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A Delphi study which seeks to determine expert consensus on the core components and processes of a developmental psychosocial gender identity assessment with a gender diverse young person and their family
No full textIntroduction: Children, young people, and families are increasingly seeking clinical support regarding their gender identity, though the landscape of this support in England is changing. An independent review recently raised several concerns regarding the processes and quality of clinical care, including that the assessment procedures were inconsistent and varied between clinicians.
Aim: This study aimed to establish consensus amongst an expert group regarding the core components and processes of a developmental psychosocial gender identity assessment with a gender diverse young person and their family. It aimed to produce a detailed description of the assessment procedure that would be clinically useful for staff working in new gender services.
Method: Clinicians with recent experience in conducting the assessments were recruited to an expert panel. The Delphi technique was followed. Experts completed three rounds of iterative questionnaires that explored various aspects of a developmental gender assessment, including their purpose, processes, domains, components, and the clinical stance. Expert responses were evaluated against a consensus threshold that included quantitative and qualitative criteria.
Results: Statistical agreement was high throughout the study, though 491 comments were provided that discussed the items and their implications. There were frequent concerns regarding how the statements could be interpreted and subsequently how the information that was gathered may be used. Fifty-six items met the final consensus threshold.
Discussion: A new holistic assessment framework is being implemented within NHS services for gender diverse children and young people. Many findings from this study align with this framework. Additionally, this study has provided a more detailed description of the assessment procedure. It is, therefore, hoped that this study’s findings can be used to support the ongoing implementation of a new service model in the NHS by supporting clinicians to deliver more consistent gender identity assessments with children, young people, and families
What are the lived experiences of Black women with psychosis and how do they make sense of these experiences: An IPA study
No full textEvaluating the impact of Impatiens glandulifera on riparian erosion.
No full textImpatiens glandulifera is an invasive non-native species (INNS) commonly associated with erosion due to its perceived negative impact on native species diversity, which is thought to lead to a reduction in soil cover during winter months. As an INNS, it is widely managed for its supposed environmental harm, with common control methods including cutting and hand-pulling. However, hand-pulling may exacerbate erosion by disturbing soil structure. As I. glandulifera is particularly prolific in riparian zones, any erosion may contribute to sedimentation in nearby watercourses, potentially degrading water quality.
Despite frequent claims linking I. glandulifera to increased erosion, little empirical evidence exists to substantiate this association. There is also no clear consensus on whether the species significantly reduces native plant abundance or diversity. Furthermore, no prior studies have evaluated the impact of managing I. glandulifera on sediment loss.
This research quantifies sediment loss, native species abundance and diversity, and soil physical properties in areas invaded by I. glandulifera across seven sites in the Yorkshire-Derwent catchment, UK. Additionally, sediment loss from riverbanks was assessed before and after management interventions using a Before-After-Control-Impact (BACI) experimental design.
This study’s key finding is that I. glandulifera presence does not cause elevated sediment loss and that it does not reduce native species abundance or diversity. Species composition was found to differ significantly in invaded areas, suggesting that I. glandulifera segregates into microhabitats due to competitive interactions with perennial herbs and grasses. Moreover, hand-pulling was shown to moderately increase sediment loss compared to cutting.
This is the first study to simultaneously examine the effect of I. glandulifera on both riparian sediment loss and vegetation composition. This approach was crucial in providing a robust defence of results that challenge a widely accepted viewpoint in the scientific community and these findings will help land managers make informed decisions regarding the risks associated with the invasion and management of I. glandulifera
Exploring Trauma Related Changes and the Feasibility of Post Traumatic Growth in People with Intellectual Disabilities
No full textIntroduction: Adults with intellectual disabilities (ID) are more likely to experience traumatic events, such as abuse and discrimination, than the general population. Subsequently, considerable research has explored the negative impact of trauma in this clinical group, such as rates and symptoms of post-traumatic stress disorder. Within the wider literature, there has been increased acknowledgment that positive changes can also result from trauma, which has been termed post-traumatic growth (PTG). This thesis aims to explore this phenomenon in people with ID.
Method: Firstly, a scoping review of qualitative studies looking at how trauma impacts on people with ID was conducted, to examine evidence relating to PTG. This was followed by a critical realist thematic analysis of ten semi-structured interviews with people with ID. These interviews explored how people with ID changed following a traumatic event.
Results: In the scoping review, data from 20 papers supported the theoretical feasibility of PTG occurring in people with ID. The empirical study revealed four interconnected themes in how participants changed following trauma: 1) The importance of others listening and helping; 2) The impact of pain and suffering; 3) The power of connecting with others and the need for improved services; 4) Trauma can be a life changing force. Two causal mechanisms were hypothesised to underpin these themes: 1) Participants having a need to seek safety and containment during the trauma and 2) Beliefs and schemas being disrupted and re-formed.
