230582 research outputs found
Sort by
A longitudinal mixed-methods study of barriers and facilitators to the implementation of routine PTSD screening for care-experienced young people
Get PDFBackground: Care-experienced young people (CEYP) have higher rates of PTSD than their peers; however, their post-traumatic stress disorder (PTSD) symptoms are often missed. The Child Revised Impact of Events Scale (8 items; CRIES-8) is a well-validated and widely available screening tool, which could identify children at risk of PTSD. Objective: This project aimed to understand barriers and facilitators for the use of the CRIES-8 with CEYP accessing mental health services, as a means of increasing their access to evidence-based support. Methods: We recruited 243 mental health professionals from 28 mental health teams across England and provided training in the CRIES-8 and cognitive therapy for PTSD. Focus groups and interviews were conducted approximately every three months for 12–18 months, as well as a brief one-off questionnaire about implementation completed 6–9 months post-training. Qualitative data were analysed via thematic analysis. Results: While 80% of the sample did use the CRIES-8, only 50% used it with CEYP, and overall use was sporadic and inconsistent. The main barriers included capacity, CEYP access to mental health services, and professionals’ beliefs around diagnoses and routine outcome measures, particularly for CEYP. Flexibility and proactivity amongst the team were important facilitators. In practice, there were a variety of methods to implement the CRIES-8, each with a different impact on service resources and the young person completing it.Conclusions: Further service-based research to develop and test methods to address the identified barriers is essential to ensure that CEYP receive access to best-evidenced, needs-matched treatments.</p
Hydroponics and geopolitics: soilless farming and visions of state power, c.1936–1972
Get PDFFrom the late 1930s to today, the technological lure of hydroponics has inspired many geopolitical imaginations of planetary transformation. Hydroponics, or soilless farming, refers to a bundle of technologies to raise crops outside of arable land, using nutrient solutions in water, sand or gravel media. Envisioned as a technology with the potential to overcome food scarcity, soil exhaustion and climate limitations, hydroponics featured in many 20th-century geopolitical imaginations, often as a tool unlocking greater state power over formerly inhospitable regions and reducing territorial competition. In this article, we investigate three such geopolitical imaginations, as articulated by a raft of agronomists within the US Army, the Zionist movement, and the British Commonwealth. Engaging with these agronomists as international thinkers, we reveal how they fabricated geopolitical visions of hydroponics as part of new infrastructures of American transoceanic airpower, Israeli desert reclamation and postcolonial community development in South Asia and Africa. Through these three cases, we argue that geopolitical imaginations of hydroponics traded in distinctive geographical imaginations, epistemic politics and ideas of state power, placing emphasis on transforming frontiers, controlling plant productivity and enabling the contrasting politics of military hegemony, territorial occupation or postcolonial democracy alike. To conclude, we reflect on how hydroponics remains entangled with geopolitical speculation today, amid concerns with global climate change and agrarian shocks. Casting present-day anxieties through past futurisms, we suggest future avenues for the study of hydroponic imaginations within historical International Relations
The US-Sino Tech War Through the Eyes of Secondary States:An Analysis of the Reactions of the US Five Eyes Allies to Huawei’s 5G
No full textThis paper contributes to the scholarly debate on secondary states’ agency in the context of US–China technological competition by examining how members of the Five Eyes (FVEY) intelligence alliance, excluding the United States, responded to perceived security risks posed by Huawei’s 5G infrastructure. While all FVEY states ultimately excluded Huawei from national networks, the pathways to this outcome diverged markedly, reflecting differences in threat perception, institutional processes, political priorities, and strategic cultures. Australia acted decisively, leveraging established mechanisms to implement a hardline stance; Canada and New Zealand proceeded cautiously, balancing domestic politics and trade concerns; and the United Kingdom initially resisted US pressure before reversing course amid domestic scrutiny. These variations show that alliance cohesion cannot be assumed, even among long-standing intelligence partners, and that convergence in policy outcomes does not imply convergence in underlying rationale, though all members ultimately reached a de facto similar outcome. The study underscores the limits of US influence over allied interpretations of asymmetric technological threats and highlights the critical role of secondary states in shaping technological geopolitics. By illuminating how liberal democracies navigate security, economic, and political imperatives in asymmetric competition, it provides insights into the challenges of multilateral coordination over emerging technologies
Nutritional status with tirzepatide in obesity:A post hoc analysis of the SURMOUNT-1-4 randomized clinical trials
Get PDFBackground: Nutritional deficiencies are common among people with obesity, before and during treatment, such as with very-low-calorie diets and metabolic/bariatric surgery. Obesity management medications (OMMs) can reduce appetite and dietary intake, potentially affecting nutritional status. The impact of OMMs on nutritional outcomes in people with obesity warrants further study.Methods: We conducted a post hoc analysis of available nutritional status-related data from the randomized, placebo-controlled, phase 3 SURMOUNT-1-4 trials of tirzepatide (N = 4726). Descriptive statistics were utilized to explore available nutritional status-related data from clinical trial reports, including investigator-reported treatment-emergent adverse events (TEAEs) based on 14 MedDRA preferred terms, chosen to identify cases of macronutrient malnutrition; investigator-reported vitamin deficiency-related TEAEs; biomarkers assessed systematically during the trials (albumin; total lymphocyte count [TLC]); reasons for early treatment discontinuation; and participants reaching body mass