Open Research Exeter - University of Exeter
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John Marston’s ‘Poules-worke’: Smellscapes and Scent Effects in <i>Antonio and Mellida</i>, <i>Antonio’s Revenge</i>, J<i>ack Drum’s Entertainment</i>, and <i>What You Will</i>
No full textJohn Marston’s use of olfactory effects in his late Elizabethan plays for the Children of Paul’s – Antonio and Mellida, Antonio’s Revenge, Jack Drum’s Entertainment, and What You Will – demonstrates the extent to which his children’s company drama works with the specific site of its production. By introducing odours into his plays that would be familiar to residents of and visitors to the Paul’s area, including tobacco, perfume, torch fumes, and incense, Marston prompts his audiences to reconceptualize one of London’s most important sites by scrutinizing the religious, commercial, social, and theatrical significance of its multi-layered smellscape. In the process, he develops an olfactory profile for the new Paul’s that identifies his theatre with refined luxury, fashion, and sometimes risqué sensuality.</p
Rewards-based crowdfunding as an institutional carrier: The cross-border backing of environmental projects
No full textEntrepreneurs pursuing environmental projects face a paradox: they are most needed in weak institutional contexts, but in these contexts, they are also most under-resourced. We investigate whether global rewards-based crowdfunding platforms can mitigate this paradox by channeling cross-border (financial) resources to environmental projects, especially in weak institutional contexts. Drawing on institutional theory, we conceptualize such platforms as cross-border institutional carriers that transmit backer support across borders guided by pro-environmental community logics. Using Kickstarter data spanning campaigns in 153 countries and backers from 226 countries and territories, we find a positive relationship between projects' environmental orientation and their likelihood of attracting cross-border funding. Moreover, this cross-border support originates from countries with stronger environmental institutions and is especially directed toward projects in weaker institutional contexts. Our findings differ from prevailing expectations from international entrepreneurial finance research focused on venture capitalists and angels, which emphasize cross-border disadvantages for risky, environmental projects in weak-institutional contexts, while we report cross-border fundraising advantages for these projects. Our study contributes to research on the nexus of institutional theory, international entrepreneurship, and crowdfunding research by showing how international crowdfunding platforms can enable the bottom-up diffusion of pro-environmental values and resources across country borders.</p
Spatial control of crystallinity in additively manufactured PAEK: strategies for interlayer and intralayer functional grading
No full textThis study presents a novel framework for manufacturing polyaryletherketone (PAEK) based functionally graded materials (FGMs) with controlled, stepwise stiffness gradients. While traditional material extrusion (MEX) gradients are often limited to vertical variations due to discrete layer stacking, we propose two strategies to achieve discontinuous interlayer or intralayer gradation using a commercial printer. First, we produced a stepwise interlayer (vertical) stiffness gradient using a single material (slow crystallising PAEK AM200) by actively modulating thermal profile to create distinct sections varying in crystallinity (ranging from 9 % to 49 %). Second, we achieved a discrete intralayer (horizontal) gradient by combining fast crystallising PEEK 450 (t1/2 = 1.4 s) and slow crystallising PAEK AM200 (t1/2 = 15 s) within the same layer, resulting in sharp material interfaces. By spatially controlling the crystallinity through both thermal parameters and material selection, this work unlocks new design possibilities for complex, high performance thermoplastic components.</p
Improving the identification and management of Binge Eating Disorder and Bulimia Nervosa in adults aged 16 and over in primary care in the United Kingdom
No full textBackground: Recent empirical research suggests that binge eating disorder (BED) and bulimia nervosa (BN) may not be appropriately identified and managed in primary care, despite available practical support (Chapter 2).
Aim: To improve the identification and management of BED and BN in adults aged 16 and over in primary care in the UK.
Methods: This programme of research comprised three main studies. A systematic review of qualitative research was conducted to describe perceptions about the identification and management of BED and BN in primary care settings (Chapter 3). Findings from the review informed a national survey to map current practice in UK primary care (Chapter 4). A qualitative study consisting of interviews and focus groups with healthcare professionals (HCP) and people with lived experience was then conducted to develop recommendations for improving the identification and management of BED and BN in UK primary care (Chapter 5). All studies integrated perspectives from healthcare professionals and people with lived experience and were designed and interpreted with the support of a patient and public advisory group.
