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Aims: Individuals with severe mental illness (SMI) are at significantly higher risk of physical health comorbidities compared with the general population. Factors such as long-term antipsychotic use, lifestyle choices, and reduced healthcare engagement contribute to this increased risk. Comprehensive annual physical health checks are recommended to identify and manage these risks. This study aimed to evaluate and improve the process of conducting annual physical health checks for patients with SMI in a Glasgow psychiatric rehabilitation unit, focusing on identifying risk factors, promoting a multidisciplinary team (MDT) approach, and ensuring timely follow-up of outstanding health concerns.
Methods: National guidelines from the National Institute for Health and Care Excellence (NICE), the National Institute for Health and Care Research (NIHR), and NHS Scotland were reviewed to establish key standards for physical health monitoring in psychiatric rehabilitation. A structured audit tool was developed covering systemic and lifestyle reviews, physical examinations, medication monitoring, external specialty input and general health screening. Annual health reports and clinical notes were retrospectively reviewed for 30 inpatients with a minimum one-year admission between November 2023 and October 2024. Based on audit findings, a new structured health check template and an improved MDT handover protocol were implemented before re-auditing their next review.
Results: Twenty-eight patients agreed to be reviewed, with 25 assessed using the old template and 15 so far with the new template. The proportion of patients receiving their health check within 12 months increased from 28% (7/25) to 73.3% (11/15). Physical examinations were documented in 96% (24/25) of previous reviews, with action-oriented comments in 40% (10/25). Following the introduction of the new template, documentation increased to 100%, with 53.3% (8/15) of cases including actionable comments. Systemic enquiry documentation improved from 92% (23/25) to 100%, with action-orientated comments rising from 36% (9/25) to 73.3% (11/15). Health screening documentation improved from 60% (15/25) to 100%, with 60% (9/15) requiring action. Diabetes risk was previously recorded in only 8% (2/25) of cases but increased to 100%, with 75% (10/15) prompting action. Previously, 60% (15/25) of outstanding health concerns were discussed within the MDT, whereas 86.6% (13/15) were formally addressed post-implementation.
Conclusion: This study highlights the effectiveness of a structured template in improving the quality and consistency of annual physical health checks in psychiatric rehabilitation. The new template enhanced documentation, facilitated multidisciplinary discussions, and improved identification of health risks. Strengthening MDT handover processes ensures timely follow-up, reinforcing the importance of structured, standardised approaches in psychiatric physical healthcare.
Advancements in VLBI instrumentation, driven by the geodetic community’s goal of achieving positioning accuracy of 1 mm and stability of 0.1 mm/y, have led to the development of new broadband systems. Here, we assess the potential of these new capabilities for space weather monitoring. These enhanced VLBI capabilities were used to investigate interplanetary scintillation (IPS), a phenomenon caused by the scattering of radio waves due to density irregularities in the solar wind. Compact radio sources near the Sun were observed using the AuScope VLBI array in Australia, which consists of 12-m telescopes at Hobart, Katherine, and Yarragadee. The baseline lengths between these telescopes are approximately 3 400 km (Hobart–Katherine), 3 200 km (Hobart–Yarragadee), and 2 400 km (Katherine–Yarragadee). The observations covered solar elongations from 6.5$^\circ$ to 11.3$^\circ$ and frequencies between 3 and 13 GHz. The study focused on phase scintillation as an indicator of turbulence in the solar wind. As the solar elongation decreased, we observed an increase in the phase scintillation index, consistent with theoretical models. Importantly, the broadband system also detected IPS using relatively weak radio sources. Additionally, the phase scintillation increased with baseline length, in agreement with Kolmogorov turbulence with an index of 11/3. These findings demonstrate the effectiveness of geodetic broadband VLBI in capturing detailed features of the solar wind. This capability enables continuous space weather monitoring and advances our understanding of solar and interplanetary dynamics.
Does political polarization lead to dysfunctional behavior? To study this question, we investigate the attitudes of supporters of Donald Trump and of Hillary Clinton towards each other and how these attitudes affect spiteful behavior. We find that both Trump and Clinton supporters display less positive attitudes towards the opposing supporters compared to coinciding supporters. More importantly, we show that significantly more wealth is destroyed if the opponent is an opposing voter. This effect is mainly driven by Clinton voters. This provides the first experimental evidence that political polarization leads to destructive behavior.