index (BMI) < 18.5 and < 22 kg/m2.Results: Investigators reported 3 of 14 TEAEs potentially related to macronutrient malnutrition. TEAE incidence of Abnormal loss of weight, Underweight, and Hypoalbuminemia was 0.03 %, 0.06 %, and 0.03 % with tirzepatide and 0 %, 0 %, and 0.06 % with placebo, respectively. Vitamin deficiency-related TEAEs were reported for 0.99 % and 1.07 % of tirzepatide- and placebo-treated participants, respectively. Albumin <3.3 g/dL occurred in 0.06 % and 0.13 % of tirzepatide- and placebo-treated participants, respectively, while TLC <910/μL occurred in 2.90 % and 1.77 %. Treatment discontinuations potentially related to nutritional status (primarily achievement of desired weight and perceived excessive weight loss) occurred in 0.53 % of participants. Overall, 0.38 % and 0.06 % of tirzepatide- and placebo-treated participants reached BMI <18.5 kg/m2.Conclusions: TEAEs and treatment discontinuations due to macronutrient malnutrition were uncommon in the SURMOUNT-1-4 trials of tirzepatide for obesity. Lack of routinely collected vitamin and mineral levels during the trials limited assessment of the impact of tirzepatide treatment on micronutrient status. Systematic assessment of nutritional status before and during OMM treatment would enhance future trials.Clinicaltrialsgov identifiers: NCT04184622 (SURMOUNT-1); NCT04657003 (SURMOUNT-2); NCT04657016 (SURMOUNT-3); and NCT04660643 (SURMOUNT-4).Keywords: Nutritional status; Obesity management medication; SURMOUNT-1-4 trials; Tirzepatide; Treatment-emergent adverse events
N07 When the body tires, the mind resists:resilience as a buffer against fatigue-insights into quality of life in Crohn's disease
No full textBackground: Fatigue is one of the most burdensome and under-recognised symptoms in Crohn’s disease (CD), often persisting even in remission and profoundly affecting physical, psychological, and social functioning (Radford et al., 2021; Regueiro et al., 2023). As fatigue is only partially explained by disease activity, psychological resources such as resilience may play a crucial protective role . Resilience, defined as the ability to adapt and recover from adversity, may help mitigate the negative impact of chronic illness on health-related quality of life (HRQoL) (Jin et al., 2023). This study aimed to explore the relationships between fatigue, resilience, and HRQoL in adults living with CD.Methods: A cross-sectional survey was conducted among 50 adults with a confirmed diagnosis of CD. Three validated instruments were used: WHOQOL-BREF to assess HRQoL, the Inflammatory Bowel Disease Fatigue Scale (IBD-F) to measure fatigue, and the Resilience Scale (RS-14) to evaluate psychological resilience. Descriptive statistics and non-parametric correlations (Spearman’s rho) were performed to explore associations between variables.Results: Fatigue showed a strong negative correlation with both HRQoL and resilience. Patients reporting higher levels of fatigue experienced lower satisfaction with life, poorer psychological and social functioning, and greater difficulties in coping with daily stressors. Conversely, higher resilience scores were positively associated with HRQoL, suggesting that resilience may buffer the adverse effects of fatigue.Conclusion: Fatigue is a key determinant of reduced QoL in CD, while resilience appears to be an important adaptive resource supporting psychological well-being and daily functioning. Incorporating resilience-building interventions and psychosocial assessment into routine nursing practice could enhance patient well-being and complement medical treatment in IBD care.References:Jin, Y., Bhattarai, M., Kuo, W. C., & Bratzke, L. C. (2023). Relationship between resilience and self‐care in people with chronic conditions: A systematic review and meta‐analysis. Journal of Clinical Nursing, 32(9-10), 2041-2055. https://doi.org/10.1111/jocn.16258Radford, S. J., McGing, J., Czuber-Dochan, W., & Moran, G. (2021). Systematic review: the impact of inflammatory bowel disease-related fatigue on health-related quality of life. Frontline gastroenterology, 12(1), 11-21. 10.1136/flgastro-2019-101355Regueiro, M., Hunter, T., Lukanova, R., Shan, M., Wild, R., Knight, H., Bannikoppa, P., & Naegeli, A. N. (2023). Burden of fatigue among patients with ulcerative colitis and Crohn’s disease: results from a global survey of patients and gastroenterologists. Advances in therapy, 40(2), 474-488. 10.1007/s12325-022-02364-
On baptisms
Get PDFSuppose a causal theory of reference for utterances of proper names is correct. For an utterance of a name to refer to an object: (1) there must be a ‘baptism’, an event where the name is bestowed on the object; (2) the utterance must be suitably causally related to the baptism. The latter condition has seen significant research, but the act and conditions of baptising are surprisingly under-explored. I offer an account of baptisms. Most previous work has assumed one of two simple pictures: that baptisms are explicit ceremonies or that they are uses of a name with certain relational properties, each motivated by certain paradigmatic cases. In the first two sections of this essay I describe both pictures and explain how they fail. The paradigm cases are telling though, and in the third section I develop an account of baptisms which explains all the cases so far considered. On my account, a baptism of an object with a name is an act of instituting a rule to the effect that later uses of that name will refer to that object
Defective Buildings Are a Nuisance
Get PDFThis article highlights the potential for nuisance to provide another avenue to leaseholders of defective buildings who want to seek remediation. The Supreme Court’s decision in Fearn v Tate Gallery expanded the scope of nuisance, focusing on whether there was substantial interference with property use, without the need for physical invasion. Unsafe cladding and fire safety defects diminish the amenity and utility of leasehold flats, so that many are unsafe and unsellable. Landlords, as freeholders, can be considered ‘neighbours’ under nuisance law and therefore held liable for failing to remediate hazards. Applying nuisance to defective premises could allow leaseholders the remedy of an injunction, therefore allowing remediation. Unlike the criticised Fearn, which prioritised the interests of wealthy occupiers of the Neo Bankside apartments over the general public, this article explores the possibility of using nuisance for public good through the remediation of buildings with potentially life-threatening defects
