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Correction to: Cohesional behaviours in pyroclastic material and the implications for deposit architecture
Get PDFIn the original manuscript, the SAoR (static angle of repose) was reported to have been measured using a platform diameter of 12 cm. This was an unfortunate error, and the actual diameter of the platform is 8.5 cm. The subsequent results from this have meant that the trends and patterns in the data are the same, but the values of the data are lower. For example, in Fig. 4a, the static angle of repose values ranges from ~20 to ~45°. The changes of the platform measurement error show that the actual values should be from ~30 to ~55°. The following sections in the manuscript have been corrected. In the Methodology section, the line "To determine the static angle of repose (SAoR) for each experiment, samples of 100 g of material were released from a funnel held 3.5 cm over a circular platform (Av diameter = 12 cm)" should be "To determine the static angle of repose (SAoR) for each experiment, samples of 100 g of material were released from a funnel held 3.5 cm over a circular platform (Av diameter = 8.5 cm)". In the Results section, the lines "For the 0% moisture condition, the SAoR ranges from 21 (V2, V4, V5) to 23° (V1, V3). Interestingly, these results show that under 0% moisture conditions, the SAoR is broadly similar (within 2°) regardless of particle size or sorting (Fig. 4a)" should be "For the 0 wt.% moisture condition, the SAoR ranges from 29° (V2, V4, V5) to 32° (V1, V3). Interestingly, these results show that under 0 % moisture conditions, the SAoR is broadly similar (within 3°) regardless of particle size or sorting (Fig. 4a)". Old incorrect Fig. 4 (Figure presented.) New correct Fig. 4 (Figure presented.) Fig. 4 a SAoR for volcanic material with varying moisture percentages with standard deviation error bars; b DAoR critical angle of volcanic material with varying moisture percentages with standard deviation error bars The paragraph, “When increasing moisture contents to 5%, the SAoR values increase to approximately double those achieved with 0% moisture, reaching from 42 (V5, V6) to 47° (V4). However, this relationship is not linear with increasing moisture content (Fig. 4a). All materials show a rapid increase in SAoR with moisture to around 25°. But beyond a moisture content of 0.5%, a division is evident between the fine and coarse mixtures; those with higher Sauter mean diameters (V2, V3 and V4) quickly increase to SAoR values of ~ 45° at moisture contents of 2.5%, before becoming invariant with additional moisture content. Mixtures with large Sauter mean diameters (V5, V6) mostly show a more gradual increase in SAoR with moisture content. V5, with a Sauter mean diameter of 55.6 × 10−6 m, shows an intermediate behaviour, whilst V6 with a Sauter mean diameter of 112.9 × 10−6 m shows a more linear relationshipfor SAoR with moisture between 0.5 and 5%. However, V1, with a Sauter mean diameter of 56.3 × 10−6 m, shows a rapid increase, similar to V2, V3 and V4. This may be due to the high fines content and sorting index (Table 1)” should be “When increasing moisture contents to 5 wt.%, the SAoR values increase to approximately double those achieved with 0 wt.% moisture. However, this relationship is not linear with increasing moisture content (Fig. 4a). All materials show a rapid increase in SAoR with moisture to around 36–46°. But beyond a moisture content of 0.5 wt.%, a division is evident between the fine and coarse mixtures; those with lower Sauter mean diameters (V2, V3 and V4) increase to SAoR values of ~55° at moisture contents of 2.5 wt.% before becoming invariant with additional moisture content. Mixtures with higher Sauter mean diameters (V5, V6) mostly show a more gradual increase in SAoR with moisture content. V5, with a Sauter mean diameter of 0.02 mm, shows an intermediate behaviour, while V6, with a Sauter mean diameter of 0.03 mm, shows a more linear relationship for SAoR with moisture between 0.5–5 wt.%. However, V1, with a Sauter mean diameter of 0.06 mm, shows a rapid increase, similar to V2, V3 and V4. This may be due to the high fines content and sorting index (Table 1)”. In the Discussion section, the lines “The material behaviours revealed by the BTD, SAoR and DAoR tests raise important questions regarding the impact of moisture within a dynamic, moving PDC. The experiments show that in a dry (0% moisture) state, the material analysed has a low cohesivity as evaluated by the friction angles. As well as fines concentration, sorting is seen to play a key role (Table 1). This can be seen in V1 (5% SAoR: 45°), which is well sorted and displays the largest volumes of fines (35.76%), whereas V4 (5% SAoR: 47°) is very well sorted and has one of the lowest volumes of fine material (0.11%).” should be “The material behaviours revealed by the BTD, SAoR and DAoR tests raise important questions regarding the impact of moisture within a dynamic, moving PDC. The experiments show that in a dry (0 wt.