11237 research outputs found
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Materiality and Representation in Architectural Environment of the Arctic city
No full textPaper presents the ‘Warm’ city concept, a theoretical model for the architectural development of Russian Arctic cities, aimed at sensually rich environment, that cultivates a sense of belonging.</p
The Role of Business in Addressing Health Inequity through Nature
No full textWelcome to our briefing paper on the role of business in addressing health inequity through nature. It’s been prepared to introduce you to some of the topics and participants you’ll encounter at the upcoming event. To understand the role of Nature as a partner for sustained health and wellbeing, the relevance of nature-based solutions, regenerative place-making, the importance of healthy air, soil, water, and food.Globally, healthcare systems are predicted to face an additional $1.1 trillion cost due to climate-induced impacts on population health including respiratory diseases, dementias, and mental illness.Poor health costs the UK economy an estimated £138 billion per year due to absence and impact on productivity at work. A UK workers lose an average of 6.1 days a year due to formal absence, with the majority of lost working hours due to employees not working effectively as a result of ill-health. Public services have been weakened by a decade of austerity, with local government, social security benefits, and the National Health Service particularly affected. Earlier life expectancy gains slowed dramatically and, for some groups, reversed. Over the past decade, the number of young people out of work for health reasons has doubled to 190,000 from 93,000. This means people in their 20s are now more likely to be economically inactive due to ill health than people in their 40s. The increasing prevalence of mental health issues has been one of the key factors in this rise. One-in-three people aged between 18-24 reported symptoms of depression, anxiety or bipolar disorder in 2021-22. This was up from one in four people in 2000.</p
Breastfeeding self-efficacy, body image, body acceptance, and partner support: associations in Israeli postpartum women
No full textProblem: Research suggests that breastfeeding self-efficacy (i.e., a mother’s perceived ability and confidence to breastfeed her new-born) is associated with body image experiences and wider psychosocial factors. However, much of this work is focused on negative body image and has relied on samples from predominantly Westernised, industrialised nations. Background: To extend knowledge, we sought to examine the extent to which indices of positive body image (body appreciation), negative body image (body dissatisfaction, breast size dissatisfaction), and psychosocial factors (body acceptance by others, postpartum partner support) are associated with breastfeeding self-efficacy in sample of mothers from Israel. Hypothesis: We hypothesised that body appreciation, body dissatisfaction, breast size dissatisfaction, body acceptance by others, and postpartum partner support would each be significantly associated with breastfeeding self-efficacy in Israeli mothers. Method: A total of 352 mothers from Israel, with an infant aged six months or younger, were asked to complete an online survey that measured the aforementioned constructs. Findings: Correlational and linear model analyses indicated that only body appreciation was significantly associated with breastfeeding self-efficacy. Body acceptance by others was significantly associated with breastfeeding self-efficacy in correlational but not regression analyses. These effects were consistent across primiparous and multiparous mothers. Discussion: In Israeli mothers, at least, a limited set of body image and body image-related indices appear to be associated with breastfeeding self-efficacy. Conclusion: Overall, these findings suggest that positive body image may be associated with breastfeeding self-efficacy in women from Israel, though more research is needed.</p
Markers for the detection of Lewy body disease versus Alzheimer's disease in mild cognitive impairment: a systematic review and meta-analysis
No full textNo description supplied</p
A proven reoffending study of individuals managed under the multi-agency public protection arrangements (MAPPA) in England and Wales
No full textIntroduction: Past research into the effectiveness of multi-agency public protection arrangements (MAPPA) in reducing reoffending it limited. Thus, the current study aimed to evaluate proven reoffending patterns for MAPPA managed individuals.
Methods: Proven reoffending for 39,501 MAPPA managed individuals was investigated by (1) examining patterns in the timing and frequency of proven reoffending for MAPPA managed individuals; (2) examining 1-, 3-, and 5-year proven reoffending patterns of MAPPA managed individuals by MAPPA category, age, and gender; and (3) comparing crime harm levels and recall to custody for MAPPA managed individuals pre- and post-MAPPA adoption.