Discussion: These results are consistent with the possibility that people with ID could experience PTG, in addition to trauma related distress. Emphasis was placed on the role of others facilitating PTG in people with ID by providing emotional and practical support. The clinical and research implication of these results are discussed along with the strengths and limitations of the thesis
An exploration of systemic practice students’ experiences of reflecting team participation
No full textBackground: Andersen’s (1987) reflecting team is a method in systemic family therapy wherein a team of clinicians have a reflective conversation in the presence of the family, aiming to introduce tentative ideas and multiple perspectives to the therapeutic process. While systemic practice students participate in the method throughout their training, prior literature has focused on therapist and family experiences of the method, the content of reflections, and students’ experiences of their training more generally.
Method: A constructivist grounded theory (Charmaz, 2014) methodology was adopted to qualitatively explore systemic practice students’ experiences of reflecting team practices and how these experiences contribute to their learning. Students were recruited from a range of UK systemic training courses and 16 participated in semi-structured interviews, analysed using theoretical sampling, coding, memo-writing, and constant comparison techniques.
Results: Findings demonstrated six theoretical concepts which included four key processes students navigate in reflecting team conversations: aiming for a “good reflection”: individual meaning evolves; learning from others, risk taking and feedback; bridging teaching and practice; and developing self and voice. Additionally, two theoretical concepts were identified as conditional contexts which influence students’ experiences of the former four processes: the need for a “safe enough” foundation and working within the context of power relations.
Discussion: Findings are discussed alongside prior research and theory to consider implications for future students. Recommendations are made for training courses to place greater emphasis on the reflecting team method, and greater clarity on competency assessment are needed, indicating that revisions to the Blue Book (AFT, 2015) would be beneficial. The importance of training courses and supervisors emphasising social identity and difference is also noted, as well as identifying a need for group relational reflexivity, and for white students to avoid positioning their black and brown peers to be the ones to speak about race
Elucidating the Impact of Material, Process and Structural Parameters on Fragmented Fibre Release from Textiles During Laundering
No full textFragmented fibres (FF) are increasingly recognised as a pervasive environmental contaminant, contributing to the pollution of air, water, and soil. Their presence in natural ecosystems can potentially harm living organisms by acting as carriers and sources of toxic chemicals. In humans, there is emerging evidence on the potential risks associated with synthetic FF to toxicity, and their role as vectors for pathogens/parasites. Natural and regenerated FF may also contain hazardous chemical residues and can pose environmental and health threats. Household laundering is reported to be a major source of FF emissions, accounting for nearly 5 million kilograms of discharge annually into aquatic environments.
This thesis advances understanding of how textile materials (fibre type) and structures influence FF release during laundering to fundamentally understand the impact of key textile variables. Standardised laundering tests were conducted to systematically assess the influence of fibre properties, yarn structure, fabric construction, and surface finishes. Fibre Fragmentation was quantified through gravimetric analysis and correlated with fibre mechanical properties and manufacturing parameters. This research is pioneering in isolating key textile variables under controlled conditions, enabling the development of novel structure-property relationships governing FF release. The experimental findings reveal the complex interactions between fibre mechanics, yarn processing, and fabric construction.
In addition, a novel fluid dynamics visualisation methodology was developed to capture fibre motion and detachment under turbulent flow conditions, simulating the hydrodynamic forces encountered during washing. This system provides, for the first time, real-time insights into fibre behaviour during turbulence, enabling a mechanistic analysis of fibre motion that leads to fatigue and detachment.
