Factors affecting energy expenditure and the efficiency of fuel utilization : feeding and exercise models

The first aim of this dissertation was to monitor both rat and human responses to short-term perturbations in energy balance brought about through food energy restriction and refeeding, exercise training and the cessation of exercise training or surgical lipectomy. The second aim of this dissertation was to identify factors which might explain differences in food energy intake in weight-matched, weight-stable "large and small eaters". The final aim of this dissertation was to identify factors which might explain differences in resting energy expenditure in a large sample of weight-stable men and women, including exercising and non-exercising persons, and including persons who may be regarded as "restrained eaters"

Charities and Resilience : From Austerity to COVID-19

Peer reviewedPostprin

Investigation of governance in Scottish charities

This thesis investigates governance in large Scottish charities. In particular, the focus is on internal aspects of governance, predominantly the functioning of the board. The influence of business on charities is also investigated through considering the impact of individuals with business expertise on the boards of charities. Charity governance in the Scottish context has been under-research, this thesis attempts to fill this research gap. A multi-method approach was employed, encompassing both quantitative and qualitative research. The study utilised a survey in the form of a selfcompletion questionnaire, and three case studies to examine governance in Scottish charities. Social construction provides the framework of the analysis. This thesis provides an insight into the functioning of the boards of Scottish charities, in-line with previous research in other countries, governance issues are apparent. However, in relation to the impact of business expertise in charities, there is evidence that business members of charitable boards make contributions to the governance of these organisations, and charities can gain considerable value from having outside specialists on the board

Cultural intelligibility of anxiety: young women, consumer culture, and the ‘project’ of the self

This thesis critically explores the role of consumer culture in young women’s understanding of self. Drawing on media and cultural studies literature as well as post-structuralist and critical perspectives, this study asks: how does consumer culture guide or influence a young woman’s way-of-being in everyday life? Despite arguments that consumer culture, underpinned by neoliberal principles of personal responsibility and individualism, has become the institution of reference for young women, consumer research on the experiences of women, and from feminist perspectives, is generally sparse. Moreover, claims that consumer culture may covertly subjugate young women by encouraging practices of self regulation are in contention with consumer research that emphasises consumption as a means of self-expression and agency. Therefore, a qualitative, feminist study was conducted in which, over 18 months, fifteen women, aged 20 to 34, engaged in multiple in-depth interviews. The data generation process typically consisted of four interviews over a nine-month period: the first interview covering life history and background was followed by an in-home ‘show-and-tell’ interview about the participant’s ‘stuff’. The third interview addressed participants’ engagement with digital technologies also through a ‘show-and-tell’ approach and the final interview was semi-structured, addressing themes emerging from previous interviews. This generated 50 interviews lasting two hours on average, as well as data from observation, photographs and engagement with social network sites. From a critical thematic analysis, four significant findings emerged. Firstly, in relation to being a woman, participants felt pressure to ‘have it all’ in terms of both traditional (e.g., getting married, raising children, being attractive) and progressive (e.g., achieving career success) ideals. Whilst some disagreed that women continue to be subjugated, most participants experienced a sense of mounting pressure and expectations compared to men and subscribed to neoliberal principles of personal responsibility in combatting gender inequality. Secondly, participants reflexively experienced being a consumer as an unavoidable, often burdensome and anxiety-provoking position that encouraged the making of the self through appearance, as well as adherence to hegemonic feminine ideals. A consumer orientation was further reinforced by increasingly pervasive digital spaces, particularly social media, infused with advertising and consumption. From this, a third finding emerged related to the understanding of self: participants often experienced or expressed a sense of self as a task, an individualistic project for which they felt responsible. Constantly comparing themselves to others to benchmark the project of the self, participants worked to continually craft a story of success and agency despite unpredictability of the life course and contradictory events sometimes conspiring. Moreover, participants who did not feel they had achieved career goals placed greater emphasis on crafting an ideal appearance. The fourth finding addresses the importance of others in understanding the self. Rather than experiencing an ‘identity’ as formed individually, participants looked to others (e.g., family, peers, media, ideologies) to understand the self. Focusing on the opinions of others was associated with anxiety, which varied in degree but was part of all participant accounts. This study suggests that consumer culture is indeed an institution of reference for young women as they experience a sense of self through consumption practices, increasingly digitally mediated. In this sense, the findings align with theorisations in consumer research. However, for the participants of this study, the experience of living the subject position ‘consumer’ is anxiety provoking, particularly in light of postfeminist, neoliberal discourses that encourage experiencing the self as a ‘project’ for which the individual is responsible. As reflected in the data, a self-as-project orientation triggered anxiety given disjointedness between the desire to manage or control the self fostered by dominant discourses, and the impossibility of doing so as reflected by lived experience. This positioning engendered alienation from the self and therefore anxiety that was further sparked by increasing individualism and competition with others; feelings of shame and envy; and a forward-looking temporal positioning. Therefore, findings suggest that consumer research’s conceptualisations of ‘identity’ as a ‘project’ in which individuals can express themselves through marketplace resources is problematic, if not further perpetuating the subjugation of women by rendering them as ‘free’ to consume their way into being. This calls into question individual agency and the role of cultural influences in the making of subjects. Therefore, findings suggest that, from an emancipatory perspective, consumer research examining processes of subject constitution might be more productive to understandings ‘identity’ and the ‘self’ in a particular space and time, with attention to implicit power relations

