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The role of beliefs in adult experiences of trauma therapy
No full textThis thesis portfolio comprises three parts: a systematic literature review, an empirical paper, and appendices.Part One: Systematic Literature ReviewThe systematic literature review explored the impact of client-therapist ethnic matching in therapy. This exploration mapped across different aspects of the therapeutic journey. Fifteen studies met the inclusion criteria following a systematic literature search. The use of narrative synthesis allowed for qualitative and quantitative literature to be integrated into findings. An established quality assessment checklist was utilised by the researcher to appropriately assess the qualities of the identified papers. The review focused on session attendance, symptom and functional improvement, and the therapeutic relationship. Methodological differences, clinical implications and areas for future research are discussed.Part Two: Empirical PaperThe empirical paper explored the role of beliefs in adult experiences of trauma therapy. Five participants completed semi-structured interviews. Interpretative Phenomenological Analysis (IPA) was utilised to analyse the qualitative data. Five main themes emerged: ‘beliefs about identity, self-perception, and inner conflict’, ‘beliefs about empathy as an attribute of compassion, ‘beliefs about gender, safety, and stereotypes’, ‘beliefs about growth, coping, and psychological resilience’ and ‘belief systems, meaning making and flexibility’. Interactions across themes also surfaced, with considerations as to how narratives influenced specific aspects of each theme. Clinical implications, limitations, and areas for future research are discussed.Part Three comprises the Appendice
Artificial Intelligence-Driven Healthcare Supply Chain Resilience: The Mediating Effect of Organisational Transparency
No full textThis study aims to investigate how AI-driven technologies can enhance organisational transparency and strengthen the resilience of healthcare supply chains during crises. It establishes a theoretical framework based on two key theories: the resource-based view, which emphasises the strategic importance of valuable resources, and institutional theory, which examines how societal norms and regulations influence organisational behaviour. Using survey data collected through a pre-tested instrument, the study employs partial least squares structural equation modelling (PLS-SEM) to analyse the complex relationships among variables. The findings reveal that organisational transparency plays a crucial role in improving operational effectiveness and resilience within healthcare supply chains—an area that has often been overlooked in previous research. This research expands the theoretical boundaries of both the resource-based view and institutional theory by explaining how the adoption of AI-based technologies can be effectively utilised to make informed decisions in the context of healthcare, where protecting sensitive public health information is paramount, without compromising the goal of building resilience during crises. The results contribute valuable theoretical insights to the field of operations and supply chain management from a societal perspective. Additionally, the study demonstrates that integrating AI technologies with organisational transparency is essential for navigating disruptions in healthcare and addressing ethical and privacy considerations surrounding data management. Ultimately, this research provides practical insights for managers and policymakers facing supply chain challenges during health crises, highlighting key implications and suggesting future research avenues to further explore the connections between AI technologies, organisational transparency, and healthcare supply chain resilience
Assessing the potential for co-location between mussel aquaculture and the offshore wind industry using Earth Observation
No full textEnergy and food security are United Nations goals (no. 7 and 2). To meet energy and food demand, both the offshore wind energy and the aquaculture industries have set ambitious growth targets that will inevitably affect the marine environment. The completion of these objectives is space-demanding and can strain marine ecosystems and raise conflicts between stakeholders. By sharing the same space, human activities could be contained in a much smaller area, letting untouched maritime zones be protected, for a more resilient ocean in the light of climate change. As well as reducing pressure on marine ecosystems, combining uses at sea can enhance sustainable socio-economic activities. Therefore, working together is vital: cohesion instead of competition for space.This thesis focuses on harvesting wind and seafood (mussels) at the same time and location. It brings together satellite remote sensing, numerical modelling, geographic information systems, and a mechanistic model, the Dynamic Energy Budget model, to predict mussel growth rates. This thesis provides a deeper understanding of the environmental impact of the offshore wind industry, particularly from a co-existence perspective with mussel aquaculture. It highlights opportunities for co-location with current offshore wind farms as well as future options regarding the offshore wind sector development and climate change. It also proposes new approaches for finer spatial planning of aquaculture cultivation plots within offshore wind farms for optimal performance
Genomic, morphological and migratory patterns in recovering Atlantic salmon populations
