Evaluating Response to a Brief Distress Tolerance Intervention Delivered in an Adult Secondary Care Community Mental Health Service

Brief distress tolerance interventions aimed at improving ability to tolerate psychological discomfort are being used trans-diagnostically, by both clinicians and paraprofessionals. Such brief interventions, delivered by a range of professionals could help to bridge the current worldwide gap between demand for and availability of mental health support. Despite a good theoretical rationale for the effectiveness of distress tolerance skills, empirical evidence for stand-alone interventions is lacking. This report details an evaluation of a six-to-eight-week distress tolerance intervention delivered in a community mental health setting by clinicians and paraprofessionals, using routinely collected outcome data. The aim was to better understand data completion, the proportion of responders and any pre-intervention differences between responders and non-responders. Pre intervention routine outcome measures were found to be reasonably complete, with good post-intervention follow up. Distress tolerance specific measures were less complete. Where it was possible to calculate reliable change (n=163), 58.3% of clients were classified as responders to the distress tolerance intervention which is comparable with CBT outcomes, and response rate is improving over time. There was no evidence that clients were more or less likely to respond depending on their age, presenting problem, mood scores pre-intervention, referrer discipline or the role of the person delivering the intervention. Responders were found to have significantly poorer ability to tolerate distress pre-intervention compared with non-responders. Men were disproportionately likely to be non-responders which may indicate a need for improved access

Adverse childhood experiences' impact on the perinatal period: a scoping review

Background/Aims: Those with a history of adverse childhood experiences are known to experience worse mental health and poorer obstetric and neonatal outcomes. This scoping review explored the perinatal experiences of women with a history of adverse childhood experiences. Methods: Qualitative studies that explored lived experiences of the perinatal period for women with a history of adverse childhood experiences were included in this scoping review. Three databases, CINAHL, Medline and PsychInfo, were systematically searched for qualitative papers in June 2024 and eight papers were reviewed. Results: Three themes emerged: pregnancy as a turning point, witli the sub-theme of the pregnancy identity; interpersonal connections; and experiences of maternity care, with the sub-themes trust and judgement and control and triggers. Conclusions: For women with a background of adverse childhood experiences, the perinatal period may be experienced uniquely, with notions around their sense of identity and relationships shaped by their past. Implications for practice Caregivers should actively deliver and promote trauma-informed care to account for potential vulnerabilities and enable a positive perinatal experience

The impact of the matrix and buffer properties on residual stresses in TRISO particles during manufacture and early life

A three-dimensional finite-element model was developed using Abaqus to simulate the fabrication and initial power ramp-up of a tri-structural isotropic (TRISO) particle, featuring a UO2 kernel, encapsulated in either a SiC or graphite matrix. After sintering, the residual compressive hoop stress in the SiC coating layer reached -540 MPa when encapsulated in a graphite matrix, 94 MPa more compressive than in a SiC matrix. However, following the initial power ramp-up, the predicted compressive hoop stresses in the SiC layer of a particle embedded in a SiC matrix (-388 MPa) were significantly greater than in a graphite matrix (-222 MPa), emphasizing the matrix material's critical role in the stress state of the SiC layer. Model validation attempts were made with the experimental measurements of the residual stresses of a zirconia-kernel surrogate particle. We found that in a fully-bonded surrogate TRISO particle, the stress state of the SiC layer is highly sensitive to the buffer porosity with compressive SiC layer hoop stresses ranging from up to -1.06 GPa at a porosity of 0.14 to -0.77 GPa at a porosity of 0.60. Partial kernel/buffer delamination simulations revealed a significantly varied geometric stress distribution, with tensile stresses reaching up to +54 MPa and compressive stresses up to -546 MPa at different axes of the sectioned plane in the model. This finding suggests that contrary to the common assumption of complete delamination at the kernel/buffer interface during fabrication, partial delamination is a more plausible explanation for the high compressive stresses observed in the SiC layer experimentally

Living by the Rule:Contemporary Art and the Medieval Monastery

How might assumptions about contemporary life be unsettled by historical models, specifically the 'Rule’ which underpinned medieval monastic life? And how does the rich visual material culture of that historical model find connections with contemporary art? This unique publication offers a vivid means of staging the encounter between the medieval and the contemporary, with many unexpected resonances sounding between recent works and much earlier objects and texts. Offering new perspectives on extraordinary artworks from monastic contexts, such as the Arundel and Gorleston Psalters, and works in a variety of media by celebrated contemporary artists, including Danh Vo, Elizabeth Price, Richard Wright and Andrea Büttner, Living by the Rule makes a compelling case for looking beyond the chronological tracing of art history

Patient satisfaction and experiences with menopause care for people with autoimmune diseases: an international mixed-methods study from the Menopause MATTERs Project

