Exploring UK fathers' help-seeking for Paternal Postnatal Depression

Background: Men’s help-seeking is known to be restricted by stigma, but less is known about their seeking for paternal postnatal depression (PND) specifically. Fathers are not routinely screened for PND. Aims: This study explored fathers’ help-seeking processes for paternal PND, including their motivators and perceived barriers. Method: Eight fathers from the United Kingdom who self-identified as suffering from PND took part in semi structured interviews. Interview data were analysed using Interpretative Phenomenological Analysis (IPA). Results: PND was not recognised as affecting fathers. Fathers felt their needs were minimal in comparison to mothers and did not want to ask for support from professionals. Help-seeking was usually with their GP (family doctor). Some were offered anti-depressant medication, disappointing them and believing this approach unsuited to their emotional experiences to fatherhood. Instead, they wanted therapy and parenting support, and to be aware of consequences of disclosure. Whilst health visitors (maternal, child and family nurses) visited the home, fathers perceived they were attending to the mother, and feared disclosing their own mental health difficulties, fearing this would result in removal of the child and breakup of the family. Some Help-seeking was initiated by their partners. Overall, fathers wanted a safe space where they are asked away from their partners, with time to talk. Conclusion: Fathers may need sensitive and confidential professional support after the birth of their child. Professionals should routinely ask fathers about their well-being, whilst health visitors should reassure fathers that they are there to support them as well as the mother, allaying suspicions among men disclosing mental health difficulties could destabilise the family unit Implications: Current policies and working patterns in the UK disadvantage fathers and leave their needs invisible. Investment in a universal support system, and training of professionals in the needs of fathers with mental health difficulties is needed

Sand-mining-driven reduction in Tonle Sap Lake’s critical flood pulse

The Tonle Sap Lake (TSL), one of the world’s most productive lake–wetland ecosystems is sustained by an annual flood pulse that reverses Lower Mekong River flow into the lake during the monsoon and returns freshwater downstream during the dry season. Recent declines in the reverse flow have previously been attributed to climate change and upstream damming. However, here we show that between 1998 and 2018, riverbed lowering of the Mekong mainstem, driven by sand mining and upstream sediment trapping, has reduced the reverse flow by between 40 and 50% (high- to low-flow year range; 47% for medium flows). Projections to 2038, with additional riverbed lowering driven by ongoing sand mining, predict reverse flow declines of 69% (64–73%) compared with 1998. We show how these changes affect the lake’s flow regulation services across the Lower Mekong system. Specifically, the reduced TSL reverse flow increases flows to the Mekong Delta by ~26 km3 (31–23 km3) during the monsoon, heightening flood risk, while decreasing dry-season flows by ~59% (50–61%), contributing to intensified saltwater intrusion and diminished agricultural yields across the Mekong’s Delta. Our results underscore how excessive sand extraction is an existential threat to the TSL–Mekong system’s sustainability

Hope in Folded Pages: Zine‐Making, Decolonial Praxis and the Power of Participatory Arts for ‘a Peaceful and Sustainable Life’

This paper presents the co-creation of River of Hope, an animation exploring climate resilience among communities along the Red River in Northern Vietnam. Developed through a transnational collaboration between Vietnamese youth, UK and Vietnamese researchers and a UK-based animation artist, the project demonstrates how participatory digital arts can surface cultural connections and insights often obscured by generational and linguistic divides. Central to the project was the use of zine-making as a creative, accessible and culturally responsive method of Participatory Action Research (PAR). Far from a simple data collection tool, zine-making became a transformative, process-led method through which youth expressed emotional responses to climate change, shared local knowledge and shaped the animation's themes and imagery. The tactile, visual nature of zine-making enabled participants to communicate beyond language, cultural and generational barriers, engaging deeply with both personal and collective experiences of environmental change. Crucially, the process of making zines was itself a site of learning, trust-building and creative agency. It supported intercultural dialogue and positioned youth as co-creators, not subjects, of climate knowledge. This methodological innovation highlights how arts-based participatory methods can democratise research, amplify marginalised voices and humanise climate discourse. In digital and hybrid research settings, zines functioned as both method and medium, offering inclusive and emotionally resonant pathways for youth engagement. Our findings show how embedding participatory arts within a decolonial, youth-centred framework can bridge cultural divides and advance more just, locally grounded approaches to global climate action

Associations of objective and perceived social status with well-being in dyads of people with dementia and their caregivers: findings from the IDEAL programme