% moisture) state, the material analysed has a low cohesivity as evaluated by the angle of repose. As well as fines concentration, sorting is seen to play a key role (Table 1). This can be seen in V1 (5 wt.% SAoR: 56°), which is well sorted and displays the largest volumes of fines (35.76 %), whereas V4 (5 wt.% SAoR: 57°) is very well sorted and has one of the lowest volumes of fine material (0.15 %)”. The original article has been corrected
Clinical and cost-effectiveness of Cancer Patients’ Needs Assessment in Primary Care (CANAssess2): A pragmatic cluster randomised controlled trial
Get PDFBackgroundThe Needs Assessment Tool-Cancer (NAT-C) is a consultation guide to identify and triage patients’ and carers’ unmet needs. Its effectiveness in primary care is unknown. MethodsPragmatic, unblinded cluster randomised controlled trial comparing clinical and cost-effectiveness of the NAT-C in primary care versus usual care (UC) in adults with cancer in England. Eligible general practices (willing to be trained and deliver NAT-C; practice-level consent) were randomly assigned (minimisation, 1:1, stratified by size, locality, training status) to deliver a NAT-C consultation plus UC, or UC alone. Eligible patients (≥18 years, cancer – any stage, not in remission) and carers (family or friend nominated by patient) consented to complete questionnaires at baseline, 1, 3, and 6-months and attend a NAT-C appointment if registered with an intervention practice. Primary outcome was at least one moderate-severe unmet need at 3-months (Supportive Care Needs Survey Short Form 34 [SCNS-34]). Secondary outcomes included at least one moderate-severe unmet need at 1- and 6-months; and at all timepoints: level of unmet needs (SCNS-34 score), symptoms (ESAS-r), quality of life (EQ-5D-5L, EORTC QLQ-C15-PAL), performance status (AKPS), carers’ ability to care and well-being. Effectiveness analyses were according to intention-to-treat. The original sample size target of 1080 participants across 54 practices was reduced in a protocol amendment to 950 across at least 38 practices due to recruitment challenges and improved retention. Registration: ISRCTN15497400
Verbal fluency difficulties in Chinese insomnia patients: insights from semantic and phonemic tasks
No full textInsomnia is a prevalent sleep disorder associated with cognitive difficulties, including reduced performance in executive control and semantic memory. This study explores the impact of insomnia on language retrieval processes using the Chinese Verbal Fluency Test (VFT), addressing the need for cognitive research beyond English-speaking populations. We hypothesised that insomnia-related difficulties in semantic memory and executive control would result in reduced VFT performance. Participants with insomnia (N=20) and matched healthy controls (N=20) were recruited from a community outpatient clinic in China to complete an online Chinese VFT, generating words for semantic categories (e.g., animals) and phonemic conditions (e.g., words beginning with “bai” [白, “white”]). Compared with controls, the insomnia group produced fewer correct responses across both tasks; the between-group gap was larger for semantic correct responses. Clustering and switching analyses showed fewer switches in the semantic task for the insomnia group and a reduced phonemic mean cluster size, suggesting difficulties in executive control processes. Together, these convergent results indicate reduced efficiency in both semantic memory retrieval and control-guided search during word production. By employing a Chinese VFT and parallel semantic and phonemic tasks, the study extends current evidence beyond alphabetic languages and highlights how language-specific demands can shape fluency performance. Overall, the findings clarify how sleep disturbances may influence core components of language processing and support the value of process-level fluency measures in characterising cognitive difficulties linked to insomnia
Experiences of Compassion and COVID-19 Lockdown in Young People
