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The Role of Prehabilitation in Improving Brain Health and Cognition After Chemotherapy in Patients with Colorectal Cancer : Study Protocol of the Chemo Brain Prehab Project
No full textIntroduction: Regional disparities in the incidence of colorectal cancer remain a concern within the United Kingdom, particularly in the North West of England, with 37% higher incidences than the national average. Given the growing burden of treatment-related side effects such as cognitive impairment, this study aims to investigate whether prehabilitation can improve brain health and cognitive function in patients with colorectal cancer receiving adjuvant and neoadjuvant chemotherapy. Methods: This randomised control trial will recruit eighty-six patients with stage II and III colorectal cancer, who will receive adjuvant and neoadjuvant chemotherapy (fluorouracil, capecitabine, or oxaliplatin) and will be randomised between prehabilitation and standard care groups. The prehabilitation group will be provided an individualised, home-based exercise programme before and during chemotherapy, multivitamin supplementation, telephone check-ins, and activity devices. The standard care group will be provided with information about physical activity and nutrition at the start of the intervention. Habitual physical activity will be tracked in all patients. Assessments will be conducted at baseline, 72 hours before the first chemotherapy administration, and 72–96 hours after the final treatment. Outcome measures will include cardiopulmonary fitness, neurotrophic biomarkers, electroencephalographic activity, cognitive function tests, and a cognitive-related quality of life assessment. Discussion: This study protocol is designed to test whether home-based prehabilitation can improve brain health and reduce chemotherapy-related cognitive impairments in patients with colorectal cancer. Insights from this work may support the development of more accessible and effective prehabilitation programmes to address treatment specific cognitive impairment. Trial registration: ClinicalTrials.gov NCT0734121
“It’s Almost as if I’ve Relapsed” : An Interpretative Phenomenological Analysis of Addiction Therapists’ Experiences With Supporting Their Clients Through Repeated Relapse
Get PDFBackground: Although addiction therapists are faced with immense pressures to effectively support clients through relapses and overdose risks, the evidence base on relapse remains significantly limited. Aims: This study aims to generate novel understandings of substance misuse relapse from a lived experience perspective of addiction therapists. Methods: Data were generated through semi-structured interviews with seven addiction therapists across specialist addiction treatment services in England, and subsequently analyzed using interpretative phenomenological analysis. Findings: The analysis revealed three superordinate themes around the impact that supporting clients through relapse has on addiction therapists’ psychological wellbeing, their treatment approaches, and their therapeutic relationships. Conclusion: Relapse can shape how therapists perceive and engage with recovery of their clients. Although therapists sometimes consider relapse as a positive experience, they often feel negative psychological effects from it, including emotional withdrawal, self-doubt, and compassion fatigue. This paper sets out the implications for policy, practice, and research
The unfolding of conceivable practice trajectories as market-making opportunities
Get PDFRecently, scholars increasingly emphasize the role of consumers as market-makers – going beyond mere purchasing decisions. However, amidst this newfound attention to consumer-driven market-shaping acts for established markets, little attention is given to how consumers and their practices can be utilised in the making of not-yet (established) markets. This paper contends that focussing on conceivable practices as a lens to examine nascent, future markets and tracking their trajectories, is crucial for unlocking their potential as market-making precursor. To address this gap, this article examines the market-making opportunities offered by conceivable practice trajectories. Using practice theory, the authors investigate the practice trajectories of 20 German motorists following a theories-in-use approach. To understand how practices unfold, a new interview-based research method, the Futures Practice Wheel, is developed. Thereby, highlighting how prospective accounts of practice dynamics provide market-shaping opportunities through trajectory arrangements, consumer trajectory evaluations, and the trajectory level in the unfolding of practices
Just transition as transition in justice : Really learning from, about and with China
