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The SPACES feasibility trial: a co-produced physical activity intervention for people with severe mental illness
Get PDFBackground
People with severe mental illness (SMI) experience a lower life expectancy compared to the general population. Taking part in regular physical activity can decrease the risk of physical health conditions (e.g. cardiovascular disease). People with SMI are less physically active than those without SMI. This is due to a variety of factors. Currently, physical activity interventions are not a part of standard care for people with SMI. Interventions that have been examined have lacked lived-experience input and produced limited engagement. An intervention has been co-produced to support people with SMI to increase their levels of physical activity.
Methods
The feasibility of delivering the Supporting Physical Activity through Coproduction in People with Severe Mental Illness (SPACES) intervention was evaluated in a two-armed randomised feasibility study. The recruitment and follow up processes, and the acceptability and suitability of the intervention were assessed. Physical activity levels were measured using an accelerometer. Progression to a definitive study was evaluated in accordance with set a priori criteria.
Results
In total 73 people consented and 71 people were randomised across 6 National Health Service (NHS) sites. Thirty-five were allocated to the control and 36 to the intervention. Nine people formally withdrew from the study; 8 from the control and 1 from the intervention. Overall follow-up rates of 87% and 76% were observed at the 3- and 6-month follow-ups respectively. The group intervention was delivered by NHS staff at all six sites.
Conclusion
The SPACES feasibility study met the pre-determined progression criteria to a definitive randomised controlled trial
PIEZO1 channel mechanosensing in hepatobiliary physiology and disease
No full textThe hepatobiliary system is constantly exposed to dynamic mechanical forces, including fluid shear stress, bile canaliculi pressure, and extracellular matrix stiffness. While traditionally studied for its metabolic and detoxifying functions, it is now increasingly recognised as a mechanosensitive organ. This review focuses on PIEZO1 mechanically gated ion channels that transduce physical cues into calcium-dependent signalling events. PIEZO2, the only other PIEZO isoform, is not known to be relevant in the hepatobiliary system. We examine the current knowledge on PIEZO1 in liver physiology, highlighting its roles in liver sinusoidal endothelial cells, hepatocytes, and macrophages. In health, PIEZO1 regulates key processes such as bile acid synthesis (via nitric oxide–mediated suppression of CYP7A1), bile flow, antioxidant defence, and iron homeostasis. In disease, PIEZO1 activity is linked to pathological processes such as inflammation, fibrosis and angiogenesis in the context of cirrhosis and hepatocellular carcinoma. We discuss the idea that the liver alternates between two functional states depending on portal vein flow: a high-flow state favouring detoxification and metabolism, and a low-flow state that prioritises bile acid production. Understanding how PIEZO1 contributes to these transitions offers new insights into liver’s ability to adapt its function and metabolism. Further research on hepatobiliary PIEZO1 will advance the understanding of how physical exercise promotes health and opens new opportunities for enhancing liver regeneration after surgical resection and liver function in chronic diseases such as fibrosis and cirrhosis
Leveraging Employees' Social Capital for Organizational Resilience in Small and Medium-Sized Enterprises: The Role of High-Involvement Work Practices
Get PDFEmployees' bridging social capital (EBSC), conceptualized as the collective bridging social capital that employees bring into the organization, has been recognized as a potential resource for fostering organizational resilience (i.e., the ability to survive and thrive when confronted with unexpected disruptions and challenges), especially for small and medium-sized enterprises (SMEs) operating in a turbulent business environment. However, the questions of how and when EBSC relates to organizational resilience remain underexplored. Drawing on dynamic capabilities theory, we propose that knowledge sharing—a dynamic and emergent process where knowledge is introduced, exchanged, combined, and integrated within organizations—represents a key process through which EBSC may be associated with organizational resilience. We further propose that this mechanism is stronger in organizations that extensively implement high-involvement work practices (HIWPs). Using data from 1131 participants (including top management team members, middle-level managers, and entry-level employees) across 175 SMEs in Nigeria, we find that the relationship between EBSC and knowledge sharing, as well as the indirect association between EBSC and organizational resilience via knowledge sharing, is stronger when HIWPs are high rather than low. These findings highlight the importance of HIWPs in leveraging EBSC to enhance organizational resilience, providing practical insights for SMEs seeking to harness EBSC for organizational advantages
Fracture properties, structural heterogeneity, and permeability in the Þeistareykir geothermal system, NE Iceland
