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Some trials have evaluated peer support for people with mental ill health in high-income, mainly English-speaking countries, but the quality of the evidence is weak.
Aims
To investigate the effectiveness of UPSIDES peer support in high-, middle- and low-income countries.
Method
This pragmatic multicentre parallel-group wait-list randomised controlled trial (registration: ISRCTN26008944) with three measurement points (baseline and 4 and 8 months) took place at six study sites: two in Germany, and one each in Uganda, Tanzania, Israel and India. Participants were adults with long-standing severe mental health conditions. Outcomes were improvements in social inclusion (primary) and empowerment, hope, recovery, health and social functioning (secondary). Participants allocated to the intervention group were offered UPSIDES peer support.
Results
Of the 615 participants (305 intervention group), 337 (54.8%) identified as women. The average age was 38.3 (s.d. = 11.2) years, and the mean illness duration was 14.9 (s.d. = 38.4) years. Those allocated to the intervention group received 6.9 (s.d. = 4.2) peer support sessions on average. Intention-to-treat analysis showed effects on two of the three subscales of the Social Inclusion Scale, Empowerment Scale and HOPE Scale. Per-protocol analysis with participants who had received three or more intervention sessions also showed an effect on the Social Inclusion Scale total score (β = 0.18, P = 0.031, 95% CI: 0.02–0.34).
Conclusions
Peer support has beneficial impacts on social inclusion, empowerment and hope among people with severe mental health conditions across diverse settings. As social isolation is a key driver of mental ill health, and empowerment and hope are both crucial for recovery, peer support can be recommended as an effective component of mental healthcare. Peer support has the potential to move global mental health closer towards a recovery- and rights-based orientation.
The COVID-19 pandemic caused widespread disruption to early childhood education and care services worldwide, affecting children’s well-being and placing unprecedented caregiving burdens on families. This paper compares the childcare-related social policy responses in three countries representing distinct welfare regimes: South Korea (Productivist/East Asian), France (Conservative-Corporatist), and the UK (Liberal). Focusing on four key domains – ECEC services, family leave, work environment, and financial support – it examines how each country addressed childcare challenges during the pandemic. The findings show that, while some similarities emerged in responding to shared challenges, the policy responses diverged considerably. These differences were shaped not only by pandemic-specific health strategies but also by pre-existing welfare structures and childcare systems. France utilised its strong public infrastructure and introduced special childcare leave; Korea expanded temporary family leave and financial aid while relying heavily on informal care; and the UK prioritised employment protection with limited direct caregiving support. The study underscores the importance of institutional flexibility and multi-layered care systems in building crisis-resilient childcare policies.
The production and circulation of common wares during the late antique period in North Africa has been largely overlooked by past scholarship, despite their potential to shed light on late antique production, workshop organisation and regional ceramic economies. This paper provides the first detailed study of a distinctive type of late antique, wheelmade common ware, the so-called African ‘painted ware’ (APW). It first presents a critical overview of the distribution of painted wares and their typology, decoration and chronology based on existing publications. It then develops a typology of vessel shapes, but also decoration patterns based on a large, well-preserved assemblage of painted ceramics recently excavated by the DAI, INP and UCL at the archaeological sites of Bulla Regia and Chimtou in the Medjerda valley, Tunisia. To understand the composition, technology and provenance of the wares, petrographic and chemical analysis was conducted on 57 painted sherds from the two sites. The results suggest the existence of a production centre in the Medjerda Valley, with potters using local calcareous clay tempered with sand, while the decoration was obtained using iron-based pigments. Comparison with published painted wares at other sites contributes to an initial insight into regional distribution patterns of the painted ware.
