Open Research Exeter - University of Exeter
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Acetylcholine dynamics in the retrosplenial cortex during spatial uncertainty
No full textAdaptive behaviour requires updating internal models in response to uncertainty, which can be divided into expected and unexpected forms. The retrosplenial cortex (RSC) is a hub for spatial navigation and the default mode network, integrating egocentric and allocentric inputs, contextual information, and multiple spatial hypotheses. This positions the RSC as a key region for investigating how the brain represents uncertainty. Computational theories propose that acetylcholine (ACh) signals expected uncertainty, while noradrenaline signals unexpected uncertainty, but recent work suggests ACh may encode both prediction error and expected variance. How ACh contributes to uncertainty signalling in the dysgranular RSC (dRSC) remains largely unexplored.
Using a head-fixed mouse virtual reality paradigm, I manipulated spatial uncertainty while monitoring ACh dynamics with GRAB-ACh3.5 and neuronal activity with two-photon calcium imaging in the dysgranular RSC (dRSC). Mice learned to anticipate reward in stable environments and adapted flexibly to changes in reward location or environmental context. GRAB-ACh imaging revealed that dRSC cholinergic dynamics are strongly modulated by uncertainty. Novel environment switches evoked large, sustained increases in ACh that diminished with repeated exposure, consistent with novelty signalling. Reward relocations produced smaller, phasic responses. Increasing expected uncertainty generated a gradual tonic rise in ACh, mirrored by pupil dilation. Critically, unexpected change under high expected uncertainty elicited both a strong phasic peak and a sustained ACh response, suggesting multiplexed coding of prediction error and expected variance. Two-photon imaging showed that dRSC neurons maintain stable positional maps but reorganise in response to uncertainty: global remapping after environment switches, partial reorganisation after reward shifts, and broadened activity fields under expected uncertainty. Muscarinic blockade disrupted positional coding in novel environments, directly linking ACh signalling to spatial representation dynamics.
Together, these findings identify ACh in dRSC as a key modulator of adaptation to uncertainty, balancing stability and reorganisation of spatial and reward codes.</p
‘I really don't have time to talk and listen to all those people’: care responsibilities and privileged irresponsibility in the devolution of social services in the Netherlands
No full textThis paper analyses the micro-scale geographies of care within newly devolved social services in The Netherlands. Across Europe, welfare reforms have reconfigured the spatial organisation of care, shifting responsibilities to municipalities and expecting closer collaboration between citizens, civil-society organisations and local governments. We analyse how these spatial and institutional transformations shape the everyday negotiation of care responsibilities within Buren Helpen Elkaar, a locally organised initiative that mobilises volunteers to support residents (primarily elderly people) to continue living independently at home. Drawing on Tronto's political ethics of care, we investigate how care is interpreted, allocated and enacted across local actors. The analysis is based on qualitative data from thirty-six interviews, participatory observations and policy and organisational documents. Our findings show that, despite its promise of fostering more cooperative citizen-state relations, the initiative is marked by dynamics of ‘privileged irresponsibility’. Professionals and volunteers withdraw from particular tasks by claiming to be ‘too busy’, by narrowing definitions of legitimate need or by shifting responsibility to other actors. By tracing how responsibility is negotiated and redistributed in place, the paper offers a micro-scale account of devolved welfare that foregrounds the relational dynamics shaping local care provision. It also shows how everyday practices can undermine the intentions of welfare reforms and contribute to uneven outcomes across communities.</p
The role of self-compassion and mindfulness in the association between adverse childhood experiences and psychological distress: A meta-analytic mediation analysis
