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Exploring the attitudes, beliefs, barriers, and facilitators to the uptake of and adherence to exercise and physical activity among Saudi women diagnosed with coronary artery disease: a qualitative study
Get PDFIntroduction: Coronary artery disease (CAD) is the leading cause of death
among women in Saudi Arabia. However, women often underestimate their
CAD risk. Physical activity (PA) is an integral part of secondary prevention of
CAD. PA is known to lower mortality rates and improve the quality-of-life among
individuals with established CAD. PA levels vary between different ethnicities
and genders. In Saudi Arabia, the percentage of women meeting the PA
recommendation is as low as 10%. Despite the low prevalence rate among
Saudi women in general, little is known about their PA habits post-diagnosis of
CAD.
Aim: To explore attitudes, beliefs, barriers, and facilitators to the uptake of and
adherence to exercise and PA among Saudi women diagnosed with CAD.
Methods: A descriptive qualitative study was undertaken. Thirty-two semi
structured interviews were conducted between June 2024 and November 2024,
sixteen with Saudi women diagnosed with CAD and sixteen with healthcare
professionals. The theoretical domain framework informed the data collection
and data analysis, which was undertaken using framework analysis. The
findings were fed into the COM-B model and the behavioural change wheel
(BCW) to identify a potential intervention to promote PA uptake and adherence
among Saudi women post-CAD diagnosis.
Findings: Nine themes and subthemes were identified from both datasets.
Religious and sociocultural influences were highlighted as a main theme as
women reported familial and social obligations take priority over being
physically active, and discussed the effect of the lack of exercise during their
upbringings on their ability to uptake and adhere to exercise and PA. Other
themes discussed knowledge gap, social and professional support and the
perceived barriers and facilitators to being physically active.
Conclusion: This study has provided an insight into the experience of Saudi
women diagnosed with CAD with exercise and PA. Identified facilitators and
barriers were used to develop a potential PA-promoting intervention to improve
overall health and well-being, which was visually illustrated in a logic model
featuring the intervention’s key ingredients, based on the findings of the
application of the COM-B model and BCW
Does Orthodontic Treatment Improve the Oral Health Related Quality of Life of Young People? A Longitudinal, Cohort Study
No full textNanoscale calibration of expansion microscopy to resolve the dynamics of endosome nanodomains in EGFR trafficking
No full textSustainable silica microcapsules for agrochemical applications
No full textPolymer microcapsules have been widely used to deliver agrochemical actives for crop protection but are now regarded as microplastic pollutants. In this Thesis, alternative inorganic microcapsules have been developed to address this environmental problem. Silica was identified as a suitable microcapsule material owing to its low cost and benign environmental profile. First, silica deposition onto micron-sized latex particles using the well-known Stöber silica process was optimised with the aid of an adsorbed layer of chitosan. This model system was chosen to understand the problem of secondary nucleation, but the ethanol-rich nature of the reaction milieu made it unsuitable for microcapsule syntheses. Next, chitosan and hydroxypropyl cellulose (HPC) were used as dual emulsifiers to stabilise a series of oil-in-water emulsions, which were characterised in terms of their mean droplet diameter and electrophoretic behaviour. Various parameters (emulsifier concentration, stirring rate, chitosan/HPC mass ratio, solution pH etc.) were systematically optimised to obtain relatively stable emulsions comprising oil droplets of 5-10 µm diameter. Such oil droplets were coated with a thin overlayer of silica using two soluble silica precursors: tetraethyl orthosilicate (TEOS) and tetramethyl orthosilicate (TMOS). More specifically, TEOS was dissolved in the oil phase prior to emulsification, and TMOS was added to the aqueous phase immediately after emulsification. Various parameters were optimised to control silica deposition onto the oil droplets while varying the target silica shell thickness from 50 to 200 nm. The resulting silica microcapsules were characterised by optical microscopy, laser diffraction, scanning electron microscopy, aqueous electrophoresis, fluorescence microscopy and thermogravimetry. A UV spectroscopy assay was performed to assess the retention of sparingly water-soluble molecules within the microcapsules, revealing that these species were released within a few hours at 20 °C. The retention of the highly hydrophobic Nile Red dye was subsequently monitored by fluorescence microscopy, showing no signs of release over a period of months
“It’s like winning the lottery!”: Using poetic inquiry to re/present parents’ experiences of the education, health and care needs assessment and planning process
Get PDFEducation, health and care plans (EHCPs) were introduced following the enactment of the Children and Families Act (2014) and publication of the SEND Code of Practice: 0-25 years (Department for Education [DfE] & Department of Health [DoH], 2015). They are statutory documents which specify a child or young person’s special educational needs (SEN) and the provision they require (DfE & DoH, 2015, p. 280).
Low parental confidence (Cullen & Lindsay, 2019) in a SEND system that does not appear to “prioritise, recognise or reward inclusion” (ISOS Partnership, 2024, p. 63) is contributing to increasing numbers of requests for education, health and care (EHC) needs assessments (Marsh & Howatson, 2020). The financial stability of the SEND system has been questioned (Sibieta & Snape, 2024) and is described to be in a state of “crisis” (ISOS Partnership, 2024, p. 6). Parents and carers share emotive stories of their battles to obtain EHCPs for their children (Keville et al., 2025; Sandiford, 2025) and report feeling ignored (Hughes, 2024) and dismissed (Hammond, 2024; Starkie, 2024) in the EHC process.
