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Predictors and Correlates of Loneliness and Social Isolation in People With Dementia: Longitudinal Findings From the IDEAL Programme
No full textKey Points:
• We investigated the prevalence and predictors of loneliness and social isolation in a large cohort of people with dementia over a 24-month period.
• The proportion of people who could be categorised as lonely or social isolated increased over the 24-month period.
• People with dementia who lived alone, had higher depression scores and were more socially isolated were at a greater risk of loneliness at baseline.
• Increased participation in cultural activities, higher perceived availability of green or blue spaces and higher neighbourhood trust were associated with less social isolation at baseline.
• Only perceived neighbourhood trust was associated with change in loneliness longitudinally.Data Availability Statement:
The data that support the findings of this study are openly available in UK Data Service at http://reshare.ukdataservice.ac.uk/854293/, reference number 10.5255/UKDA-SN-854293.Objective:
To identify predictors of loneliness and social isolation experienced by people with dementia at baseline and over time.
Methods:
Using data from the Improving the experience of Dementia and Enhancing Active Life (IDEAL) cohort study (2014–2018), we examined the prevalence and predictors of loneliness and social isolation in 1547 people with mild-to-moderate dementia over 24 months. Loneliness was measured using the six-item De Jong Gierveld Scale at baseline and 24 months and social isolation by the six-item Lubben Social Network Scale at baseline, 12 and 24 months. Generalised linear mixed effects models examined possible predictors of loneliness and social isolation including individual characteristics, depression, cognition, cultural participation, and neighbourhood characteristics.
Results:
At baseline 35.4% of people with dementia were categorised as being lonely and 28.8% as socially isolated, increasing to 39.3% and 32.0% 2 years later. Over the 24-month follow-up none of these predictors were associated with changes in social isolation scores. Only perceived neighbourhood trust was associated with change in loneliness longitudinally. At baseline, depressive symptoms, living alone, smaller social networks and lower neighbourhood trust were associated with greater loneliness. Cross-sectionally, loneliness and lower cognitive ability were associated with greater social isolation, and greater cultural participation, more green and blue spaces nearby and higher neighbourhood trust were associated with lower social isolation scores.
Conclusions:
The findings highlight the importance of the local environment and cultural participation for people with dementia. Enhancing interactions with the local neighbourhood through initiatives such as dementia friendly communities may help to reduce loneliness and social isolation.‘Improving the experience of Dementia and Enhancing Active Life: living well with dementia. The IDEAL study’ was funded jointly by the Economic and Social Research Council (ESRC) and the National Institute for Health and Care Research (NIHR) through grant ES/L001853/2. Investigators: L. Clare, I.R. Jones, C. Victor, J.V. Hindle, R.W. Jones, M. Knapp, M. Kopelman, R. Litherland, A. Martyr, F. Matthews, R.G. Morris, S.M. Nelis, J. Pickett, C. Quinn, J. Rusted, J. Thom. ESRC is part of UK Research and Innovation (UKRI). ‘Improving the experience of Dementia and Enhancing Active Life: a longitudinal perspective on living well with dementia. The IDEAL-2 study’ was funded by Alzheimer's Society, Grant Nos. 348, AS-PR2-16–001. Investigators: L. Clare, I.R. Jones, C. Victor, C. Ballard, A. Hillman, J.V. Hindle, J. Hughes, R.W. Jones, M. Knapp, R. Litherland, A. Martyr, F. Matthews, R.G. Morris, S.M. Nelis, C. Quinn, J. Rusted. This report is independent research supported by the National Institute for Health and Care Research Applied Research Collaboration South-West Peninsula
Mapping Decolonial Cinema
Full text linkThe articles that animate this special issue aim to map and investigate decolonial practices in cinematic worlds from the Global South. Whilst the scope is for obvious reasons limited to only few practices and context, this approach emphasises the potential of these cinemas to resist hegemonic filmic (and more generally cultural) forms and to move beyond thematic concerns, formal strategies and industrial frameworks generated and sanctioned in the Global North. ..
As large as microscopic life: A comprehensive guide to accurate estimates of body mass and allometric scaling for the aquatic micro-world
No full text........