Results: Taken together, our findings show that proven reoffending rates for individuals managed under MAPPA are substantially lower than those reported in proven reoffending statistics for England and Wales.
Discussion: Our results suggest that MAPPA is making a positive contribution to a managing individuals convicted of sexual and violent offenses. Additionally, our findings provide the best evidence to date that MAPPA management may also be effective at reducing less serious offenses which do not typically involve immediate removal from society. These findings are considered in light of their theoretical and practical implications while potential limitations and avenues for future research are outlined.</p
Reflexive advocacy: The role of the interviewer in presuppositional interviews in qualitative research
No full textThe presuppositional interview in qualitative research requires the researcher to be interviewed about their thoughts, assumptions, and presumptions about their research. Its purpose is to recognise the impact of our thoughts, feelings, and actions in the ways in which we, as the researcher, exists in the research process. In earlier papers, we have discussed the purpose of the presuppositional interview, however, there is little attention in the literature about the person who interviews the researcher about their research, the presuppositional interviewer. The purpose of this paper is to discuss this unique role because the function and conversational structure differs from other types of interviewing. We propose the role of the presuppositional interviewer role is a reflexive advocate, as their engagement is intentionally directed toward supporting the researcher to develop insights about themselves, in the context of their research. The interviewer has no part in the interpretation. Instead, they are engaging in an activity which promotes the need to support and celebrate curiosity, but that remains in the domain of the researcher. To achieve this, we discuss the role and purpose of the presuppositional interviewer and offer practical guidance as to how to interview with presuppositional purpose.</p
Patient-reported outcome and experience measures (POEM) of a community-based glaucoma clinic in Cambridge, UK: an observational study
No full textObjectives: Glaucoma care demand in UK hospitals has exploded in recent years. This has resulted in a push to community (shared, virtual, etc) care models to reduce the burden on hospital systems and on patients. The study aimed to ascertain patient's experiences around various aspects of their care delivered in community clinics. Design: Observational study. Setting: Glaucoma Community Clinic, Cambridge, UK. Participants: Ninety-six consecutive patients (M:F 47:49, mean age 70±12 years), recruited from July to September 2022. Outcome measures: Patients completed a modified glaucoma patient-reported outcome and experience measure (POEM) regarding their clinic experience and perspective on their diagnosis, treatment and fear of blindness. Patient's thoughts of feeling safe under the community clinical team were gathered. Patient demographics including age, gender, postcodes and education history were used to find their corresponding Lower-Layer Super Output Areas and socioeconomic status. Results: Patients had positive perceptions of their clinic experience. Ninety-six per cent of patients reported that their experience of attending the community clinic was comfortable, and 93% (n=92) felt the experience was the same as expected from the hospital. Feeling safe under the clinician team produced a mean Visual Analogue Scale (VAS) score of 90 (SD 15) and feeling care was organised produced a mean VAS score of 87 (SD 17). Age, gender, disease characteristics and socioeconomic status had no influence on perceived experience. Patients aged Conclusions: A large majority of patients expressed a positive experience, felt safe under the care of their clinical team and their care was well organised. Relatively younger patients (<60 years) and those with no confirmed diagnosis would likely benefit from more consultation time and educational materials to improve their understanding of glaucoma.</p
Temporal trends of physical fights and physical attacks among adolescents aged 12-15 years from 30 countries from Africa, Asia, and the Americas
