11237 research outputs found
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From Henley to Thames: institutional entrepreneurship and the Oxford-Cambridge women's boat race
No full textThe integration of the Oxford-Cambridge women’s boat race onto the tideway was hailed as a landmark moment for gender equality in sport. This research investigates how that transformation unfolded across media narratives, athlete experiences, and institutional processes. Through three interconnected qualitative studies, this thesis presents a comprehensive, multi-faceted account of the factors that shaped this landmark event and how gendered change materialises within a tradition-bound sporting institutions.Study 1 explores how the Women's Boat Race was framed in UK print and online media between 2011 and 2015. Using a structured media framing approach informed by Linstrom and Marais (2012), with interpretive emphasis on Entman’s (1993) conceptualisation of framing devices, the study analyses 177 mainstream news articles to identify dominant frames: economic, progress, powerlessness, tradition, and human impact. These frames revealed inherent tensions between celebration and marginalisation, exposing how media narratives simultaneously elevated the women’s race as a symbol of progress while reinforcing gendered hierarchies. By tracing evolving portrayals of athletes, sponsorship, and tradition, the study demonstrates the critical role of media in shaping public discourse around gender equality in elite sport.Study 2 shifts focus to the lived experiences of ten female athletes from the Oxford and Cambridge Women’s Boat Clubs who competed in the Boat Race between 2011 and 2024. Employing narrative inquiry and a metaphorical structure inspired by the Tideway course, this study examines how rowers navigated identity, resilience, and institutional constraints. Findings highlight the physical, emotional, and logistical challenges female rowers faced, including inadequate facilities, marginal funding, and symbolic exclusions, despite outward progress.Study 3 examines the institutional dynamics that enabled the 2015 integration of the Women's Boat Race. Using semi-structured interviews with ten stakeholders, including sponsors, organisers, coaches, and board members, and grounded in institutional work and institutional entrepreneurship, this study analyses how field-level conditions (such as legitimacy threats and resource disparities) intersected with actor-led strategies. Key findings show that external sponsorship, particularly through Newton Investment Management and the leadership of Helena Morrissey, as an institutional entrepreneur, helped reshape institutional arrangements to facilitate the amalgamation of the Women’s Boat Race into the Boat Races. However, the study also reveals the partial nature of the transformation, with symbolic inclusion not always matched by deeper structural or cultural change. Themes such as legitimacy pressure, sponsorship as a catalyst for reform, media framing as institutional work, and the persistence of traditional hierarchies illustrate the complex and negotiated nature of gender equality in legacy sporting events.Collectively, these three studies offer a multi-dimensional account of how media, lived, and institutional processes emerged to reshape the status of women’s rowing within a historically exclusive tradition. The thesis makes theoretical contributions to sport sociology, media studies, and institutional theory, showing how gender reform in sport materialises not as linear progress but through tension, advocacy, and negotiation. While the 2015 Tideway debut was a pivotal step, findings across the three studies emphasise that lasting equality necessitates deeper structural embedding, continuous cultural change, and a sustained commitment to visibility and support for female athletes.</p
Lens shape change is influenced by zonular anchorage and stretching mechanism
No full textThis study investigates the influence of zonular anchorage position and loading mechanism on lens accommodation using finite element analysis. Axisymmetric models of the lens–zonule–ciliary body complex were developed, incorporating anterior, equatorial, and posterior zonular bundles. Four model variants were generated by varying anchorage position (near the pars plicata or pars plana) and loading mechanism (synchronous or asynchronous). Lens morphology, central optical power (COP) and zonular forces were analysed during simulated accommodation. The synchronous loading mechanism induced greater changes in posterior lens and nuclear radii of curvature and produced a wider range of accommodative change, while the asynchronous mechanism induced higher anterior surface steepening and peak central optical power but a smaller accommodative range. Zonular anchorage position slightly affected outcomes only in models with synchronous loading mechanism such that models with anchorage position near the pars plicata yielded greater changes in COP. A nonlinear relationship between central optical power and zonular force was consistently observed, suggesting an optimal range of zonular tension for maximizing lens performance. These findings indicate that zonular loading mechanism significantly influence lens shape and optical performance.</p
Designing a theory-informed feedback system for prehospital cardiac arrest care: a qualitative study