Disaster governance and inequality-responsive accounting: Grenfell and Grand Kartal fires in times of institutional neglect, spatial justice and the evasion of accountability
Full text linkInfrastructures are never neutral; they reflect social priorities, institutional silences, and unequal entitlements to safety. This article explores how disaster governance practices contribute to the differentiated distribution of vulnerability and the systematic neglect of marginalised lives. Through a comparative case study of the Grenfell Tower fire in the United Kingdom and the Grand Kartal Hotel fire in Turkey, we examine how institutional breakdowns interact with austerity, outsourcing and technocratic accounting regimes to both produce harm and obscure responsibility. Grounded in critical urban theory and interpretive approaches to accounting, we propose the framework of Inequality-Responsive Accounting, which conceptualises accounting as a spatial and political instrument shaped by broader power relations. The framework introduces five interrelated tools: vulnerability mapping, accountable regulation tracking, chain of responsibility audits, spatial equity budgeting and redistributive risk accounting. These tools enhance institutional responsiveness to marginalised groups and disrupt procedural routines that displace substantive accountability. Our analysis shows how accounting systems act as selective mechanisms of recognition and exclusion, influencing whose lives are safeguarded and whose are treated as expendable. By tracing the political geographies of disaster governance, the article highlights how infrastructural inequality is sustained through ostensibly routine institutional operations.This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors
Toxic experts in longevity business: A multilevel relational framing of emergence
No full textIn this paper, we introduce and theorize the concept of toxic experts as individuals who, by virtue of their perceived or actual expertise, systematically engage in behaviors characterized by professional and intellectual vices. Despite maintaining an appearance of legitimacy, toxic experts exploit public trust by disseminating unsubstantiated, misleading, or harmful claims for personal and commercial gain. Drawing on a multidisciplinary framework, we integrate diverse insights to explain how toxic expertise emerges and persists. Specifically, we combine ethical and epistemic perspectives that distinguish genuine expertise from opportunistic misrepresentation. We analyze how social and institutional recognition shapes expert authority. Then we examine how structural transformations of work erode professional integrity and identify cognitive mechanisms that sustain trust in unverified claims. Using the case of the longevity biotechnology business, we develop a multilevel relational theoretical framework that identifies: (i) the historical and socio-cultural preconditions that enable toxic experts to emerge, (ii) the social and cognitive processes through which they gain and maintain legitimacy, and (iii) prevention strategies centered on cascaded accountability reforms. Our contextualized perspective challenges the depiction of toxic experts as isolated deviant individuals, revealing them instead as products of broader social, institutional, and ideological conditions. We argue that mitigating their influence requires cascaded regulatory interventions at societal and institutional levels to restore public trust and prevent toxic outcomes.The authors received no financial support for the research, authorship, and/or publication of this article
Re-evaluating the nature of Euroscepticism in border regions: Narratives of Europe in a European election year (Deliverable 3.2: Report on the results of interviews and focus groups)
No full textIn this report, we present a narrative analysis of our original politician interview and citizen focus group data to investigate how borders are featured and narrated in European election campaigns, and how border region residents respond to border narratives in the broader frame of their perceptions of the European project. We use ‘structured narrative analysis’, whereby we seek out recurring narratives about borders. In this, we include both master narratives that were identified a priori, and narratives that emerge spontaneously from the bottom up. ...UKRI Horizon Europe Guarantee, ref. no. 10065228 (this project has received funding from the European Union’s Horizon Europe research and innovation programme under grant agreement No 101095186 (B-SHAPES.
Prioritising cardiopulmonary exercise testing for adults with cystic fibrosis: a service evaluation
Full text linkWe are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.Data availability:
The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.Background:
Cystic Fibrosis is an inherited, life-limiting condition causing a range of symptoms including lowered exercise tolerance. Approximately 95% of people with cystic fibrosis in the United Kingdom are now eligible for new genetic modulator therapies. As a result, cystic fibrosis centres are treating older populations in greater numbers. Cardiopulmonary exercise testing measures aerobic capacity, however it is resource intensive. Identifying whether routinely collected clinical measures are associated with reduced aerobic capacity is needed to aid prioritisation of cardiopulmonary exercise testing.
Methods:
Maximal cardiopulmonary exercise testing data were collected from July 2022 to January 2024, alongside routine clinical data (spirometry, body mass index, diabetic status, Pseudomonas aeruginosa colonisation status, modulator status, age and sex). Peak oxygen uptake was analysed as a percentage predicted value (VO2peakpp).
Results:
Overall aerobic capacity at the centre was low (mean peak oxygen uptake 79.16% predicted). No relationship was identified between body mass index and aerobic capacity (β = 0.23, 95%CI -0.91, 1.37, p = 0.69). When adjusting for other clinical measures, having cystic fibrosis related diabetes (β=-17.56, 95%CI -27.17, -7.95, p < 0.001) and younger age (β = 16.62, 95%CI 4.13, 29.12, p = 0.01) were associated with a reduction in VO2peakpp.
