Understanding How, Why and for Whom Link Work Interventions Promote Access in Community Healthcare Settings in the United Kingdom: A Realist Review

Introduction: Inequity in access to healthcare in the United Kingdom can have a profound impact on people's ability to manage their health problems. Link work interventions attempt to overcome the socioeconomic and structural barriers that perpetuate health inequalities. Link workers are typically staff members without professional clinical qualifications who support patients to bridge the gap between services. However, little is currently known about how and why link work interventions might be effective. This realist review attempts to understand the contexts and resultant mechanisms by which link work interventions affect access to community healthcare services. Methods: The authors completed a systematic search of empirical literature in Embase, CINAHL, Medline, PsychInfo and SocIndex, as well as grey literature and CLUSTER searches. Context, mechanism and outcome (CMO) configurations were generated iteratively in consultation with an expert panel and grouped into theory areas. Results: Thirty‐one eligible manuscripts were identified, resulting in nine CMO configurations within three theory areas. These pertained to adequate time in time‐pressured systems; the importance of link workers being embedded across multiple systems; and emotional and practical support for link workers. Conclusion: Although link work interventions are increasingly utilised across community healthcare settings, the contexts in which they operate vary considerably, triggering a range of mechanisms. The findings suggest that careful matching of resources to patient need and complexity is important. It affords link workers the time to develop relationships with patients, embed themselves in local communities and referring teams, and develop knowledge of local challenges. Patient or Public Contribution: The team included people with lived experience of mental health conditions and a carer who were involved at all stages of the review

Creative destruction in science

Drawing on the concept of a gale of creative destruction in a capitalistic economy, we argue that initiatives to assess the robustness of findings in the organizational literature should aim to simultaneously test competing ideas operating in the same theoretical space. In other words, replication efforts should seek not just to support or question the original findings, but also to replace them with revised, stronger theories with greater explanatory power. Achieving this will typically require adding new measures, conditions, and subject populations to research designs, in order to carry out conceptual tests of multiple theories in addition to directly replicating the original findings. To illustrate the value of the creative destruction approach for theory pruning in organizational scholarship, we describe recent replication initiatives re-examining culture and work morality, working parents\u2019 reasoning about day care options, and gender discrimination in hiring decisions. Significance statement It is becoming increasingly clear that many, if not most, published research findings across scientific fields are not readily replicable when the same method is repeated. Although extremely valuable, failed replications risk leaving a theoretical void\u2014 reducing confidence the original theoretical prediction is true, but not replacing it with positive evidence in favor of an alternative theory. We introduce the creative destruction approach to replication, which combines theory pruning methods from the field of management with emerging best practices from the open science movement, with the aim of making replications as generative as possible. In effect, we advocate for a Replication 2.0 movement in which the goal shifts from checking on the reliability of past findings to actively engaging in competitive theory testing and theory building. Scientific transparency statement The materials, code, and data for this article are posted publicly on the Open Science Framework, with links provided in the article

Human third-party observers accurately track fighting skill and vigour along their unique paths to victory

Sexual selection via male-male contest competition has shaped the evolution of agonistic displays, weaponry, and fighting styles, and is further argued to have shaped human psychological mechanisms to detect, process, and respond appropriately to cues of fighting ability. Drawing on the largest fight-specific dataset to date across the sports and biological sciences (N = 2765 fights), we examined how different indicators of fighting ability in humans reflect unique paths to victory and indicate different forms of perceived and actual resource-holding power (RHP). Overall, we discovered that: (1) both striking skill and vigour, and grappling skill and vigour, individually and collectively predict RHP; (2) different RHP indicators are distinguished by a unique path to victory (e.g., striking skill is a knockout-typical strategy, whereas grappling vigour is a submission-typical strategy); and (3) third-party observers accurately track fighting skill and vigour along their unique paths to victory. Our argument that different measures of RHP are associated with unique paths to victory, and third-party observers accurately track fighting vigour and skill along their unique paths to victory, advance our understanding not only of human contest competition, but animal contest theory more broadly

Beyond facial width-to-height ratios: Bizygomatic width is highly sexually dimorphic when adjusting for allometry

A large and ever-growing literature implicates male facial width-to-height ratio (bizygomatic width divided by facial height) as a secondary sexual trait linked to numerous physical and psychological perceptions. However, this research is based entirely on the premise that bizygomatic width is sexually dimorphic, which recent research has called into question. Unfortunately, statisticians for the last 125 years have noted that morphological ratio measurements may engender spurious correlations and biased effect-size estimates. In the current study, we find that bizygomatic width is highly sexually dimorphic (equivalent d = 1.39), even after adjusting for 92 allometric measurements, including multiple facial height and other craniofacial measurements (equivalent d = 1.07) in a sample of 6068 men and women. By contrast, facial width-to-height ratio (fWHR) measurements demonstrated a statistical pattern consistent with the age-old argument that morphological ratio measurements may engender spurious correlations and biased effect-size estimates. Thus, when avoiding facial ratio measurements and adjusting for allometry in craniofacial measures, we found strong support for a key premise in the human evolutionary and behavioural sciences that bizygomatic width exhibits male-biased sexual dimorphism

