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Integrated care services: Developing strategies for integrated care - A relational content analysis.
Get PDFObjectives The Health and Care Act, 2022 established 42 Integrated Care Systems [ICSs] to oversee strategy, planning, and funding for health and social care within designated areas. Concerns have emerged about the ability of ICS strategy writers to balance national targets with local needs. There is recognition that initial strategies lacked sufficient depth and breadth, necessitating revisions. This paper aims to support ICS strategy writers to meet the requirements of these revisions
Study design A two-phase, systematic relational content analysis was performed. First phase producing aims for future ICS strategies. The second phase, a thematic analysis, produced guidance on intervention themes. Methods The first phase relational content analysis synthesised four foundational documents in the creation of the Health and Care Act, 2022. This allowed a second phase of analysis which aims to offer ICS strategy writers support in the form of a strategy framework.
Results The first phase analysis identified two aims: 1) to provide a sustainably streamlined, collaborated and personalised approach to health and social care access; 2) to be proactive in enabling people to stay healthy from their homes and communities. The second phase of analysis produced four themes to support the creation of a strategy framework, designed to support ICS strategy writers.
Conclusions This paper identified key national policy drivers and expectations that ICS and Joint Future Planning should consider while preparing their strategies. It highlighted components of effective ICS strategy with the aim of moving towards a personalised, joined up health and care system; the need for data in ensuring evidence-based interventions are prioritised in future ICS/ICB strategy; stronger connection to community and the important role of community led workers; prevention and early detection across the care pathway-delivered through a joined-up approach between clinicians and community-led workers; and addressing wider socio-economic determinants of the communities
Adolescent domestic abuse and its consequences: a rapid systematic review
Get PDFPurpose: As a phenomenon, abusive behavior between adolescents in intimate relationships remains relatively invisible, due in part to the persistent yet unfounded assumption that domestic abuse is something that occurs between adults. This review investigates adolescent domestic abuse (ADA), by focusing on the impacts and risk factors for adolescents, particularly those under the age of 16, experiencing ADA.
Methods: We conducted a rapid systematic review by searching three electronic databases (PsycInfo, Embase, and Social Sciences Citation Index). We utilized pre-existing systematic reviews to identify relevant primary studies. Findings of the included studies were described and summarized using narrative synthesis.
Results: Seventy-nine studies were identified for inclusion. Synthesis of the findings of these studies identified five categories of risk and protective factors, including bullying and parental intimate partner violence, social and cultural factors, school and neighborhood environment and health and wellbeing. However, the review also identified a gap of qualitative research and a lack of attention to how ADA intersects with cultural factors, gender differences, criminalization, and poor mental health. Many of the studies report on school-based settings, limiting understanding of the role of neighborhood factors in prevention, protection and recovery. Participatory research on help-seeking behaviors of adolescents is rare.
Conclusions: The review synthesized risk and protective factors associated with ADA, especially those occurring between younger adolescents. It highlighted the complex interplay and overlap between using and experiencing violence and abuse and the need for systematic research to inform the development of advocacy, interventions and prevention that is right for young people
Aspiration and Wrongful Harm: Why the State Owes a Duty to Cultivate Hope
Get PDFThis article argues that the failure of the state to foster the development of the capability to aspire among disadvantaged citizens constitutes a form of wrongful harm. Drawing on the Capability Approach, theories of justice, and recent sociological research on the capacity to aspire, I show that aspiration is not merely a matter of private preference, but a socially embedded capability shaped by structural conditions. When state institutions fail to cultivate this capacity – or worse, actively impede its development – particularly among the disadvantaged, they undermine a central aspect of moral agency. I advance a normative reframing of aspiration deprivation as a state-inflicted harm: under this account, low aspirations are not a tragic by-product of poverty but represent a systematic violation of citizens’ moral personhood and a denial of their capacity for self-authorship. This paper offers a novel account of aspiration as a capability, the deprivation of which grounds duties of rectification, not merely reform. I conclude by arguing that the state’s failure to support this central human capability demands reparative justice – an obligation rooted not in charity or benevolence, but in respect for persons as moral equals
Efficient statistical inference methods for assessing changes in species