Get PDFHumanity is undergoing an unprecedented and irreversible transformation, reshaping both the planet and society. The concept of "just transition" has become a central narrative in climate and environmental discourses, yet prevailing scholarship often treats justice as a fixed, universal ideal, attaching it to transition without critically examining its contextual and evolving nature. This Perspective challenges such static interpretations, arguing that just transition should be understood as an ongoing process embedded in historically and culturally specific contexts, and so as a question, not a settled standpoint. We delineate what just transition is not: it is neither a predefined endpoint, nor simply the absence of injustice, nor a mechanism that inherently flattens power hierarchies. Drawing on empirical insights from China, we illustrate how local understandings of justice are shaped by place-specific cultural values and historical power structures. By critiquing dominant assumptions and advocating for a more dynamic, context-sensitive approach, this Perspective contributes to a more inclusive and globally relevant discourse on just transition, offering critical insights for scholars and policymakers navigating the complexities of sustainability transformations
Between Two Worlds: Transnational Feminism and Aesthetic Resistance in The Fury (Neshat, 2023)
No full textThis chapter examines the evolution of Shirin Neshat’s transnational feminist practice by placing two of her short films, The Last Word (2003) and The Fury (2023), in dialogue. It argues that The Fury marks a significant shift in Neshat’s aesthetic and political vocabulary, moving from the culturally specific and poetically inscribed register of The Last Word to a more expansive, confrontational and formally hybrid mode shaped by diasporic experience. While The Last Word stages a symbolic encounter with censorship through the poetry of Forough Farrokhzad, The Fury intensifies Neshat’s longstanding engagement with gendered violence, surveillance, trauma and authoritarian power, and reimagines the female body as an active site of affect, rage and embodied resistance. Drawing on concepts of accented cinema, hybridity and transnational feminism, the chapter situates The Fury within interconnected global systems of domination rather than a simple binary of East and West. The film’s shifting spatial registers, between interiors marked by Iranian-style repression and the textured urban landscapes of Brooklyn, render diasporic identity as an in-between condition shaped by fracture, ambiguity and continual negotiation. Through its choreography of exposure and concealment, its doubling, fragmentation and non-linear temporalities, The Fury transforms personal trauma into a collective and transnational feminist uprising. Taken together, the two films reveal a twenty-year trajectory in which Neshat moves from poetic interiority and allegory to a cinematic language grounded in embodied protest, solidarity and the transformative possibilities of the third space
An Interview with Shirin Neshat
No full textThe interview offers intimate insights into Shirin Neshat's creative process, her engagement with themes of gender, displacement, and resistance, and her unique ability to merge personal narrative with broader political and cultural critique. It also explores her collaborations, inspirations, and the challenges she has faced as an Iranian artist working within a global framework. This chapter serves as a cornerstone for the volume, providing a first-hand perspective that illuminates the philosophical and emotional depth underpinning Neshat’s remarkable body of work
Vulnerability of marine megafauna to global at‐sea anthropogenic threats
Get PDFMarine megafauna species are affected by a wide range of anthropogenic threats. To evaluate the risk of such threats, species’ vulnerability to each threat must first be determined. We build on the existing threats classification scheme and ranking system of the International Union for Conservation of Nature (IUCN) Red List of Threatened Species by assessing the vulnerability of 256 marine megafauna species to 23 at‐sea threats. The threats we considered included individual fishing gear types, climate‐change‐related subthreats not previously assessed, and threats associated with coastal impacts and maritime disturbances. Our ratings resulted in 70 species having high vulnerability (v > 0.778 out of 1) to at least 1 threat, primarily drifting longlines, temperature extremes, or fixed gear. These 3 threats were also considered to have the most severe effects (i.e., steepest population declines). Overall, temperature extremes and plastics and other solid waste were rated as affecting the largest proportion of populations. Penguins, pinnipeds, and polar bears had the highest vulnerability to temperature extremes. Bony fishes had the highest vulnerability to drifting longlines and plastics and other solid waste; pelagic cetaceans to 4 maritime disturbance threats; elasmobranchs to 5 fishing threats; and flying birds to drifting longlines and 2 maritime disturbance threats. Sirenians and turtles had the highest vulnerability to at least one threat from all 4 categories. Despite not necessarily having severe effects for most taxonomic groups, temperature extremes were rated among the top threats for all taxa except bony fishes. The vulnerability scores we provide are an important first step in estimating the risk of threats to marine megafauna. Importantly, they help differentiate scope from severity, which is key to identifying threats that should be prioritized for mitigation
Mapping components of behavioural weight management interventions using electronic survey and component selection by expert consensus: the BE:COME Study
