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A Difficult Start for the UK Labour Government, But Time Still on Their Side
Get PDFThe newly elected Labour Government in the United Kingdom (UK) promised change. However, the first six months have been disappointing, characterized by misjudged announcements regarding the Winter Fuel Allowance and Employers' National Insurance contributions. Yet, there is still time to get back on track with welfare reform and create a new welfare state that other countries can replicate. To this end, this article argues for a shift from means-testing to universalism across welfare provision. It further contends that a basic income should be gradually introduced per affordability and public support. Additionally, it proposes that these changes be funded through taxation on wealth, particularly targeting online billionaires profiting from automation. Welfare reform represents an opportunity for Labour to make a difference and regain public trust and support, as evidence indicates public backing for restoring our public services. With the election of a Labour Government in the UK, there is a once-in-a-generation chance to address welfare reform and establish a new welfare state that other countries can admire. So far, the Labour Government's rhetoric and actions have been aligned with dampening expectations. The new government has experienced a disappointing first ten months, marked by controversy after controversy stemming from inexperience and incompetence. Moreover, they have begun using anti-welfare rhetoric, such as the threat to remove driving licenses from benefit fraudsters. Therefore, we argue that Labour needs to be reminded of its mission to restore public services
Exploring the Role of Physical Activity in Individuals with Comorbid Cancer and Dementia: A Scoping Review.
Get PDFBackgroundComorbid cancer and dementia, which share common risk factors and significantly burden the healthcare system, affect a growing number of individuals, especially the ageing population. As both conditions place a substantial burden on healthcare systems and may be underdiagnosed, there is an urgent need to explore effective management strategies, including the potential benefits of physical activity, which has shown promise in mitigating cognitive decline and improving physical function in both cancer and dementia populations. This scoping review aimed to explore the current knowledge of physical activity for individuals with comorbid cancer and dementia, identifying gaps in understanding and highlighting the need for future research in this area.SummaryThis scoping review followed the 5-stage framework outlined by Arksey and O'Malley, with a focus on identifying the effects of physical activity on individuals with comorbid cancer and dementia. The review involved a comprehensive search across multiple databases, selecting relevant studies based on predefined criteria, and summarizing key findings to highlight research gaps and inform future studies. Out of 263 records identified from multiple databases, none were retained for full-text screening due to exclusions based on review articles, non-human participants, lack of comorbid cancer-dementia, and absence of a physical activity/exercise component.Key messagesThere is a significant gap in research on physical activity in individuals with comorbid cancer and dementia. Future studies are essential to explore the impact of exercise on the development and outcomes of these conditions, which could improve preventative strategies and care pathways for this growing population
The View From the Boundary: How County Cricket is Covered Amid the Digital Mediatization of Sport
Get PDFCounty cricket is a traditional mainstay of sports media in the UK, especially the local press, radio and television. However, technological disruption and financial pressures affecting local journalism and cricket itself have led to concerns the domestic game is now less visible, with media attention dominated by international fixtures and franchise leagues shown on pay TV channels. This study aims to complement scholarship on digital mediatization of sport and media work by developing empirical insights into how English domestic cricket is covered in this context. Twenty semi-structured interviews were carried out and the transcripts subjected to thematic analysis, to explore the working practices of county cricket journalists and other content producers. The operation of a network of written reporters paid by governing body the England and Wales Cricket Board (ECB) is considered, as well as video streaming, local radio commentaries, liveblogging and in-house media. The study offers insights to help better understand how domestic cricket maintains its profile in an era of declining investment by traditional media, and the challenges and opportunities of working in county cricket media in that context. It finds notable breadth and innovation in modern coverage, although it is heavily reliant on both ECB funding and the use of precariously employed freelancers
A mixed methods approach to training for the mitigation of modifiable risk factors for hamstring strain injury and the development of athletic performance.