Get PDFThis thesis portfolio comprises three parts:Part One: Systematic Literature ReviewA systematic literature review of the experiences of UK secondary school children and how the COVID-19 lockdowns have impacted their wellbeing. The review identified seven studies and completed a narrative synthesis which identified two themes; ‘Mental Health and Mental Wellbeing’ and ‘The Effect on Skills for the Future and Need for Support’. The narrative which developed from the synthesis summarised some potential long-term impacts and effects of this group after lockdowns and the return to school. These were discussed in the context of clinical implications for practice and schooling settings, as well as recommendations for future research.Part Two: Empirical PaperAn empirical paper exploring how UK university students experience the flows of compassion following the COVID-19 pandemic. The study focused on the cohort attending Year 11 in the academic year 2019-2020 who did not complete their GCSE exams. Semi-structured interviews were completed with 11 participants and reflexive thematic analysis was used to develop themes and create narrative and meaning from the data. The study found two main themes; ‘Disruption at a Pivotal Point in Life’ and ‘Heightened Awareness of Mental Health’. Themes and data provide insight into the ongoing challenges faced by this cohort. Overall, participants found it easier to engage in the flow of giving compassion to others, whilst being able to understand and recognise the importance of self-care and self-compassion, as well as receiving compassion from others. These findings have clinical implications for practice in mental health services and among universities and their student support services.Part Three comprises the AppendicesThe appendices related to both the systematic literature review and empirical paper; and includes reflective and epistemological statements
The cost of drug repurposing: parallel economic evaluation of mirtazapine for severe breathlessness in the multinational BETTER-B trial
Get PDFAbstractBackground: Breathlessness is a prevalent, distressing symptom in advanced respiratory disease. Proven treatments are lacking. Mirtazapine, an antidepressant, is increasingly prescribed. The placebo-controlled BETTER-B trial did not find significant clinical benefit of mirtazapine for severe breathlessness, and patient experiences were mixed. Given mirtazapine’s low cost and wide availability, it is important to understand effects more broadly.Methods: We conducted a parallel cost-effectiveness analysis of mirtazapine versus placebo. BETTER-B recruited 225 adults with chronic obstructive pulmonary disease and/or Interstitial Lung Diseases in seven countries between 2021 and 2023. We calculated quality-adjusted life years (QALYs) using EuroQoL EQ-5D-5L and national value sets, and combined self-reported healthcare and informal care frequencies with unit costs. Primary trial endpoint was at day 56, with sensitivity analysis at day 180 (trial exit). Findings: In primary analysis mirtazapine reduced QALYs (-0.006 (95% confidence interval (CI): -0.012 to -0.001)) and was associated with higher total costs (+€231 (95% CI: -218 to +680)). For willingness-to-pay thresholds of €20,000-€40,000 per QALY, mirtazapine had a 1%-2% likelihood of being cost-effective. These findings were substantively unaffected by sensitivity analyses to timeframe, perspective, outcome measurement, and modelling strategy.Interpretation: Repurposing mirtazapine to treat severe breathlessness negatively impacted patient outcomes while being associated with higher formal and informal costs, and should be discouraged. Off-label prescribing of repurposed medicines without robust evidence risks unnecessary strain on healthcare systems and families. Economic evaluation within testing of repurposed medicines is important. Parallel cost-effectiveness analyses can deliver high-value information even when the efficacy trial finds no effect
Essays on Cross-Listing Dynamics: Implications for Performance and Governance for Firms from Emerging Economies
Get PDFThis thesis aims to examine the implications of cross-listing for emerging market firms across three dimensions: capital market outcomes, governance mechanisms, and capital structure dynamics. Motivated by conflicting evidence about cross-listing benefits and the effectiveness of governance mechanisms, this thesis investigates how cross-listing affects cost of capital, firm valuation, and debt-to-equity ratio (DER) optimisation; evaluates the effectiveness of Anglo-American governance standards imposed on emerging market firms; and analyses how cross-listing influences leverage adjustment processes under different market conditions.Data is obtained for emerging market firms cross-listed on major international exchanges during 2000-2023. The study employs advanced econometric techniques including Doubly Robust estimation, Two-Way Fixed Effects, Two-Stage Least Square (2SLS), Random Effect Instrumental Variable (RE-IV), Limited Information Maximum Likelihood (LIML), and System Generalised Method of Moments to address endogeneity concerns