This research sought to capture parents’ and carers’ lived experiences of the EHC needs assessment and planning process through narrative interviews. Drawing on poetic transcription (Glesne, 1997) and Gee’s (1991) linguistic approach to narrative, the narratives of two parents from the Yorkshire and Humberside region are re/presented in poetic form.
This research concludes that the process of obtaining an EHCP is often complex and difficult to navigate; can lack collaboration, transparency and coordination; does not necessarily achieve its aims of being person-centred; and does not always deliver quality EHCPs for children and young people. Parents’ and carers’ experiences are more positive when they feel supported, listened to and valued, and where there is clear communication throughout the EHC process.
Implications for practice for LAs, educational settings and wider services, including educational psychologists, are discussed
Building an amino acid geochronology for Quaternary Europe: a story of time and temperature.
No full textThe Quaternary period (the last 2.5 Ma) is marked by dramatic climate oscillations between cold glaciations and warmer interglacials. This shaped landscapes and influenced the evolution and dispersal of plant and animal communities. Europe has a rich Quaternary record, but a robust chronology is required to understand the impact of past climates on ecosystems. This knowledge may help predict the future effects of present-day climate change, including regional leads and lags. However, dating this record is challenging due to the often discontinuous nature of Europe’s terrestrial deposits. Additionally, most of the Quaternary falls beyond the limits of many radiometric dating methods.
Recent advances in amino acid dating, using intra-crystalline protein decomposition (IcPD) in bithyniid snail opercula, have enabled the construction of regional aminostratigraphies for Britain and the East European Plain. In this thesis, the use of IcPD is expanded across continental Europe, building regional frameworks for Germany, Hungary, and Poland. These frameworks include material from multi-aged sites spanning much of the Quaternary, anchored and validated at some sites by independent chronology. Expanding this dating approach to a wider geographical area has enabled the differences in IcPD extent due to temperature variations to be assessed to determine if any regional frameworks can be cross correlated to one another. Both climate and sub-surface temperature variables are shown to be important. Systematic differences due to sub-surface factors such as depth and the geothermal gradient show that material buried below 80 m is not directly comparable to near-surface deposits. Systematic differences in IcPD due to latitude and continentality in near-surface deposits have been assessed by exploring Quaternary temperature reconstructions. The systematic differences increased with age until racemic equilibrium was reached. This indicated that regions where colder conditions persisted for longer (and have had a higher degree of continentality) have opercula with reduced IcPD. This work has established and validated new aminostratigraphic frameworks across northern and central continental Europe, which can now be used to answer questions relating to Quaternary chronostratigraphy. In addition, this work has improved knowledge of the real-world effects of temperature on IcPD, laying the groundwork for a pan-European aminostratigraphic framework
Shantytown Redevelopment Projects: State-led redevelopment in Chongqing, China
Get PDFSince 1978, China's transition from a planned to a market economy, driven by neoliberal reforms, has profoundly reshaped the governance of shantytown redevelopment projects (SRPs). While market forces dominate urban redevelopment, the state remains pivotal, particularly in directing large-scale urban transformations. This duality has sparked debates over the state's role in policy implementation, market intervention, and the resulting disparities among stakeholders involved in SRPs. In 2008, the central government launched a nationwide shantytown redevelopment initiative, marking a turning point in urban governance. These projects aimed not only to improve substandard living conditions but also to align redevelopment efforts with broader goals, including economic growth, social stability, and urban modernization. The 18T Redevelopment Project in Chongqing serves as a flagship case, involving the relocation of over 6,000 households and a large number of shantytown tenants. It encapsulates the complexities of balancing state intervention, market dynamics, and stakeholder interests within the SRP governance framework. This study investigates the implementation of SRPs in Chongqing by examining stakeholder engagement and the operationalization of state-led governance mechanisms in the 18T project. Drawing on in-depth interviews with government officials, developers, and residents, as well as detailed policy analysis, the research unveils a governance model shaped by a top-down authoritarian approach infused with managerialist strategies and populist elements. The findings reveal a complex interplay between policy design, state-individual relations, and stakeholder dynamics, offering critical insights into the evolving governance landscape of urban redevelopment in China
From Tone to Tempest: Pricing Subtle Signals and Environmental Risks in Financial Markets
No full textExtraterrestrial impacts and their consequences for the biosphere
No full textThe K-Pg mass extinction was an important period of Earth’s history, reducing biodiversity by some 75% and paving the way for mammals to rise to ecological dominance. Occurring 66 million years ago, a large asteroid collided with the Earth’s surface as the Deccan Trap large igneous province was also active. Although the K-Pg asteroid impact is the likely primary driver behind this mass extinction, it is difficult to measure the impact of the co-occurring volcanism on the extinction event.
A high-resolution Paleogene surface temperature record is utilised to investigate the biosphere’s recovery on Earth following the K-Pg impact.