Get PDFPermeability in the Þeistareykir geothermal system of Iceland is structurally controlled. Natural fracture networks are abundant in Þeistareykir and contribute significantly to fluid flow. Understanding which features enhance permeability and hydraulic conductivity, and how their properties interact with lithology and reservoir structure, is key to predicting reservoir behaviour. To address this, we utilise a range of borehole data to characterise natural fractures in terms of their occurrence, orientation, relative distribution, their relationship with the major lithological units and permeable flow zones in the subsurface. Results show systematic variations in fracture density, thickness, and distribution pattern across different lithologies and depths, with orientations ranging from NNW-SSE, N-S, NNE-SSW to NE-SW. Fractures exhibit the highest intensity in the deeper acidic intrusive units or coarser grained basalt with a predominant N-S-trend and bimodal dip distribution. However, permeability is controlled by a complex interplay of fracture geometry, openness and connectivity rather than simply high fracture abundance or a preferential set of fractures. Permeable feed zones show diverse structural expressions, ranging from high-density fracture clusters and large-aperture fractures to intensely fractured damage zones and multiple intersecting fracture sets. These findings demonstrate that the structural character of the potential fluid-flow channels is highly variable in Þeistareykir. The results of this study can be incorporated into fracture and flow models to enhance our understanding of the permeability distribution and fluid pathways in the Þeistareykir geothermal system
InAs/InAlGaAs Quantum Dot Lasers on InP and Si
Get PDFWe report the development of InAs/InAlGaAs quantum-dot (QD) lasers grown on both InP and Si substrates. A modified indium flush technique was employed to control dot-height distribution and tailor the emission wavelength by using a strained partial capping layer. Using this approach, 7-stack InAs/InAlGaAs QD lasers on InP substrates exhibit a low threshold current density (Jth) of 63 A/cm2 per QD layer and high-temperature operation up to 140 °C. Furthermore, electrically pumped InAs/InAlGaAs QD lasers directly grown on Si are also demonstrated, with a low Jth of 1.35 kA/cm2 and a maximum operating temperature of 100 °C. This work highlights the effectiveness of the modified indium flush in achieving high-performance InAs/InAlGaAs QD lasers. These results represent a significant step forward in the development of high-performance C-/L-band QD lasers in the InAs/InAlGaAs/InP material system for Si photonics
The State of Palliative Care in Nigeria: A Scoping Review
No full textContext
Globally, about 85% of palliative care need is unmet. Africa accounts for 20% and 52% of adult and pediatric palliative care burden worldwide, respectively. Nigeria has progressing palliative care provision and meets only 0.2% of national need.
Objectives
To describe extant literature detailing palliative care knowledge, implementation, medicine availability, education, policy, vitality, and research in Nigeria, propose areas for future scientific inquiry, and inform interventional targets.
Methods
Arkey and O’Malley design for scoping reviews reported per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. PubMed, Embase, Cochrane CENTRAL, Web of Science, Scopus, and African Index Medicus were searched in January 2024 and updated in December 2024. Full-text, peer-reviewed articles in English describing palliative care in Nigeria were included.
Results
Of the 6,116 search results, 290 underwent full-text review and 59 satisfied inclusion criteria. Most studies examined palliative care knowledge, attitudes, and practices while few evaluated implementation practices or interventions. Palliative care awareness in Nigeria is low; however patients, family caregivers, and healthcare professionals have expressed interest in expanded education, infrastructure, and culturally-appropriate delivery models. Persistent challenges include opioid availability, delayed referral, inconsistent education, insufficient institutional and federal policy, and absent professional validation.
Conclusions
The gaps in palliative care in Nigeria identified by this review can inform interventional targets for national acceptance and equitable delivery. It is critical to prioritize multi-level policy changes to expand access to high-quality palliative care services and mitigate the growing burden of suffering among the seriously ill
Cocreating a Field Practical through a Participatory and Inclusive Approach, Involving Lectures, Measurements and Data Analysis, to Understand Key Air Quality Concepts
Get PDFMiddle managers as barriers or enablers in tackling racial discrimination in the NHS: a qualitative research study
Get PDFObjective: To explore the role of senior and mid-level managers as barriers or enablers to change in tackling the discriminatory challenges experienced by Black and Minority Ethnic (BME) employees working in the National Health Service (NHS).
Design: A multi-level, multi-sourced qualitative study of five NHS Trusts in England.
Setting and participants: 26 qualitative interviews with senior leaders and BME network chairs (27 participants) and five focus groups (37 participants) with BME employees, across five NHS Trusts in England.
Results: Our findings revealed that discrimination, racial harassment, incivilities, lack of progression and exclusion experienced by BME employees appear to be deeply ingrained in the culture of the NHS. Despite numerous national and local initiatives aimed at promoting inclusivity and addressing discriminatory behaviours, our findings also revealed a notable disparity between what senior leaders thought was effective in addressing discriminatory behaviours and the actual lived experiences of BME employees. Finally, a key finding was the pivotal role middle managers played in setting the tone for whether discriminatory behaviours are challenged or allowed to persist, which directly impacts on the overall experiences of BME employees within the NHS.
Conclusions: Our results provide evidence that not only does racial discrimination continue to be experienced by NHS BME employees, but that middle managers are key to addressing and improving this situation. Despite there being national policies and initiatives addressing racial discrimination, our study found that positive change, whether at an individual or organisational level, is dependent on the actions and commitment of middle managers
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