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Specialist palliative care improves patient experience, reduces bed days and saves money: An economic modelling study of home- and hospital-based care
No full textBackground: High-quality evidence suggests that specialist palliative care reduces the odds of dying in hospital. The economic implications have not been established. Aim: To evaluate the cost-effectiveness of home- and hospital-based specialist palliative care for adults with poor prognosis in England. Design: Health-economic decision-modelling using five-state Markov cohort models with a 24-h cycle and lifetime horizon. Setting/participants: We evaluated home- and hospital-based care separately. We modelled counterfactuals using Cochrane review evidence of treatment effects on place of death and quality of life. We estimated place of death distributions, utilisation, quality-adjusted life years, and unit and intervention costs from the literature. Results: Home-based care was associated with reduced costs of £7908 per person (95% confidence interval: −18,044 to 395) and increased quality-adjusted life years by 0.035 per person (0.033 to 0.037). Hospital-based care reduced costs by £6480 per person (−11,482 to −1671) and increased quality-adjusted life years by 0.033 per person (0.031 to 0.035). We estimated that for England in 2022, specialist palliative care supported over 20,000 people to die outside of hospital, saved approximately 1.5 million hospital bed days and reduced system expenditures by £817 million. Conclusion: Specialist palliative care reduces hospital bed days, deaths in hospital and healthcare costs, as well as improving quality of life, among adults in England. A minority who might benefit currently receive specialist palliative care and needs are growing rapidly. Expanding access may yield further gains, but bridging current gaps in access also requires new approaches to reaching and meeting the needs of underserved groups
Exploring the Impact of Microplastics (Polyethylene terephthalate) in Lung cells
No full textIntroductionMicroplastics (MPs) are plastic particles smaller than 5 millimetres that arise either from intentional production or the breakdown of larger plastics. They have been detected across diverse environments, including air, water, and soil, and more recently in human tissues such as the lungs. While their health impacts are not yet fully understood, evidence suggests that some particles can evade clearance mechanisms in the respiratory tract and trigger inflammatory responses, particularly in vulnerable individuals. Laboratory studies often use polystyrene beads as models, though airborne pollution is more commonly composed of fibres such as polypropylene (PP) and polyethylene terephthalate (PET). The detection of MPs in biological fluids like blood and urine further raises concern about their potential to move within the body and accumulate in organs.Based on this, we hypothesize that:MPs at environmentally relevant levels and sizes cause inflammation in lung cells associated with lung diseases.MethodsThis study investigated the effects of MPs on lung-related cell models and tissue. MPs in suspension were first characterized spectroscopically and dyed to distinguish them from environmental contamination. Their impact was assessed on A549 epithelial cells and alveolar macrophages (Daisy cells), focusing on cell viability (LDH and MTT assays), barrier integrity (TEER), and oxidative and cytokine responses. Silicon dioxide (SiO2) served as a positive control due to its known toxicity, while cellulose fibres (200–300 μm) were used as a negative control.ResultsExposure to PET MPs induced distinct oxidative and immune responses in A549 epithelial cells and Daisy macrophages. In A549 cells, low concentrations (0.02 mg/ml) reduced ROS, while higher doses (1 mg/ml) triggered oxidative stress; TEER reduction at 0.1 mg/ml indicated impaired barrier integrity. Cytokine analysis showed suppression of IL-15, TARC, and I-309. Daisy cells showed similar ROS trends, with increases at 1 mg/ml, and cytokine profiling revealed broad suppression (IL-12p40/p70, IL-13, IL-1β, IFN-γ, TNF-β) but strong induction of GRO-α, suggesting selective pro-inflammatory signalling.ConclusionPET MPs seem to exert dose-dependent effects on oxidative stress, barrier integrity, and cytokine signalling, with higher concentrations promoting cellular stress and immune disruption. Given their persistence and ubiquity, PET MPs pose risks to human health and ecosystems, underscoring the need for coordinated strategies to reduce plastic pollution
The Causes and Effects of Financial Crises from Macro and Micro Perspectives: An Empirical Investigation from Top Ten Emerging Countries