This thesis showcases the development and usage of a new model that allows for the injection of discrete, single-time events into a non-linear interpolating solver; this injection is used to emulate recovery after the K-Pg impact in deep-time. This model, called SMITE, utilises a dynamic vegetation model linked to a climate and biogeochemical model. SMITE is used to explore the hypothesis that vegetation change due to the impact could have driven the temperature profile of the geological record; the confirmation of which would negate the impact of the large igneous province.
I find that plausible vegetation feedbacks can reproduce the duration of warming seen within the geological record, but the model overpredicts the degree of warming present after the K-Pg impact, indicating that relatively low fire intensities or very fast regrowth times may be more plausible than severe scenarios. This work supports the hypothesis that vegetation recovery following the impact was rapid, and that the asteroid impact was the likely primary driver behind the K-Pg mass extinction.
Future work aims to better constrain vegetation re-establishment and regrowth to better recreate the geological record
Interrogating fungal adjuvant and glycan nanoparticles for modulating interleukin-23 expression via the dendritic cell receptor DC-SIGN
Get PDFThe seronegative spondyloarthropathies (SpA) are a group of inflammatory diseases affecting the joints. They are intricately linked to interleukin (IL) -23 biology and respond to anti-IL-23 directed therapy. Although established as a pivotal cytokine in the pathogenesis of SpA, the in vivo factors that regulate IL-23 production, both overproduction and downregulation, remain poorly defined. The IL-23/IL-17 pathway is also inextricably linked to fungal immunity and emerging evidence suggests that intestinal microbiota and fungal cell wall glycans may critically influence IL-23 production. Mannose and fucose containing carbohydrates represent a large proportion of the molecules present on bacterial and fungal surfaces and are key binders to the tetrameric C-type lectin DC-SIGN, making this lectin a potential candidate for triggering high IL-23 production by dendritic cells (DCs) in vivo.
This thesis is split into two parts and investigates how DC-SIGN is involved in the regulation and modulation of the IL-23/IL-17 axis in DCs. Part A explored the importance of multivalent lectin-glycan interactions (MLGIs). A detailed understanding of how multivalent ligands interact with tetrameric lectin DC-SIGN, including the underlying structural and biophysical mechanisms, is vital to design glycoconjugates that can potently and selectively target MLGIs for therapeutic intervention. Such insights can also clarify how variations in glycan type and flexibility induce distinct signalling outcomes. To this effect, glycan conjugated gold nanoparticles (GNP-glycans) were developed to probe MLGIs with DC-SIGN. Binding studies combining dynamic light scattering, isothermal titration calorimetry, and a fluorescence quenching assay were used to provide structural information on DC-SIGN, e.g. binding site orientation, binding mode, and inter-binding site spacing, which is critical to design specific multivalent binders. These studies further revealed how key aspects of glycoconjugate design can affect the binding affinity. Importantly, multivalency enhanced binding affinity into the low nanomolar range but was impacted by linker length, density and glycan type, which was intricately linked to both thermodynamic contributions and binding mode. Increasing the linker length weakened binding affinity due to the increased entropic penalty upon constraining longer, more flexible linkers, and lowering the glycan density reduced enthalpy changes of binding due to increased strain and a reduced ability of GNP-glycans to bridge multiple carbohydrate recognition domains (CRDs) on one lectin simultaneously. These GNP-glycans potently inhibited DC-SIGN-mediated augmentation of Ebola virus glycoprotein-driven cell entry, with a positive correlation observed between binding affinity and IC50, demonstrating the therapeutic potential of multivalent glycoconjugates.
Part B explored how signalling through DC-SIGN can modulate IL-23 production in DCs. Cooperation between different innate signalling pathways in DCs is crucial for initiating adaptive immunity to pathogens, and carbohydrate-specific signalling through DC-SIGN provides DCs with the plasticity to tailor immunity to the nature of invading microbes. Here, DCs were co-stimulated with Toll-like receptor ligands in the presence of the DC-SIGN ligands, and their cytokine responses were compared to controls in the absence of DC-SIGN ligands. While free fucose and dimannose ligands differentially regulated IL-23 production, GNP-glycans did not significantly modulate IL 23 production, despite exhibiting nanomolar binding affinity to DC-SIGN, highlighting the importance of ligand concentration and glycoconjugate shape/size, as well as binding strength, in initiating signalling cascades. Furthermore, fucose and dimannose ligands skewed T cell responses toward Th17 and Th2 profiles, respectively. Blocking DC-SIGN did not totally abrogate immune modulation, indicating the input of other mannose and fucose binding lectins in co-signalling. Therefore, a GNP based affinity pull down assay was developed as a way to isolate and identify other GNP-glycan binding proteins on the cell surface. Interaction between the dimannose based affinity tags and DC-SIGN was glycan specific, and selective over non-targets. Proteomic approaches were used to identify the isolated DC-SIGN from its peptide sequence.
Overall, these findings advance understanding of DC-SIGN–mediated regulation of the IL-23/IL-17 axis, reveal structural principles underpinning multivalent glycan recognition, and point toward strategies for therapeutic modulation of inflammatory and infectious disease pathways
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