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The mechanisms by which a whole-school intervention might improve sexual health: qualitative realist research nested in a trial in English secondary schools
No full textWhole-school interventions go beyond classroom education, promoting health by modifying school environments. These can be effective in delaying sexual debut and increasing contraception use but mechanisms are poorly understood. Qualitative research within realist evaluation can explore mechanisms via building ‘context-mechanism-outcome configurations’, describing how interventions trigger mechanisms that interact with context to generate outcomes. We explored these for the Positive Choices whole-school sexual health intervention within the intervention arm of a randomised trial conducted 2021–2025. Using ‘dimensional analysis’, we analysed 52 interviews with teachers and 40 focus-groups involving 266 students from 22 English secondary schools. Our results suggest seven mechanisms through which whole-school interventions might ‘work’: improving knowledge using diverse pedagogies; improving confidence and ability to talk by normalising talk about sexual health; changing gender attitudes through challenging stereotypes and providing insights and empathy with others' perspectives; promoting access to sexual health and other services via helping students understand their needs and entitlements; building school engagement by providing new student roles on decision-making groups; increasing inclusion of sexual-minority students by normalising consideration of non-heterosexual identities and practices; and reducing sexual harassment and abuse by helping students understand consent and when to intervene in harassment. Contextual contingencies included: high initial student needs; teacher skills and commitment; and school commitment and capacity. Our research suggests novel mechanisms via which whole-school interventions might promote sexual health. Quantitative analyses will now be conducted to examine these mechanisms and contingencies
Does being a service user of social work or an unpaid carer influence motivation to study social work?
No full textThis study draws upon findings from a cross-sectional survey of 278 social work students enrolled at one of six universities across Ireland. Multivariate multiple regression was used to examine the effects of being a past or current user of social work services, or a past or current unpaid carer, on their motivation to become a social worker. Most respondents were 23–30 years old and female. Wanting to help people and overcoming oppression were the main motivators to engage in professional training. Half identified as past or current unpaid carers, which significantly predicted motivation to become a social worker. Less than a third reported previous/current social work support due to witnessing domestic abuse, or the consequences of mental ill health or addiction as a child or adolescent. Others disclosed firsthand experiences of poverty, mental illness, addiction, bereavement or custody battles with ex-partners. Being a past or current service user significantly predicted motivation to become a social worker. The discussion suggests that universities explore ways to improve support for care experienced students or student carers to prevent withdrawals. Examples include a more robust and accessible mental health service, increased financial support, flexible approaches to assessment and meeting the requirements of placements.<br/
A systematic review of dialectical behaviour therapy, mentalisation-based treatment and internal family systems therapy for borderline personality disorder with comorbid depression and/or anxiety
No full textBorderline Personality Disorder (BPD) is highly comorbid with depression and anxiety, creating additional difficulty in treating the conditions and poorer prognosis than BPD alone. Dialectical behaviour therapy (DBT) and Mentalisation-Based Treatment (MBT) are specialised psychotherapies for BPD that have demonstrated positive effects for reducing BPD symptoms and scores on depression and anxiety measures. Although developed for treating PTSD, Internal Family Systems (IFS) therapy is effective for addressing past trauma that is also common in BPD. This systematic review investigated the effectiveness of DBT, MBT and IFS for treating BPD with comorbid depression and/or anxiety (BPD + D/A). Using the PRISMA protocol, five academic databases were searched for relevant studies and relevant treatment outcomes. Findings were extracted from 12 included studies. Only studies with a confirmed diagnosis of comorbid depression and/or anxiety disorders were included. This review found that DBT and MBT demonstrated significant reductions in BPD and depressive/anxious symptomatology, emotional and interpersonal difficulties, and impulsive behaviours. These therapeutic approaches also demonstrated reduced numbers of visits to emergency departments, reduced numbers of contacts with mental health services and reduced duration of contacts. None of the studies investigated IFS therapy outcomes for BPD + D/A. These findings are concordant with past research and have implications for increasing the use of DBT and MBT for BPD + D/A. Findings also demonstrate the effectiveness of brief DBT interventions as a more practical option for service users with BPD who experience frequent crisis periods and may struggle to commit to a traditional 12-month program. However, findings should be interpreted cautiously due to small and majority-female samples, mixed study designs and a lack of follow-up data
A Michaelis‐Arbuzov‐Type pathway to a protected 2ʹ‐deoxy‐2ʹ‐selenomethyl‐adenosine‐3ʹ,5ʹ‐phosphoroselenolate guanosine dinucleotide for use in modified m7G cap synthesis
No full textIn this paper, a solution‐phase total synthesis is described of the 5ʹ‐O‐phosphorylated 2ʹ‐deoxy‐2ʹ‐selenomethyl‐adenosine 3ʹ,5ʹ‐phosphoroselenolate guanosine dinucleotide (4) using a rt, 2,6‐lutidine‐mediated, nucleoside 3ʹ‐H‐phosphonate/5ʹ‐selenocyanate Michaelis‐Arbuzov ligative coupling, whose potential mechanism is discussed herein. Our route to 4 is predicated upon the highly efficient new 2ʹ‐O‐triflate selenocyanate anion displacement of 10 in MeCN, to obtain the 2ʹ‐selenocyanate 9, which was allied with an Amosova NaBH4/MeI mediated reductive selenomethylation in MeOH. A novel solid CPR II‐mediated 5ʹ‐O‐phosphitylation of the dinucleotide alcohol 6 and a 70% aqueous t‐BuO2H oxidation successfully installed the 5ʹ‐O‐phosphate moiety within 4 without oxidizing the 2ʹ‐selenomethyl group. It is envisaged that 4 will be of value for a future total synthesis of the m7G cap 1; a molecule of potential utility for therapeutic mRNA manufacture.<br/