Get PDFHamstring strain injuries (HSIs) are the most common non-contact injuries in various sports, including soccer, American football, rugby union, Australian rules football, cricket, and sprinting. Epidemiological studies have highlighted the significant loss of training and competition time associated with HSIs, with a typical 25-player soccer squad experiencing 5-6 hamstring injuries per season, each resulting in approximately 14 days of absence. Despite extensive research into injury risk factors, rehabilitation, and mitigation techniques, the incidence of hamstring injuries continues to rise, particularly in men's elite European professional soccer. Research has indicated that exercises like the Nordic hamstring exercise (NHE) can reduce HSI incidence, though this claim has been debated due to methodological discrepancies. Compliance with injury prevention programmes is crucial, with higher compliance rates leading to greater success in reducing HSI rates. Despite the potential benefits of evidence-based prevention programmes, adherence remains a challenge, particularly with high-volume training. The results of recent studies indicate that lower volume NHE programmes can be effective, indicating the feasibility of incorporating such exercises into athletic training schedules. Given the limitations of single-exercise interventions, there is a need for research into more comprehensive training programmes that combine resistance training with high-speed running (HSR) to effectively reduce HSI risk and enhance athletic performance. The overarching aim of this thesis was to inform exercise selection, athlete assessment, and training practices to mitigate HSI risk and improve athletic performance, reflecting the applied practices of strength and conditioning, injury rehabilitation and sport science practitioners.This research investigated hamstring training practices and perceptions for injury prevention and athletic performance enhancement through both quantitative and qualitative analyses. Chapter 3 utilised a mixed-methods survey to gather data from sport and exercise practitioners across various sports, exploring their training methods, including HSR and approaches to resistance training. The survey revealed significant disparities in training practices, highlighting the influence of educational background, professional role, and multi-disciplinary team (MDT) dynamics. It emphasised the importance of practitioner education, effective communication within MDTs, and developing evidence-informed training practices tailored to sport-specific demands and athlete characteristics.Building on these findings, Chapter 4 expanded through semi-structured interviews with twelve practitioners, providing a deeper qualitative understanding of nuanced approaches to hamstring training. It explored the rationale behind training decisions, the challenges practitioners faced, and strategies employed to enhance athlete compliance and engagement. Key themes included micro-dosing of the NHE, integrating hip hinge exercises like Romanian deadlifts (RDL), and applying isometric training during congested fixture periods. The study highlighted the critical role of MDT dynamics and continuous athlete education in effective training interventions.Together, these chapters highlighted the need for more ecologically valid research including concurrent resistance training with HSR, rather than single exercise interventions. The insights aimed to bridge the gap between research and real-world application, providing a robust foundation for developing effective training strategies to reduce hamstring injury incidence and enhance athletic performance.Chapter 5 focused on establishing the most appropriate normalisation method for electromyography (EMG) based on within-session reliability and variability of various maximal voluntary isometric contraction (MVIC) methods. The study concluded that the manual resistance method (hip extension) provided a reliable and time-efficient means of normalising EMG data for the hamstring and gluteal muscles, which was then utilised in the exercise comparisons conducted in Chapter 6.Chapter 6 compared the kinetic and EMG characteristics of the RDL and good morning (GM) exercises. Utilising the established EMG normalisation method from Chapter 5, this chapter aimed to develop a biomechanically robust basis for exercise selection decisions. The findings indicated that while higher absolute loads were lifted during the RDL, both exercises produced comparable joint moments and muscle excitations, indicating that the GM could serve as an alternative hip-hinge exercise requiring lower absolute loads yet potentially yielding similar training adaptations.Together, these chapters provided a comprehensive understanding of hamstring training practices and the reliability of EMG normalisation methods, informing evidence-based decisions in exercise selection for reducing hamstring injury risk and enhancing athletic performance.Chapter 7 investigated the reliability and bilateral force asymmetry during the NHE using a NordBord device. The study aimed to quantify knee flexor strength, assess bilateral force asymmetry, and determine the reliability of peak force (PF) and mean force (MF) measures. Nineteen strength-trained male participants performed three maximal NHE trials. Data collection focused on PF, MF, and instantaneous force (IF) throughout the exercise. The study found moderate to excellent reliability for PF across trials, with improved reliability and reduced variability when