Get PDFThe global decline of biodiversity, driven by habitat degradation and climate breakdown, is a significant concern. Accurate measures of change are crucial to provide reliable evidence of species’ population changes. Meanwhile citizen science data have witnessed a remarkable expansion in both quantity and sources and serve as the foundation for assessing species’ status. The growing data reservoir presents opportunities for novel and improved inference but often comes with computational costs: computational efficiency is paramount, especially as regular analysis updates are necessary. Building upon recent research, we present illustrations of computationally efficient methods for fitting new models, applied to three major citizen science data sets for butterflies. We extend a method for modelling abundance changes of seasonal organisms, firstly to accommodate multiple years of count data efficiently, and secondly for application to counts from a snapshot mass-participation survey. We also present a variational inference approach for fitting occupancy models efficiently to opportunistic citizen science data. The continuous growth of citizen science data offers unprecedented opportunities to enhance our understanding of how species respond to anthropogenic pressures. Efficient techniques in fitting new models are vital for accurately assessing species’ status, supporting policy-making, setting measurable targets, and enabling effective conservation efforts
Environmental and social accountability in emerging economies: Strategic pressures from and responses to vulnerable local communities
Get PDFDrawing on Oliver’s typology of strategic responses (1991), this study demonstrates the strategic pressures that vulnerable local communities in Nigeria have exerted on cement companies and the multiple strategies that these companies have devised to discharge their environmental and social accountability (ESA). The data for this study were obtained through semi-structured interviews and document analysis. By exploring the role of local communities in Nigeria, our findings highlight the changing context of ESA in emerging economies in which local communities, often referred to as weak and passive stakeholders, have forced multinational companies to respond to their commitment to ESA. However, the extent to which local communities’ voices can alter companies’ profit maximisation that compromises people’s welfare and the environment has caused concern. The power and influence wielded by companies, which has enabled them to devise a multitude of strategic responses, has subtly dominated local voices and actions, confining ESA practices largely to the content of their annual statements. This raises concerns about current mechanisms for discharging ESA to promote sustainable development and attain sustainable development goals (SDGs) in emerging economies. In investigating the aforementioned, the paper also addresses the call made by prior work delineating the nexus between corporations and local communities in shaping ESA in the unique contexts of emerging economies
The relationship between sleep, interoception, and autistic traits – what role does thermoregulation play?
Get PDFAutistic individuals often experience differences in interoception, including difficulties perceiving or interpreting bodily signals (Shah et al., 2016), and commonly report sleep disturbances (Pavlopoulou, 2020). Thermoregulation, which depends on interoceptive feedback, plays a key role in sleep onset and maintenance (Harding et al., 2020). Although interoception is closely linked to sleep regulation (Wei & Van Someren, 2020), no research has directly examined the relationship between sleep, interoception, and thermoregulation in autism. This study investigated whether interoceptive abilities, thermoregulation, and autistic traits predict sleep difficulties in adults. A general population sample (N = 234) completed an online survey assessing global sleep difficulty (GSD) (measure: PSQI), alongside measures of interoceptive attention (IAT), interoceptive accuracy (IAS), temperature sensitivity (STRAQ-1), trait anxiety (GAD-7), and autistic traits (AQ-28). FDR-corrected correlations showed that GSD was positively associated with trait anxiety (r = .436, p < .001), interoceptive attention (r = .195, p = .019), and high temperature sensitivity (r = .227, p = .022), and negatively associated with interoceptive accuracy (r = –.178, p = .028). Hierarchical regression for GSD showed that trait anxiety (β = .46, p < .001) and age (β = .24, p < .001) were the only significant predictors, explaining 27% of the variance in GSD (F(9, 224) = 9.39, R² = .27, p < .001). A separate regression model predicting sleep latency (SOL) found that trait anxiety was the only significant predictor, though the model explained a modest amount of variance (F(1, 232) ≈ 3.66, R² = .031, p = .027). These findings underscore the central role of anxiety in sleep disturbance and support further research into interoceptive profiles in autistic and sensory-sensitive individuals. Interventions targeting anxiety and interoception may offer novel pathways for improving sleep in neurodivergent populations
A Cost-Effective Saliva-Based Human Epigenetic Clock Using 10 CpG Sites Identified with the Illumina EPIC 850k Array
Get PDFBackground/Objectives: DNA methylation profiles have emerged as robust biomarkers of ageing, leading to the development of “epigenetic clocks” that estimate biological age. Most established clocks (e.g., Horvath’s 353-CpG pan-tissue clock and Hannum’s 71-CpG blood clock) require dozens to hundreds of CpG sites. This study presents a novel saliva-specific epigenetic clock built on 10 sites identified from Illumina MethylationEPIC (850 k) array data.