Emergency department (ED) visits for epilepsy are common, costly, and often clinically unnecessary. Configuration of care pathways (CPs) that could divert people away from ED offer an alternative. The aim was to measure patient and carer preferences for alternative CPs and to explore the feasibility of implementing the preferred CPs in the National Health Service (NHS) England with a wider group of stakeholders.
Methods
Formative work (provider survey, service-user interviews, knowledge exchange, and think-aloud piloting) informed a discrete choice experiment (DCE) with six attributes: access to care plan, conveyance, time, epilepsy specialist today, general practitioner (GP) notification, and epilepsy specialist follow-up. This was hosted online with random assignment to two of three scenarios (home, public, or atypical). Logistic regression generated preference weights that were used to calculate the utility of CPs. The highest ranked CPs plus a status quo were discussed at three online knowledge exchange workshops. The nominal group technique was used to ascertain stakeholder views on preference evidence and to seek group consensus on optimal feasible alternatives.
Results
A sample of 427 people with epilepsy and 167 friends or family completed the survey. People with epilepsy preferred paramedics to have access to care plan, non-conveyance, one to three hours, epilepsy specialists today, GP notification, and specialist follow-up within two to three weeks. Family and friends differed when considering atypical seizures, favoring conveyance to urgent treatment centers and shorter time. Optimal configuration of services from service users’ perspectives outranked current practice. Knowledge exchange (n=27 participants) identified the optimal CP as feasible but identified two scenarios for resource reallocation: care plan substitutes specialist advice today and times of strain on NHS resources.
Conclusions
Preferences differed to current practice but had minimal variation by seizure type or stakeholder. This study clearly identified optimal and feasible alternative CPs. The mixed-methods approach allowed for robust measurement of preferences, whilst knowledge exchange examined feasibility to enhance implementation of optimal alternative CPs in the future.
Clostridioides difficile (C. difficile) is one of the most common causes of healthcare-associated infections (HAIs). Elimination of C. difficile spores is difficult as they are resistant to common hospital-grade disinfectants. Copper-impregnated surfaces provide continuous reduction of multiple pathogens, potentially lowering the risk of infections. This manuscript aims to evaluate the efficacy of copper-impregnated surfaces on C. difficile spores.
Methods:
Control (no copper) coupons and copper coupons containing 20% copper-oxide were inoculated with C. difficile spore loads ranging from 105 to 107 spores, with or without 5% fetal bovine serum soil load. After 4 hours of contact time, the C. difficile spores were recovered, plated on C. difficile growth media, and colony forming units were counted. The efficacy of copper (log10 kill) was estimated using a Bayesian latent variables model.
Results:
After 4 hours, unsoiled copper bedrail and copper table coupons at mean spore inoculation resulted in a 97.3% and 96.8% reduction in spore count (1.57 and 1.50 log10 kill, respectively). That of soiled bedrail and table coupons showed a 91.8% and 91.7% reduction (1.10 and 1.10 log10 kill, respectively).
Conclusions:
Copper coupons can substantially reduce C. difficile spores after 4 hours, but results vary depending on the initial spore concentration and presence or absence of organic material. Higher initial spore loads or excess organic material may prevent spores from contact with copper surfaces, thus decreasing kill efficacy. Continuous sporicidal effect of copper-impregnated surfaces may decrease spore burden and help prevent transmission of spores.
Advances in artificial intelligence (AI) have great potential to help address societal challenges that are both collective in nature and present at national or transnational scale. Pressing challenges in healthcare, finance, infrastructure and sustainability, for instance, might all be productively addressed by leveraging and amplifying AI for national-scale collective intelligence. The development and deployment of this kind of AI faces distinctive challenges, both technical and socio-technical. Here, a research strategy for mobilising inter-disciplinary research to address these challenges is detailed and some of the key issues that must be faced are outlined.
