerational impoverishment. The article makes a case for the adoption of an environmental justice lens into CSPP, emphasising the need for a more holistic understanding of intergenerational poverty
Digital credit for all? An empirical analysis of mobile loans for financial inclusion in Kenya
Get PDFDigital credit has shown considerable success in Kenya and is expected to provide opportunities for individuals excluded from formal loans because of their lower socioeconomic status. However, evidence supporting the greater positive impact of digital credit on financial inclusion than that of traditional loans is lacking. This study employs a multinomial logistic regression to investigate the impact of digital credit services, particularly mobile banking and FinTech loans (MBLs and FTLs), on financial inclusion in Kenya. MBLs appear to be less accessible to vulnerable populations, such as women, low-educated groups, and casual workers although both MBLs and FTLs are equally accessible to rural populations. In contrast, FTL services show no such constraints in terms of accessibility for women and low-income workers. This disparity indicates the relative inaccessibility of MBLs to vulnerable groups compared to that of FTLs; however, note that greater loan access does not always benefit vulnerable groups
'Being a social worker... it’s in my DNA': Retaining experienced child and family social workers: The role of professional identity
Get PDFThe retention of experienced child and family social workers is a significant issue in the United Kingdom, the United States and Europe. Failure to retain experienced practitioners has serious implications for the protection and support of vulnerable children. Existing research and workforce interventions have focused on the support of early-career social workers to prevent exit. Relatively few studies have examined what can be learned from experienced social workers who have remained in the profession long-term. This study captures the voices of experienced stayers. Data consist of interviews with social workers (n = 58) across 11 local authorities in England who have remained in practice for ≥8 years. Findings suggest that a strong sense of professional identity (PI) sustains social workers and promotes retention. For experienced social workers, staying in the profession long-term involves navigating a series of identity challenges over the course of their career, conceptualized here as Critical Career Episodes (CCEs). Based on these findings, we suggest that retaining experienced social workers involves support to navigate CCEs alongside meaningful opportunities for learning and development. We identify three key factors that support and sustain ongoing PI development and support retention: generativity, specialism and mobility. The article concludes with recommendations to support workforce retention
Richard J. Miller, The Rise and Fall of Animal Experimentation: Empathy, Science and the Future of Research:New York, USA: Oxford University Press, 2023. Pp. 1–291. £22.99. Hbk. ISBN 9780197665756
No full textThe historical continuity of the use of non-human animals in biomedical research is contingent upon several factors, most notably, the notion that human beings are superior to other animals and that non-human animals are not subjects of a life but rather mere objects that have a use-value. Miller’s book is not the first account of the historical development of animal experimentation, and it follows the work of many scholars such as Richard French and Nicolaas Rupke. Their work outlines vivisection’s rise and inculcation into standard biomedical research practice in the modern era, including its legal regulation, political resistance and morality. The Rise and Fall of Animal Experimentation draws on similar themes of ethics, politics, law and scientific practice. However, it offers a welcome departure from these previous interpretations by focussing on a history traced back to Greek antiquity. Miller demonstrates how the beliefs of the ancient Greek philosophers, such as Aristotle, are still present in biomedical scientists’ justifications for using non-human animals in experiments
Hormonal contraceptive use and physical performance, body composition, and musculoskeletal injuries during military training
No full textPurpose: To investigate associations between hormonal contraceptive use and physical performance, body composition, and musculoskeletal injuries in basic military training. Methods: Female British Army recruits (n = 450) were grouped as nonusers (n = 182), combined oral contraceptive users (COCP; n = 184), or progestin-only users (POC; n = 144). Physical performance (2.4-km run, lift strength, leg power), body composition, iron and vitamin D status, and bone metabolism were measured at the start (week 1) and end (week 13) of training. Lower body musculoskeletal injuries were recorded from medical records. Results: Training decreased 2.4-km run time (−3.7%) and fat mass (−9.6%), and increased lift strength (4.5%), leg power (1.5%), lean mass (5.4%), and whole-body (0.9%), arms (1.8%), and legs (1.4%) areal bone mineral density (P ≤ 0.015); the training response was not different between groups (P ≥ 0.173). Lift strength was lower in COCP users than nonusers (P = 0.044). Whole-body, trunk, and leg areal bone mineral densities were lower in POC users than nonusers and/or COCP users (P ≤ 0.041). There were no associations between hormonal contraceptive use and musculoskeletal or bone stress injury (P ≥ 0.429). Training did not change ferritin (P = 0.968), but decreased hemoglobin and total 25-hydroxyvitamin-D, and increased parathyroid hormone, c-telopeptide cross-links of type 1 collagen (βCTX), and procollagen type 1 N-terminal propeptide (PINP; P ≤ 0.005); the training response was not different between groups (P ≥ 0.368). Total 25-hydroxyvitamin-D was higher, and βCTX and PINP were lower, in COCP users than nonusers and POC users; parathyroid hormone was lower in COCP users than nonusers; and βCTX and PINP were higher in POC users than nonusers (P ≤ 0.017). Conclusions: Hormonal contraceptive use was not associated with performance or injury outcomes in military training
The development of the Negative Mental Imagery Questionnaire (MIQ-N)
Get PDFBackground: Mental imagery plays a key role in the onset and maintenance of psychological disorders, and has become the target of psychological interventions for the treatment of several anxiety-related conditions. However, there are currently no transdiagnostic measures designed to assess the varied dimensions of mental imagery relevant to psychopathology. Aim: To develop and validate a new measure assessing the experiences and appraisals of negative mental imagery. Method: The initial item pool was generated through a comprehensive literature review and interviews with subject-matter experts. An online community sample provided data for the exploratory (n = 345) and confirmatory (n = 325) factor analyses. Results: The new 16-item Negative Mental Imagery Questionnaire demonstrated four subscales (Intrusiveness, Controllability, Beliefs about Mental Imagery, and Realness). Reliability and validity were good to excellent for both the full- and sub-scales. Conclusions: Appraisals of mental imagery captured by the new measure are consistent with previous research on mental imagery and psychopathology
A Nature-based Solutions framework for embedding climate change mitigation and adaptation into urban land use plans through Strategic Environmental Assessment (SEA)
Get PDFClimate change impacts comprise a particular challenge for authorities when reconciling the implications of land use planning decisions. Whilst Strategic Environmental Assessment (SEA) is typically applied to the development of urban land use plans, the selection of mitigation and adaptation strategies for climate change impacts can have knock-on effects on nature. However, Nature-based Solutions (NbSs) could provide an innovative means of addressing climate change mitigation and adaptation without these knock-on effects. The main aim of this research is therefore to propose a conceptual framework for embedding NbSs into the main stages of the SEA process to potentially enhance climate change mitigation and adaptation in urban land use planning. This is achieved through a systematic literature review of academic and grey literature sources, with subsequent content analysis. This study demonstrates the value of matching these manifold NbS approaches to climate change impacts potentially addressed in SEA process stages and suggests how this might be achieved in practice focusing on urban land use plans