No full textIntroduction: Feedback is a vital yet underused tool for improving clinical outcomes in prehospital emergency care. This study aimed to develop and pilot a novel, theoretically grounded feedback mechanism for helicopter emergency medical service (HEMS) clinicians involved in out-of-hospital cardiac arrest (OHCA) in the East of England, UK. Methods: Semistructured interviews were conducted in September 2022 with HEMS clinicians from Essex & Herts Air Ambulance, and the feedback process was co-designed with the Essex Cardiothoracic Centre (Essex, UK). Using the COM-B model (Capability, Opportunity, Motivation-Behaviour), we conducted qualitative interviews with prehospitalists (seven paramedics, three prehospital doctors) to explore gaps in existing feedback processes and identify their information needs, then iteratively co-developed a structured feedback proforma with stakeholders. Results: Three themes emerged, specifically about weaknesses in current feedback and preferences for an improved system: (1) dissatisfaction with current ad hoc, ‘punitive’ approaches; (2) the educational and emotional importance of timely, targeted feedback; and (3) a strong preference for standardised, confidentiality-compliant delivery methods. The resulting feedback proforma included working diagnoses, key investigations completed, optimisation opportunities and patient outcomes (if already available), to be delivered within 24–48 hours of hospital admission. Conclusions: Our study underscores the importance of stakeholder-driven development in shaping an effective prehospital feedback mechanism for OHCA aligned to clinicians’ needs. By exploring feedback preferences and mapping insights onto the COM-B model, we highlight how knowledge, context and motivation can all steer behavioural change. Further research is needed in diverse emergency medical service contexts to test its impact on clinical practice and patient outcomes.</p
EEG Changes Associated with Hallucinations Caused by Charles Bonnet Syndrome
No full textCharles Bonnet Syndrome (CBS) is characterised by the presence of visual hallucinations following visual loss in many patients. The neuropathophysiology of CBS is poorly understood. We used electroencephalography (EEG) in individuals with frequent hallucinations in
order to identify changes in neural activity that co-occur with hallucination onset. We found reduced α power in occipital electrodes at the onset of the hallucinations compared to offset (p < 0.05), suggesting that intermittent periods of low endogenous alpha may create the neural conditions for hallucination to emerge in CBS patients. This is the first group study that shows a repeatable marker of brain activity changes in CBS that occur either at the onset or just prior to the onset of the hallucination. This offers important implications for both research and clinical practice. It could aid in early detection and prediction of hallucination onset and improve our understanding of the neural mechanisms
underlying CBS. It also may help reduce stigma around the condition by validating the patient experience through measurable brain changes.</p
Botulinum toxin and redress in the UK, findings from a cross-sectional survey
No full textDear Editor, In the United Kingdom, an estimated 900 000 cosmetic botulinum toxins (BoNT) injections are performed annually. However, unlike other specialized medical interventions, in the United Kingdom many are delivered by individuals without formal healthcare qualifications and under minimal regulatory oversight. Owing to a lack of regulations in the United Kingdom surrounding BoNT, these injections can be carried out by practitioners with multiple backgrounds and levels of training.</p
Recommendations from the European interdisciplinary council on ageing on physical activity and diet for mental health conditions in older adults
No full textThe global rise in life expectancy is accompanied by an increase in the prevalence of mental health conditions among older adults, including mild cognitive impairment (MCI), dementia, delirium, depression, anxiety, and other severe mental illness. These conditions significantly impact independence, increase healthcare costs, and increase mortality risk. Mounting evidence underscores the central role of modifiable lifestyle factors—particularly physical activity and diet—in the prevention and management of these conditions. This consensus, developed under the auspices of the European Interdisciplinary Council on Ageing (EICA), synthesizes current evidence and expert perspectives. Regular exercise, ranging from aerobic and resistance training to mind–body practices, improves cognition, mood, and physical resilience, while also mitigating cardiometabolic and functional risks. Similarly, adherence to dietary patterns such as the Mediterranean or MIND diets has been consistently associated with reduced incidence of cognitive decline, Alzheimer’s disease, and comorbid chronic illnesses, although much of the evidence is observational. Landmark multidomain trials, including the Finnish FINGER and U.S. POINTER studies, have shown that combined interventions targeting diet, physical activity, cognitive stimulation, and social activity can slow cognitive decline in at-risk populations. Lifestyle strategies that promote brain health may enhance functional outcomes in dementia and, in turn, mitigate the risk of delirium. However, widespread implementation of such strategies faces numerous barriers, including physical frailty, socioeconomic constraints, health system fragmentation, and stigma. To overcome these barriers, caregivers, healthcare and public health professionals, policymakers, and community organizations must collaborate in designing accessible, culturally sensitive, and sustainable interventions at a policy level. Emerging digital tools, group-based programs, and co-designed approaches offer novel opportunities to enhance adherence and impact. Integrating lifestyle interventions into standard healthcare pathways represents an urgent, cost-effective strategy to promote mental health and resilience in ageing populations worldwide. This document provides actionable recommendations to guide policy, research, and clinical implementation across diverse health systems.</p
Gestational diabetes mellitus and adverse maternal and neonatal health outcomes: an umbrella review of meta-analyses