We present the second data release for the GaLactic and Extragalactic All-sky Murchison Widefield Array eXtended (GLEAM-X) survey. This data release is an area of 12 892-deg$^2$ around the South Galactic Pole region covering 20 h40 m$\leq$RA$\leq$6 h40 m, -90$^\circ$$\leq$Dec$\leq$+30$^\circ$. Observations were taken in 2020 using the Phase-II configuration of the Murchison Widefield Array (MWA) and covering a frequency range of 72–231 MHz with twenty frequency bands. We produce a wideband source finding mosaic over 170–231 MHz with a median root-mean-squared noise of $1.5^{+1.5}_{-0.5}$ mJy beam$^{-1}$. We present a catalogue of 624 866 components, including 562 302 components which are spectrally fit. This catalogue is 98% complete at 50 mJy, and a reliability of 98.7% at a 5 $\sigma$ level, consistent with expectations for this survey. The catalogue is made available via Vizier, and the PASA datastore and accompanying mosaics for this data release are made available via AAO Data Central and SkyView.
Observations of glacier melt and runoff are of fundamental interest in the study of glaciers and their interactions with their environment. Considerable recent interest has developed around distributed acoustic sensing (DAS), a sensing technique which utilizes Rayleigh backscatter in fiber optic cables to measure the seismo-acoustic wavefield in high spatial and temporal resolution. Here, we present data from a month-long, 9 km DAS deployment extending through the ablation and accumulation zones on Rhonegletscher, Switzerland, during the 2020 melt season. While testing several types of machine learning (ML) models, we establish a regression problem, using the DAS data as the dependent variable, to infer the glacier discharge observed at a proglacial stream gauge. We also compare two predictive models that only depend on meteorological station data. We find that the seismo-acoustic wavefield recorded by DAS can be utilized to infer proglacial discharge. Models using DAS data outperform the two models trained on meteorological data with mean absolute errors of 0.64, 2.25 and 2.72 m3 s−1, respectively. This study demonstrates the ability of in situ glacier DAS to be used for quantifying proglacial discharge and points the way to a new approach to measuring glacier runoff.
Aquatic ecosystems - lakes, ponds and streams - are hotspots of biodiversity in the cold and arid environment of Continental Antarctica. Environmental change is expected to increasingly alter Antarctic aquatic ecosystems and modify the physical characteristics and interactions within the habitats that they support. Here, we describe physical and biological features of the peripheral ‘moat’ of a closed-basin Antarctic lake. These moats mediate connectivity amongst streams, lake and soils. We highlight the cyclical moat transition from a frozen winter state to an active open-water summer system, through refreeze as winter returns. Summer melting begins at the lakebed, initially creating an ice-constrained lens of liquid water in November, which swiftly progresses upwards, creating open water in December. Conversely, freezing progresses slowly from the water surface downwards, with water at 1 m bottom depth remaining liquid until May. Moats support productive, diverse benthic communities that are taxonomically distinct from those under the adjacent permanent lake ice. We show how ion ratios suggest that summer exchange occurs amongst moats, streams, soils and sub-ice lake water, perhaps facilitated by within-moat density-driven convection. Moats occupy a small but dynamic area of lake habitat, are disproportionately affected by recent lake-level rises and may thus be particularly vulnerable to hydrological change.
A large body of research demonstrates positive impacts of the Coping Power Program as a preventive intervention for youth behavioral outcomes, but potential collateral effects for caregivers is less known. The current study examined whether the youth-focused Coping Power Program can have a secondary impact on caregiver self-reported symptoms of depression and in turn result in longer-term impacts on child disruptive behavior problems including aggression, conduct problems and hyperactivity. Data from 360 youth/caregiver pairs across 8 waves of data (grades 4 through 10) were analyzed. We used two methodological approaches to (a) assess indirect effects in the presence of potential bidirectionality using timepoint-to-timepoint dynamic effects under Autoregressive Latent Trajectory modeling and (b) estimate scale scores in the presence of measurement non-invariance. Results showed that individually delivered Coping Power (ICP) produced greater direct effects on conduct problems and indirect effects on general externalizing and hyperactivity (through reductions in caregiver self-reported symptoms of depression), compared to group Coping Power (GCP). In comparison to GCP, ICP produced similar direct effects on reductions in caregiver depression. Child-focused prevention interventions can have an indirect impact on caregiver depression, which later shows improvements in longer-term reductions for child disruptive problems.
Education has two distinct but interconnected layers. There is an outer layer concerned with knowledge transfer and skills and an inner layer concerned with the development of character and relationships with others, both individually and socially. This inner layer provides the individual with the capacity to influence and to change society. In that sense, such an inner layer is ‘political’. In this article we argue that the ‘political’ in education can take two distinct forms: either that of dialogue or of defiance. We claim that the former is epitomised by the philosophy of Martin Buber and the latter by the philosophy of Frantz Fanon. Our analysis contrasting these two philosophies clarifies the implications for education, and thereby for the individual and for society.