Speech disfluencies of preschool-age children who do and do not stutter

Purpose—The goals of the present study were to investigate whether (1) the speech disfluencies of preschool-age children are normally distributed; (2) preschool-age children who do (CWS) and do not stutter (CWNS) differ in terms of non-stuttered disfluencies; (3) age, gender, and speechlanguage ability affect the number and type of disfluencies children produce; and (4) parents’ expressed concern that their child stutters is associated with examiners’ judgments of stuttered disfluency. Method—Four hundred and seventy two children participated, of which 228 were CWS (56 girls), and 244 CWNS (119 girls). Participants provided conversational speech samples that were analyzed for frequency of occurrence of (a) stuttered disfluencies, (b) non-stuttered disfluencies, and (c) total disfluencies. Results—Results indicated that the underlying distributions of preschool-age children’s stuttered and non-stuttered disfluency counts followed a negative binomial distribution (i.e., were not normal), with more children “piling up” at the low end [none or few disfluencies] and fewer children scoring in the upper [more severe stuttering] end of the distribution. Findings also indicated that non-stuttered disfluencies significantly predicted CWS/CWNS talker group classification, information that may be helpful to augment, but not supplant, talker group classification criteria based on stuttered disfluencies. Moreover, expressed parental concern about stuttering was strongly associated with frequency of stuttered disfluencies

The prevalence of constant supportive observations in a high, medium and low secure service

Aims and Method We explored the prevalence and use of constant supportive observations (CSO) in high, medium and low secure in-patient services in a single NHS mental health trust. From clinical records, we extracted data on the length of time on CSO, the reason for the initiation of CSO and associated adverse incidents for all individuals who were placed on CSO between July 2013 and June 2014. Results A small number of individuals accounted for a disproportionately large amount of CSO hours in each setting. Adverse incident rates were higher on CSO than when not on CSO. There was considerable variation between different settings in terms of CSO use and the reasons for commencing CSO. Clinical Implications The study describes the prevalence and nature of CSO in secure forensic mental health services and the associated organisational costs. The marked variation in CSO use between settings suggests that mental health services continue to face challenges in balancing risk management with minimising restrictive interventions

Exploring the Impact of Efficacy Messages on Cessation-Related Outcomes Using Ecological Momentary Assessment

