Personalisation at the Core of Success: Process Evaluation of the LISTEN Randomised Controlled Trial Evaluating a Personalised Self‐Management Support Intervention for People Living With Long Covid

Background: The development and evaluation of rehabilitation interventions designed to support people with Long Covid (LC) remains an important ongoing priority. Many people with LC experience episodic, debilitating symptoms that can reduce their ability to engage in all areas of activity. The Long CovId personalised Self‐managemenT support co‐design and EvaluatioN (LISTEN) trial co‐designed and evaluated a personalised self‐management support intervention to build confidence and support people to live better with LC. This paper describes the context, implementation, mechanisms of impact and impacts from the LISTEN intervention, in comparison with usual LC services accessed within the National Health Service (NHS). Methods: A mixed methods process evaluation was nested within the LISTEN pragmatic, multi‐site, randomised controlled trial. Data were collected from sites in England and Wales between September 2022 and January 2024. Observations and focus groups with healthcare practitioners (HCPs) delivering the intervention were conducted to assess fidelity. Standardised implementation measures, focussed on intervention feasibility, acceptability and appropriateness, were gathered from HCPs and intervention participants. Semi‐structured interviews were undertaken with a subset of participants across both trial arms. Data were analysed independently using descriptive statistics, or reflexive thematic analyses, and subsequently integrated, drawing upon the Consolidated Framework for Implementation Research v2. Findings: Thirty‐six HCPs participated in the process evaluation, and 197 intervention participants completed standardised implementation measures. Across both trial arms, 49 participants took part in semi‐structured interviews. Six integrated themes were constructed from all data sources describing and illustrating links between the context, implementation, mechanisms of impact and impacts: ‘Delivery during uncertainty and ambiguity’, ‘Diversity and consistency of usual care’, ‘Drivers for self‐care and the impact of self‐generated expertise’, ‘Appropriate if unexpected support’, ‘Personalisation at the core of success’ and ‘A spectrum of change’. Conclusion: The LISTEN intervention is an appropriate, feasible intervention for participants and HCPs. The intervention can be delivered to a high level of fidelity following training and with ongoing HCP support. Access, receipt and perceptions of NHS LC services were variable. Personalised, relational interventions, such as LISTEN, can foster favourable impacts on confidence, knowledge and activity and are acceptable and strongly recommended within LC rehabilitation services. Patient or Public Contribution: The study was supported by a patient and public involvement and engagement (PPIE) group from project conception to study end. Using their lived expertise, seven people with LC supported accessible recruitment (e.g., materials), data collection (e.g., topic guides), data interpretation (e.g., theme construction and reviewing findings) and dissemination activities (e.g., online webinars). Trial Registration: ISRCTN36407216, registered 27/01/2022

Maternal physiological parameters and routine laboratory tests to screen for maternal sepsis: an observational cohort study

Maternal sepsis can lead to poor outcomes for the mother and neonate, and early diagnosis and treatment of infection is important to prevent sepsis. Current guidance to recognise maternal sepsis includes assessment of physiological markers, however normal physiological changes of pregnancy can hinder the diagnosis of sepsis. This study investigated the utility of routine clinical variables, including laboratory tests, in screening for maternal sepsis. Patients considered at risk of obstetric sepsis were recruited into a single centre cohort study. Microbiological, histological and clinical data categorised patients into three diagnostic groups: 'infection confirmed', 'infection unknown' and 'infection unlikely'. Differences in physiological and routine laboratory variables were investigated. Between November 2020 and December 2022, 154 pregnant patients were recruited. Comparison between 'infection confirmed' (n=58) and 'infection unlikely' (n=17) showed statistical differences in temperature (P <0.001), neutrophil count (P =0.003) and leukocyte count (P =0.004) at the time of recruitment. Temperature was the best discriminator with an area under the receiver operating characteristic curve (AUC-ROC) of 0.82 (95% CI 0.70 to 0.94, P <0.0001) with an optimal threshold of ≥37.5°C. This observational cohort study demonstrated that maternal temperature ≥37.5°C (rather than the threshold of 38°C found in most screening tools) may be important in screening patients at risk of developing maternal sepsis. When temperature ≥37.5°C persists, medical care should be expedited and maternal infection considered

Environments and the experience of flow: A scoping review

Investigations into the impact of natural and built environments on mental health often place greater emphasis on hedonic experience over other meaningful aspects of human wellbeing such as flow. Psychological flow occurs during episodes of deep immersion in intrinsically motivated activities. Giving rise to feelings of fulfilment and self-transcendence, it can contribute to both hedonic and eudaimonic wellbeing. Although individual differences and social contexts can enable or inhibit flow, it is not entirely clear how natural and built environments are associated with flow experiences. The objective of this review is to map existing primary research concerning how environments (natural and built) relate to flow experiences. A total of 60 included sources, published between 1975 and the end of 2022, illustrate that flow is not only impacted by the environment, but also connected to place-based meaning. Four themes reflect the type of source findings, highlighting the importance of 1. contact with nature, 2. person-environment fit, 3. aesthetics and 4. relationship to place. Review findings explore areas for future research and potential implications for nature-based interventions