Results: The review critically appraised and synthesised evidence from 25 qualitative studies, which highlighted that knowledge and understanding, HCP-patient interactions, attitudes and emotions, and treatment and referral pathways are key factors that independently, yet interrelatedly, impact the identification and management of BED and BN in primary care. The national survey indicated variations in practice across the country and among healthcare professionals (n=347) and in patients’ lived experiences (n=251), such as the use of self-referral to eating disorder services or access to different disorder-specific self-help tools. Respondents with BN were almost four times more likely to receive a clinical diagnosis than individuals with BED. This was also mirrored in management practices, such that individuals with BED relied on self-help, while those with BN were referred to eating disorder services. Interviews and focus groups with 26 participants (14 HCPs, 12 people with LE) suggested that to improve the identification and management of BED and BN in primary care, (1) relevant education needs to be provided to HCPs, patients, their families and the public, (2) functional screening pathways embedding suitable and accurate screening tools need to be developed, (3) current referral and treatment pathways must be improved to simplify referral processes and provide interim management options for patients, and (4) guidelines must be clear, specific, and co-designed to support implementation of the aforementioned suggestions.
Conclusions: This thesis provides a state-of-the-art picture of the perceptions of healthcare professionals and patients towards the identification and management of BED and BN in primary care and of current primary care practice. It develops evidence-informed recommendations for change and suggests next steps for research, integrating both healthcare professional and patient perspectives, and drawing on good practice seen in other countries or in other health conditions within the UK.</p
ADHD (over) diagnosis: fiction, fashion and failure.
No full textWhen thoroughly assessed, the prevalence of attention-deficit hyperactivity disorder (ADHD) in children/adolescents is estimated at 5%. There is no evidence that ADHD is over-diagnosed in the UK. Indeed, available data point to under-diagnosis, even though rigorous updated post-COVID-19 pandemic data are not available. Some cases may be misdiagnosed due to low-quality assessment, poor adherence to national guidance or inappropriate differential diagnosis. Beyond the controversy around over- or under-diagnosis and over-medicalisation of ordinary behaviours or emotions, the main issue is that UK clinical services cannot adequately support individuals with ADHD who need help. There is a risk that the narrative claiming 'ADHD is over-diagnosed' could be used to deny people with properly-diagnosed ADHD the care they deserve.</p
Corporate green revenue and syndicated loan pricing
No full textHow do banks contribute to the green economy? Using a unique dataset detailing firms' revenue exposure to green business activities, we present new evidence that firms generating revenue from green products and services are associated with lower syndicated loan spreads. We find that the green revenue effects on loan spreads are attributable to firms' prospects tied to climate change-related opportunities and banks' environmental orientation. Foreign banks subject to mandatory environmental, social, and governance (ESG) disclosure regulations reduce the loan spreads to green revenue firms. We also find suggestive evidence that firms with green revenue tend to file more green patents following loan origination. While banks typically perceive green innovation as riskier and demand higher loan spreads, this effect is offset if a firm also generates green revenue. Collectively, our results highlight the pivotal role that banks play in channeling financial resources toward green business practices.</p
Le constitutionnalisme autoritaire
No full textL’autoritarisme est souvent présenté comme intrinsèquement incompatible avec le constitutionnalisme, entendu dans son sens libéral comme un système fondé sur la constitution, qui vise à restreindre le pouvoir arbitraire par l’instauration de normes et règles établissant une série de contraintes constitutionnelles qui conditionnent l’émergence d’un gouvernement limité. À titre d’exemple, le constitutionnaliste hongrois Gábor HALMAI assimile le constitutionnalisme au constitutionnalisme libéral et soutient que « si la principale caractéristique du constitutionnalisme est le pouvoir légalement limité du gouvernement, ni l’autoritarisme ni les régimes illibéraux ne peuvent satisfaire aux exigences du constitutionnalisme ». Selon lui, le populisme, l’illibéralisme et l’autoritarisme s’opposent aux limites constitutionnelles au pouvoir, au respect de l’État de droit, de même qu’à la protection des droits fondamentaux, des composantes qui, à son avis, « constituent les principaux éléments du constitutionnalisme ». Suivant cette interprétation, les formes non libérales de constitutionnalisme, comme les constitutionnalismes populiste, illibéral ou autoritaire, ne peuvent être que des oxymores. De même, bien qu’elles existent d’un point de vue matériel, les constitutions dans les régimes autoritaires doivent souvent être considérées comme des « constitutions factices » (sham constitutions) ou des « constitutions dénuées de constitutionnalisme ». Ce chapitre désigne ce premier ensemble de points de vue comme l’approche « libérale » du constitutionnalisme.</p