excluding the first trial. MF, while also showing improvements, demonstrated slightly lower reliability and higher variability than PF. The analysis revealed significant between-limb differences in MF, favouring the right limb, and higher IF in the right limb for most of the exercise duration. These findings indicate that relying solely on PF might mask underlying bilateral force asymmetries, highlighting the importance of including MF and IF measures in assessments. This chapter concluded that monitoring multiple force metrics during the NHE was crucial for accurately identifying bilateral asymmetries and informing targeted training interventions. The insights gained were applied in future exercise comparison and training intervention studies within this thesis.Finally, Chapter 8 examined the effects of integrating knee flexor-biased (NHE) and hip hinge-biased (RDL) resistance training programmes with concurrent HSR on hamstring strength, sprint performance, jump performance, and lower body strength in academy soccer players. The study addressed the lack of ecological validity in previous research, which often focused on single exercise interventions, by employing a more comprehensive training approach. Thirty-seven participants from a football academy were randomly assigned to one of three groups: NHE, RDL, or control. Over six weeks, all groups engaged in a standardised resistance and HSR training programme, with only the RDL, NHE or reverse lunge (control) differing between programmes. The training aimed to progressively increase load while maintaining consistent volume, with sessions held twice weekly. Pre- and post-intervention assessments included countermovement jumps (CMJ), countermovement rebound jumps (CMJ-R), isometric mid-thigh pull (IMTP), and 20 m sprints. Results indicated significant improvements in all groups, with the NHE group showing the greatest increase in eccentric knee flexor strength, likely due to the specificity and supramaximal nature of the NHE. Both training interventions experienced significant improvement in 20 m sprint performance. However, both intervention groups and the control group experienced significant improvements in 5 m sprint performance, indicating that the sprint intervention was sufficient to improve 5 m acceleration performance, but addition of either the NHE or RDL is required to significantly improve 20 m sprint performance. The study concluded that combining resistance training with HSR enhanced athletic performance and reduced hamstring injury risk, with each training focus providing distinct benefits. The findings supported the integration of varied resistance training strategies in athlete conditioning programs to optimise performance and injury prevention
Development of an Artefact to Support Homeowner Decision-making for Housing Retrofit
Get PDFThe sustainability in the UK housing sector is not adequate. Housing retrofit is reported to improve the sustainability. The progress of housing retrofit is low. The underlying reason can be suggested as the limited interest of the homeowners to retrofit their houses. The research aims to develop an artefact for an information system to encourage homeowners to undertake sustainable housing retrofit. The objectives of the research are to study the factors influencing homeowners’ interest in housing retrofit, identify the requirements for an artefact to support homeowner decision-making, develop the artefact and validate the artefact for the intended capabilities. The research process was approached from design science. Accordingly, the research was conducted by identifying the research problem, outlining the solution, defining the requirements, developing the artefact, validating the artefact, and contributing to the body of knowledge. The research problem and the solution were justified with a literature review. A mixed-method methodological choice was used with both interviews and a questionnaire survey to develop the artefact. Artefact validation was done by semi-structured interviews. The research findings supported developing an artefact for an information system to encourage homeowners to retrofit their houses. Homeowner decision-making behaviour, the social system of the homeowner and the technical system of housing retrofit were focused for this purpose. Apart from the utility of the artefact, the study will contribute to the knowledge of developing artefacts for non-technical audiences. Further, the data collection by the system shall facilitate information for better sustainability policy decisions. The research complements the stakeholder engagement model of “one stop shop” for housing retrofits. Research recommends a digital one stop shop localised to the homeowner’s neighbourhood. Existing similar solutions have only basic capabilities compared with the proposal. The research also recommends reframing housing retrofit from an investment focus to a consumption focus. It also suggests considering a homeowner-centric approach to retrofit over the existing property-centric approach. There are total six recommendations to encourage homeowners to retrofit their houses
Interventions for Neglected Diseases Caused by Kinetoplastid Parasites: A One Health Approach to Drug Discovery, Development, and Deployment
