Change in the incidence of Parkinson’s disease in a large UK primary care database

Parkinson’s disease (PD) has the fastest rising prevalence of all neurodegenerative diseases worldwide. However, it is unclear whether its incidence has increased after accounting for age and changes in diagnostic patterns in the same population. We conducted a cohort study in individuals aged ≥50 years within a large UK primary care database between January 2006 and December 2016. To account for possible changes in diagnostic patterns, we calculated the incidence of PD using four case definitions with different stringency derived from the combination of PD diagnosis, symptoms, and treatment. Using the broadest case definition, the incidence rate (IR) per 100,000 person years at risk (PYAR) was 149 (95% CI 143.3–155.4) in 2006 and 144 (95% CI 136.9–150.7) in 2016. In conclusion, the incidence of PD in the UK remained stable between 2006 and 2016, when accounting for age and diagnostic patterns, suggesting no major change in underlying risk factors for PD during this time period in the UK

Considering uncertain futures in shrinking regions: Inventing, reinventing, and responding to narratives through scenario planning

Shrinking places experience a number of social, political, and economic barriers to engaging in future planning. Often, these barriers manifest through the form of narratives and stories which can inspire selective retelling and an inability to adequately address and prepare for uncertain futures. Narratives in shrinking regions tend to produce and reproduce themselves through the lens of the growth paradigm, ultimately leading to narratives that emplot experiences of shrinkage as “bad”. With the ‘entrepreneurial city’ or the ‘growing city’ as the dominant narrative attached to urbanism, cities experiencing shrinkage often reproduce narratives that push them towards growth-oriented planning responses. This thesis discusses the role of narratives in planning, narratives of shrinkage and how those narratives are produced and reproduced in shrinking places, and how scenario planning might create a process for reversing or challenging the reproduction of narratives and provide a platform for imaginative revision. Narratives of shrinkage are engaged through the analysis of planning documents and news stories from Peoria, Decatur and Danville using deductive coding. These documents and narratives perpetuate the growth paradigm through measures of success and planned strategies and highlight embedded feelings of defeatism and poor self-image. Scenario planning is discussed as a possible process to engage and transform these narratives while engaging future uncertainties, allowing communities to challenge growth-oriented ideas of success and prepare for the future with resiliency and robustness

“I am what I am”: narratives of effective change leadership in UK sport coaching systems

The role of the leader in UK sport coaching systems has rarely attracted attention, either academically or within sport policy in the UK. Yet, individuals holding these roles within National Governing Bodies of Sport play a critical role in creating the structures necessary for the development of effective sport coaching strategy and coach education across the UK. This research addressed this gap by examining the experiences of effective change leaders within UK coaching systems, with the intention of gaining critical insights to inform future developments within the sector. Adopting a constructivist-interpretive approach within a collective case-study umbrella, this research used life-history interviews to co-construct individual narratives to ‘tell’ the stories of six effective coaching systems leaders. These narratives were then analysed to identify key themes for each individual, followed by a template analysis to generate five cross-case themes: ‘I know who I am’, Curiosity, Great People, Nurturing Environments and Courage. The findings are also synthesised in a new ‘Model for Coaching Systems Leadership in the UK’. It is argued that the sport coaching sector in the UK would benefit from a new leadership narrative that views authentic leaders as an integral component of coaching system development at every level

Inter-parental conflict and children's externalising problems during the transition from primary to secondary school

Background: The prevalence rates of aggressive and antisocial behaviour among children and adolescents are a cause for concern among parents, teachers and policy makers. The aetiology of these dimensions of child psychopathology remains high on the research agenda. Attention has been directed at specific family relations, including inter-parental and parent-child relationships, and school-based factors, such as student-teacher relationships and school transitions, as aspects of children's social environment that may contribute to externalising problems. This thesis explores the role of home-school interplay by examining the pathways through which pre- and post-transition inter-parental conflict is associated with children and adolescents' externalising problems in secondary school. Method The thesis employs a mixed methods design. Multivariate analysis using both cross-sectional and prospective, longitudinal research designs are used to assess relationships between inter-parental conflict and children's externalising problems during the transition from primary to secondary school. This is supplemented by a thematic analysis of qualitative responses identifying the school-based factors that children, their parents and teachers have identified as helpful and unhelpful to foster adaptation to school transition. Results Findings emphasise the importance of family relations for children's school- based adjustment. Inter-parental conflict preceding and co-occurring with the school transition consistently predicted externalising problems in secondary school via children's responsibility attributions for the conflict. The results also underscore the value of considering the interface between home and school for understanding variation in children's psychological adjustment by showing that inter-parental conflict increases children's transition-related anxiety, which predicts poor adjustment to secondary school. Supportive teacher behaviour appears to be a significant factor that helps children prepare for the transition. It appears to be particularly important for children experiencing heightened levels of discord and hostility within the home, who may be among those at greater risk of manifesting externalising problems. Conclusions It is important to consider aspects of the home and school environment to understand variation in children's externalising problems in school during periods of transition. Results are discussed and recommendations made for policy and practice aimed at reducing aggression and antisocial behaviour during this critical period of normative life stress