No full textThis thesis provides a detailed investigation into the causes, dynamics, and consequences of financial crises in emerging economies, spanning the period 1990–2023 and focusing on ten representative countries: Mexico, India, Thailand, Indonesia, Malaysia, South Africa, Russia, Brazil, China, and Turkey. The study adopts a multidimensional approach, integrating macroeconomic, institutional, and microeconomic perspectives to examine both the determinants of crises and their socioeconomic and firm-level impacts.The introductory and literature review chapters set the theoretical foundation, contrasting orthodox and heterodox approaches. While orthodox models emphasize market efficiency and rational expectations, they often fail to explain speculative bubbles and systemic fragility. Conversely, heterodox theories such as Minsky’s Financial Instability Hypothesis highlight the cyclical nature of crises but do not sufficiently account for political volatility and institutional weaknesses in emerging economies. To bridge these gaps, this study synthesises insights from heterodox approaches and Krugman’s currency crisis model to formulate hypotheses addressing both internal vulnerabilities (debt accumulation, speculative behaviour) and external shocks (exchange rate pressures, balance of payments crises).The stylized facts presented in chapter three, provided historical and empirical evidence of recurrent crisis episodes, demonstrating how emerging markets remain highly vulnerable due to dependence on external capital and exposure to global shocks. Case studies of countries such as Brazil, Turkey, Mexico, and Russia illustrate how crises often manifest as twin or triple crises, exacerbated by contagion effects and commodity price volatility.The methodology (chapter four) detailed the quantitative research design, data sources, variable construction, and econometric strategies. Logistic regression, System Generalised Method Moment (GMM), and panel fixed-effects models were employed to address the core research questions, supported by rigorous diagnostic testing to ensure robustness.Empirical analysis of crisis determinants, presented in chapter five confirmed that low GDP growth, weak regulatory quality, high income inequality, large international debt, currency depreciation, and balance of payments imbalances significantly heighten the likelihood of crisis. Political stability emerged as an important mitigating factor when controlling for country-specific heterogeneity.The socioeconomic consequences (Chapter 6) revealed that financial crises increase poverty levels and, through rising unemployment, deepen economic hardship for vulnerable populations. Although income inequality was less directly affected, poverty persistence underscores the need for targeted social protection. Education expenditure unexpectedly showed a short-term positive link with poverty and inequality, raising concerns about allocation efficiency.At the microeconomic level, the analysis of firm productivity (Chapter 7) found evidence of a ‘cleansing effect’, whereby crises force restructuring and efficiency gains among surviving firms. However, larger firms, constrained by structural rigidities, experienced more pronounced productivity declines. High-tech and low-tech firms exhibited distinct responses, highlighting the importance of technological orientation in shaping resilience.Finally, in the concluding chapter (Chapter 8), we provide some policy recommendations by stressing the importance of strengthening governance and institutions, developing proactive social safety nets, improving labour market resilience, ensuring equitable and efficient education investment, and tailoring firm support measures to enhance productivity and adaptability. These findings offer actionable guidance for policymakers in designing effective early warning systems and resilience-building strategies.Overall, this thesis highlights that financial crises in emerging economies are multidimensional phenomena, rooted in structural vulnerabilities and carrying significant social and economic costs. By linking macroeconomic determinants, institutional quality, and firm-level performance, the study provides an integrated perspective that advances both academic understanding and policy relevance
The carbon footprint of household mobility: A consumption-based analysis
No full textUnderstanding the micro-foundations of environmental impact is crucial for climate finance and policy. Using detailed panel data from the China Household Finance Survey (2015, 2017, 2019), this paper uniquely quantifies the impact of household mobility on household consumption patterns, carbon emissions, and energy use. We demonstrate that mobility acts as a powerful catalyst, significantly boosting consumption and, consequently, environmental footprints at the household level. Heterogeneity analysis reveals that demographic factors and regional economic development play critical moderating roles, suggesting targeted policy levers. These micro-econometric insights provide essential evidence for policymakers navigating the financial and economic implications of China’s dual-carbon targets (peak 2030, neutrality 2060) amidst ongoing socio-economic transformation