No full textPopulation recovery is a key goal for conservation, but our understanding of how genetic and phenotypic variation, including local adaptation, emerges in recently recolonised or recovering systems is limited. This complicates the conservation of fitness-related traits that support resilience and long-term population viability. We employed single nucleotide polymorphism markers, geometric morphometrics and acoustic telemetry to investigate the recovery of Atlantic salmon (Salmo salar) in a large river system, which began more than 40 years ago following presumed extirpation in the mid-1900s. We observed genetic differentiation between Atlantic salmon in different tributaries that may reflect natural recolonisation through straying and/or the recovery of remnant populations previously believed to be extinct. Fine-scale philopatry was found to maintain the genetic divergence between tributaries, as confirmed by genetic assignment and telemetry tracking of returning adults, with some individuals displaying ‘search’ behaviour across tributaries. Despite this population structuring, neither consistent genomic signatures of selection nor morphological divergence were detected, indicating no evidence for early stage local adaptation or for differing selective pressures between tributaries. The patterns instead align with stochastic demographic processes (i.e. founder effects and genetic drift), which was further supported by the low contemporary effective population sizes detected across tributaries. These findings highlight the importance of continued genomic and ecological monitoring during population recovery, as improving environmental conditions may promote the re-establishment of remnant populations and/or facilitate recolonisation. This may, in turn, lead to the formation of reproductively isolated units and, over time, the emergence of locally adapted traits of conservation value for Atlantic salmon and other threatened migratory species
The Advanced Practitioner in Primary Care
No full textDescriptionEquipping Advanced Practitioners with the skills, insight, and confidence to lead in modern primary careThe Advanced Practitioner in Primary Care is a timely resource that provides current and aspiring Advanced Practitioners (APs) with a practical roadmap for delivering high-quality, patient-centred care in complex and fast-paced primary care environments. Built on the four pillars of advanced practice—clinical practice, leadership, education, and research—this text supports practitioners in bridging the gap between academic theory and clinical application.Written by experienced clinicians and educators, this book is framed by national and international guidelines—applicable to adult, paediatric, and mental health contexts—and reinforced by real-world case studies that contextualise concepts and build confidence in managing diverse clinical scenarios.Providing the structured support and evidence-informed guidance necessary for confident, competent, and reflective practice, The Advanced Practitioner in Primary Care:Covers complex consultation skills, clinical reasoning, systems-based clinical assessments, and decision-making with evidence-informed guidanceAddresses the management of uncertainty and diverse patient presentations, including frailty and paediatricsOffers practical insights on getting the most from supervision and professional development pathwaysIncludes a dedicated chapter on prescribing and medication management tailored for APsDiscusses the evolving scope of the AP role in the context of local, national, and international policyThe Advanced Practitioner in Primary Care is essential reading for trainee and established APs working in primary care, as well as for nurses, paramedics, pharmacists, physiotherapists, and other professionals transitioning into general practice. It is also ideal for postgraduate programmes in advanced clinical practice and a valuable resource for educators and primary care teams supporting AP development
Providing restorative supervision to healthcare professionals working in higher education: a descriptive qualitative study
No full textBackground: Maintaining staff wellbeing is crucial to providing a high standard of education for students. Restorative supervision enables reflection on the emotional and psychological impact of the work allowing understanding of the challenges and rewards that are intrinsic to high quality teaching.Aim: To explore whether Restorative Supervision can support health care professionals working in higher education.Methods: Fifteen health professional academic staff within a Faculty of Health Sciences at a UK Higher Education Institution took part. Six, 1hr restorative supervision sessions over a 6-month time scale were delivered between February and August 2022. Each participant attended a 90-minute focus group in November 2022.Findings: Four key themes emerged: Role identity, Compassionate relationships, “Me Time”, Empowerment and impact.Conclusion: Higher Education Health Professional Lecturers suffer layers of emotional burden from multiple sources. Lecturers provide emotional student support which requires empathy, time, and compassion. Restorative supervision actively encourages reflection and self-care
Are there inequities in the assessment or management of pain for people with severe mental illness living with life-threatening diseases? A mixed-methods systematic review