Get PDFKinetoplastids are protozoa that possess a unique organelle called a kinetoplast. These include the parasites Trypanosoma cruzi, T. brucei and related African trypanosomes, and Leishmania spp. These parasites cause a variety of neglected tropical diseases in humans and livestock, with devastating consequences. In the absence of any vaccine, pharmaceutical interventions are the mainstay of control, but these have historically been underfunded, fragmented, and inadequately aligned with the complex zoonotic and ecological realities of the parasites’ transmission dynamics. In this review, the landscape of current and emerging drugs for treating leishmaniasis, Chagas disease, and African trypanosomiasis is critically evaluated across both veterinary and human contexts. It examines the challenges of legacy compounds, the pharmacological shortcomings in multi-host, multi-tropic and multi-stage disease systems, and the gaps in veterinary therapeutics, specifically for African animal trypanosomiasis and canine leishmaniasis but also the animal reservoir of T. cruzi. Emphasis is placed on pharmacokinetic divergence between species, the accompanying risks with the use of off-label human drugs in animals, and the ecological effects of environmental drug exposure. We propose a far-reaching One Health framework for pharmaceutical research and development, promoting dual-indication co-development, ecological pharmacology, regulatory harmonisation, and integrated delivery systems. In this context, we argue that the drug development pipeline must be rationalised as a transdisciplinary and ecologically embedded process, able to interrupt parasite transmission to human, animal, and vector interfaces. Our findings reveal that we can bridge age-old therapeutic gaps, advance towards sustainable control, and eventually eliminate the neglected diseases caused by kinetoplastid protozoan parasites by aligning pharmaceutical innovation with One Health principles. This article aims to promote future research and development of innovative drugs that are sustainable under the One Health framework
‘It definitely prepares you’: an interpretative phenomenological analysis of student midwives’ preparedness to care for bereaved parents using performance-based simulation
Get PDFLimited opportunities in clinical practice result in student midwives feeling ill-prepared to care for bereaved parents experiencing baby loss. Bereavement simulation is an effective pedagogical approach. Evidence for its effectiveness as a transformative teaching strategy to prepare students for this aspect of care is limited. Aim To explore student midwives’ experiences of caring for bereaved parents within a simulated settingDesign: Interpretative phenomenological analysis was applied to gain insight into the students’ lived experience. Mezirow’s transformative learning theory (TLT) was used to assist students to critically reflect on the simulation.Setting: The study was conducted at a Higher Education Institute in the Northwest of England. Nine third-year student midwives participated in a performance-based simulated scenario.Method: Data was collected using semi-structured interviews and analysed following Interpretative Phenomenology’s heuristic frameworkFindings: One of the generic themes identified, included ‘a unique learning experience’ and its related sub-themes ‘you felt you were really in the situation’; ‘a nice atmosphere for the debrief’; ‘seeing how others deal with it’, and ‘it definitely prepares you’, characterised the transformational learning process the student underwent after initially encountering bereaved parents. The simulated scenario represented a disorientating dilemma which they found challenging. Through critical self-reflection, students altered their perspectives about grief and loss and integrated new knowledge and skills that they could apply to caring for grieving parents.Conclusion: Performance-based simulation is a creative approach to bereavement education that can prepare midwifery students to embrace the complexities of grief and loss and holistically support bereaved parents in their journey of grief
A method for determination of hematocrit using the mobile app “HaemoCalc”: Validity, reliability, and effect of user expertise
Get PDFWe evaluated validity, reliability, and effect of user expertise of “HaemoCalc”, a mobile phone application for hematocrit (Hct) measurement from fingerpick blood samples, compared to a traditional Hawksley microhaematocrit reader (MHR). Experiment 1 examined the effect pitch angle during image capture exerted on the validity of Hct values. Twenty participants' samples were analyzed at 0°, 10°, and 20° directly over the sample, and 33° with a 10 cm setback. Analysis of variance (ANOVA) revealed a significant effect of angle on Hct values (p < 0.01). Measurements at 33° pitch differed from other angles and the MHR (p < 0.001, d = 2.31–3.06). Bland–Altman analysis showed good agreement at 0°, 10°, and 20° (mean differences: −0.4% to 1.0%) but poor agreement at 33° (mean difference: −4.4%, LOA: −0.7% to 8.4%). Experiment 2 assessed inter‐ and intra‐rater reliability of expert and novice users (n = 12). Participants performed three trials each. HaemoCalc and MHR showed excellent reliability (ICC = 0.95–1.00). No differences were observed between experts and novices (p = 1.000, d = 0.01–0.39). HaemoCalc is a valid and reliable tool for Hct measurement at small pitch angles and in expert and novice users. The HaemoCalc app offers scalability, repeatability, health and safety benefits, and potential applications in medical education and remote learning
Early Laser for Burn Scars (ELABS) - Randomised controlled trial of pulsed dye laser treatment and standard care versus standard care alone for the treatment of hypertrophic burn scars.