Embedding rewilding in policy: Perspectives on overcoming barriers and unlocking opportunities
Full text linkRewilding initiatives are increasing in number across Europe and the UK in response to a growing awareness of substantial nature depletion, despite a lack of policy, guidance and legislation.Ongoing transformations of UK environmental policies offer a ‘policy window’ in which rewilding could become established as a key strategy for nature recovery.Here, we present the results of discussion sessions held as part of a British Ecological Society Policy Training workshop. A total of 46 participants, academics, practitioners and young people interested in rewilding attended. Our discussion focused on three pre-determined thematic discussion sessions: (1) barriers to rewilding and trade-offs; (2) species reintroductions; (3) facilitating rewilding in policy. Using thematic analysis, four emerging cross-cutting themes were identified from our workshop discussions: (a) environmental stewardship & public engagement, (b) cross-policy approaches, (c) incentivising rewilding and (d) an evidence base for rewilding.Policy Implications. Given the UK's considerable biodiversity loss, restoring ecosystem processes and function on a large scale is increasingly urgent, and operationalising rewilding through supportive environmental policy structures should be a key priority for government
Hope in Folded Pages: Zine‐Making, Decolonial Praxis and the Power of Participatory Arts for ‘a Peaceful and Sustainable Life’
Full text linkThis paper presents the co-creation of River of Hope, an animation exploring climate resilience among communities along the Red River in Northern Vietnam. Developed through a transnational collaboration between Vietnamese youth, UK and Vietnamese researchers and a UK-based animation artist, the project demonstrates how participatory digital arts can surface cultural connections and insights often obscured by generational and linguistic divides. Central to the project was the use of zine-making as a creative, accessible and culturally responsive method of Participatory Action Research (PAR). Far from a simple data collection tool, zine-making became a transformative, process-led method through which youth expressed emotional responses to climate change, shared local knowledge and shaped the animation's themes and imagery. The tactile, visual nature of zine-making enabled participants to communicate beyond language, cultural and generational barriers, engaging deeply with both personal and collective experiences of environmental change. Crucially, the process of making zines was itself a site of learning, trust-building and creative agency. It supported intercultural dialogue and positioned youth as co-creators, not subjects, of climate knowledge. This methodological innovation highlights how arts-based participatory methods can democratise research, amplify marginalised voices and humanise climate discourse. In digital and hybrid research settings, zines functioned as both method and medium, offering inclusive and emotionally resonant pathways for youth engagement. Our findings show how embedding participatory arts within a decolonial, youth-centred framework can bridge cultural divides and advance more just, locally grounded approaches to global climate action
Curating memories of a future past: Anticipated nostalgia, prospective memory and travel decisions
No full textTourism often includes temporal dimensions due to time differences between booking and travel, leading to future imaginings and anticipations of both the journey and its positive outcomes upon returning home. Yet, we know little about the dynamic or bi-directional of these projection processes. This study introduces “anticipated nostalgia” to tourism research, revealing these bidirectional mental time-travel processes and their influence on tourist decision-making. Employing a constructivist cognitive framework and a grounded theory approach from psychology, our findings suggest that anticipated nostalgia acts as a cognitive heuristic, enhancing travel impulsivity, shaping prospective memories, and influencing proactive memory behaviors. We identify key factors influencing anticipated nostalgia, showing how prospective memory helps understand tourists' imaginative engagement with the future and therefore, decision-making processes
Design and Material Characterisation of Additively Manufactured Polymer Scaffolds for Medical Devices