Full text linkBackground: Pain relief is a fundamental human right, yet evidence suggests access to analgesia is not equitably distributed. People with severe mental illness (SMI) experience significant disparities in healthcare during life, which may also be mirrored at the end of life. This systematic review examines the extent of inequities and underlying factors contributing to disparities in pain care for people with SMI and life-threatening diseases. Methods: A mixed-methods systematic review of MEDLINE, EMBASE, AMED, CINAHL, PsycINFO and EThOS (January 2000–September 2024), hand-searching key journals and citation tracking. Two reviewers independently screened studies, and data were extracted using a standardised approach. A narrative synthesis was used to integrate findings. Results: Two thousand nine hundred seven records were identified, with eight studies meeting the inclusion criteria. Study quality ranged from ‘very low’ to ‘high’. All quantitative studies were retrospective analyses of routine healthcare data, examining analgesic prescribing for people with schizophrenia. Despite variability in outcome measures, all studies found that individuals with schizophrenia received significantly less analgesia than those without SMI. Four qualitative studies explored clinicians’ views on providing pain care to patients with SMI; only one study included patient experiences. Identified barriers to optimal pain management included patient-related factors (e.g. difficulties in pain expression, behavioural symptoms), clinician-related factors (e.g. diagnostic overshadowing, stigma) and systemic issues (e.g. fragmented care, restrictive prescribing practices). Conclusion: There is a striking lack of research on pain assessment and management for people with SMI and life-threatening illnesses, yet available evidence indicates clear inequities in care. These disparities may be driven by intersecting structural, social and clinical barriers, contributing to poorer end-of-life experiences. Addressing this gap requires urgent action from clinicians, policymakers and researchers. Future work should combine population-based studies to quantify prescribing disparities with qualitative research involving people with lived experience of SMI and their carers. Participatory, co-produced approaches are essential
Just add water: urban blue spaces increase avian richness and functional diversity
Full text linkUrban blue spaces are highly valuable for both people and nature. They provide key ecosystem services, including flood alleviation, pollution absorption and microclimate regulation. They also support human health and wellbeing, through cultural services such as recreation and tourism, and the provision of food resources. Crucially, urban blue spaces support biodiversity, including threatened species, and despite often being small, may have disproportionate effects on their surrounding environment, acting as critical habitats within urban systems. However, research on the role of urban blue spaces within ecological contexts remains limited. Here, we assessed urban bird communities across green and blue spaces to quantify the ecological effects of urban water bodies. We surveyed birds along 22 paired 1km transects in the city of Kingston Upon Hull, UK, recording species and abundance across both winter and breeding seasons. Our findings indicate that blue spaces significantly increase bird species richness during summer (P=.016), though not in winter. However, we found that the taxonomic distinctiveness of bird communities is consistently greater around blue spaces across both seasons (P<.05). Similarly, functional diversity based on species-level ecological traits was higher around water (P=.01). In addition, we show that urban blue spaces could be important for avian conservation, supporting more red and amber-listed species than green spaces during the summer (P<.05). Overall, our results show that urban blue spaces play a critical ecological role within cities by enhancing the complexity of avian communities, which in turn could improve human wellbeing and contribute to urban sustainability
Masticatory muscle anatomy and functional performance of rodents and Djadochtatherioid multituberculates
No full textRodents exhibit conservative anatomy adapted for gnawing, which can be divided into four morphotype categories. This project quantifies and compares the mechanical advantage of a sample of rodents across the tree, evaluating the variation between the morphotypes during incisor and molar biting at a range of gape angles. Once the variation of rodents was established, this was compared and contrasted with that of three Cretaceous multituberculates, a fossil mammal group that has several similarities to modern rodents. Through 2D lever-arm mechanics and PCAs and MANOVAs of the data, the rodent morphotypes are compared with each other and with the multituberculate fossils. According to the results of this project, multituberculates are functionally distinct on homologous muscles but can individually be more similar to extant rodents than to each other, to a degree, and the morphotype categories within rodents are functionally distinct. The variation within each morphotype is broad, however, suggesting that assumptions should not be made about the mechanical efficiency and function of organisms based on their morphotype category without a more detailed exploration of their anatomical and functional characteristics. This project explores, supports and builds upon established interpretations of the functional difference between morphotypes and provides a stepping stone to future research on extant and fossil rodents and fossil multituberculates. Incorporation of multiple factors such as bite point and gape angle are critical to differentiating the categories, with the sample being more mechanically similar during gnawing and the extremes of high and low gape accounting for most of the variance in efficiency
Giving nurses a sense of contribution and effectiveness at work.
Full text linkThis article is the first in a series in which The King’s Fund (2022) ABC model are used to examine how the Professional Nurse Advocate (PNA) role can support effective leadership within clinicalpractice. The purpose of this article is to explores how the principles of the PNA training and the A-EQUIP model have the potential to support nurses with compassionate leadership approaches. These can all impact positively on leaders and the health and wellbeing of staff. Evidence has shown that using a compassionate approach can lead to increased staff morale, motivation and commitment which in turn impacts on the quality of patient care