Introduction:Observational studies indicate that cigarette package inserts with efficacy messages about the benefits of quitting (i.e. response efficacy) and recommendations for successful cessation increase smokers’ self-efficacy to quit and promote sustained cessation. However, the effects of inserts with such efficacy messages have not been studied using experimental designs. This study used ecological momentary assessment (EMA) to assess smokers’ responses to efficacy inserts.Material and Methods:In a randomized case-crossover study among smokers from the United States (n=23), participants received a one-week supply of cigarettes with efficacy inserts and a one-week supply without any inserts, and were randomized to use the packs with inserts on either the first or second week of the study. For 14 consecutive days, participants used a smartphone to answer brief surveys on cessation-related variables during smoking sessions and at the beginning of each day. Multilevel mixed-effects linear and logistic regression models compared responses during the insert period to those of the non-insert period.Results:The insert period was associated with greater desire to quit (b=0.21, p=0.012), motivation to quit (b=0.18, p=0.001), self-efficacy to cut down (b=0.26, p\u3c0.001) and to quit (b=0.28, p\u3c0.000), and response efficacy/ perceived benefits of quitting (b=0.13, p=0.012). Insert exposure was not significantly associated with forgoing cigarettes (OR=1.9, p=0.2).Conclusions:Results from this EMA study suggest that inserts with efficacy messages may promote determinants of smoking cessation. This is consistent with observational research in Canada, which is the only country to use inserts with efficacy messages as well as pictorial warnings about smoking risks on the outside of packs. Future studies should assess the extent to which efficacy inserts can not only be used to communicate health information to smokers but also work in synergy with pictorial warnings

Assessing the operational feasibility and acceptability of an inhalable formulation of oxytocin for improving community-based prevention of postpartum haemorrhage in Myanmar: a qualitative inquiry

Objective: This study assessed the potential operational feasibility and acceptability of a heat-stable, inhaled oxytocin (IOT) product for community-based prevention of postpartum haemorrhage in Myanmar. Methods: A qualitative inquiry was conducted between June 2015 and February 2016 through focus group discussions and in-depth interviews. Research was conducted in South Dagon township (urban setting) and in Ngape and Thanlyin townships (rural settings) in Myanmar. Eleven focus group discussions and 16 in-depth interviews were conducted with mothers, healthcare providers and other key informants. All audio recordings were transcribed verbatim in Myanmar language and were translated into English. Thematic content analysis was done using NVivo software. Results: Future introduction of an IOT product for community-based services was found to be acceptable among mothers and healthcare providers and would be feasible for use by lower cadres of healthcare providers, even in remote settings. Responses from healthcare providers and community members highlighted that midwives and volunteer auxiliary midwives would be key advocates for promoting community acceptance of the product. Healthcare providers perceived the ease of use and lack of dependence on cold storage as the main enablers for IOT compared with the current gold standard oxytocin injection. A single-use disposable device with clear pictorial instructions and a price that would be affordable by the poorest communities was suggested. Appropriate training was also said to be essential for the future induction of the product into community settings. Conclusion: In Myanmar, where home births are common, access to cold storage and skilled personnel who are able to deliver injectable oxytocin is limited. Among community members and healthcare providers, IOT was perceived to be an acceptable and feasible intervention for use by lower cadres of healthcare workers, and thus may be an alternative solution for the prevention of postpartum haemorrhage in community-based settings in the future

The Relationship between Physical Activity and the Objectively-Measured Built Environment in Low- and High-Income South African Communities

There is limited data concerning the built environment and physical activity (PA) in a country with a history of socio-politically motivated, spatial and economic disparities. We explored the extent to which objectively measured attributes of the built environment were associated with self-report or device-measured PA in low- and high-socioeconomic status (SES) communities. Methods: In a convenient sample of residents (n = 52, aged 18–65 years) from four urban suburbs in low- and high-income settings near Cape Town, South Africa, self-reported transport- and leisure-time PA, and device-measured moderate-to-vigorous PA (MVPA) data were collected. Built environment constructs derived from individual-level street network measures (1000 m buffer, ArcGIS, 10.51) were obtained. We assessed PA between four groups, based on income and GIS walkability (derived by a median split, low or high SES and low or high walkable). Results: No relationships between self-reported MVPA and GIS-measured walkability were found. Only intersection density was significantly, inversely associated with moderate and total MVPA (rho = −0.29 and rho = −0.31, respectively, p < 0.05). In the high SES group, vigorous PA was inversely associated with intersection density (rho = −0.39, p < 0.05). Self-report transport PA differed between groups (p < 0.013). Conclusions: Results suggest that the construct of walkability may relate to volitional (leisure) and utilitarian (transport) PA differently, in highly inequitable settings