Effectiveness of UK-based support interventions and services aimed at adults who have experienced or used domestic and sexual violence and abuse: A systematic review and meta-analysis

Background: Domestic and sexual violence and abuse (DSVA) is prevalent and harmful. There are a range of support services and interventions available to those affected by it, but evidence of their effectiveness is uncertain. We synthesised evidence on the effectiveness of UK-based interventions and services for DSVA. Methods: We conducted a systematic review and, where possible, meta-analysis. We searched MEDLINE, EMBASE, PsycINFO, Social Policy and Practice, ASSIA, IBSS, Sociological abstracts, SSCI and grey literature sources for publications published from inception to July 2023. We included randomised controlled trials, non-randomised comparative studies, pre-post studies, and service evaluations of support interventions or services for adults who had experienced or perpetrated DSVA. The intervention typology and selection of outcomes was determined based on co-production with stakeholders. The quality of the studies was assessed independently by two reviewers. Where meta-analysis was not possible, we synthesized studies with vote counting based on the direction of effect. Results: Twenty-nine UK-based studies were included: 11 on advocacy, five on outreach, six on psychological interventions or services for victims-survivors, and six on perpetrator programmes. Meta-analyses showed benefits, with 58.7% (95% CI 53.6, 63.8) of advocacy and 46.2% (95% CI 39.1, 53.3) of outreach intervention and service participants reporting cessation of abuse at case closure. Vote counting was performed for psychological support interventions and perpetrator programmes, and showed positive effects on self-esteem and attitudes towards sexual offending. Most studies had a high risk of bias. Conclusions: There appear to be benefits of UK-based advocacy and outreach services, psychological support interventions, and perpetrator programmes. However, risk of bias and methodological heterogeneity means that there is uncertainty regarding the estimated effects. There is need for more robust research, and a co-produced core-outcome set to facilitate future research in this field

Increasing myopia in Scotland at age 3.5-5.5 years: a retrospective epidemiological study

Purpose: Scotland has comprehensive child vision screening at age 3.5-5.5 years, with ~85% participation (40,000-50,000 screening episodes annually). Orthoptists deliver the screening, including presenting vision, cover test, and other tests. Screening failures are referred for eye examinations, including cycloplegic refraction. The study aims to report refractive error data from these examinations (~5,000-6,000 annually) for three years pre- and two years postpandemic and to investigate correlations between myopia and socio-economic factors. Methods: Right eye data from eight Scottish Health Boards (HB) are reported for spherical equivalent refraction (SER) for the years 2013-14, 2014-15, 2015-16, 2020-21, 2021-22. Associations were investigated between the proportion of the sample in each HB with myopia and the proportion of the population in each HB with different levels of deprivation index, classification on a rural/urban continuum, and dwelling type. Results: Refractive error frequency distributions revealed a myopic shift in SER over the five years. Median SER (interquartile range) was, in 2013-14, +1.38D (+0.50 to +2.75); 2014-15, +1.38D (+0.25 to +2.63); 2015-16, +1.38D (+0.50 to +2.75); 2020-21, +1.13D (+0.25 to +2.25); 2021-22, +1.25D (+0.38 to +2.25). The increase in myopia was statistically significant in each of the last two years compared with each of the first three (p<0.0005). The proportion of myopes (≤-0.50D) increased from <7.8% annually 2013-16 to 11.51% in 2020-21, 10.65% in 2021-22 (linear trend: r 2=0.94, p=0.006). Associations between the proportions of children in each HB with myopia and: deprivation index was low and not statistically significant; proportion of population in the most urban environment was high (r2 = 0.79; p=0.003), and proportion of dwellings that were flats/apartments was high (r2 = 0.83, p=0.002). Conclusions: In this predominantly Caucasian population, proportions of children with myopia have increased post-COVID. A strong association exists between myopia and living in flats/apartments and urbanicity, but not with a deprivation index

Timing Legitimacy: Identifying the Optimal Moment to Launch Technology in the Market