No full textBackground Behavioural weight management interventions are the main funded interventions for people living with obesity in the United Kingdom, but there is high intervention variability, including mode of delivery, dietary, physical activity and behavioural components. Objective To map individual components of behavioural weight management interventions used in pragmatic clinical trials and those commissioned in the real world. To decide on the components which vary across the interventions and are hypothesised to be of importance to attendance, completion and weight loss. Design Cross-sectional survey. Setting Behavioural weight management interventions in two separate scenarios: randomised controlled trials and real-world services (local authority and commercial) Main outcome measure Identification of components of interest that demonstrate variation in both settings. Methods Mapping exercise of randomised controlled trials and real-world services using the standardized reporting of adult behavioural weight management interventions to aid evaluation. Selection of components by expert group consensus derived from online survey and discussion. Data sources Mapping performed by a local contact for real-world services and by one BECOME researcher for randomised controlled trials. Study expert group provided their opinions via online survey and discussion. Results Real-world services providing data on 19 services and 6 randomised controlled trials were mapped using an intervention template. Survey and discussion led to expert group consensus of components for analysis within a meta-analysis. Summary descriptions are provided for each programme displaying variability in eligibility and exclusion criteria. Results provide a description of real-world services and randomised controlled trials, demonstrating variation between the programme components, for example, programme delivery (face-to-face group based was the most common answer for 28.6% randomised controlled trials and 63.2% real-world services), setting (community centre was the most common answer for 0% of randomised controlled trials and 69.2% real-world services) and total duration of the programme (12 weeks for 7.1% randomised controlled trials and 57.9% real-world services). Limitations The standardised reporting template is lengthy and can take up to 1.5 hours to complete. The template for randomised controlled was not completed by the trials themselves. An expert group derived the components of interest, which could produce different results with a different group of people. Conclusions Our work has provided an example of how standardized reporting of adult behavioural weight management interventions to aid evaluation can be implemented. Interventions were included in this study if they were compliant with National Institute for Health and Care Excellence guidance. We have described important differences between interventions used in randomised controlled trials and in existing services. The interventions vary in many components, particularly between real-world services and randomised controlled trials; United Kingdom trials differed to those delivered in the real world. This lack of evidence to inform decision-making as to the most effective components of behavioural weight management interventions will ultimately hamper the commissioning of such programmes. Future work There were components that were of interest to the expert group, which were not either suitable for analysis or part of the standardized reporting template of adult behavioural weight management interventions to aid evaluation template; there were also population subgroups that we were unable to include in future research as we did not include this information on the data request. This research is preparatory work for the BECOME study, and further planned work will determine which components are effective and their effects on different subgroups, along with a cost-effectiveness analysis of any effective component. Funding This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number NIHR129523
Chinese International Students, UK Universities, and Adaptation : Using Interpretative Phenomenological Analysis for Wellbeing
No full textReimagining the first year experience in higher education through a focus on knowledge engagement
No full textThe first year experience in higher education is vital for students as they transition into university life. While existing research has largely centred on students’ integration into institutions and the development of generic attributes, this study advocates for a shift in focus towards students’ engagement with specific knowledge areas within their discipline. Drawing on transition- and peer learning research, we highlight the methodological and conceptual challenges when focusing on generic aspects of the transition. By emphasising the importance of students’ relationships with knowledge and the role of teachers in facilitating this process, we propose a reconceptualised approach to the first year experience. This article calls for the prioritisation of academic engagement and disciplinary knowledge as integral components of the first year journey, shedding light on previously overlooked aspects of this critical transitional period