No full textPurposeThere is a scarcity of literature on temporal trends in physical fighting and physical attacks among the global adolescent population. Therefore, we aimed to examine these trends in a nationally representative sample of school-going adolescents aged 12–15 years from 30 countries in Africa, Asia, and the Americas, for which temporal trends of physical fighting and physical attacks are largely unknown.MethodsCross-sectional data from the Global School-based Student Health Survey 2003–2017 were analyzed. Self-reported data on past 12-month physical fights and physical attacks were collected. For each survey, the prevalence and 95% confidence interval of physical fights and physical attacks were calculated. Linear regression models were used to examine crude linear trends.ResultsData on 190,493 students aged 12–15 years were analyzed [mean (standard deviation) age 13.7 (1.0) years; 48.9% boys]. The mean prevalence of past 12-month physical fight and physical attack was 36.5% and 37.2%, respectively. Significant decreasing trends in physical fights were observed in 16/30 countries, while significant increasing trends were found in 2/30 countries. For physical attacks, significant decreasing and increasing trends were observed in 13/26 and 1/26 countries, respectively. The remaining countries showed stable trends.DiscussionIt is encouraging that decreasing trends in physical fighting and physical attacks were observed across a large number of countries. However, stable trends were also common, while increasing trends also existed, suggesting that global efforts to address adolescent violence are still required.</p
Reducing toxicity in the treatment of lymphoma
No full textWhile prognosis for lymphoma patients has improved significantly in recent years due to modern treatments, diagnostics and imaging techniques, short-term and late effects of treatment continue to have a detrimental impact on their health. This project set out to investigate three different strategies for reducing the toxicity of treatment for lymphoma: i) drug substitution in Hodgkin lymphoma, (ii) a radiotherapy-free approach to treating primary mediastinal large B-cell lymphoma (PMBL), and (iii) chemotherapy-free treatment of post-transplant lymphoproliferative disorder (PTLD). These strategies are commonly used in clinical practice but have not been tested in prospective, randomised clinical trials.Retrospective, observational, multicentre study designs were chosen to evaluate the above approaches to reducing the toxicity of treatment. To assess the impact of chemotherapy on stem cell genomic health, an analysis of mutation burden and mutational signatures was performed in haematopoietic stem and progenitor cells (HSPC) of previously treated Hodgkin lymphoma patients.The key findings were that replacing procarbazine with dacarbazine in Hodgkin lymphoma treatment maintains an excellent 36-month progression-free survival (PFS) of 92.4%. The substitution also confers several toxicity benefits. Additionally, patients treated with dacarbazine-containing regimens had a far lower excess mutation burden in HSPC. This project showed for the first time that procarbazine is linked to the SBS25 mutational signature.R-DA-EPOCH (Rituximab with dose-adjusted Etoposide, Prednisolone, Vincristine, Cyclophosphamide, Doxorubixin) is highly effective treatment for PMBL (3-year PFS 92.8%). However, in this real-world study 31% of patients received consolidative radiotherapy, while in the landmark Phase II trial radiotherapy was omitted(Dunleavy et al., 2013). In PTLD, our data suggest that a risk-stratified approach with first-line Rituximab monotherapy is effective and safe in real-world practice as well as in clinical trials.In conclusion, the real-world data suggest that the strategies I have studied are effective in reducing toxicities of lymphoma treatment. Choice of chemotherapy regimen may also impact on HSPC genomic health.</p
The management of femoroacetabular impingement syndrome with concomitant hip osteoarthritis Tönnis grade 2: laying the foundation for a randomised controlled trial
No full textBackground: There is inconclusive and contradictive evidence regarding the best management of femoroacetabular impingement (FAI) with concomitant hip osteoarthritis (OA) Tönnis grade 2 or more. Methods: A systematic and scoping review were performed to outline gaps in the evidence regarding outcomes of hip arthroscopy and non-operative management for our patient population. Statements were developed based on these findings to further perform a Delphi survey with an international expert-panel group. Consensus findings were used to design a randomized controlled trial to deliver level I evidence. Results: There is contradictory evidence regarding outcomes of hip arthroscopy for FAI with Tönnis stage 2 OA or more. There is no evidence on non-operative management outcomes. Experts did not achieve consensus on the best management for FAI with concomitant Tönnis stage 2 OA. However, a consensus was reached that Tönnis stage 3 are poor candidates for hip preservation surgery. A randomized controlled trial protocol was developed based on the clinical equipoise outlined and the findings of the systematic review, scoping review and Delphi survey. Conclusion: In an area with gaps in the literature and clinical equipoise on the best management strategy for FAI with concomitant Tönnis stage 2 OA, there is a clear need for a randomized controlled trial to deliver level I evidence, the protocol of which was designed as part of this thesis.</p
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