Objectives: To understand the experiences and satisfaction with menopause care for women with autoimmune diseases. Study design: Exploratory, mixed-methods study (between December 2024 and March 2025) using an online survey for peri-, menopausal, and postmenopausal individuals (≥18 years), with and without confirmed autoimmune diagnoses. Survey participants were purposively selected for semi-structured interviews. Main outcome measures: Satisfaction with menopause care as measured across nine (co-designed) domains of: availability and access to clinicians, clinicians' knowledge, involvement in decision-making, consideration of primary disease, clinicians' empathy for physical and mental health symptoms, continuity and follow-up support, information received, flexibility in treatment. Other outcomes included qualitative themes from interviews with patients, types of clinicians consulted for menopause and reasons for seeking private menopause care and process measures of access to care. Results: Satisfaction was significantly lower amongst women with autoimmune diseases (n = 3754) than those without autoimmune diseases (n = 480) across the nine metrics studied (p < 0·001). Qualitative analysis identified three themes: (1) menopause care was reactive and dependent on patients advocating for themselves; (2) there was fragmented and siloed care between specialties, with limited integration of the intersection between autoimmune diseases and menopause; and (3) mental health concerns often overshadowed menopause and autoimmune disease symptoms. Conclusion: The menopausal transition must be recognised as a unique stage in the management of autoimmune diseases. Our study suggests that menopause advice and care would benefit from increased clinician proactivity, empathy and knowledge. Greater evidence to inform clinical guidance and interdisciplinary training and integration is required

Effect of Active and Assisted Living technologies on psychosocial well-being in older adults: systematic review

Background: In a rapidly aging society, the concept of psychosocial well-being becomes increasingly relevant, independent of health. Indeed, psychosocial well-being is closely related to autonomy, independence, and self-efficacy. Technological approaches that support older adults in leading active, healthy, and independent lives are framed within the concept of Active and Assisted Living (AAL). However, evidence regarding their impact on psychosocial well-being remains limited. Objective: This systematic review evaluates the psychosocial effects of AAL technologies in older adults. Methods: We included intervention studies reporting psychosocial outcomes related to older adults’ use of AAL technologies. We excluded studies involving participants receiving continuous on-site healthcare assistance or with moderate to severe mental health problems, technologies restricted to basic home automation or lacking advanced data processing and automation, and interventions focused on rehabilitation after acute events. Studies using not-validated measures or without quantitative evaluation of outcomes were also excluded. Searches were conducted in MEDLINE, HealthSTAR, Cochrane Central Register of Controlled Trials, IEEE Xplore, APA PsycArticles, Scopus, and Web of Science from inception to January 2025. Key attributes of eligible publications were critically discussed using a 2 × 2 logic which frames findings by both technological performance and psychosocial outcome. Results: Of 6,349 records identified, 15 independent studies were included. AAL solutions targeted promotion or guidance of physical activity, self-management of chronic conditions, fostering healthy and safe habits or distraction from pain. Twelve studies assessed health-related quality of life (HRQoL) and close concepts. Depression was the second most investigated outcome, followed by fear of falling, with QoL and loneliness also reported. Conclusion: This review offers a critical analysis of both the findings and the methodologies employed in the selected studies, acknowledging the complexity of drawing unequivocally positive or negative conclusions regarding the impact of AAL technologies on the psychosocial well-being of older adults. The results highlight the need for a shared conceptual framework to inform the design, assessment, and validation of technologies intended to support daily living

The Global Threat of Sinking Deltas

River deltas are essential socio-ecological systems, sustaining dense human 30 populations, major economic centers, and vital ecosystems worldwide. Rising sea levels 31 and subsiding land threaten the sustainability of these valuable landscapes with relative sea-level rise and associated flood, land-loss, and salinization hazards. Despite these risks, vulnerability assessments are impeded by the lack of contemporary, high-resolution delta-wide subsidence observations. Here, we present spatially variable surface elevation changes across 40 global deltas using interferometric synthetic aperture radar. Using this dataset, we quantify delta surface elevation loss and reveal the prevalence and severity of subsidence in river deltas worldwide. Our analysis of three key anthropogenic drivers of delta elevation changes shows that groundwater storage have the strongest relative influence on VLM in 10 of the 40 deltas. In the other 2 deltas, the contributions vary with mixed influences from multiple drivers or are dominated by sediment flux or urban expansion. Furthermore, we find that contemporary subsidence surpasses absolute (geocentric) sea-level rise as the dominant driver of relative sea-level rise for most deltas over the 21st century. These findings emphasize the need for targeted interventions addressing subsidence as an immediate and localized challenge, in parallel with broader efforts to mitigate/adapt to climate change-driven global sea-level rise

(Un)making the Frontex PeDRA controversy: Freedom of information and the regime of opacity in EU migration management

This paper examines the controversy surrounding ‘PeDRA’—a Frontex surveillance programme for harvesting data from illegalized migrants—to explore how opaque security practices are transformed into objects of public-political contestation. By centring the EU’s freedom of information (FOI) mechanism as both a methodological and analytical vantage point for interrogating the regime of opacity in EU migration management, it contributes to debates in critical border and security studies concerned with mundane entanglements between secrecy and security. How do FOI mechanisms intervene in the politics of controversy and broader epistemic struggles surrounding Europe’s border regime, and what forms of (non-)knowledge do they engender? Drawing on a large trove of confidential records, the analysis shows, first, how FOI disclosures can be mobilised to trace the emergence of controversies by exposing the internal contestations and irregularities that underpinned the unlawful expansion of PeDRA. Second, it identifies the obfuscatory tactics that EU border bureaucracies deployed to strategically manage the political reverberations of the controversy, both in the public arena and the bureaucratic backstage. While FOI mechanisms cannot undo the irreducible opacity of datafied bordering infrastructures, the paper concludes that they remain vital tools for rendering security practices (partially) visible and, thus, politically contestable