and establish causal relationships across different industries, firm sizes, and market periods.The findings show that cross-listing often increases Weighted Average Cost of Capital contrary to conventional assumptions, yet creates significant long-term firm value through Tobin's Q, particularly in Energy and Food, Beverage & Tobacco industries. The debt-to-equity ratio analysis demonstrates that cross-listing enables more flexible capital structure management despite higher capital costs. Board governance mechanisms show no significant association with market performance, indicating that Anglo-American governance structures prove inadequate for emerging market firms. Dual-class share structures enable systematic minority shareholderexpropriation despite enhanced regulatory oversight.The capital structure analysis reveals that smaller firms demonstrate higher leverage adjustment speeds toward target debt-to-equity ratios, whilst cross-listing becomes particularly valuable during financial crises when international market access enables continued optimisation. Value firms exhibit slower leverage adjustments than growth firms regardless of size. This study demonstrates that cross-listing benefits depend critically on firm characteristics, industry environments, and market conditions rather than providing universal advantages. The thesis findings have implications for corporate managers, investors, and policymakers regarding cross-listing decisions and regulatory frameworks
Persistent informality: preparing the EU’s input into international climate negotiations
Get PDFIn 2004 a largely informal system for preparing the European Union’s (EU’s) input into and representation at the international climate change negotiations was introduced. This system has persisted largely unchanged for over two decades. At its core are lead negotiators and issue leaders who remain in place beyond the six-monthly rotating EU Presidency. They are recruited from both the Member States and the Commission on the basis of their professional aptitude. Using theoretical approaches which focus on efficiency, power/competition and norms/culture as core drivers for informal governance in the EU, this paper explains how this informal system has emerged and evolved as well as why it has persisted without major modifications over two decades. Although efficiency has been a major driver, a wider consensus norm/culture within the EU constituted an essential precondition for the establishment of the informal lead negotiator/issue leader arrangement and constrained the impact of power and competition both between and within the Member States and the Commission, thus reducing the risk of inter– and intra-institutional turf battles
Using digital technology to support wellbeing and independence among people living with incurable cancers: a systematic review
Get PDFPurpose: The purpose of this systematic review is to summarise and evaluate the feasibility, acceptability, and potential efficacy of using digital technology to deliver physical activity and/or nutrition interventions to promote wellbeing and independence among adults with advanced or incurable cancer. Methods: Systematic structured searches for any experimental study exploring physical activity and/or nutrition intervention delivery with digital technology were conducted in PsycINFO, MEDLINE, EMBASE, CINAHL, Web of Science Core Collection, and the Cochrane Central Register of Controlled Trials. All records were screened, extracted, and quality assessed by two authors. Main outcomes were feasibility and acceptability of using technology to help deliver interventions, with secondary outcomes of potential efficacy in any measure of quality of life, wellbeing, or function. Result: Twenty-nine eligible studies were included. Digital interventions were mostly feasible and acceptable, with high retention rates and participant satisfaction. Many participants expressed willingness to recommend the interventions to others or continue use. Engagement rates were generally high, although fewer studies addressed diet and nutrition than exercise and physical activity interventions. Conclusion: Digital supportive care interventions may be feasible, well-accepted, and tolerated by individuals with incurable cancer. These platforms could effectively improve this population’s support for physical activity and symptom management. However, the heterogeneity in study designs highlights the exploratory nature of these interventions. To advance the field, future research should focus on adequately powered studies, improved generalisability, and standardised tools for measuring outcomes. Trial registration: This trial has been prospectively registered in PROSPERO (ID: CRD42021295936)