The objectives of the study were to determine somatic cell count (SCC) and evaluate the presence of pathogens (IMI – intramammary infection) in late lactation (LL), followed by the start (colostrum, CL) and approximate peak (established lactation, EL) of the next lactation, as well as to assess the possible transmission of IMI from lactation to lactation. The study was performed on a dairy farm in northern Slovakia. A total of 489 half udder milk samples (242, 80 and 167 in LL, CL and EL, respectively) were collected. Pathogens were identified using MALDI-TOF MS and PathoProof (the latter only in LL). SCC was determined only in LL and EL. Samples were divided according to SCC in four groups from lowest (SCC1 < 500 × 103 cells mL−1) to highest (SCC4 ≥ 2000 × 103 cells mL−1). SCC was higher in LL than in EL. The prevalence of pathogens identified using MALDI-TOF MS was 16.5, 38.8 and 12.6% in LL, CL and EL, respectively. Non-aureus staphylococci and mammaliicocci (NASM) were the most common isolated pathogens in goat milk and colostrum. Staphylococcus (S.) caprae and S. epidermidis species tended to cause persistent IMI in the next lactation. The identification of pathogens using PathoProof was higher than with MALDI-TOF MS. Of all the pathogens (n = 262) identified using PathoProof, the most common were Staphylococcus spp. (86.7%) of which 65.8% exhibited the β-lactamase gene. Additionally, Escherichia coli (4.2%), S. aureus (2.7%), Enterococcus spp. (2.3%), Streptococcus uberis (1.9%), Mycoplasma spp., Protetheca spp. (0.8% each), Arconabacterium pyogenes/Peptoniphilus indolicus and yeast (0.4% each) were also detected using PathoProof. Better identification of pathogen presence in samples with high SCC could contribute to the discussion about SCC as an indicator of subclinical mastitis in goats.
Water hyacinth is an invasive aquatic plant that has been associated with major negative economic and ecological impacts in water systems worldwide, including Rwanda, since its establishment in the country in the 1960s. While biological control is considered the most sustainable management method, the success of biocontrol agents depends on various abiotic factors, with temperature being critical. This study assessed the suitability of potential water hyacinth biocontrol agents such as: Neochetina weevils, Megamelus scutellaris Berg (Hemiptera: Delphacidae), and Cornops aquaticum Bruner (Orthoptera: Acrididae) for regions with a temperate climate by testing their thermal boundaries. Using thermal physiology limits and CLIMEX modelling, we found that Neochetina eichhorniae Warner and N. bruchi Hustache (Coleoptera: Curculionidae) had lower thermal minimums (CTmin) of 2.4°C and 2.6°C, respectively, compared to Megamelus scutellaris (4.7°C) and Cornops aquaticum (6.2°C). CLIMEX modelling predicted the suitability of Neochetina weevils and C. aquaticum across Rwanda, while M. scutellaris appeared unsuitable for the colder northern regions of the country but appropriate for the central and eastern regions. These findings suggests that the historical failure of Neochetina weevils introduced to Rwandan water bodies in 2000 was not due to temperature extremes. Rather, other factors such as release numbers or water quality may have played a role. This study provides crucial information for future biocontrol efforts in Rwanda and similar temperate regions, highlighting the importance of pre-release thermal tolerance assessments and climate modelling to predict biocontrol agent establishment and efficacy.
I discuss and clarify the relationship between the recent wave of “intrinsic” coordinate-free approaches to Maxwell gravitation and the coordinate-based discussions of Saunders (2013) and Wallace (2020).
This study presents an innovative framework to improve the accessibility and usability of collaborative robot programming. Building on previous research that evaluated the feasibility of using a domain-specific language based on behaviour-driven development, this paper addresses the limitations of earlier work by integrating additional features like a drag-and-drop Blockly web interface. The system enables end users to define and execute robot actions with minimal technical knowledge, making it more adaptable and intuitive. Additionally, a gesture-recognition module facilitates multimodal interaction, allowing users to control robots through natural gestures. The system was evaluated through a user study involving participants with varying levels of professional experience and little to no programming background. Results indicate significant improvements in user satisfaction, with the system usability scale overall score increasing from 7.50 to 8.67 out of a maximum of 10 and integration ratings rising from 4.42 to 4.58 out of 5. Participants completed tasks using a manageable number of blocks (5 to 8) and reported low frustration levels (mean: 8.75 out of 100) alongside moderate mental demand (mean: 38.33 out of 100). These findings demonstrate the tool’s effectiveness in reducing cognitive load, enhancing user engagement and supporting intuitive, efficient programming of collaborative robots for industrial applications.