No full textBackground: Adverse childhood experiences have been widely associated with psychological distress. A growing body of literature suggests that mindfulness and self-compassion may be a pathway linking adverse childhood experiences to psychological distress. Objective: The aim of the current meta-analysis was to investigate the mediating role of mindfulness and self-compassion in the relationship between adverse childhood experiences and psychological distress using structural equation modeling meta-analysis. Methods: A systematic literature search initially identified 15,058 studies from three electronic databases: PsycINFO, Scopus, and PubMed. After applying inclusion and exclusion criteria, 29 articles were eligible for inclusion in the current meta-analysis. Two-staged structural equation modeling meta-analysis was used to examine correlations among mindfulness, self-compassion, adverse childhood experiences, and psychological distress. This method estimated a pooled correlation matrix under a random-effects model. Results: We analyzed 29 independent datasets containing data from 19,854 participants. The results showed that both mindfulness (β = 0.09, 95 % CI [0.06, 0.12]) and self-compassion (β = 0.09, 95 % CI [0.06, 0.11]) mediated the associations between adverse childhood experiences and psychological distress. Conclusions: Given that the present findings were based on cross-sectional data, further research with rigorous designs, such as experimental and intervention studies, is needed to investigate the mediating effects of self-compassion and mindfulness on the relationship between adverse childhood experiences and psychological outcomes This review calls for further longitudinal research to test whether self-compassion and mindfulness act as mediators in the link between ACEs and psychological distress.</p
Evidencing the Circular Economy's Value Creation Potential in Material-Intensive Capital Projects: Identifying, Initiating, and Implementing System-Wide Circular Innovation Orchestration Across Asset Lifecycles
No full textPublic infrastructure assets, delivered via material-intensive capital projects, face growing pressure to meet net-zero targets while managing costs. Regulatory demands for 2050 net-zero prompt a rethink of value creation, as emissions persist beyond project completion and often conflict with budgets.
This doctoral research proposes an alternative value creation framework in three phases. It begins with developing a Material-Focused Circular-Economy Innovation (MFCI) Framework that integrates circular economy principles into the value chain of capital project delivery. Next, it evaluates the framework's potential for value creation using hybrid material flow modelling and hotspot analysis over 100 years, based on data from England’s flood risk management projects, including 296 projects for portfolio analysis and three case studies for project-level analysis. Finally, it uses qualitative methods with paradox theory to explore tensions and barriers in the Collaborative Public–Private Supply Chain Network (CPPSCN) for orchestrating the framework.
The MFCI Framework identifies sixteen feasible CE strategies that improve resource productivity and long-term value throughout the asset lifecycle. Findings reveal that uniform project-level carbon budgets are sub-optimal, masking high-impact materials and assets at the portfolio level. Project-level findings show the MFCI approach has significant potential: in a “Circular Now” scenario, material inflows decrease by 32–43%, carbon by 20–45%, costs by 10–28%, and the Benefit–Cost Ratio (BCR) increases by 2-10%. In a “Circular Future” scenario, reductions are 35–66% in materials, 40–65% in carbon, 25–53% in costs, and BCR rises 15–31%.
The qualitative analysis shows that orchestrating the MFCI framework depends on integrating innovation and decision-making across material, project, and asset levels. The Source–Pathway–Receptor (SPR) analogy provides a rationale for holistic integration, with material productivity offering a performance lens for coupling material-project-asset-level interdependencies. Combining all findings, a material-focused CPPSCN design is proposed to navigate the tensions of orchestrating the MFCI framework.