Purpose: Social status is related to disparities in health and well-being outcomes in people with dementia (PwD). Few studies have explored the interpersonal influence of social status of PwD on the well-being of their caregiver, or vice versa. We investigated this relationship using measures of objective and perceived (subjective) social status. Methods: The actor-partner interdependence model was used to investigate dyadic relationships of social status and well-being in 1042 PwD and their spousal caregivers from the IDEAL study. Objective indicators of social status included education, social class and socioeconomic classification. Perceived social status included social comparison and ratings of status in society and in one’s community. Results: Of the objective social status indicators, actor effects were only observed for caregiver education and their own well-being. Actor effects for perceived social status were stronger and independent of objective social status for both PwD and caregivers. Caregiver social status also influenced the well-being of PwD. Conclusion: This study provides empirical evidence on the interpersonal influence of social status, especially perceived social status, on well-being in PwD and caregivers. Interactions between PwD, caregivers and wider society may influence the perception of relative social position and impact on living well with dementia

Sequence Outlier Detection and Application of Gated Recurrent Unit Autoencoder Gaussian Mixture Model Based on Various Loss Optimization

In the era of big data, detecting outliers in time series data is crucial, particularly in fields such as finance and engineering. This article proposes a novel sequence outlier detection method based on the gated recurrent unit autoencoder with Gaussian mixture model (GRU-AE-GMM), which combines gated recurrent unit (GRU), autoencoder (AE), Gaussian mixture model (GMM), and optimization algorithms. The GRU captures long-term dependencies within the sequence, while the AE measures sequence abnormality. Meanwhile, the GMM models the relationship between the original and reconstructed sequences, employing the Expectation–Maximization (EM) algorithm for parameter estimation to calculate the likelihood of each hidden variable belonging to each Gaussian mixture component. In this article, we first train the model with mean-squared error loss (MSEL), and then further enhanced by substituting it with quantile loss (QL), composite quantile loss (CQL), and Huber loss (HL), respectively. Next, we validate the effectiveness and robustness of the proposed model through Monte Carlo experiments conducted under different error terms. Finally, the method is applied to Amazon stock data for 2022, demonstrating its significant potential for application in dynamic and unpredictable market environments

The influence of moisture on pyroclastic density current dynamics and deposits: implications for understanding volcanic stratigraphy

Pyroclastic Density Currents (PDCs) are hazardous, multiphase currents of heterogeneous volcanic material and fluid. Moisture can enter a PDC system through internal (e.g., pre-eruptive) or through external processes during transport. Prior to this thesis, the impact of moisture on PDC systems has been largely overlooked, and the role of moisture on PDC behaviour, properties of pyroclastic materials and the resulting depositional architecture formed during PDC-forming eruptions has not been addressed. The work outlined in this thesis utilises geomechanical, geotechnical and analogue models alongside fieldwork observations to gain a better insight into the role and behaviour of moisture in PDC systems.This work demonstrates that the addition of moisture into pyroclastic material alters the angle of repose, cohesion, and shear strength. This changes material properties from flowable to non-flowable and impacts the fluidisation profiles and gas escape structures formed. Further investigation of pyroclastic material using geotechnical equipment has shown that shear strength increases at low moisture contents and shear thickening behaviours occur at high moisture contents. This indicates that moisture-rich layers are more likely to resist shearing and be preserved in volcanic successions.Characterisation of PDC deposits in Tenerife have revealed distinct erosional and remobilisation behaviours of flow-unit ash layers that are associated with varying moisture conditions. Additionally, experiments utilising a fluidised flume, and the sectioning of a ballotini current and substrate in gelatine, have allowed internal features to be observed. The addition of moisture to the substrate effectively suppressed erosion, remobilisation, and the formation of various features within the substrate.These results are crucial for understanding flow unit architecture and estimating the frequency of PDC emplacement units during explosive eruptions. A greater understanding of PDC deposits and the processes that formed them is essential for improving our interpretation of current conditions and deposit formation which isessential for future hazard assessments