Professional Registration of Probation Practitioners in a Devolved Welsh Probation Service

In this paper, we consider the newly implemented Probation Professional Register Policy Framework in the context of the intent of the Welsh Government (WG) to work towards the devolution of justice, including probation. Thus, we reflect on devolution and its potential implications, the specific forms of partnership working and development in Wales, probation organisational culture, and questions of probation's legitimacy. We suggest that to make the most of the professional register's potential for professionalisation of probation practice, it needs to be embedded in an organisational structure and culture that fully owns and promotes the ethics and values of partnership working, taking a rights-based approach in the support for those who cause harm to victims and communities, and evidence-based practice

A mixed-methods exploration of regular consumers’ experiences of plant-based meat alternatives (PBMA) in Singapore and the United Kingdom

Research on plant-based meat alternatives (PBMA) often focuses on its initial acceptance among new consumers with limited investigation into consumers who regularly incorporate PBMA in their diets. This study used a mixed methods approach to investigate PBMA consumption patterns, including motivations and barriers to sustained consumption, among 404 regular consumers (defined as PBMA consumption of at least once a week) in Singapore and the UK (SG: n=228; UK: n=176; 57.9% women; 69.8% aged 21-40 years old). Quantitative results showed similar PBMA consumption between Singapore and the UK (p=.498) but motives and barriers to sustained consumption and their consumer characteristics (i.e., food choice motives, food neophobia) were significantly different (p<.001). UK consumers showed greater agreement with motivational statements and were more sustainability-driven while Singapore consumers showed greater agreement with barrier statements and valued the impact of food on their body more. Product-related motives (β=.22, p<.001) and accessibility barriers (β=.15, p=.024) predicted overall PBMA consumption in both countries. Qualitative results suggest that whilst UK and Singapore consumers were satisfied with PBMA, they wanted higher nutritional quality, greater accessibility to affordable options and a wider variety. Further improvements in these areas could encourage repeated purchases and support the long-term adoption of PBMA

Unravelling the origin of enhanced CO2 selectivity in amine-PIM-1 during mixed gas permeation

Previously, it has been reported that amine-PIM-1, a polymer of intrinsic microporosity obtained by reduction of nitrile groups of PIM-1 to primary amine groups, shows enhanced CO2 selectivity during mixed gas permeation studies with respect to single gas measurements for gas pairs involving CO2. This distinct and potentially useful behaviour was ascribed to the affinity of CO2 for the polymer amine groups. Here, we demonstrate that enhanced selectivity originates from both CO2 physisorption and chemisorption. A combination of 13C and 15N solid-state NMR spectroscopic analyses of a CO2-loaded amine-PIM-1 membrane allowed the identification and quantitative determination of both chemisorbed and physisorbed species and the characterization of polymer-CO2 interactions. Experiments with 13C isotopically enriched CO2 unequivocally demonstrated the conversion of 20% of the NH2 groups into carbamic acids at 298 K and a CO2 pressure of 1 bar. Chemisorption was supported by the strong heat of CO2 adsorption for amine-PIM-1 that was estimated as 50 kJ mol−1. Molecular dynamics simulations with models based on the experimentally determined polymer structure gave a detailed description of intra- and interchain hydrogen bond interactions in amine-PIM-1 after chemisorption, as well as of the effect of chemisorption on polymer porosity and physisorption

Understanding the Optoelectronic Processes in Colloidal 2D Multi‐Layered MAPbBr₃ Perovskite Nanosheets: Funneling, Recombination and Self‐Trapped Excitons

Colloidal chemistry methods have made quasi 2D perovskites readily accessible. Ultrathin perovskites exhibit charge transport properties which are beneficial for solar cells and the combination of layers with different thicknesses directs charge carriers toward thicker layers with a smaller bandgap. However, detailed knowledge about the mechanisms by which excitons and charge carriers funnel and recombine in these structures is lacking. Here, colloidal 2D methylammonium lead bromide (MAPbBr3) Ruddlesden-Popper perovskites with a broad combination of layers (n = 3 to 10, and bulk fractions with n > 10) is characterized by femtosecond transient absorption spectroscopy and time-resolved photoluminescence. It is found that second- and third-order processes dominate in MAPbBr3 nanosheets, indicating exciton-exciton annihilation (EEA) and Auger recombination. Long-lived excitons in thin layers (e.g., n  =  5, Eb =  136 meV) funnel into high n within 10–50 ps, which decreases their exciton binding energy below kBT and leads to radiative recombination. Parallel and consecutive funneling compete with trapping processes, making funneling an excellent tool to overcome exciton self-trapping when high-quality n-n interfaces are present. Free charge carriers in high-n regions on the other hand facilitate radiative recombination and EEA is bypassed, which is desirable for LED and lasing applications