The thesis contributes theoretically by integrating paradox theory and circular economy into a unified orchestration framework, methodologically by combining quantitative and qualitative evidence across multiple levels, and practically by demonstrating the value-creation potential of the MFCI framework and management responses to addressing the orchestration tensions.</p
Climate psychology as music theatre in Laura Bowler’s Houses Slide
No full textThis article analyses Houses Slide, a music theatre piece for soprano and orchestra composed by Laura Bowler, first presented by London Sinfonietta in 2021 in a performance directed by Katie Mitchell. Billed as the world’s first bicycle-powered classical concert, this performance brought together three cultural trends: new music in the Western classical tradition about climate change, efforts to make live performance environmentally sustainable, and heightened performer physicality and theatrical elements in the presentation of contemporary classical music. The article examines Houses Slide as a stage composition that interweaves musical and extra-musical elements, with particular focus on performer physicality, and investigates its representation of climate psychology. The article argues that Houses Slide staged key eco-psychological tensions through music theatre, translating them into aesthetic experience that could help audience members to weather the psychological disturbances of climate change.</p
Exploring the role of modifiable sex/gender-specific risk and protective factors for anxiety among young people in high income countries: A systematic narrative review
No full textBackground: Anxiety is the most common mental health problem in young people and sex/gender differences have been consistently reported, with girls and young women experiencing twice the chance of anxiety compared to boys and young men. There is a limited understanding, however, of the underlying causes of these differences. This systematic review aims to synthesise research identifying modifiable sex/gender-specific risk and protective factors for anxiety among young people aged 16-24 in high income countries.Methods: A systematic literature search was conducted on 29th February 2024 and updated on 4th July 2025 across MEDLINE (Ovid), PsycINFO (Ovid), EMBASE (Ovid), Scopus, Sociological abstracts, and Web of Science. Observational studies reporting estimates of sex/gender-specific associations between modifiable risk and protective factors and anxiety according to DSM-5 categories were included. Results were summarised using narrative synthesis.Results: 85 studies were included. Modifiable factors were grouped into levels: individual; interpersonal relationships; local community; and wider environment and society levels. The review identified conflicting results for sex/gender differences, demonstrating the methodological limitations of the evidence base and the complexity of the modifiable risk and protective factors implicated in the explanations for sex/differences in anxiety among young people aged 16-24 years. Potential sex/gender-specific risk factors emerged; early alcohol use initiation, parental overprotection and social media may be more anxietyinducing in females than in males.Conclusions: This review indicates that sex/gender differences may exist in the associations between modifiable risk and protective factors and anxiety. Future longitudinal studies are crucial to understanding how these pathways differ by sex/gender. Studies are needed which explore whether sex/gender influences the relationship between anxiety and gender discrimination, peer relationships, school/college context, the workplace and the school-towork transition. Such evidence has the potential to guide the development of effective sex/gender-specific mental health interventions.</p
A ten-year retrospective analysis of medical school rankings in the United Kingdom
No full textBackgroundNational rankings are employed by higher education (HE) institutions to guide strategic decisions and by prospective applicants and their supporters to guide decisions about where to study. Given the increased marketisation of HE and the use of rankings in decision making, it is essential to understand the nuances of rankings: how different systems lead to different rankings, the correlation between rankings of high-profile programmes such as medicine and that of their institutions, and how rankings shift over time. To date, no studies have assessed agreement between ranking systems for medical programmes in the United Kingdom (UK). Given that various ranking systems are used globally to compare institutions within and across countries, a deeper understanding of these ranking systems is crucial.MethodRetrospective data across a ten-year period (2016–2025) were obtained on the national rankings of medicine programmes in the UK: the Complete University Guide, Guardian, and The Times. The data were analysed to investigate agreement in ranking of medical programmes over time and the agreement between overall ranking of an institution and the ranking of its medical programme.ResultsRanking systems showed a high level of agreement with each other. However, mean scores over the ten-year period varied by ranking system, whereby institutions occupying the ‘top three’ positions were not wholly consistent across systems. Associations between institutional rank and that of institutions’ medicine programmes were statistically significant (r = 0.36–0.38, p < 0.01).ConclusionsAgreement between ranking systems for medical programmes in the UK is present, yet there remains notable variation for some institutions within those ranking systems, likely due to different components and weightings that make up these scores. The weak association between overall rank and medical ranks implies that the presence of a medical school at an institution does not guarantee a high overall rank – higher universities can have lower medical schools, and vice versa. This suggests that prospective students should consider an array of factors when deciding on where to study; not rankings alone.</p
Managing care challenges related to lack of awareness in the person with dementia: Report of a stakeholder consultation
