Always make it current

No. 6 (June 2025) in the 'Mastery in Writing' series of articles: https://www.paramedicpractice.com/content/mastery-in-writing. Georgia Howat and David Hepworth joining you this month on the Mastery in Writing series. We were having a conversation about what constitutes an ‘up-to-date’ source/citation. It's a question students often ask, and the answer varies, context dependent on who, what and why you are referencing. You'll be familiar with 5–10 years as the suggestion for current evidence, which sounds reasonable in terms of currency – but isn't always when it comes to your academic writing. Let's think context

Rethinking early warning scores

Dr Stephanie Heys, Susan Rhind, Camella Main and Daisy Pegler discuss misplaced metrics when caring for pregnant and recently pregnant women in pre-hospital care. Despite escalating global concern around the high rates of morbidity and mortality in pregnant patients, the early signs of clinical deterioration in pregnant patients often go unrecognised, particularly in the pre-hospital environment (Ebert et al, 2020; McCullough et al, 2024). A critical, yet underappreciated, contributing factor is the application of generic early warning scores, such as the National Early Warning Score 2 (NEWS2). The NEWS2 has been applied with a blanket approach in the pre‑hospital setting without considering groups of patients where they are not validated, such as pregnancy and immediately following pregnancy

Embedding anti racism in education with Professor Sally Elton-Chalcraft [podcast]

In this podcast series the University of Cumbria profiles its researchers, hearing in detail about their work and the impact this has on wider society. Professor Sally Elton-Chalcraft, Director of the Learning Education and Development Research Centre at the University of Cumbria, discusses addressing racism in education, with a focus on riots following the Southport stabbings (podcast duration: 30 minutes)

Seasonal forest resources support fish biomass in floodplain lakes of an Amazonian tributary

The Flood Pulse Concept is a foundational ecological theory that emphasizes the critical role of lateral connectivity between a river channel and its floodplain. Many tropical rivers inundate the surrounding floodplain in the flood stage, thereby receiving large amounts of terrestrial organic matter that can be decomposed by microbes and directly consumed by animals. This dynamic could simultaneously drive down oxygen concentrations while also supporting fish production. We used two lines of evidence to investigate the fate of terrestrial organic matter during the low‐ and high‐water seasons in the Juruá River, Amazonas, Brazil: spot measurements of dissolved oxygen and isotopic measurements (δ13C, δ15N) of fishes and food source pathways originating from C3 and C4 plants, phytoplankton, and periphyton. Dissolved oxygen concentrations were low (mean ≤ 3.0 mg/L) throughout the floodplain during high water, while higher values (mean = 6.5 mg/L) were evident during low water, suggesting variable rates of ecosystem respiration, production and atmospheric exchange across seasons. Most fish species, including the commercially and culturally important pirarucu (Arapaima sp.), had a strong dependence on terrestrial C3 plants during the falling‐water season (median source proportions 34%–77%), while fishes shifted to rely on the phytoplankton pathway (median proportions 11%–82%) during low water. Our results demonstrate that terrestrial C3 plant resources are channeled into the food web through detritivorous fishes, such as bodó (Liposarcus pardalis), and frugivorous fishes, such as pacu ( Mylossoma aureum ). During high water, a dispersed food web takes shape as fish move into the flooded forest, driven by terrestrial resources and accompanied by low oxygen conditions. During low water, a concentrated food web emerges in the remaining oxbow lakes, consistent with fast‐growing algal resources

Embedding critical project management approaches into public entrepreneurship

Projects create the future and come in many shapes and sizes, including large organisational and infrastructure projects, but also smaller, socially focused projects aimed at the public and citizens. This chapter takes a broad view of public entrepreneurship and projects as entrepreneurship for the public good, including a range of individuals and organisations motivated to progress community priorities. The chapter utilises ‘critical project management’ approaches of project studies and responsible project management to inform this context. This is particularly important with the call to integrate citizen stakeholders, co-production and co-creation into project design and delivery. Two real-life community projects provide illustrative examples to identify some connecting themes between public entrepreneurship and community projects, using Geraldi and Söderlund’s (2018) typology of project studies. The last section highlights four aspects crucial for community projects and public entrepreneurship in theory and practice: understanding, connections and future directions. Learning materials are attached to assist academics and practitioners to explore the relationship between critical project management and public entrepreneurship

Winner-loser plant trait replacements in human-modified tropical forests

Anthropogenic landscape modification may lead to the proliferation of a few species and the loss of many. Here we investigate mechanisms and functional consequences of this winner–loser replacement in six human-modified Amazonian and Atlantic Forest regions in Brazil using a causal inference framework. Combining floristic and functional trait data for 1,207 tree species across 271 forest plots, we find that forest loss consistently caused an increased dominance of low-density woods and small seeds dispersed by endozoochory (winner traits) and the loss of distinctive traits, such as extremely dense woods and large seeds dispersed by synzoochory (loser traits). Effects on leaf traits and maximum tree height were rare or inconsistent. The independent causal effects of landscape configuration were rare, but local degradation remained important in multivariate trait-disturbance relationships and exceeded the effects of forest loss in one Amazonian region. Our findings highlight that tropical forest loss and local degradation drive predictable functional changes to remaining tree assemblages and that certain traits are consistently associated with winners and losers across different regional contexts

Developing occupational therapy and physiotherapy clinical support workers in their role in supporting student education