Full text linkAdditive manufacturing has been adopted in several industries including the medical field to develop new personalised medical implants including tissue engineering scaffolds. Custom patient-specific scaffolds can be additively manufactured to speed up the wound healing process. The aim of this study was to design, fabricate, and evaluate a range of materials and scaffold architectures for 3D-printed wound dressings intended for soft tissue applications, such as skin repair. Multiple biocompatible polymers, including polylactic acid (PLA), polyvinyl alcohol (PVA), butenediol vinyl alcohol copolymer (BVOH), and polycaprolactone (PCL), were fabricated using a material extrusion additive manufacturing technique. Eight scaffolds, five with circular designs (knee meniscus angled (KMA), knee meniscus stacked (KMS), circle dense centre (CDC), circle dense edge (CDE), and circle no gradient (CNG)), and three square scaffolds (square dense centre (SDC), square dense edge (SDE), and square no gradient (SNG), with varying pore widths and gradient distributions) were designed using an open-source custom toolpath generator to enable precise control over scaffold architecture. An in vitro degradation study in phosphate-buffered saline demonstrated that PLA exhibited the greatest material stability, indicating minimal degradation under the tested conditions. In comparison, PVA showed improved performance relative to BVOH, as it was capable of absorbing a greater volume of exudate fluid and remained structurally intact for a longer duration, requiring up to 60 min to fully dissolve. Tensile testing of PLA scaffolds further revealed that designs with increased porosity towards the centre exhibited superior mechanical performance. The strongest scaffold design exhibited a Young’s modulus of 1060.67 ± 16.22 MPa and withstood a maximum tensile stress of 21.89 ± 0.81 MPa before fracture, while maintaining a porosity of approximately 52.37%. This demonstrates a favourable balance between mechanical strength and porosity that mimics key properties of engineered tissues such as the meniscus. Overall, these findings highlight the potential of 3D-printed, patient-specific scaffolds to enhance the effectiveness and customisation of tissue engineering treatments, such as meniscus repair, offering a promising approach for next-generation regenerative applications
Differences in physical and technical performance characteristics between 11 v 11 chronological and bio-banded soccer match-play in youth soccer
Full text linkObjectives: Bio-banding groups athletes by biological maturity rather than chronological age, to reduce variation in physical characteristics, to promote more equitable competition and development opportunities. We investigated whether physical and technical performance characteristics differed between chronological and bio-banded 11v11 match-play formats in youth soccer. A secondary aim was to examine whether these differences varied by maturity status and timing.Design: Twelve Junior Premier League teams (N=139 players) from the U13, U14, and U15 age groups participated. Each team played six, 20-minute matches: three in chronological age and three in bio-banded formats. Bio-banding was based on the percentage of predicted adult height (PAH%): pre-PHV (96%).Methods: Players wore foot-mounted inertial measurement units to record physical (distance covered, high-speed running >4m/s, sprinting >5.5m/s, and accelerations/decelerations ±2.6m/s/s) and technical (total touches, possessions, time on ball and one-touch/short/long possession counts) performance characteristics. Data were analysed using t-tests and ANOVA with Bonferroni correction. Significance was set at p<0.05, and effect sizes (Cohen’s d) were calculated. A multivariate analysis was also conducted. Results: Whole sample analysis showed significantly more time on the ball per possession (d=0.17), and fewer one-touch actions (d=0.25) in bio-banded matches. Post-PHV players covered significantly more high-intensity distance (d=0.63) but recorded fewer total touches (d=0.60), total possessions (d=0.65) and one-touch possessions (d=0.71) in the bio-banded format. There were significant differences between pre- and mid-PHV players for all physical metrics across both chronological and bio-banded matches (d=0.48-72), and between maturity groups (pre-post-PHV, mid-post-PHV) for technical actions in chronological format. However, these differences in technical characteristics were not mirrored in bio-banding matches.Conclusions: Bio-banding was associated with altered physical and technical demands, especially for post-PHV players. Findings suggest bio-banding may provide an appropriate competition format, exposing players of varying maturity status to different developmental challenges, which may support more equitable and balanced experiences across maturation