Conclusion:
Annual CPET for all pwCF may not be necessary or available. This service evaluation found associations with younger age and CFRD and reduced VO2peak who could be targeted for exercise testing and training intervention in the future.No funding was received to fund this project
The pollution load of combined sewer overflows and risks to England’s waterbodies: Relating event duration monitoring data to discharge consents from wastewater treatment works
No full textData availability: Data are available as Electronic supplementary information.All data used in this study are available through publicly accessible datasets (as cited). Data generated through the analyses are provided as Electronic Supplementary Information in the Supplementary Materials.Supplementary files:
Supplementary information: https://www.rsc.org/suppdata/d5/ew/d5ew00860c/d5ew00860c1.csv
CSV (4518K).
Supplementary information: https://www.rsc.org/suppdata/d5/ew/d5ew00860c/d5ew00860c2.xlsx
XLSX (1503K).
Supplementary information: https://www.rsc.org/suppdata/d5/ew/d5ew00860c/d5ew00860c3.csv
CSV (855K).
Supplementary information: https://www.rsc.org/suppdata/d5/ew/d5ew00860c/d5ew00860c4.pdf
PDF (138K).The increasing frequency of Combined Sewer Overflows (CSOs) has heightened public concern, triggered government action, and driven water authorities worldwide to commit to major infrastructure upgrades. In England, the installation of Event Duration Monitors (EDMs) has revealed how often and for how long spills occur annually, discharging untreated or dilluted sewage to the receiving environment. However, overflow frequency and duration are poor proxies for pollution loads or ecological risk. This study provides the first national estimation of pollution loads from individual CSOs and the risks they pose to receiving waterbodies, drawing on permitted effluent limits from connected Wastewater Treatment Works (WWTWs) and receiving waterbody characteristics. A source-pathway-receptor framework is used to classify risk across England’s wastewater systems in relation to CSO discharges and their impacts. The findings challenge the Environment Agency’s position that CSOs are not a primary driver of waterbody status failure, indicating their ecological impacts may be underestimated. For 2023, estimated aggregated CSO loads frequently surpassed those from the effluents of their WWTWs, with affected waterbodies receiving loads from CSOs four times higher for BOD and double for Suspended Solids. While nutrient loads exhibit lower relative contributions, the presence of wastewater systems where CSO loads equal or exceed treated effluent loads demonstrates that nutrient management strategies focusing solely on WWTWs risk overlooking a critical source. The study demonstrates how a systems approach integrating all available data, can strengthen evidence-based policy making, and support water companies in prioritising investments that can deliver measurable environmental improvements.Dr Theodoros Giakoumis acknowledges support from the Brunel Research Initiative & Enterprise Fund (BRIEF), award No. 11937130, which provided partial funding for Sawsan Diya’s contribution to the digitisation of South West Water CSSs and for connecting their EDM 2023 to WWTWs
Caveolar Endocytosis Governs Nanoneedle Transfection
Full text linkSupporting Information:
The Supporting Information is available free of charge at https://pubs.acs.org/doi/10.1021/acsnano.5c11011#_i36 .Nanoneedles are emerging as a safe and scalable strategy for the genetic modification of primary human cells. However, a limited understanding of how interactions at the biointerface lead to functional gene expression continues to hinder clinical translation. While direct membrane penetration, permeabilization, and endocytosis have been proposed as intracellular delivery avenues, the mechanistic connection between delivery and successful transfection remains unclear. Here, we identify caveolae-mediated endocytosis, dependent on Caveolin-1, as a key mechanism enabling nanoneedle transfection. By selectively modulating Caveolin-1 expression in primary human regulatory T cells and MG63 cells and investigating endolysosomal processing, we show that although nucleic acids can be efficiently delivered in the absence of Caveolin-1, gene expression occurs only when caveolar endocytosis is present. These findings reveal a mechanistic basis and establish a broader design principle for nanoneedle transfection: interfacing must be accompanied by the engagement of permissive cellular trafficking pathways to achieve gene expression.C.C. acknowledges funding from the European Union under the ERC Starting Grant ENBION 759577 and the Medical Research Council under the Confidence in Concept award (MC_PC_18052) and King’s-China Scholarship Council (202106230065)
Data sources:
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