Small business futures in society

[Introduction to special issue of Futures]</p

Implementing Germ Defence digital behaviour change intervention via all primary care practices in England to reduce respiratory infections during the COVID-19 pandemic: an efficient cluster randomised controlled trial using the OpenSAFELY platform

Background: Germ Defence (www.germdefence.org) is an evidence-based interactive website that promotes behaviour change for infection control within households. To maximise the potential of Germ Defence to effectively reduce the spread of COVID-19, the intervention needed to be implemented at scale rapidly. Methods: With NHS England approval, we conducted an efficient two-arm (1:1 ratio) cluster randomised controlled trial (RCT) to examine the effectiveness of randomising implementation of Germ Defence via general practitioner (GP) practices across England, UK, compared with usual care to disseminate Germ Defence to patients. GP practices randomised to the intervention arm (n = 3292) were emailed and asked to disseminate Germ Defence to all adult patients via mobile phone text, email or social media. Usual care arm GP practices (n = 3287) maintained standard management for the 4-month trial period and then asked to share Germ Defence with their adult patients. The primary outcome was the rate of GP presentations for respiratory tract infections (RTI) per patient. Secondary outcomes comprised rates of acute RTIs, confirmed COVID-19 diagnoses and suspected COVID-19 diagnoses, COVID-19 symptoms, gastrointestinal infection diagnoses, antibiotic usage and hospital admissions. The impact of the intervention on outcome rates was assessed using negative binomial regression modelling within the OpenSAFELY platform. The uptake of the intervention by GP practice and by patients was measured via website analytics. Results: Germ Defence was used 310,731 times. The average website satisfaction score was 7.52 (0�10 not at all to very satisfied, N = 9933). There was no evidence of a difference in the rate of RTIs between intervention and control practices (rate ratio (RR) 1.01, 95% CI 0.96, 1.06, p = 0.70). This was similar to all other eight health outcomes. Patient engagement within intervention arm practices ranged from 0 to 48% of a practice list. Conclusions: While the RCT did not demonstrate a difference in health outcomes, we demonstrated that rapid large-scale implementation of a digital behavioural intervention is possible and can be evaluated with a novel efficient prospective RCT methodology analysing routinely collected patient data entirely within a trusted research environment. Trial registration: This trial was registered in the ISRCTN registry (14602359) on 12 August 2020. � 2023, The Author(s).</p

Hong Kong Criminal Procedure

This book sets out the basic principles and practices of criminal procedure in Hong Kong, which is still to a large extent based on the laws of England and Wales. Criminal procedure in Hong Kong is best understood in the context of legal developments in England and Wales and other commonwealth jurisdictions, notably Canada and Australia. However, criminal procedure in Hong Kong is not simply a derivative of English law; political and legal changes effected by the handover of Hong Kong to the Peoples’ Republic of China in 1997, and the concomitant advent of law reforms initiated by the government of the Hong Kong Special Administrative Region are also fully reflected in this text. This book forms the first part of a series on criminal justice in Hong Kong – the other titles being on the law of evidence and criminal law (general principles and specific offences). The cross-references in the three volumes underscore the practical and theoretical interplay between the three subject areas, which will prove useful for academics, students, and practitioners alike.</p

If you find me on the floor, stick some sugar in my mouth: The social production (and protection) of insulin risk among IPED communities

IntroductionInsulin is used among image and performance enhancing drug (IPED) communities for its anabolic effects, but its use carries significant risks, with the acute danger being hypoglycaemia, which can be life-threatening if not properly managed. Within these communities, harm reduction practices and informal peer knowledge exchange play a critical role in the way substances are consumed. This qualitative study sought to understand these community practices regarding non-medical insulin use among people who use IPEDs.MethodSemi-structured interviews were conducted with people who use IPEDs, and specifically, insulin. Participants were asked about their risk practices, harm reduction strategies, and the community dynamics that shape their use of insulin. Our analysis centred on how social and material networks of peers, technologies, and information flows contribute to the social production and protection of risk.ResultsThe study involved an international cohort of 14 participants (13 men, 1 woman, aged 25-45, M = 33.34) who used insulin for non-medical purposes. The analysis revealed two themes: Intersecting Risks, which encompassed the physical, psychosocial, and self-imposed risks associated with insulin use, and Social Protection of Risks, focusing on community-driven harm reduction strategies. People who use insulin actively construct risk through community-driven knowledge and informal education. Social protection is facilitated through peer networks, where harm reduction strategies are shared.DiscussionThis research underscores the importance of community-care in harm reduction and challenges individualised models of risk management. It highlights the need for community-centred health interventions that recognise the relational dynamics of risk management among IPED-using communities.</p

Assessing the Prevalence and Drivers of Trichomonas gallinae in UK Hawfinch (Coccothraustes coccothraustes) Populations