Get PDFHypertrophic burn scarring (HBS) is described as "the greatest unmet challenge after burn injury". This ELABS trial hypothesised that early pulsed dye laser (PDL) treatment of HBS improves both scar quality and quality of life (QoL). A parallel arm randomised controlled trial to assess the effectiveness and cost-effectiveness of PDL was undertaken at seven centres in the UK. Patients were eligible if their burn injury was within three months of wound healing, and ineligible either with history of keloid scarring or aged < 16 years. A total of 153 (77 male, 76 female) participants were recruited between Nov 17, 2021, and Jun 30, 2023, and were randomised using software in a 1:1 ratio stratified by study centre; 138 (69 each arm) were included in the final complete-case analysis. Both study arms received standard care, and the intervention arm received three PDL treatments. The primary outcome was patient-rated scar quality (POSAS) at six months. The trial was registered with International Standard Randomised Controlled Trial Number registry (ISRCTN14392301). Early PDL showed a statistically significant improvement in patient-rated scar quality (p = 0·041) and the secondary outcome, participant's perception of change in scar quality (p = 0·01), at six months. There were no statistically significant differences for Quality-of-Life, observer-rated POSAS scar quality, or colour measurement. Early PDL was not cost-effective at 6 months follow-up for the willingness-to-pay threshold of £20,000 per Quality-Adjusted-Life-Year (QALY). There were no unexpected adverse events related to the intervention. Early PDL treatment of HBS is safe and shows improvement for patient-rated scar quality but not QoL at six months. As scar maturation is prolonged and dynamic, longer-term follow-up of upwards of two years is required both to understand the eventual clinical effect on scar outcome and to make any definitive conclusion concerning cost-effectiveness. [Abstract copyright: Crown Copyright © 2025. Published by Elsevier Ltd. All rights reserved.
Effectiveness of Functional Resistance Training in Hospital to Prevent Deconditioning and Improve Discharge Pathways: A Service Evaluation.
No full textDeconditioning is a complex process of physiological change following a period of inactivity. This can be observed in a clinical setting when hospital patients have prolonged periods of bed rest. Prolonged bed rest negatively affects health-related outcomes such as cardiovascular, respiratory and musculoskeletal function, and is linked to increased mortality. To combat deconditioning in patients, a functional resistance exercise intervention may be suitable to employ. Exercise interventions can successfully prevent and reverse muscle loss and functional decline, the main component of deconditioning. This service evaluation investigates functional resistance training (FRT) as a preventive measure against inpatient deconditioning, conducted from September 2023 to January 2024 with 146 inpatients admitted to medical or orthopaedic wards. Inclusion criteria were age 65 years or older, ability to follow instructions, no baseline hoisting, and sufficient medical fitness. FRT was delivered by sport and exercise professionals. Outcome measures were strength and function-based and were completed pre- and post-intervention. Statistical analysis was conducted using IBM SPSS Statistics 29 (Windows). Normality was assessed via the Shapiro-Wilk test, with statistical significance set at p ≤ 0.05. Paired t-tests compared admission and discharge outcomes to evaluate the intervention's effectiveness. Spearman's ρ was used to assess correlations between engagement rate and each outcome measure. As this is an evaluation of a current service, with no additional interventions carried out, or additional data collected, ethics approval was not required. Preliminary findings reveal high engagement (average 80%) and significant improvements (p ≤ 0.001) in muscle strength, grip strength, 30-s sit-to-stand test (30STS), and DeMorton's Mobility Index (DEMMI) post-FRT. Handheld dynamometry indicates a notable 30%-50% increase in muscle strength, while grip strength improved by 11%. However, a 20% reduction occurred in patients with < 50% engagement, suggesting deconditioning without FRT. The 30STS observed a 100% increase in repetitions, indicating improved lower limb strength. DEMMI scores showed a statistically significant enhancement in overall mobility post-intervention. Notably, 26 pathways were downgraded with over 80% engagement, suggesting FRT-engaged patients are more likely to downgrade. The positive effects on muscle and grip strength, lower limb function, and overall mobility underscore FRT's potential as a valuable clinical intervention. Downgrades in discharge pathways suggest positive financial implications of FRT. Further research with larger samples and controlled designs is crucial for validating these findings and determining optimal FRT protocols in healthcare settings. [Abstract copyright: © 2025 John Wiley & Sons Ltd.
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