Methods: Saliva DNA methylation was analysed from 3408 individuals (age range 15–89 years, 68% male, 32% female, no diagnosed disease) from the Muhdo Health Ltd. dataset (2022–2024), and 10 CpG sites were selected where methylation levels showed the strongest positive correlations with chronological age (Pearson r = 0.48–0.66, p < 1 × 10−20). These CpGs map to genes involved in developmental and metabolic pathways (including ELOVL2, CHGA, OTUD7A, PRLHR, ZYG11A, and GPR158). A linear combination of the 10 methylation sites was used to calculate a “DNA methylation age”.
Results: The 10-CpG clock’s predictions were highly correlated with chronological age (r = 0.80, R2 = 0.64), with a mean absolute error of ~5.5 years. Its performance, while slightly less precise than Horvath’s or Hannum’s multi-CpG clocks, is notable given the minimal marker set. It was observed that all 10 clock CpGs undergo age-related hypermethylation. The biological significance of these loci is discussed, along with the potential health and forensic applications of a saliva-based epigenetic age predictor.
Conclusions: This study demonstrates that a saliva-specific epigenetic clock using only 10 CpG sites can capture a substantial portion of age-related DNA methylation changes, providing a cost-effective tool for age estimation
Taming the radical: Domesticating forum theatre in leadership development
Get PDFArts-based approaches to leadership development are becoming increasingly popular because of their potential to highlight the symbolic, aesthetic and sensual dimensions of organizing, thus opening up new possibilities for insights and action. However, our study shows that such interventions can also surface complex dynamics and can be co-opted in ways that diminish their more empowering potential. Our focus is on one such leadership development initiative within a UK based education institution focussing on Forum Theatre, a specific form of dramaturgy typically used to challenge structures of power and oppression. We draw on semi-structured interviews with senior level participants and facilitators to ask whether the programme was effective as a means of learning and empowering the participants. Our findings suggest that the co-option of Forum Theatre to serve organizational interests raises significant concerns when it requires a domestication of its more radical potential
Association Between Financial Hardship, Resilience and Comorbid Depression and Anxiety Symptomatology in Youth From Bogota, Buenos Aires, and Lima
Get PDFObjectives
This study aims to explore the association between reported financial hardship and the presence of comorbid depression and anxiety symptomatology and to identify whether resilience modifies this relationship.
Methods
This is a case–control study with 1705 adolescents and young adults from deprived urban areas in Bogota (Colombia), Buenos Aires (Argentina), and Lima (Peru). Cases of comorbid depression and anxiety symptomatology were defined when the score of PHQ-8 and GAD-7 was higher than 9. The self-report questionnaire asked whether their family had experienced financial hardship and if it was more than a year ago, in the last year, or both periods. The association of financial hardship with comorbid depression and anxiety symptomatology was explored using logistic regressions. We assessed the possible effect modification of resilience (CD-RISC-10).
Results
Financial hardship was associated with comorbid depression and anxiety symptomatology, with the highest odds ratios for hardship reported in the last year and for hardship reported both more than a year ago and in the last year. High resilience was associated with a lower chance of comorbid depression and anxiety symptomatology, especially among participants who reported financial hardship more than a year ago.
Conclusions
This study reinforces the need for financial support programmes and community-based interventions targeting economically vulnerable youth to prevent adverse mental health outcomes
Frugal Meets Circular: A Transformative Approach towards Sustainability
Get PDFSustainability is a holistic notion that encompasses environmental, social, and economic factors as its core components. Approaches attempting to balance the three pillars of sustainability have faced criticism due to the challenge of comparing values such as biodiversity, landscape beauty, costs, profitability, equity, health, and cultural values, which are not clearly commensurable. The concepts of Frugal Innovation and Circular Economy have made significant contributions to advance sustainability and SDGs. Frugal Innovation refers to developing affordable solutions with limited resources while maintaining quality. Circular economy refers to closing the material loop while minimizing waste and maximizing resource use. Scholars have discussed the role of Frugal Innovation and Circular Economy independently in achieving sustainability, however studies integrating these two concepts together are limited. This study explores the interaction between Frugal Innovation, Circular Economy and Sustainability. To advance this knowledge, a systematic literature review supported by PRISMA review methodology has been conducted from the year 2014 until 2024. Our results indicate the synergistic effect of frugal innovation and circular economy in advancing sustainability. Both concepts support each other by increasing efficiency, producing sustainable affordable solutions and scalability. From a policy level, there is a need to develop a conceptual framework integrated with the United Nation (UN) SDGs that are mostly targeted by Circular Economy and Frugal Innovation. Overall, it is particularly important that all stakeholders including government, industry and academia collaborate to promote integrated Circular Economy and Frugal Innovation strategies through aligned policies and joint initiatives