Together, these contributions offer new mechanistic insight into the drivers of fibre fragmentation and provide insights for designing low-shedding textiles. This work supports the development of structure-informed mitigation approaches to contribute to broader efforts aimed at reducing the environmental impact of fragmented fibre pollution at source
The Impact of Attention to Foreign Market Knowledge on SMEs International Performance: The interplay of Business Model Innovation and Market-Positioning Culture
No full textComplex Decision-Making Under Threat
Get PDFResearch suggests that threat may disrupt complex decision-making. Nevertheless, findings are mixed, likely due to indirect, incidental experimental manipulations of threat, an overreliance on summative performance measures, and underexplored motivational influences. This thesis confronts these methodological and conceptual gaps. For my first empirical chapter, I developed and validated a virtual world to manipulate threat during a complex decision-making task. In this paradigm, threat was directly linked to decision-making (and not merely a distraction from the decision-making task). Participants performed worse under threat, taking longer to improve from baseline and scoring lower through the final trials. Moreover, computational modelling revealed that participants in the threat condition were more responsive to short-term rewards and less likely to perseverate on a given choice. In my next empirical chapter, we used an adapted probabilistic reversal learning task to examine decision-making under two specific forms of uncertainty: volatility and stochastic variability. Threat led to higher learning rates and inverse temperature estimates, indicating increased responsiveness to feedback and a greater tendency to exploit current beliefs. These two sets of studies suggest that contrary to the notion of threat rigidity, being under threat increases reward responsivity in ways that affect performance differently as a function of context. The final empirical chapter investigates the effect of evaluative threat on motivational factors relevant to complex decision-making. Specifically, I examined the effects of real-world military training on the motivation to engage with complexity. Results suggest that the evaluative nature of training might interfere with one’s willingness to deal with complexity. However, formative training can mitigate this risk, which may promote motivation to engage with uncertainty. Altogether, these findings help explain current contradictions in the literature. They furthermore offer a foundation for future work supporting individuals who must make difficult decisions within hazardous environments
Investigating Neurophysiological Dysfunction in C9ORF72 Patient-derived Striatal and Lower Motor Neurons
Get PDFFrontotemporal dementia and related amyotrophic lateral sclerosis (FTD/ALS) are fatal neurodegenerative diseases that sit on opposite ends of a clinical disease spectrum typically characterised by progressive degeneration of cortical and motor neurons. However, it is becoming increasingly evident that FTD/ALS pathologically impacts other brain regions. Recently, the striatum, a crucial integrative hub within the brain, has been shown to have a major role in cognitive functions impacted in FTD/ALS, displays classical TDP-43 pathology and neuronal atrophy. Altered neuronal excitability is a hallmark feature of neurodegenerative disease and contributes to disease onset and progression. Here, I have investigated whether electrophysiological function relating to intrinsic excitability and responsiveness to major ionotropic receptors are pathologically relevant in FTD/ALS. To this end, enriched cultures of induced pluripotent stem cell-derived striatal medium spiny neurons (MSNs) and lower motor neurons (LMNs) harbouring C9ORF72 repeat expansion mutations, the most common genetic impairment within the FTD/ALS spectrum, were generated. Using whole-cell patch-clamp electrophysiology my data provides novel evidence of reduced excitability in C9 MSNs, driven by deficits in AP waveform components and delayed outwardly-rectifying K+ (Ik) channel dysfunction. Pharmacological targeting of big conductance Ca2+-activated potassium (BK) channels and voltage-gated K+ channels (Kv3) restored IK channel function and rescued AP waveform deficits, but not intrinsic hypoexcitability, suggesting an interplay between ion channel dysfunction and structural AIS abnormalities. In contrast, C9 LMNs displayed stable excitability under basal and acute KCl stress conditions but exhibited increased excitability upon chronic KCl depolarising stress, implicating homeostatic plasticity mechanisms. Furthermore, C9 LMNs showed potentiated excitatory and inhibitory neurotransmission, with a shift toward NMDAr-mediated signalling, highlighting potential excitotoxic vulnerability. These data implicate complex, regionally specific pathophysiological impairments in C9FTD/ALS that varies between neuronal populations, which has significant implications for future therapeutic strategies
An Authenticity-Oriented Framework for the Conservation of Kelantan Traditional Malay Houses (KTMH-AoCF)
Get PDFTraditional Malay houses (TMH) in Kelantan represent a significant aspect of Malaysia’s architectural and cultural heritage. However, rapid modernisation, urban expansion, and shifting socio-economic conditions have led to alterations that compromise their authenticity. This research investigates the evolution of TMH, focusing on how changes in materials, spatial configurations, and conservation approaches impact their authenticity and heritage value. The study seeks to address the central question: How can the authenticity of Kelantan Traditional Malay Houses be effectively preserved within contemporary conservation practices?
This study uses a qualitative methodology to integrate historical analysis, empirical fieldwork measured drawing reviews, and semi-structured interviews with homeowners, conservation experts, and heritage practitioners. Site observations document physical transformations in KTMH, while legislative and policy analyses assess the effectiveness of existing conservation frameworks. The study also draws upon international and national conservation guidelines to contextualise authenticity-oriented conservation strategies.
Findings indicate that KTMH has undergone consistent and inconsistent changes over time. A key challenge is balancing the need for adaptation with preserving authenticity, as many interventions prioritise convenience over cultural continuity. Additionally, current conservation policies exhibit gaps in addressing the specific needs of vernacular timber structures, leading to inconsistent conservation practices.
This study culminates in developing an Authenticity-Oriented Framework for the Conservation of Kelantan Traditional Malay Houses (KTMH-AoCF), offering a structured approach to maintaining authenticity while accommodating necessary modifications. The framework emphasises context-driven conservation, continuity in traditional craftsmanship, adaptive reuse, and community participation to ensure the sustainable preservation of KTMH and comprises six key components of Authenticity: (a) Form and Design, (b) Materials and Substance, (c) Use and Function, (d) Traditions, Techniques, and Management Systems, (e) Location and Setting, and (f) Spirit and Feeling. This research contributes to heritage conservation discourse by redefining authenticity as a dynamic and adaptable concept rather than a static ideal. It advocates for culturally responsive conservation strategies that respect tangible and intangible heritage values, ensuring the survival of KTMH as a living architectural legacy for future generations
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