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Antidepressant prescribing trends for adult patients in the UK and Ireland during the COVID-19 pandemic: A systematic review
No full textNo description supplied</p
Alliances with frenemies: Capability-building mechanisms linking coopetition to firm performance
No full textCoopetition functions as a double-edged sword, offering both benefits and costs. Drawing on the capability-building perspective, we examine the intermediate mechanism through which coopetition gives rise to superior performance. We explore two interrelated yet seemingly paradoxical learning capabilities, namely absorptive capacity (AC) and unlearning, which serve as mediating mechanisms that link coopetition to financial and non-financial performance. Our findings from a sample of 190 Iranian SMEs confirm that AC mediates the effect of coopetition on both financial and non-financial performance, whereas unlearning did not directly mediate any of these relationships. However, we found that unlearning serves as an important catalyst for the development of AC, which in turn affects performance. This study contributes to the literature by examining the bridging mechanism underlying the performance impact of coopetition and contributes to the debate on the development of capabilities in coopetition partnerships.</p
The Other perspectives on the development and life course of offending
No full textA longitudinal view has now become a prominent way of seeing offending and the person behind that offending. Understanding offending, as well as its patterns, causes, and correlates, over the course of a person's life has, no doubt, significant implications for crime prevention and intervention (see as examples Blumstein, 2011; MacLeod, Grove, & Farrington, 2013; Welsh, Paterson, Rocque, et al., 2024). The apparency of the previous statement may not have been the case as, when the longitudinal approach to offending was an emerging area of study and not as the organising framework of developmental and life course criminology (DLC / DLCC) as it is known now, cross-sectional research designs were seen as adequate enough to study offending. At the time, age effects on crime were cogently argued to be invariant based on available evidence, in that age distributions for crime followed a consistent curve, regardless of social and cultural context, a ‘brute fact’ of criminology (Hirschi & Gottfredson, 1983). Life events, such as leaving school, were unable to explain offending meaningfully beyond age because they were considered proxies for it. Thus, longitudinal study was considered redundant.</p
Stories and science: two roles for palaeontology in the Anthropocene
No full textPeople have observed and collected fossils for thousands of years, sometimes using these to tell stories about mythical beasts or events. In more recent times, fossils have been fundamental to the development of a deep understanding of Earth’s dynamic processes, including its evolving biosphere, with notable contributions to the development of this science from Western, Middle Eastern and Asian traditions. Thus, fossils have been used both through technical studies in scholarly research and for telling stories about our broader relationships with the biosphere. Here, we examine the fossil records of two aspects of anthropogenic impact on the biosphere, those of extinction and of non-native species. We discuss how a scientific understanding of the fossil record grounds our projections of future environmental change, while storytelling is an essential art that helps people understand and forge a more sustainable relationship with a biosphere that has maintained life for billions of years. This article is part of the theme issue ‘The biosphere in the Anthropocene’.</p
Mediation analysis investigating the mechanisms of two school-based smoking prevention interventions in adolescents from Northern Ireland and Bogotá
No full textBackground: Reviews have highlighted a lack of evidence on how successful intervention strategies for adolescent smoking prevention can be effectively adapted for low-middle income countries (LMICs). The MECHANISMS study compared behavioral mechanisms between two school-based smoking prevention programs for adolescents in Northern Ireland (NI; a high-income setting) and Bogotá, Colombia (middle-income). ASSIST works via peer education and diffusion. Dead Cool uses conventional classroom pedagogy. Both interventions were previously trialed in the UK and were culturally adapted for Bogotá. We investigated whether changes in smoking/vaping outcomes differed by intervention or setting. Mediation analyses were conducted to test the hypothesized intervention mechanisms.Methods: Full school year groups in 12 secondary schools participated during one semester (n=1344, target age 12-13 years). Outcomes included willingness to pay (WTP) to support anti-smoking norms, self-report and objectively measured smoking behavior, smoking intentions, susceptibility, knowledge, and attitudes. Mediators included injunctive and descriptive smoking/vaping norms, self-efficacy to resist tobacco, perceived risks and benefits, perceived behavioral control, and exposure to advertising. Structural equation models examined intervention and setting effects on outcomes. Multiple mediator models were conducted using the product-of-coefficients approach.Results: Most significant intervention effects showed more anti-smoking outcomes for Dead Cool compared to ASSIST, although exposure to advertising was lower for ASSIST (media: unstandardized coefficient (b)=-1.19, pConclusions: Our results suggest school-based programs may be an appealing target for adolescent smoking prevention in LMICs and support using social norms strategies. Future research should identify additional mediating constructs for adolescent smoking prevention in LMICs (integrating intrapersonal, social, environmental, cultural, and political factors), investigate how to optimize the communication channels in peer education and diffusion programs, and provide empirically testable mechanisms.</p
Experience and Acceptability of a Reduced-Energy Whole-Diet Intervention in Women with Gestational Diabetes: a Qualitative Study of the Dietary Intervention in Gestational Diabetes Trial