In this article, we take the charitable activities of the Shaolin Temple as a case study for our analysis of the Chinese Communist Party’s (CCP) management of religion under Xi Jinping. Our fieldwork and in-depth interviews reveal that the Shaolin Temple has, through its charitable work, assumed the attributes of a “cultural broker” for the CCP. And because the temple has an abundance of symbolic capital and is respected by the public, it presents the CCP with a “dictator’s dilemma.” On the one hand, the CCP allocated resources to the temple’s orphanage so that it could assist the regime with its poverty alleviation efforts; on the other hand, there is a danger that the temple may gain sufficient ideological and discursive power to threaten the CCP’s rule. So, for political security reasons, the Party bureaucracy endeavours to maintain tight control over the orphanage.
Traditional regression models typically estimate parameters for a factor F by designating one level as a reference (intercept) and calculating slopes for other levels of F. While this approach often aligns with our research question(s), it limits direct comparisons between all pairs of levels within F and requires additional procedures for generating these comparisons. Moreover, Frequentist methods often rely on corrections (e.g., Bonferroni or Tukey), which can reduce statistical power and inflate uncertainty by mechanically widening confidence intervals. This paper demonstrates how Bayesian hierarchical models provide a robust framework for parameter estimation in the context of multiple comparisons. By leveraging entire posterior distributions, these models produce estimates for all pairwise comparisons without requiring post hoc adjustments. The hierarchical structure, combined with the use of priors, naturally incorporates shrinkage, pulling extreme estimates toward the overall mean. This regularization improves the stability and reliability of estimates, particularly in the presence of sparse or noisy data, and leads to more conservative comparisons. Bayesian models also offer a flexible framework for addressing heteroscedasticity by directly modeling variance structures and incorporating them into the posterior distribution. The result is a coherent approach to exploring differences between levels of F, where parameter estimates reflect the full uncertainty of the data.
Researchers’ racial and gender identities influence their outcomes in academia and the field of political science. This letter interrogates how researcher identity affects the research process: specifically elite interview recruitment. Within an ongoing research project we embed a pre-registered audit experiment randomizing the gender of the researcher conducting outreach to estimate whether there are differences in interviews scheduled holding all other confounders constant. We find that when outreach is conducted by a woman, elites are more likely to schedule an interview. This letter contributes to our understanding of bias and inequality during the research process. In addition, our study offers a new approach to audit experiments that limits deception and wasted time for elites.
We study the 2017 pension reform in Finland, raising the statutory retirement age of the studied cohorts from 63 to 63 years and 6 months. Using monthly-based register data and a differences-in-differences approach, we estimate the reform’s impact on retirement, employment, unemployment, disability, sickness, and inactivity. Results indicate a significant 19-percentage-point increase in employment between the old and new retirement ages, alongside notable rises in unemployment, inactivity, and disability. Largely – but not entirely – this stems from the persistence of the previous labor market state. Gender differences are not large, but the effects vary considerably across education, income, employment sector, and self-employment status.
This study examined if and how first responders in Nigeria provide Psychological First Aid to emergency victims. Key objectives include assessing first responders’ awareness of Psychological First Aid, determining their level of PFA training and level of PFA utilization with emergency treatment.
Methods
A descriptive cross-sectional survey that adopted a mixed-method approach was utilized. This study was carried out among first responders living in Lagos State, Nigeria. The quantitative aspect of the study consisted of 386 respondents. In contrast, for the qualitative study, 17 participants were selected using snowball sampling across various strata of first responders based on their diverse roles and experience in emergency response.