We are living through an era of increased robotization, with robots becoming integrated into settings such as factories, hospitals, transportation systems, military, workplaces, households and healthcare. But what are the social and moral implications arising from our interpersonal connections with robots? Can robots have significant moral status? Can we be friends with a robot? When your robot lover tells you that it loves you, should you believe it? In this conversation, philosopher of technology John Danaher considers whether we are robots ourselves; whether we should understand our relationships with robots by analogy with non-human animals; whether robot friendships can complement and possibly enhance human friendships; whether robots have an inner life; whether robots are capable of deceiving us; and much more.
JOHN DANAHER is a Senior Lecturer in Law at the National University of Ireland (NUI) Galway. He researches on a wide range of topics at the interface of philosophy, law and technology, and he is host of the popular “Philosophical Disquisitions” podcast.
ANTHONY MORGAN is editor of The Philosopher and commissioning editor for philosophy at Agenda Publishing.
Anthony Morgan (AM): In an interview, the philosopher Kevin O’Regan said that he believes he is a robot, and, furthermore, that people get upset when he tells them that they are robots because they feel that they’re persons and not robots. He goes on to say that the fact that he is a robot doesn't mean that he doesn't suffer pain or fall in love or appreciate art. It just means that there are no “magical mechanisms” explaining these phenomena, such as free will. What insights do you think we can glean from thinking about whether we are robots ourselves?
John Danaher (JD): I consider our world to be a collection of mechanistic structures knitted together in very complicated ways, and so we are in principle very sophisticated mechanisms. Hence if we can create mechanisms that are as sophisticated as us – they may not be exactly functionally equivalent but they may behave and act in much the same way – then they can have all the qualities and attributes that we have, and possibly others too. Thus there's no reason for me to think that we can't create general artificial intelligence or robots that are effectively the same as humans.
Cannabis use has been linked to psychotic disorders but this association has been primarily observed in the Global North. This study investigates patterns of cannabis use and associations with psychoses in three Global South (regions within Latin America, Asia, Africa and Oceania) settings.
Methods
Case–control study within the International Programme of Research on Psychotic Disorders (INTREPID) II conducted between May 2018 and September 2020. In each setting, we recruited over 200 individuals with an untreated psychosis and individually-matched controls (Kancheepuram India; Ibadan, Nigeria; northern Trinidad). Controls, with no past or current psychotic disorder, were individually-matched to cases by 5-year age group, sex and neighbourhood. Presence of psychotic disorder assessed using the Schedules for Clinical Assessment in Neuropsychiatry and cannabis exposure measured by the World Health Organisation Alcohol, Smoking and Substance Involvement Screening Test (ASSIST).
Results
Cases reported higher lifetime and frequent cannabis use than controls in each setting. In Trinidad, cannabis use was associated with increased odds of psychotic disorder: lifetime cannabis use (adj. OR 1.58, 95% CI 0.99–2.53); frequent cannabis use (adj. OR 1.99, 95% CI 1.10–3.60); cannabis dependency (as measured by high ASSIST score) (adj. OR 4.70, 95% CI 1.77–12.47), early age of first use (adj. OR 1.83, 95% CI 1.03–3.27). Cannabis use in the other two settings was too rare to examine associations.
Conclusions
In line with previous studies, we found associations between cannabis use and the occurrence and age of onset of psychoses in Trinidad. These findings have implications for strategies for prevention of psychosis.
Extensive evidence indicates that rates of psychotic disorder are elevated in more urban compared with less urban areas, but this evidence largely originates from Northern Europe. It is unclear whether the same association holds globally. This study examined the association between urban residence and rates of psychotic disorder in catchment areas in India (Kancheepuram, Tamil Nadu), Nigeria (Ibadan, Oyo), and Northern Trinidad.
Methods
Comprehensive case detection systems were developed based on extensive pilot work to identify individuals aged 18–64 with previously untreated psychotic disorders residing in each catchment area (May 2018–April/May/July 2020). Area of residence and basic demographic details were collected for eligible cases. We compared rates of psychotic disorder in the more v. less urban administrative areas within each catchment area, based on all cases detected, and repeated these analyses while restricting to recent onset cases (<2 years/<5 years).