No full textBackgroundGestational diabetes mellitus (GDM) is rising in prevalence in many countries worldwide. Although dietary modifications are the first-line treatment for GDM, it is unclear which specific dietary approaches are most effective to improve maternal and offspring outcomes while reducing further maternal weight gain. We recently demonstrated benefits of an energy-restricted diet with modest weight loss in women with GDM.ObjectivesWe aimed to investigate the acceptability of an energy-restricted whole-diet intervention in women with GDM with a BMI ≥25 kg/m2, in a free-living environment, and to examine potential barriers and enablers of implementation of such a diet into standard clinical care.MethodsThis qualitative research study used semistructured interviews with 20 participants in the Dietary Intervention in Gestational Diabetes trial, in which women with GDM were randomized to a whole-diet intervention containing 1200 or 2000 kcal/d. We used reflexive thematic analysis to explore participants’ experiences of the study diet and GDM.ResultsWe identified 6 key themes in participants’ experience: emotional and cognitive burden of managing GDM, convenience of meal delivery, support and reassurance, hunger and appetite differences, health impacts for intervention engagement, and research participation for awareness and impact. Facilitators of study participation included support, motivation, convenience, and not wanting to be medicated. Barriers to participation were the social aspects of eating food, inconvenience, and uncertainty about the validity of dietary interventions. It was identified that participants frequently overlooked their physical health and weight management during pregnancy, despite how crucial these factors are for both maternal and infant well-being.ConclusionsPregnant women with GDM found an energy-restricted diet to be acceptable and beneficial to emotional and physical health, especially when support is provided by healthcare professionals. The convenience of meal delivery and the motivations to avoid medication use in pregnancy facilitated engagement with the intervention.</p
Importance of physical activity and frailty in diabetic foot ulcer: from observational research to a clinical trial
No full textBackgroundDiabetic foot ulcer (DFU) is a serious diabetes complication. Physical frailty is also a serious condition which is a risk factor and a consequence of diabetes. However, there is limited evidence on how frailty impacts on the risk of ulceration and mortality. Furthermore, physical activity and exercise are powerful therapies for improving physical function and cardiometabolic health. However, the activity profiles of people with DFU are largely unknown and there is a need for more exercise interventions in this population.Aims1. Use Clinical Practice Research Database (CPRD) data, to explore the observational associations between frailty and DFU, taking into account the of competing risk of mortality.2. Analyse physical activity data, measured via accelerometers, to provide a more detailed understanding of the physical activity profiles in those diagnosed with a DFU.3. SIT and be FIT study: Conduct an RCT to investigate a 12-week seated exercise programme on cardiorespiratory fitness (CRF) in people with DFU.Key findings1. Greater frailty was associated with higher rates of DFU and mortality. In women with type 2 diabetes diagnosed at the age of 60, the 10-year adjusted probability of DFU was 2.1%, 1.9%, 2.9%, and 3.2% for fit, mild, moderate, and severe frailty, respectively; corresponding estimates in men were 2.6%, 2.7%, 3.7%, and 4.4%. Risks were similar for different diagnosis ages (50 or 70 years) or diabetes duration (up to 20 years).2. Physical activity, particularly the intensity of sustained activity, was lower in those with DFUs compared to non-DFUs. Moderate to vigorous physical activity was lower in the DFU group (9 min/day [5, 17] vs. 18 min/day [16, 21], p ≤ 0.003).3. 12-weeks of seated arm ergometry improved CRF in a cohort of people diagnosed with DFU. The mean change difference for VO2peak was 2.9 ml.kg.min-1 (p = .004) adjusted for baseline.</p
Towards a precision medicine approach to the management of aortic stenosis
No full textBackgroundDefinitive treatments for severe symptomatic aortic stenosis (AS) include surgical aortic valve replacement and transcatheter aortic valve implantation. However, the optimal timing for valve intervention in asymptomatic severe AS remains debated and sociodemographic disparities in the treatment of AS have been reported. Cardiac magnetic resonance (CMR) imaging provides advanced biomarkers to improve risk stratification.Aims(i) Understand sociodemographic differences in the referral for and treatment of AS in England, (ii) establish the prognostic role of myocardial perfusion reserve (MPR) or coronary flow reserve (CFR) in AS and assess the impact of AVR on CMR-measured imaging biomarkers, including MPR and myocardial calcium handling and (iii) to compare the impact of early AVR vs standard care on the overall myocardial fibrosis burden and reverse remodelling in randomised cohort of patients with asymptomatic severe AS.Methods (i) Real-world data from a national database were used to determine sociodemographic characteristics, referral patterns and intervention rates for AS. (ii) A systematic review/metaanalysis assessed the prognostic significance of MPR/CFR. (iii) CMR studies evaluated the effect of intervention on cardiac remodeling, MPR, aerobic capacity, calcium handling and myocardial fibrosis.Results(i) Of 154,223 patients (50.4% female) with AS, 92.7% were White, 2.7% South Asian, 1.4% Black and 1.1% Other/Mixed. Women and deprived socioeconomic groups had lower referral to secondary care and intervention rates, while ethnic minorities had higher referral but lowerint ervention rates. (ii) Impaired MPR/CFR was associated with a higher incidence of MACE (HR 3.67, 95% CI: 1.66, 8.09, I2 = 63%) in 384 participants with 109 events. (iii) In a pooled analysis (n=50), MPR improved significantly 6-12 months post-AVR, with greater improvements in those with impaired baseline perfusion and correlating with improvement in aerobic exercise capacity. In a pilot manganese enhanced CMR study (n=7), no notable change in calcium handling was seen post AVR. Interim results from 83 asymptomatic patients with severe AS, randomised to early intervention vs standard care, showed greater preservation of LV systolic function in the early intervention group. Signals of less fibrosis accumulation with early intervention, did not remain significant on adjusted analysis.ConclusionsThis thesis identified sociodemographic disparities in AS management in England. It demonstrated the utility of advanced imaging biomarkers, especially the prognostic role of MPR in AS. Intervention improves MPR, however it does not alter myocardial calcium handling. Early intervention shows promise for preservation of systolic function and signals of less fibrosis accumulation, but data analysis of the full cohort (currently under follow-up) are needed.</p
“…rather than doing to, we’re doing with” - Understanding therapeutic alliance formation during groupwork intervention for men convicted of sexual offences who are subject to polygraph testing in the community.