Introduction: Global healthcare services face increasing pressures and workforce shortages. But at the same time, there are increasing learners in practice as part of longer-term workforce strategies, which, in turn, create extra demands on educators and teams. Anecdotally, we understand that clinical support workers (CSWs) are sharing responsibilities for student learning, yet there is limited understanding of this involvement or activities to support role development. The aims of this study were to (1) explore the CSW role in the practice education of students and (2) evaluate a training programme for CSWs. Method: A mixed-methods design was utilised; 17 CSWs completed a survey prior to completing a training programme, and 11 participated in focus groups after the programme. Findings: We identified five themes: (1) supporting students is an expectation , (2) supporting students ‘boosts the role’ , (3) legitimacy of the CSW role to support students , (4) application of new learning to practice and (5) enablers and barriers to engagement with the programme. Conclusion: CSWs are part of practice education ‘Communities of Practice’, evidenced through regular involvement with student learning. Responsibilities for student learning are perceived as adding value, although there is an absence of structures to legitimise the role. CSWs identified barriers and enablers to engaging with the programme, such as blended learning approaches and management support

“We’re not the right people to deal with it”: How policing the pandemic revealed significant inadequacies in UK mental health provision

The COVID-19 pandemic triggered a variety of responses. While many UK public agencies were encouraged to close their doors, police officers continued to work enforcing the rapidly changing government restrictions and first responding to emergency incidents. One pre-existing responsibility was responding to people in mental health crisis; an area both fraught with complexity and where the police are often thought ill-equipped to handle (Trebilcock & Weston, 2019). Drawing on interviews with frontline police officers and other related personnel, this chapter exposes the inadequacy of mental health provision in the UK. While documenting how the police became the service of first and last resort for mental health by both agencies and service users long before the pandemic, we also illustrate how the Covid restrictions placed on officers exposed the extent of work they do with people presenting with mental ill health. To conclude, the chapter considers how the policing pandemic response to mental health offers contemporary and new challenges to the level of police involvement in this contested and complex area

‘Sometimes I’m feeling baffled and they’re probably feeling baffled’: On the experiences of psychological therapists working with autistic people in a structured primary care service for anxiety disorders and depression

Abstract: Autistic people are more likely to experience mental health problems such as anxiety disorder and depression than are the general population. This study reports a qualitative analysis of interview data provided by 12 psychological therapists regarding their experiences of working with autistic people with anxiety disorders and/or depression within a structured primary care mental health service in the north of England. Interviews were analysed using thematic analysis. Four main themes were identified: (1) Experience and Trepidation, (2) Wrong Service, Only Service, (3) Therapeutic Environment and (4) Training and Adaptations. Participating therapists identified challenges in the structure of the services they worked in, the applicability of conventional therapies and the need for autism-specific therapy training ideally led by autistic people. Centrally, participants did not routinely feel fully equipped to separate endemic aspects of autism itself from features of a mental health disorder in an autistic person, which had left some feeling powerless to help in certain cases, or as if they may have done more harm than good. All participants were, however, able to identify positive adaptations made from practical experience, and most reported a growing confidence in working with autistic people. Lay Abstract: The experiences of psychological therapists working with autistic people in a primary care service for anxiety disorders and depression. We are a group of autistic people, academic researchers and psychological therapists, with some of us being more than one of those things. We started from the knowledge that autistic people are particularly prone to have anxiety disorders and depression. We were, therefore, interested in how current ‘talking therapy’ services in England might, or might not, be helping autistic people with those problems. To address this issue, we interviewed 12 psychological therapists in the north of England who had experience of working with autistic people with an anxiety disorder, depression or both. We found that the therapists often felt that they were not prepared or trained to give autistic people their best service. The therapists were also concerned that some of the therapies they usually applied did not always work with autistic people, or sometimes even made things worse. They felt it was important, however, that autistic people should keep using the service, as there was no other service available to them if they had an anxiety disorder or depression. There was evidence, however, that talking therapies still had positive effects for autistic people, and that therapists had therefore probably underestimated their positive impact in a lot of cases. Consequently, training was recommended such that psychological therapists might better understand mental health and specific therapy adaptations that help autistic people

Towards a sustainable resistance to brand switching: a social influence theory perspective

In the realm of branding and consumer attitudes towards brands, the focus has primarily revolved around the functional utility of products, overlooking the significance of socio-psychological attributes of brands. This study aims to address this gap by delving into the concept of brand loyalty, which encompasses various dimensions such as the intention to repeatedly purchase and repurchase a specific brand, the willingness to pay premium prices, resistance to brand switching, and advocacy of the brand to others. The current study centres on online brand communities (OBCs). OBCs offer companies a unique opportunity to share brand information, gain valuable insights into customer needs, preferences and desires, both current and potential. Employing a social constructivist approach, the study seeks to explore why customers resist brand switching. Qualitative survey data were analysed using thematic analysis to examine customers' engagement in OBCs to understand its distinctive impact on brand loyalty. Additionally, this study incorporates social influence theory to assess its effects on customer loyalty within OBCs. Findings suggest that firstly, OBC members develop attitudinal loyalty, which represents a more long-term and emotional commitment to a brand; secondly, responses relating to social influence show that there were intentional or unintentional communications that produced change(s) in others’ attitudes, beliefs, intentions, motivations or behaviours. Consumers often look to others’ opinions in OBCs when making a purchase decision