How do managers time the launch of new technologies? Without actionable frameworks to ensure consumers and other stakeholders are ready, innovation releases remain a risky endeavor. Previous work on legitimacy has focused on stages following a product launch. However, launch timing concerns shared expectations of when actions should occur prior to launch. This conceptual article evaluates the alignment between firm and stakeholder expectations regarding launch timing. It proposes that the market timing of new technology launches is structured by two dimensions: firm-led coordination and stakeholders’ willingness to change. Combining these dimensions, the authors map four types of market timing situations managers can encounter: antagonistic, synergistic, flexible, and inflexible timing. Temporal legitimacy is achieved when a firm and its key stakeholders share timing norms about the ideal moments when activities should occur in a market process. The authors conceptualize proto-markets as prefacing the well-known market legitimacy stages. This article concludes with a detailed managerial decision tree on how to create the optimal technology product launch moment and avenues of future research on market timing beyond technology launches

A Novel Digital Intervention to Facilitate Diabetes Self-Management Among People with Schizophrenia and Related Disorders: Development and Acceptability Testing of SMART

Introduction: Compared with the general population, people with schizophrenia and schizophrenia-related disorders (SSD) have a higher prevalence of type 2 diabetes (T2D) and T2D risk factors such as poor diet and sedentary lifestyle. Antipsychotic drugs significantly contribute to this risk through metabolic adverse effects, including weight gain and insulin resistance. Prevention and self-management of T2D is challenging in this population due to inherent motivational and cognitive challenges associated with schizophrenia. The objective of this study was to describe the co-design and test the feasibility, acceptability, and usability of a novel digital health intervention, Schizophrenia and diabetes Mobile-Assisted Remote Trainer (SMART), for prevention and self-management of T2D in people with SSD. Methods: SMART was developed through an iterative process including review of relevant literature (eg, disease-specific guidelines), stakeholder involvement, and user testing. A pre-post mixed-methods design was used to assess the acceptability and feasibility of SMART over 4 weeks among five outpatients with schizophrenia/schizoaffective disorder and pre-diabetes/T2D. Results: The co-design process resulted in a digital intervention, which consisted of personalised, interactive text messages, providing psychoeducation and strengthening motivation for self-care behaviours that promote effective diabetes self-management (ie, nutrition, physical activity, weight management, and stress coping). The pilot study demonstrated good acceptability of SMART (response rates 75– 95%). Trends towards improved clinical outcomes were observed in well-being, depression, anxiety, and mental health recovery. Barriers to usability included lack of mobile/internet data, precluding the ability to reply to text messages, and a preference for more hyperlinks and additional interactive features. Conclusion: The comprehensive co-design process resulted in the development of a novel digital intervention for prevention and self-management of T2D tailored to unique needs and preferences of people with SSD. The pilot study findings indicate that SMART is acceptable and potentially usable for this population. Results will inform further adaptation and a future feasibility study to examine preliminary effectiveness of SMART

Challenges and strategies for retaining Africa’s radiography workforce in the continent amidst a competitive global market: Insights from 17 countries

Introduction African countries face a critical challenge as radiography professionals and other healthcare workers migrate to high-income countries with better-resourced health systems. This study sought to identify the factors influencing the migration of qualified radiography professionals and evaluate the challenges and strategies for retaining the radiography workforce across the continent. Methods This quantitative cross-sectional study was conducted using an online questionnaire. The link to the questionnaire was widely advertised through professional body platforms, as well as the professional and social media pages of radiography professionals across Africa. Descriptive, inferential statistics and exploratory factor analysis using principal component analysis were used to examine the data. Results A total of 755 radiography professionals from 17 African countries participated. Poor salary was the most commonly cited push factor for migration, reported by 80.00 % of participants. In the exploratory factor analysis, five factors were identified, explaining 55.57 % of the variation in the data on push factors for migration among radiography professionals. These factors include the health system, economic concerns, professional challenges, political issues, and social conditions. Better salaries (86.49 %) and improved living conditions (86.35 %) were the most common pull factors. Additionally, 92.00 % of participants identified improving radiography professionals' salaries as the most effective strategy for reducing migration. Conclusion Low salaries, inadequate working conditions, and the pursuit of better opportunities abroad are key contributors to the migration of radiography professionals from Africa. To address this issue, African healthcare systems must prioritise improving remuneration, enhancing working conditions, investing in health infrastructure, and implementing targeted policies focused on professional development and career growth. Implication for practice Retaining radiography professionals in Africa requires a multifaceted approach to strengthen the workforce and improve healthcare systems

Visualizing game dynamics at a specific time: Influence of the players’ poses for tactical analyses in padel