Dietary flavonoid intake and psychological well-being – a bidirectional relationship
No full textBackground and AimHigher dietary flavonoid intake has been associated with lower risks of mortality and major chronic disease, yet its relationship with psychological well-being (PWB), a key contributor to health and quality of life, remains unclear. This study aimed to investigate bidirectional associations between dietary flavonoid intake and two PWB facets: happiness (positive emotional state) and optimism (generalized expectation of positive outcomes). Specifically, we examined whether (1) overall flavonoid-rich dietary patterns (flavodiet score), (2) intake of specific flavonoid-rich foods, and (3) total flavonoid and subclass intakes were each associated with happiness and optimism over time.MethodsData were drawn from the Nurses’ Health Study to form two analytical samples. Flavonoid intake measured in 1990 (n=44,659) was examined in relation to sustained happiness (1992-2000) while intake in 2002 (n=36,723) was analysed in relation to sustained optimism (2004-2012). Secondary analyses assessed whether higher baseline levels of each PWB facet were associated with sustained higher flavonoid intake, over up to 18 years. Associations were assessed using generalized estimating equations, adjusting for potential confounders.ResultsHigher flavodiet scores were associated with a 3-6% higher likelihood of sustained happiness [RRQ4vsQ1 (95% CI): 1.03 (1.02-1.05)] and optimism [RRQ4vsQ1 (95% CI): 1.06 (1.01-1.11)]. Specific flavonoid-rich foods (strawberries, apples, oranges, grapefruit, blueberries) were associated with a 3-16% greater likelihood of sustained PWB, across the two facets. Similarly, total flavonoid and subclass intakes were associated with a 2-18% greater likelihood of sustained PWB. Women with higher baseline levels of happiness or optimism were also more likely to sustain a higher flavonoid intake.ConclusionsConsuming ∼3 servings/day of flavonoid-rich foods is associated with sustained PWB, and higher baseline PWB is associated with sustained higher flavonoid intake over up to 18 years. This bidirectional relationship suggests that integrated interventions targeting both diet and well-being may help promote long-term health and reduce chronic disease risk
The impact of periodontitis on oral health outcomes in older adults: a systematic review
No full textObjective: To systematically review the impact of periodontitis on clinical oral health outcomes and oral health‐related quality of life (OHRQoL) in older adults (≥ 60 years).Background: Global evidence shows that severe periodontitis prevalence peaks in the 60s, yet how periodontitis relates specifically to oral health outcomes in older adults has not been comprehensively synthesised. Prior reviews in mixed‐age populations demonstrate strong links with tooth loss but less consistent associations with OHRQoL. Methods: This systematic review followed PRISMA guidelines and was registered on PROSPERO (CRD420251010568). Searches of PubMed, MEDLINE, Embase, Scopus, and Cochrane Library (to May 2025) identified studies of adults ≥ 60 years with periodontitis reporting oral health outcomes or OHRQoL. Two reviewers independently screened studies, extracted data, and assessed risk of bias. Results: Forty‐three studies met inclusion criteria: 18 longitudinal studies on clinical outcomes and 25 cross‐sectional studies on OHRQoL. Clinical studies consistently demonstrated that deeper baseline periodontal pockets, greater clinical attachment loss, and higher CPI/CPITN scores predicted adverse outcomes over 18 months to 12 years follow‐up, including tooth loss, further attachment loss, and functional decline. OHRQoL studies showed inconsistent findings, with roughly equal numbers reporting significant associations versus no relationship. Conclusions: In adults ≥ 60 years, periodontitis consistently predicts tooth loss and continued periodontal breakdown, whereas OHRQoL associations are inconsistent and appear mediated primarily through downstream consequences such as tooth loss and functional impairment, though direct effects may occur in advanced disease. These findings emphasise the importance of periodontal prevention and management in older adults
Hydrodynamic and power performance of a V-shaped floating wind-wave integrated system based on multi-field coupling
No full textWith the continuous growth of the global economy, energy security and climate change issues are increasingly receiving widespread attention from the international community, further highlighting the importance of renewable energy. Currently, various marine renewable energy systems, represented by Floating Offshore Wind Turbines (FOWTs) and Wave Energy Converters (WECs), have progressed from concept validation and prototype sea trials to demonstration projects and pilot deployments. To further enhance the power generation, optimize the system's dynamic performance, and reduce the construction and operation costs of floating offshore wind turbine systems, this study proposes and analyzes a wind-wave integrated system. This system integrates a 5 MW V-shaped FOWT with an array of Salter's Duck Wave Energy Converters (SD WECs). The integrated system effectively captures wave energy generated by the relative motion between the wind turbine and wave energy devices through a Power Take-Off (PTO) system. Under various typical sea conditions, the study first established a numerical simulation model of this integrated system using ANSYS-AQWA software. Subsequently, a multi-field coupled dynamic analysis, encompassing aerodynamic, hydrodynamic, servo-control, and elastic structural aspects, was conducted based on the open-source code F2A, to deeply investigate the integrated system's dynamic characteristics and energy output performance. The research findings provide important theoretical basis and technical support for the efficient development and utilization of marine renewable energy