No full textDementia care should be centred on the person with dementia, taking into account the person’s needs and preferences. This can be difficult if the person with dementia lacks awareness of changes related to dementia. They may appear reluctant to discuss changes or unable to recognise any needs. Awareness tends to decline as dementia progresses. However, individuals vary, with some people showing more awareness as they adjust to the diagnosis. For others, lack of awareness is a persisting condition which holds challenges for care provision. It can lead to worse outcomes for people with dementia. We don’t know the best ways to handle these difficult situations in dementia care. There is little published evidence about managing lack of awareness. I therefore carried out a stakeholder consultation to gather views, report experiences, and help find areas where further work is needed. I asked those involved in dementia care about their experiences around lack of awareness. I wanted to find out the extent of problems arising from lack of awareness, the type of problems encountered, and how these are managed. The project focused on care for people with dementia who live at home. I consulted with informal carers, clinicians, and professionals working in homecare or social care. We had discussions in small groups and shared an anonymous online survey. I also used information from previous interviews with people with dementia to show their views and share some background to this work. The online survey was completed by 24 informal carers, 19 clinicians and 11 homecare/social care professionals across nine UK regions. Nearly all the people responding had encountered lack of awareness; 75% reported encountering it often or extremely often. Lack of awareness affected the care pathway with delays reported in referrals, diagnosis and starting care packages. Disagreements were commonly experienced due to lack of awareness, both at home and in clinical settings. There were concerns about safety and safeguarding. In some cases there was complete breakdown of care at home. These situations were managed with a flexible and patient approach and avoiding confrontation where possible. The report found a number of areas where care could be improved:1. Information. More information is needed for people with undiagnosed dementia and their family members around the time of emerging symptoms and signs of dementia. Information for the general public should explain the variation in personal awareness of dementia symptoms and the value of early referral.2. Resources for education and training. More educational resources are needed for informal carers. Specific training about awareness for clinicians and homecare professionals is needed. These resources would improve understanding of awareness issues and enable sharing of effective strategies.3. Technology. Access to technological solutions such as CCTV and video doorbells could improve home safety for people who lack awareness and live alone.4. Proactive approach. A proactive approach by primary care clinicians could help earlier identification of dementia and recognition of awareness difficulties in individuals. Documenting awareness status in primary and secondary care records could help guide tailored care plans.</p
Computational aspects of nonlinear, stochastic and complex pandemic models with vaccination
No full textThe COVID-19 pandemic has stimulated extensive research on nonlinear, stochastic, and complex epidemiological models capable of explaining recurrent waves, uncertainty in disease transmission, and the impact of vaccination strategies. In this paper, we investigate the computational aspects of a six-dimensional epidemiological model with vaccination, fitted to COVID-19 data from Saudi Arabia. Particular emphasis is placed on bifurcation analysis with respect to the vaccination rate, which reveals that beyond a critical threshold, the system undergoes a Hopf bifurcation, giving rise to oscillatory epidemic dynamics. These oscillations are validated using long-horizon time-domain simulations and confirmed through phase-portrait visualizations, providing insight into the mechanisms behind recurrent waves observed in pandemic data. To contextualize this study, we conducted a literature survey of nonlinear, stochastic, fractional-order, and agent-based models, highlighting how different modeling frameworks capture memory effects, demographic stochasticity, network heterogeneity, and individual-level interactions. We also review advanced computational tools for analyzing nonstationary epidemiological time series, including spectral and bispectral methods, Lyapunov exponents, detrended fluctuation analysis, recurrence plots, Poincaré maps, and multivariate techniques for cross-country comparisons. The study highlights the importance of combining dynamical systems theory, stochastic processes, and data analytics for epidemic forecasting. We also discuss how these computational approaches can inform vaccination policy design and emphasize their relevance for preparedness against future pandemics, particularly when data availability is limited and pathogen characteristics are initially uncertain.</p
Global environments of ageing: towards co-designing climate resilient environments and communities for ageing well
No full textThis chapter reflects on two projects: Understanding Older and younger people’s PercepTions and Imaginaries of Climate Change (OPTIC) and Healthy Ageing in a Changing Climate: Creating Inclusive, Age-Friendly, and Climate Resilient Cities and Communities in the UK (HACC). Both used creative, intergenerational and participatory methods, such as comic book co-creation and deliberative dialogues, to explore older people’s climate change perspectives to enable the co-design of more inclusive, resilient and sustainable places. Despite policy, funding and resource constraints, participants identified many individual, community and intergenerational actions to address climate change on a local level. The findings underscore the value of explicitly addressing older people’s knowledge and experiences when designing climate mitigation and adaptation strategies.</p