“Chained to the bed”: Despairing, depressed, and trapped by fatherhood

Postnatal depression is routinely diagnosed in mothers, with an array of support available from healthcare professionals. Conversely, it is often not recognized as a condition affecting fathers, despite evidence suggesting that prevalences are similar. This study focused on the lived experiences of eight UK fathers with postnatal depression and identified a common sense of being trapped, needing to escape but being unable to. The role of fatherhood and its associated cultural expectations forced a situation where fathers must stay and survive, despite being miserable and experiencing intense despair. Fathers knew what was expected of them-they were aware of the need to be a “breadwinner” but at the same time knew their partners needed support at home. Struggling to achieve resulted in them feeling like failures. Fathers described being under a “dark cloud”, or in a “dark hole”, with depression being all consuming and impeding their functioning. One father described being “chained to the bed” and unable to attend to his infant at night. Despite the impact depression had on them, some fathers were reluctant to seek help. They rejected antidepressant medication. Work and the gym provided them some space just to “be”, and allowed them to escape the pressures of home life in a legitimate way. Some fathers were suicidal and unable to see a way out of their darkness. Fathers wanted to develop attachments to their infants and be happy. Support is needed for fathers’ mental health

Palliative and end-of-life care research funding: an analysis of current UK health research spending

Objectives Despite increasing demand for palliative and end-of-life care, the funding for research in this area has historically been low. Previous UK analyses in 2016 found that less than 0.3% of the funding for cancer research was directed towards palliative care research; current expenditure on palliative and end-of-life care research is unknown. We therefore sought to determine current UK expenditure on palliative and end-of-life care research. Methods Secondary analysis of publicly available research funding data—UK Health Research Analysis 2022, from the UK Clinical Research Classification System Health Research Classification System. This dataset details UK health research funding from all public sectors (including the governments of the four nations of the UK), charities, societies and professional bodies for the year 2022. Results Out of 18 023 research funding awards in total in 2022, we identified 136 relating to palliative and end-of-life care research. The total funding for palliative and end-of-life care research was £10.9 million, representing just 0.26% of the total £4.2 billion awarded. Conclusions Palliative and end-of-life care research continues to be one of the lowest-funded areas of healthcare research in the UK. More investment into palliative and end-of-life care research is urgently needed to advance evidence to meet the rising demand for palliative care

Morphine for chronic breathlessness (MABEL) in the UK: a multi-site, parallel-group, dose titration, double-blind, randomised, placebo-controlled trial

Background: The effectiveness of opioids for breathlessness seen in laboratory-based studies has not been replicated in clinical trials. We aimed to assess the effectiveness of oral morphine for breathlessness in long-term conditions. Methods: This phase 3, parallel-group, double-blind, placebo-controlled trial across 11 centres randomly assigned consenting adults (1:1, stratified by site and causal disease) with a modified Medical Research Council breathlessness score of 3 or more due to cardiorespiratory conditions to receive 5–10 mg twice daily oral long-acting morphine or placebo (as well as a blinded laxative) for 56 days. The primary outcome was worst breathlessness score in the past 24 h at day 28, measured using a numerical rating scale (NRS; 0=not breathless at all; 10=worst imaginable breathlessness). Secondary outcomes included physical activity levels, worst cough NRS, quality of life, and morphine-related toxicities. Patients who received at least one dose of study drug were eligible for inclusion in efficacy and safety analyses. The trial was registered with ISRCTN (ISRCTN87329095) and the EU Clinical Trials Register (EudraCT 2019-002479-33). Findings: Between March 18, 2021, and Oct 26, 2023, 143 participants were randomly assigned to receive either morphine (73 participants) or placebo (67 participants) and were included in the analyses; three participants did not receive the allocated treatment. Participants had a mean age of 70·5 (SD 9·4) years, were mostly male (93 [66%]), and were mostly White (132 [94%]). By day 28, 64 (88%) participants in the morphine group versus 66 (99%) in the placebo group had 90% adherence or greater. We found no evidence of difference in worst breathlessness at day 28 (morphine 6·19 [95% CI 5·57 to 6·81] vs placebo 6·10 [5·44 to 6·76]; adjusted mean difference 0·09 [95% CI –0·57 to 0·75], p=0·78) or any secondary measure, except for improved cough seen at day 56 (adjusted mean difference –1·41 [–2·18 to –0·64]). Increased moderate to vigorous physical activity was seen at day 28 (adjusted mean difference 9·51 min/day [0·54–18·48]) but this was not significant after multiple-measures correction. The morphine group had more adverse events (251 vs 162), serious adverse events (15 vs three, of which three in the morphine group and zero in the placebo group were deemed to be related to the study), and study drug withdrawals (13 vs two). There were no treatment-related deaths. Interpretation: We found no evidence that morphine improves worst breathlessness intensity. Further research is needed to understand whether there is any role for morphine in chronic breathlessness, but our findings do not support its use in this setting. Funding: NIHR Health Technology Assessment programme (HTA Project 17/34/01