Results
We found evidence of higher overall rates of psychosis in more urban areas within the Trinidadian catchment area (IRR: 3.24, 95% CI 2.68–3.91), an inverse association in the Nigerian catchment area (IRR: 0.68, 95% CI 0.51–0.91) and no association in the Indian catchment area (IRR: 1.18, 95% CI 0.93–1.52). When restricting to recent onset cases, we found a modest positive association in the Indian catchment area.
Conclusions
This study suggests that urbanicity is associated with higher rates of psychotic disorder in some but not all contexts outside of Northern Europe. Future studies should test candidate mechanisms that may underlie the associations observed, such as exposure to violence.
Almost 40 years ago David Barker made his observation that poor in utero growth increased cardiovascular disease risk in the offspring. A few years prior to this, the first baby to be conceived through IVF was born. Since then, an estimated 8 million babies worldwide have been born via one form or another of Assisted Reproductive Technology (ART). However, data from experimental animal and human clinical studies have highlighted the period around conception as being particularly sensitive to sub-optimal environmental conditions. Furthermore, there is growing concern that aspects of the ART procedures themselves may alter fetal and neonatal growth and increase the incidence of cardiovascular and metabolic diseases, cancer, asthma and neurodevelopmental issues in the children. However, a large degree of confounding factors including parental infertility, disparity in ART culture media and methods, and even the design of the follow-up studies, mean that further investigations are required in the definition of causal relationships between ART and child health.
There is evidence of an association between life events and psychosis in Europe, North America and Australasia, but few studies have examined this association in the rest of the world.
Aims
To test the association between exposure to life events and psychosis in catchment areas in India, Nigeria, and Trinidad and Tobago.
Method
We conducted a population-based, matched case–control study of 194 participants in India, Nigeria, and Trinidad and Tobago. Cases were recruited through comprehensive population-based, case-finding strategies. The Harvard Trauma Questionnaire was used to measure life events. The Screening Schedule for Psychosis was used to screen for psychotic symptoms. The association between psychosis and having experienced life events (experienced or witnessed) was estimated by conditional logistic regression.
Results
There was no overall evidence of an association between psychosis and having experienced or witnessed life events (adjusted odds ratio 1.19, 95% CI 0.62–2.28). We found evidence of effect modification by site (P = 0.002), with stronger evidence of an association in India (adjusted odds ratio 1.56, 95% CI 1.03–2.34), inconclusive evidence in Nigeria (adjusted odds ratio 1.17, 95% CI 0.95–1.45) and evidence of an inverse association in Trinidad and Tobago (adjusted odds ratio 0.66, 95% CI 0.44–0.97).
Conclusions
This study found no overall evidence of an association between witnessing or experiencing life events and psychotic disorder across three culturally and economically diverse countries. There was preliminary evidence that the association varies between settings.
The history of maize in Central America and surrounding areas has implications for the slow transition from hunting and gathering to agriculture. The spread of early forms of domesticated maize from southern Mexico across Mesoamerica and into South America has been dated to about 8,700–6,500 years ago on the basis of a handful of studies relying primarily on the analysis of pollen, phytoliths, or starch grains. Recent genomic data from southern Belize have been used to identify Archaic period south-to-north population movements from lower Central America, suggesting this migration pattern as a mechanism that introduced genetically improved maize races from South America. Gradually, maize productivity increased to the point that it was suitable for use as a staple crop. Here we present a summary of paleoecological data that support the late and uneven entry of maize into the Maya area relative to other regions of Central America and identify the Pacific coastal margin as the probable route by which maize spread southward into Panama and South America. We consider some implications of the early appearance of maize for Late Archaic populations in these areas; for example, with respect to the establishment of sedentary village life.