Reservoir-induced displacement and social participation: Evidence from the Spanish dictatorship
No full textWhat are the long-term impacts of large inflows of forcibly displaced persons on displaced-hosting social participation outcomes? This paper addresses this question by exploring the construction of reservoirs during the Spanish dictatorship (1936–1975), which forced thousands of people into displacement. I implement an instrumental variable approach using the margin of whether the reservoir closest to a municipality was planned before the dictatorship, as well as its size and distance. To this end, I rely on a newly assembled historical panel dataset on forced displacement and social participation. I show that host municipalities experience a long-term and sizable decrease in voter turnout and new associations between 1977 and 2019. In turn, a higher share of the internally displaced population relative to natives mitigate these effects. I propose two mechanisms associated with the drop in institutional and general trust in host municipalities. The findings highlight the need to strengthen social cohesion between natives and forcibly displaced groups.</p
Relationships between subtle ocular changes and microvascular complications in people with type 2 diabetes
No full textBackground:
Developing treatments for early microvascular type 2 diabetes (T2DM) complications (retinopathy (DR), peripheral neuropathy (DPN), nephropathy (DN)) is limited by insufficient understanding of early pathologies. The eye, prone to diabetic damage, is a microvascular bed accessible for ocular imaging, which has developed rapidly over recent years. There is a need for integrated investigations employing new methods to examine changes across different ocular tissues in individuals with T2DM and microvascular complications.
Aims:
1) To explore potential relationships between ocular markers in humans, in vivo.
2) To investigate whether these ocular markers vary between individuals without diabetes, individuals with T2DM and no complications (no DR, DPN, or DN), and patients with T2DM and complications.
3) To validate and where needed, develop analytical methods of quantifying retinal and choroidal biomarkers of structure and/or function, including novel biomarkers such as choroid thickness, choriocapillaris perfusion, and retinal capillary perfusion, to ensure collection of high-quality data for aims 1) and 2).
Methods:
1) Methodology development: approaches of assessing novel ocular biomarkers were developed and validated with low inter-scan coefficients of variability (CV): retinal capillary perfusion markers within three vascular plexuses (1.09%-6.11% CV), choroidal thickness (CT; mean 2.87% CV), markers of choriocapillaris (CC) perfusion (3.48%-18.70% CV). Other ocular biomarkers (retinal vessel diameters and their ratio, retinal vessel oxygenation, thickness of retinal layers, and flicker induced vasodilation (FIV) were also utilised.
2) Clinical study: participants attending the research centre underwent ocular testing forming a pool of 342 participants with data available for this thesis, including 97 T2DM-free controls. Exclusion criteria were applied to some ocular tests (e.g. patients with glaucoma excluded from retinal thickness tests).
Statistics: Correlations between ocular markers (Pearson/Spearman/partial) and differences between the three groups (ANOVA/Kruskal-Wallis/ANCOVA) were assessed. Multiple linear regression tests were used to investigate the relationship between a dependent variable and two or more independent variables.
Results: The key findings from the clinical studies are summarised below:
•Retinal capillary perfusion in all three retinal plexuses correlated with choriocapillaris perfusion in T2DM but not in individuals without diabetes.
•Choriocapillaris and retinal capillary perfusion were reduced in T2DM, even in the complication-free T2DM group.
•CT was negatively associated with DPN, thickness of retinal nerve fibre layer, and positively associated with the ganglion cell layer thickness in patients with T2DM (combined group of patients with and without microvascular complications).
•CT was positively correlated with diameters of retinal vessels (indicating possible vessel dilation across multiple ocular vascular beds) and outer retinal thickness, but almost exclusively in participants with T2DM.
•Presence of DR and DPN were associated with reduced thickness of the inner plexiform layer in patients with T2DM.
•Reduced retinal oxygen uptake is associated with a presence of DR in patients with T2DM.
•There is evidence for a positive relationship between capillary perfusion and innermost retinal layers thickness in patients with T2DM.
•Reduced in FIV (relating to neurovascular coupling) was associated with retinal neurodegeneration, but not vascular markers, in T2DM.
Conclusion: Together, these results indicate ocular pathologies in T2DM, even in the absence of complications. Diabetic ocular disease is not limited to retinal vasculature, but rather involves interlinked vascular and/or neural changes of the retina and choroid.</p