Human third-party observers accurately track fighting skill and vigour along their unique paths to victory

Sexual selection via male-male contest competition has shaped the evolution of agonistic displays, weaponry, and fighting styles, and is further argued to have shaped human psychological mechanisms to detect, process, and respond appropriately to cues of fighting ability. Drawing on the largest fight-specific dataset to date across the sports and biological sciences (N = 2,765), we examined how different indicators of fighting ability in humans reflect unique paths to victory and indicate different forms of perceived and actual resource-holding power (RHP). Overall, we discovered that: (1) both striking skill and vigour, and grappling skill and vigour, individually and collectively predict RHP; (2) different RHP indicators are distinguished by a unique path to victory (e.g., striking skill is a knockout-typical strategy, whereas grappling vigour is a submission-typical strategy); and (3) third-party observers accurately track fighting skill and vigour along their unique paths to victory. Our argument that different measures of RHP are associated with unique paths to victory, and third-party observers accurately track fighting vigour and skill along their unique paths to victory, advance our understanding not only of human contest competition, but animal contest theory more broadly

Beyond facial width-to-height ratios: Bizygomatic width is highly sexually dimorphic when adjusting for allometry

A large literature implicates male facial width-to-height ratio (bizygomatic width divided by facial height) as a secondary sexual trait linked to numerous physical and psychological outcomes. However, this research is based entirely on the premise that bizygomatic width is sexually dimorphic, which recent research has called this into question. Unfortunately, statisticians for the last 125 years have noted that ratio measurements engender spurious correlations and biased effect-size estimates. In the current study, we find that bizygomatic width is highly sexually dimorphic (equivalent d = 1.39). Further, after adjusting for 92 allometric measurements, including multiple facial height and other craniofacial measurements, bizygomatic width exhibited pronounced male-biased sexual dimorphism (equivalent d = 1.01) in a sample of 6,068 men and women born across the globe (Europe, Asia, Oceania, North, Central, and South America). In contrast, fWHR measurements demonstrated a statistical pattern consistent with the age-old argument that ratio measurements engender spurious correlations and biased effect-size estimates. Thus, when avoiding ratios and adjusting for allometry in craniofacial measures, we found strong support for a key premise in the human evolutionary and behavioral sciences that bizygomatic width exhibits male-biased sexual dimorphism

Deceptive affection is strategically expressed under relational threat—but not towards partners with low mate value

Drawing on data from 1,993 participants, we demonstrated that deceptive affectionate messages (DAMs; e.g., faking sexual pleasure, expressing affection when feeling negatively) are the behavioral output of an evolved psychological system that strategically operates to maintain significant pair bonds (i.e., high mate value partners)—but not non-significant pair bonds (i.e., low mate value partners)—and regulates the expression of this behavioral output depending on an underlying cost-benefit ratio. This system is uniquely and nonrandomly designed to increasingly generate DAMs when the target individual’s highly-valued partnership is under relational threat and increasingly withdraw DAMs when the highly-valued partnership is not under threat—but neither increasingly generate nor withdraw DAMs for non-valuable partnerships—to maximize the benefits afforded by valuable romantic partnerships

Intrasexual selection for upper limb length in Homo sapiens

Sexual selection via contest competition has equipped countless organisms with weaponry in their appendages to overpower their opponents. Here, we tested the overarching hypothesis that the selection pressures created by intrasexual contest competition shaped humans’ upper limbs – specifically the length of their arms. We tested (1) whether greater arm length confers an advantage in contest competition among adult humans, (2) several possible means by which arm length might increase success in intrasexual contest competition, and (3) whether, consistent with male-male contest competition creating stronger selection pressures than female-female contest competition, male Homo sapiens have greater upper limb length. Our results provided unambiguous support for these hypotheses. First, we found that greater arm length is associated with increased success in intrasexual contest competition, an effect driven specifically by the capacity to knock opponents unconscious. Second, in diverse and demographically representative samples from four studies, we found unequivocal, cross-cultural evidence of previously undocumented sexual dimorphism in upper limb length: after controlling for allometry, across the globe, men exhibited longer upper limbs than women, from Croatian adolescents to older Singaporean adults to United States Army personnel (total N = 6,915) born across all major world regions (Africa, Europe, Asia, Oceania, and North, Central, and South America). The current studies introduce a previously undiscovered sexual dimorphism to the biological, anthropological, and psychological sciences: upper limb length