Trichomonas gallinae is a pathogenic, protozoan parasite. It can cause lesions in the oral cavity of infected birds, known as trichomonosis, which can prevent the bird from feeding. This can lead to death of the bird by starvation. The parasite has previously been noted in chaffinches (Fringilla coelebs) and greenfinches (Chloris chloris), where it has been linked to their decline. Recently, signs of trichomonosis have been reported in UK hawfinch (Coccothraustes coccothraustes) populations. The hawfinch is a red listed bird in the UK, isolated to a few strongholds. The reason for its decline is unclear, however it has been suggested to be due to declining habitat and predation. It is not yet known how much of an effect T. gallinae could have on these populations or what drives the cases. To our knowledge, no study has yet to looked at subclinical cases of T. gallinae in hawfinches, but it has been confirmed in some by post-mortem analysis. The first chapter looked at the prevalence of T. gallinae in 3 populations of hawfinches in the UK, testing whether any biological covariates and study sites were linked to the presence of T. gallinae. This involved sampling hawfinches (both live and dissected) and using PCR to look for positive cases of T. gallinae along with any specific strains. 83 hawfinches were sampled, and 5 hawfinches were dissected. Of the live samples, 32 were positive for T. gallinae. No bird sampled showed signs of trichomonosis, suggesting that these infections were sub-clinical. Of these 17 samples were used to create a phylogenetic tree based on a primer called ITS and 12 were used to create a phylogenetic tree based on a primer called Fe-hyd. Longer term studies are needed to fully understand the effects of the parasite, but it is suggested that mitigation measures are used such as periodical moving of feed sites to minimise risk while ringing these birds. The second chapter looked at what may be driving cases of T. gallinae in hawfinches, testing whether avian community composition and bird feeder usage could be potential drivers. This used camera trapping and co-occurrence analysis to look at species associations and evaluate if these associations could be driving cases of T. gallinae. An online questionnaire was used to look at bird feeder usage.Hawfinches were associated with chaffinches at both sites that were looked at. As chaffinches are known to contract T. gallinae, this association may be driving cases. Further studies sampling both hawfinches and chaffinches at the same site are needed to fully explore if there is a link. No factor was significant in presence of hawfinches in garden. Very few respondents reported hawfinches which could suggest that these birds rarely visit gardens. Most reports of hawfinches in gardens were within 10 km of one of the sampling sites but the response rate was low. Further studies looking specifically at these areas would help confirm if hawfinches are using bird feeders and this should be combined with sampling of these feeders to see if T. gallinae is being spread at them.This study sets a foundation for future work to fully understand T. gallinae in hawfinches.</p

Self-determination theory and customer revenge behavior: explaining how customers regulate their anger and revenge behavior

Abstract Purpose: This study aims to explore and empirically examine an integrative model of the customer revenge process by linking two well-established theories of self-determination theory (SDT) and appraisal theory. Design/methodology/approach: A survey of 901 respondents, followed by a post-hoc survey of 712 individuals, was conducted to examine the autonomous versus controlled orientations for revenge motivation. Findings: The results show that customers’ orientation of motivation (OM) can regulate their revenge behavior (direct versus indirect) in case of service failures. Specifically, the interaction of OM components (i.e. autonomy, relatedness and competence) can play a significant role in the relationship between revenge predictors and revenge behavior. Implications for research and practice are discussed. Originality/value: This paper offers a novel conceptual framework to explain the moderating effects of OM on the relationship between revenge predictors and revenge behavior. This study extends the application of SDT to the context of customer anger and revenge.</p

Development of a soft gripper for replicating human grasps in forest nursery tasks

   This research aims to automate labour-intensive tasks in forest nurseries by developing a soft gripper that mimics human workers' grasps to perform the singulation and sorting of tree saplings. By analysing human workers and conducting experimental investigations, the required grasp types and grip forces were identified. The Fin Ray Effect (FRE) structure, noted for its adaptability to asymmetric shapes, was chosen as the gripper's basis. However, modifications were necessary to achieve the required power and pinch grasp types and to provide the desired grip forces. Simulation analysis explored various beam configurations and boundary conditions of FRE fingers, resulting in a proposed modified design. Experimental investigations confirmed that the proposed gripper effectively delivered required grasps and grip forces. The new design enabled three additional grasp types for FRE grippers and increased grip forces by over 200%. This gripper design is suitable for industrial pick-and-place applications where precise pinching grasp and various power grasps with sufficient payload capacity are needed.</p

Entrepreneurship as social change: a third movements in entrepreneurship book [Chris Steyaert and Daniel Hjorth (eds)]

Legacy description not available</p

Optimisation of care among patients with diabetes mellitus and acute coronary syndrome through a specialised cardiodiabetes service—A registry study

Abstract Aims: Diabetes mellitus remains a prevalent condition worldwide and a significant risk factor for atherosclerotic cardiovascular disease. Recent evidence suggests the use of glucose‐lowering therapies with cardiovascular benefit in optimising the cardiometabolic profile of patients with type 2 diabetes mellitus. However, uptake remains low. This study was carried out to assess the impact of a novel cardiodiabetes service for the management of patients with diabetes mellitus presenting with acute coronary syndromes.  Methods: A retrospective, observational, registry‐based analysis was performed among patients presenting with an acute coronary syndrome and diabetes mellitus to a regional heart centre before and after the implementation of a cardiodiabetes service. Intergroup comparison was made for the proportion of patients having a valid glycated haemoglobin during admission, initiation of guideline‐ recommended glucose and lipid‐lowering therapies.  Results: At median follow‐up of 29.7months, a valid HbA1c measurement at baseline was lower in the pre‐intervention compared to the post‐intervention group (556/711 [78.2%] vs. 302/362 [83.4%], p=0.043) while more patients in the post‐intervention group were prescribed sodium‐glucose co‐transporter inhibitors (297/362 [82.0%] vs. 359/711 [50.5%]). All‐cause mortality (5.2 vs. 12.3 [events/100 patient‐years], relative ratio [RR] 0.42, 95% confidence interval [CI] 0.28–0.61, and p Conclusion: The introduction of a joint‐speciality cardiodiabetes service improved the care and survival of patients with acute coronary syndrome and diabetes mellitus.</p

Après-coup

This multimedia installation explored the elusive, protean and fragmented nature of memory. The work was created and defined through a collaboration with sufferers of dementia, a group assembled from across England. By exploring the strong or significant memories of those for whom recall will become increasingly imperfect, après-coup aims to question the affective constitution of all memory. Drawing particularly on psychoanalytic notions and debates surrounding the mutability of the still image, this work considers the degree to which perception takes on meaning retrospectively. The exhibition further reflects upon the temporality of the still image and its status as a mnemonic device.</p