No full textThe therapeutic alliance plays a pivotal role in determining the success of group-based interventions for people convicted of sexual offences (PCoSO). However, the impact of the wider penal institutional context on this alliance, along with the way these dynamics are relationally navigated remains under-explored. Within the criminal justice system, therapeutic interactions and relations are shaped by complex power structures and paradoxical conditions. On the one hand PCoSO are subject to restrictive surveillance and risk management practices, with polygraph testing being a recent example. On the other, rehabilitative interventions have increasingly focused on desistance, promoting positive identity, access to social capital, and relational engagement.This thesis aims to understand this tension and provide insight into the ‘black box’ dynamics of therapeutic alliance formation and programme delivery within community-based groupwork treatment for PCoSO. A multi-perspectival longitudinal design was deployed to examine the therapeutic alliance within the Horizon Programme, integrating qualitative interviews and group session contact logs from 14 treatment facilitator–polygraphed group member dyads. A total of 22 participants, consisting of 8 group members and 14 therapists, were interviewed at the beginning, middle and end of treatment, resulting in 51 interviews being conducted and analysed.A key finding from this study is that the panoptic surveillance mechanisms within the probation institution shapes therapeutic interactions and the alliance through the treatment process. However, these dynamics are navigated through therapeutic interaction and relational reflexivity to develop a meaningful therapeutic alliance which enhances group members engagement and supports desistance. The humanising of interactions and actively diluting power dynamics values is central to this process. Although polygraph testing experiences causes pains for group members, it was viewed as separate from the therapeutic process due to a shared understanding of its limited therapeutic value and its potential to foster judgement and ‘othering’ within the group.</p
Voices from the Minority: Understanding the Accultura8ve Experiences of Muslim Communi8es.
No full textSystemic Literature Review This meta-ethnography explored the acculturative experiences of South Asian (SA) Muslims. Acculturation involves changes following interac8on between ancestral and host cultures, often linked to psychological distress. The aim of this review was to learn more about SA acculturative experiences to enhance intercultural competency in mental health services. An interpre8vist approach guided this meta-synthesis, using a meta-ethnographic framework to identify overarching constructs across studies. Ten qualita8ve studies were included, with quality assessed using the Joanna Briggs Ins8tute checklist (Lockwood et al., 2015). Five overarching constructs were identified: isolation (within and outside cultural groups), iden8ty (including a loss of and dual iden8ty), belonging (tied to assimilation, exclusion, and cultural loss), religion (with increased freedom post-migration), and racism. These constructs highlighted emotional struggles such as confusion, sadness, and generational conflict. Findings revealed the complexity of acculturation in SA Muslims and emphasises the need for culturally responsive mental health services.Empirical Research Project This research explored the accultura8ve experiences of British Shia Muslims to support in understanding the need for culturally sensitive clinical practice. The study aimed to improve understanding acculturative experiences and therapeutic support for this community. Using a qualitative design, 15 semi-structured interviews were analysed through Braun and Clarke’s (2022) reflexive thematic analysis. Participants included were British Shia Muslims aged 18+, living in England for at least five years. Recruitment through mosques included first, second, and third-generation individuals, acknowledging acculturation beyond immigration (Van Der Zee & Van Oudenhoven, 2022). Five themes were identified under the overarching theme ‘the road to acculturative adjustment’: belonging, mental health, religiosity, discriminatory experiences, and protective factors. The overarching theme depicted acculturation as a fluid, complex journey, consistent with Schwartz et al.’s (2010) multidimensionality acculturation model. Findings highlight the need for culturally competent clinical approaches, using an intersectional lens, to beaer support British Shia Muslims.</p