Tactical elements are crucial in team sports. The analysis of hypothetical game situations greatly benefits from positional diagrams showing where the players are. These diagrams often show the layout of the players through simple symbols, which provide no information about their poses. This paper investigates if the visualization of player poses is benefitial for tactical understanding of positional diagrams in padel. We propose a realistic, cartoon-like representation of the players and discuss its integration into a typical positional diagram. To overcome the cost of generating player representations depicting their pose, we propose a method to generate such representations from minimal user input. We conducted a user study to evaluate the effectiveness of our pose-aware diagrams. The tasks for the study were designed to encompass the main in-game scenarios in padel, which include the ballholder at the net with opponents defending, the reverse situation, and transitions between these two states. We found that our representation is preferred over a symbolic one that only indicates player orientation. The proposed method enables coaches to produce such representations within a matter of seconds, thereby significantly facilitating the creation of detailed and easily analyzable depictions of game situations

Quantifying the Macroeconomic Impact of Credit Expansions

This paper studies how credit expansions affect economic activity and quantifies the relative role of household and firm-side channels in accounting for the aggregate effects. Using data from the quasi-natural experiment of bank deregulation across U.S. states in the 1980s, we document that deregulation led to an expansion of credit and economic activity. We use this causal evidence to estimate a small open-economy heterogeneous-agent New Keynesian model that replicates the effects of this shock. In the long run, reduced borrowing costs for firms account for the lion’s share of the rise in output and employment. In the short run, the firm-side and household-side channels are equally important in driving the expansion of output and employment. Household demand is mostly associated with consumption whereas the firm side is mostly associated with investment. The finding that employment and production—including tradable output—experiences sustained growth after a credit expansion is consistent with the role we attribute to the firm-side channel

Direct shear box tests on full-scale recycled aggregate used in temporary works

The use of recycled aggregate is widely seen as an option in civil engineering projects to meet carbon offset targets. This material is used for a range of applications (e.g. load distribution platforms, sub-bases, general backfill) and can consist of natural aggregates or recycled components. Therefore, its engineering characteristics can vary widely. It is important to characterise accurately the material properties of the aggregate to guarantee safe, economical solutions. The angle of friction is often the main parameter required for geotechnical design and usually obtained by laboratory tests. However, when using standard laboratory equipment there is an upper limit to the size of particle that can be tested, rendering such apparatus inappropriate for obtaining the shear parameters of recycled aggregate (specified size fraction of 0-125mm). A new unique Giant Shear Box Facility, capable of testing samples with particle sizes up to 190mm diameter, has been established at City St George’s, University of London. Series of tests were conducted to determine the strength parameters of the recycled aggregate currently being used for working platforms on HS2 – Euston Site. Three different material specifications were tested, the results indicating that the strength parameters were a function of both aggregate constituents and grading

Exploring social, cultural and environmental factors that influence attitudes to exercise among people with Parkinson’s disease: a qualitative study

Exercise is recommended for people with Parkinson’s (PwP) but clinical exercise-based interventions are generally ineffective. Social, cultural and environmental factors can influence exercise behaviours, but these topics are under-researched. We interviewed 18 PwP using a narrative approach to identify factors influencing their exercise behaviours throughout their lives. Thematic analysis identified three themes: (1) Why I exercise, (2) What helps, and (3) Exercise with Parkinson’s. Participants had consistent core motivations to exercise: mood and well-being, body image, competition, and camaraderie. Having active partners, supportive work, and varied exercise options were among the important facilitators of long-term exercise. Participants believed strongly in the benefits of exercise for Parkinson’s, but experienced guilt about not exercising enough and frustration when symptoms made it harder to continue. This study illustrates how narrative interviews can reveal important social, cultural and environmental influences on exercise behaviour, offering potential to develop more individualised and effective exercise interventions

How to Reduce Microaggression and Other Negative Racial Experiences at Work with Continuous Improvement

While government regulation or company policy can be used to curtail discrimination at work, it is hard to regulate away negative experiences such as microaggression or perceptions of discrimination in hiring and promotion in the workplace against minority employees. Using interview data from interviews of minority ethnic staff at a UK university, I present evidence of microaggression and minority employees feeling excluded and posit that perceptions of discriminatory policy engender negative perceptions of the organization. I also show the link between employee engagement and organizational performance and propose that negative minority employees’ experiences and perceptions lower job and organizational engagement and, eventually, organizational performance. I then offer a solution through enterprise-wide CI programs to improve organizational performance directly by improving business processes and indirectly by improving minority employees’ experience, perceptions, and engagement