Current dam discharge patterns in Noxon Rapids Reservoir reduce concentration and exposure times (CET) of herbicides used for aquatic plant management. Herbicide applications during periods of low dam discharge may increase herbicide CETs and improve efficacy. Applications of rhodamine WT dye were monitored under peak (736 to 765 m3 s−1) and minimum (1.4 to 2.8 m3 s−1) dam discharge patterns to quantify water-exchange processes. Whole-plot dye half-life under minimal discharge was 33 h, a 15-fold increase compared with the dye treatment during peak discharge. Triclopyr concentrations measured during minimum discharge within the treated plot ranged from 214 ± 25 to 1,243 ± 36 µg L−1 from 0 to 48 h after treatment (HAT), respectively. Endothall concentrations measured during minimum discharge in the same plot ranged from 164 ± 78 to 2,195 ± 1,043 µg L−1 from 0 to 48 HAT, respectively. Eurasian watermilfoil (Myriophyllum spicatum L.) occurrence in the treatment plot was 66%, 8%, and 14% during pretreatment, 5 wk after treatment (WAT), and 52 WAT, respectively. Myriophyllum spicatum occurrence in the nontreated plot was 68%, 71%, and 83% during pretreatment, 5 WAT, and 52 WAT, respectively. Curlyleaf pondweed (Potamogeton crispus L.) occurrence in the treatment plot was 29%, 0%, and 97% during pretreatment, 5 WAT, and 52 WAT, respectively. Potamogeton crispus increased from 24% to 83% at 0 WAT to 52 WAT, respectively, in the nontreated plot. Native species richness declined from 3.3 species per point to 2.1 in the treatment plot in the year of treatment but returned to pretreatment numbers by 52 WAT. Native species richness did not change during the study in the nontreated reference plot. Herbicide applications during periods of low flow can increase CETs and improve control, whereas applications during times of high-water flow would shorten CETs and could result in reduced treatment efficacy.
Perinatal self-harm is of concern but poorly understood.
Aims
To determine if women's risk of self-harm changes in pregnancy and the first postpartum year, and if risk varies by mental illness, age and birth outcome.
Method
This was a retrospective cohort study of 2 666 088 women aged 15–45 years from the 1 January 1990 to 31 December 2017 linked to 1 102 040 pregnancies and their outcomes, utilising the Clinical Practice Research Datalink and Pregnancy Register. We identified self-harm events and mental illness (depression/anxiety/addiction/affective/non-affective psychosis/eating/personality disorders) from clinical records and grouped women's age into 5-year bands. They calculated the rate of self-harm during discrete non-perinatal, pregnant and postpartum periods. We used a gap-time, stratified Cox model to manage multiple self-harm events, and calculated the unadjusted and adjusted hazard ratios (adjHR) of self-harm associated with pregnancy and the postpartum compared with non-perinatal periods. Pre-planned interactions tested if risk varied by mental illness, age and birth outcome.
Results
The analysis included 57 791 self-harm events and 14 712 319 person-years of follow-up. The risk of self-harm shrank in pregnancy (2.07 v. 4.01 events/1000 person-years, adjHR = 0.53, 95% CI 0.49–0.58) for all women except for 15- to 19-year-olds (adjHR = 0.95, 95% CI 0.84–1.07) and the risk reduced most for women with mental illness (adjHR = 0.40, 95% CI 0.36–0.44). Postpartum, self-harm risk peaked at 6–12 months (adjHR = 1.08, 95% CI 1.02–1.15), at-risk groups included young women and women with a pregnancy loss or termination.
Conclusions
Maternity and perinatal mental health services are valuable. Family planning services might have psychological benefit, particularly for young women.
We previously reported a putative detection of a radio galaxy at $z=10.15$, selected from the GaLactic and Extragalactic All-sky Murchison Widefield Array (GLEAM) survey. The redshift of this source, GLEAM J0917–0012, was based on three weakly detected molecular emission lines observed with the Atacama Large Millimetre Array (ALMA). In order to confirm this result, we conducted deep spectroscopic follow-up observations with ALMA and the Karl Jansky Very Large Array (VLA). The ALMA observations targeted the same CO lines previously reported in Band 3 (84–115 GHz) and the VLA targeted the CO(4-3) and [CI(1-0)] lines for an independent confirmation in Q-band (41 and 44 GHz). Neither observation detected any emission lines, removing support for our original interpretation. Adding publicly available optical data from the Hyper Suprime-Cam survey, Widefield Infrared Survey Explorer (WISE), and Herschel Space Observatory in the infrared, as well as $<$10 GHz polarisation and 162 MHz inter-planetary scintillation observations, we model the physical and observational characteristics of GLEAM J0917–0012 as a function of redshift. Comparing these predictions and observational relations to the data, we are able to constrain its nature and distance. We argue that if GLEAM J0917–0012 is at $z<3,$ then it has an extremely unusual nature, and that the more likely solution is that the source lies above $z=7$.