Results
Findings from this study deduced that 59.6% of respondents were aware of, 27.2% were trained, and 38.3% practiced PFA. However, findings noted a significant difference in awareness based on education, as persons with tertiary education were 4.21 times more likely to be aware than those without (OR = 1.73-10.23). Qualitative findings revealed that respondents lacked access to opportunities to practice PFA due to the absence of protocols in their learning and practice environments.
Conclusions
This study highlights varying levels of awareness and training in Psychological First Aid (PFA) among respondents, indicating both opportunities and challenges in preparedness for emergency response. Strategies that promote PFA awareness among older age groups should be developed, and entry-level first responders should also receive PFA training.
We investigated the effects of maternal vitamin and mineral supplementation throughout gestation on gene expression in the jejunal mucosa of neonatal calves. Crossbred Angus heifers (n = 14) were estrus synchronized, bred to female-sexed semen, and randomly assigned to a basal diet (Control, CON; n = 7) or the basal diet plus vitamin and mineral supplement (Treatment, VTM; n = 7). After parturition, calves were removed from their dams before suckling, fed colostrum replacer, and euthanized 30 h after the first feeding. A subsample of the mucosa of the mid-jejunum was collected, and total RNA was isolated. Gene expression was measured using RNA-Seq, and differentially expressed genes (DEGs) were identified using DESeq2. We identified 528 DEGs from the jejunal mucosa between the VTM and CON calves (P ≤ 0.05 and |log2FC| ≥ 0.5). The DEGs were associated with nutrient transport, lipid metabolism, and immune-related biological processes and pathways. Interestingly, genes underlying the complement and coagulation cascades were mostly downregulated in calves born to VTM dams. On the other hand, the cytokine-cytokine receptor interaction KEGG pathway showed most genes upregulated (LIFR, KDR, TNFRSF4, TNFSF18, FLT1, and TNFRSF12A). Our results show that vitamin and mineral supplementation throughout gestation affects genes underlying tissue structure, nutrient transport and metabolism, and immune system pathways in neonates. The implications of such changes and the long-term outcomes on herd health and performance warrant further research.
Recent studies portray civil servants as potential guardians against populist attempts to undermine liberal democracy. However in polarized societies, bureaucrats, like citizens, tend to hold divergent perceptions of the threat that politicians’ actions pose to democracy. This, in turn, likely shapes bureaucrats’ responses. We examine this in the context of the attempt by Israel’s extreme right-wing populist government to curtail the powers and independence of the Israeli Supreme Court and replace legal advisors with political appointees (hereafter the “legal overhaul”). We employ a mixed-methods design, combining a survey, interviews, and a focus group with career civil servants, showing that those who perceive the legal overhaul as a threat to democracy are more inclined to exit government and less likely to voice and exert effort at work. These findings are attributed to respondents’ views of the legal overhaul as leading to future politicization, curtailed influence, and a threat to their role as civil servants.
The virtues of the scapular tip free flap for reconstruction of complex midface oncologic defects have been claimed by many. To obtain optimal functional and aesthetic results, precise positioning of the free flap used for reconstruction is paramount.
Methods
Four cases illustrate our approach to midface reconstruction with angular branch-based scapular tip flaps. A standard surgical navigation device was used both to plan bone cuts for the oncologic resection and to optimise the positioning of the flap.
Results
Case 1 illustrates the usefulness of navigation for reconstruction of total palato-septectomy defects, using a horizontally positioned flap. Optimal neo-palate height, alignment of the anterior nasal spine and nasal projection were obtained. For cases 2–4, vertical inset of the flap yielded optimal midface projection and orbital floor position.
Conclusion
Surgical navigation systems are useful adjuncts for midface reconstruction.
The Autistic Spectrum, published almost 30 years ago, remains an important text for all those who work with autistic individuals. This brief article highlights the significant contribution of Lorna Wing to how we view autism, including the observation that many of the issues being highlighted today regarding the appropriate management of autistic individuals are not new and can be found in the thoughts of Dr Wing.