No full textIntroduction: This study systematically synthesized evidence on adverse health outcomes related to gestational diabetes mellitus (GDM) via an umbrella review with integrated meta-analyses.Methods: The search covered publications from the database (PubMed/MEDLINE, Google Scholar, Embase, and CINAHL) inception to August 12, 2024. Meta-analyses of observational studies examining the impact of GDM on maternal and neonatal health outcomes were included. Two independent researchers screened and extracted data. Associations were reanalyzed and presented as equivalent odds ratios (eORs) with 95% confidence intervals (CI). The quality of meta-analyses was assessed using AMSTAR 2, and the credibility of associations was categorized into five levels: convincing (Class I), highly suggestive (Class II), suggestive (Class III), weak (Class IV), or nonsignificant (NS).Results: A total of 27 meta-analyses encompassing 85 associations were included. Among 28 significant maternal outcomes, 11 (subclinical atherosclerosis, angina, hypertension, overall cardiovascular diseases, ischemic stroke, overall stroke, combined cardiovascular/cerebrovascular diseases, subclinical left ventricle systolic dysfunction, type 2 diabetes, postpartum metabolic syndrome, and infections) were supported by convincing or highly suggestive evidence. Of 13 significant neonatal outcomes, three (atrial septal defect, congenital heart disease, and ventricular septal defect) were highly suggestive, while four of eight significant delivery outcomes (hypertensive disorders, cesarean delivery, admission to neonatal intensive care unit admission, and preterm birth) reached this level. Notably, no outcomes previously deemed nonsignificant turned significant upon reanalysis.Conclusions: These findings underscore the need for targeted prevention and management, and further research is needed to clarify causality and refine guidelines.Study Registration: PROSPERO CRD42024590322</p
From grass to protein: assessing the economic viability of mechanochemical-assisted extraction for sustainable food production
No full textGrasslands represent one of the world’s largest yet most underexploited renewable biomass resources. Here, we present a techno-economic framework for transforming grass silage into edible protein and microbial lipids through mechanochemical and biocatalytic processing. Two biorefinery configurations were evaluated using stochastic and spatial modeling: a baseline system producing protein and biogas (Scenario 1) and an integrated design incorporating lipid fermentation (Scenario 2). Both achieve strong economic performance at industrial scale, with median net present values (NPVs) of £528 million and £1.21 billion, respectively, and protein production costs of £2.97–3.40 kg–1─comparable to plant-derived alternatives. Sensitivity analysis reveals that protein extraction efficiency and product price dominate profitability, while scale and coproduct valorisation drive the largest gains in expected NPV. Spatial simulations show that sourcing 33,333 t y–1 of wet silage (25% DM) is logistically feasible across UK grasslands at delivered costs of £51–58 t–1, enabling decentralised, regionally integrated deployment. Together, these results establish grass-based biorefineries as a scalable and economically credible route to sustainable protein production, bridging agricultural residues and food technology. The study provides quantitative guidance on how process yield, market development, and spatial logistics can be co-optimized to accelerate the emergence of a circular, pasture-driven bioeconomy.</p
A commentary on the updated research priorities in ophthalmology: implications and future directions
No full textThe recently published study that refreshed the James Lind Alliance Sight Loss and Vision Priority Setting Partnership research priorities represents a significant effort in shaping the future of ophthalmic research by the UK Clinical Eye Research Strategy (UKCERS). While the study effectively re-evaluated the most pressing research needs in ophthalmology, this commentary highlights additional considerations and implications of these findings, particularly in light of emerging research and advancements in the field.</p
Healthcare 4.0: the use of digital twins prototype for healthy living
No full textObjectives: The aim of this thesis is to design and validate a behaviour-aware Digital Twin (DT)framework for Type 2 Diabetes Mellitus (T2DM) prediction and prevention. Existing approaches are often constrained by an overreliance on biomarkers, limited integration of psychosocial and lifestyledeterminants, and insufficient causal interpretability or scalability across diverse populations.Methods: A three-decade bibliometric review (1991–2024) was undertaken to identify research trends and gaps in machine learning models for T2DM. Using UK Biobank data, survival models were developed with penalized Cox regression and enriched with causal inference techniques to simulate preventive interventions. A prototype offline DT was constructed that incorporated psychosocial and behavioural determinants. Neural network coherence and centrality analyses were conducted to explore bidirectional interactions between diet, sleep, stress, and psychological factors.Results: The bibliometric review revealed persistent gaps, including dataset homogeneity, poor integration of behavioural variables, and limited clinical translation. Penalized Cox regression models achieved strong predictive performance (C-index = 0.90). Psychosocial determinants such as loneliness, insomnia, and mental health history, along with dietary factors, emerged as significant predictors, with pronounced ethnic disparities in T2DM risk. The DT prototype allowed simulation of intervention effects, showing that improvements in sleep, diet, and mental health substantially reduced estimated hazards. Neural network based analyses uncovered cascading disruption chains, with stress leading to poor sleep and unhealthy diet, that precede metabolic decline and reframe T2DM as a systemic reorganization of behavioural networks.Conclusion: This thesis shifts T2DM research from reactive, biomarker-centric prediction toward holistic, interpretable, and preventive frameworks. By embedding psychosocial and behavioural determinants within a causally informed DT prototype, it advances early detection, personalized prevention, and scalable strategies with public health significance, particularly for diverse and resource limited populations.</p
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