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Terrorist incidents lead to a range of mental health outcomes for people affected, sometimes extending years after the event. Secondary stressors can exacerbate them, and social support can provide mitigation and aid recovery. There is a need to better understand distress and mitigating factors among survivors of the Manchester Arena attack in 2017.
We explored three questions. First, what experiences of distress did participants report? Second, how might secondary stressors have influenced participants’ psychosocial recoveries? Third, what part has social support played in the relationships between distress and participants’ recovery trajectories?
We conducted a cross-sectional online survey of a convenience sample of survivors of the Manchester Arena bombing (N = 84) in January 2021 (3 years 8 months post-incident), and a longitudinal study of the same participants’ scores on mental health measures over 3 years from September 2017.
Survivors’ mental well-being scores in early 2021 were significantly lower than general population norms. Longitudinal follow-up provided evidence of enduring distress. Secondary stressors, specifically disruptions to close relationships, were associated with greater post-event distress and slower recovery. We found an indirect relationship between identifying with, and receiving support from, others present at the event and mental well-being >3 years later.
The Arena attack has had an enduring impact on mental health, even in survivors who had a mild response to the event. The quality of close relationships is pivotal to long-term outcome. Constructive support from family and friends, and people with shared experiences, are key to social cure processes that facilitate coping and recovery.
This article assesses the ‘Managing Diversity’ (MD) approach in Australia, examining its drivers, discussing its relationship to legislation designed to promote equity, and examining it as a set of management practices. It has been plausibly argued, on efficiency grounds, that responsibility for achieving equality objectives must be shifted to organisations as this links contextual conditions to organisational processes. However, even where there is some prescription and guidance such as that provided by Australian Equal Employment Opportunity (EEO) legislation targeted specifically to women employees, both practice and outcomes are variable. This is even more the case with MD where there are no guiding principles or legislative support. The article examines the best practice EEO and MD programs of Australian organisations to demonstrate the approaches and programs that are being developed at the workplace and to highlight the limitations of the ‘business case’ approach underlying such programs.
A little more than fifty years ago, French medievalist Marc Bloch (1928) tried to persuade his fellow historians of the importance and usefulness of the “comparative method.” Explanations, he argued, based on “those proverbs of common-sense psychology which have neither more nor less validity than their opposites” had to be replaced by causal explanations arrived at with the help of systematic comparison. In response to these exhortations, most historians, as Bloch himself noted, “express polite approval and then go back to work without changing their habits.” Nevertheless, the last decades have seen a remarkable growth in comparative studies in history as well as in the social sciences in general. Since 1959, the journal Comparative Studies in Society and History has played a crucial role in this regard. Yet the results of comparative historical studies have not been such as to challenge the skepticism of many historians who associate comparative approaches with facile analogies, pseudo-similarities, and questionable generalizations. Comparison too often seems to imply the sacrifice of the unique and differentiating features of each situation in the past for the sake of some broad scheme. Many historians are put off by social scientists, such as sociologist S. N. Eisenstadt (1963), whose ambitious comparative schema seem marked by typologizing with little empirical basis. To quote Bloch once more, the empirical historian will probably never become a philosopher of history or a sociologist although “he may, according to his state of mind, grant them admiration or a skeptical smile.”
If David Bell in his book Men on Horseback (2020) focuses on what is political charisma, how it functions, and what it means ‘to write its history’, this article examines how Brazil's ex-President Luís Inácio Lula da Silva (‘Lula’) acquired charisma during the dramatic 1978–80 metalworkers’ strikes in the industrial ABC region of São Paulo, Brazil. While generating a vast literature, scholars of the ABC strikes have evaded the question of how Lula, the gifted organiser, emerged as a recognisably charismatic figure. This article explains where, when and why this happened and how a charismatic bond was forged as 100,000 stigmatised, fearful, self-doubting ‘peons’ came to constitute themselves as a locally articulated social actor, a group in fusion, whose boldness and creativity led to extraordinary feats of organisation and mobilisation. Arguing against conflating charisma and populism, it also establishes the utility of the theorisation of group-making advanced in the Critique of Dialectical Reason (1960) by Jean-Paul Sartre.
It has often been observed that “Where power is, women are not.” Noting women's virtual absence from the realm of conventional politics, Jane Jaquette urged scholars in 1980 to look beyond elections in studying female political participation in Latin America. Arguing for an “expanded notion of the political,” she called for research on female participation within different social classes, especially their role in “informal networks, … clientele linkages, … strike activities, urban land seizures and barrio politics”. This article employs a community study method to investigate women's grass-roots participation in politics and labor mobilization following World War II in the region of greater São Paulo known as ABC (named after the municipios of Santo André, São Bernardo do Campo, and São Caetano).
Lula and His Politics of Cunning explores the origin, roots, and evolution of Luis Inácio Lula da Silva's vision, discourse, and practice of leadership as a process of becoming. This commentary invites historians of labor movements and the left to think beyond their geographical and chronological specializations. It argues that there is much to gain from thinking globally if we wish to achieve meaningful causal insights applicable to the sweep of capitalist development.
Much of the psychosocial care people receive after major incidents and disasters is informal and is provided by families, friends, peer groups and wider social networks. Terrorist attacks have increased in recent years. Therefore, there is a need to better understand and facilitate the informal social support given to survivors.
We addressed three questions. First, what is the nature of any informal support-seeking and provision for people who experienced the 2017 Manchester Arena terrorist attack? Second, who provided support, and what makes it helpful? Third, to what extent do support groups based on shared experience of the attack operate as springboards to recovery?
Semi-structured interviews were carried out with a purposive sample of 18 physically non-injured survivors of the Manchester Arena bombing, registered at the NHS Manchester Resilience Hub. Interview transcripts were thematically analysed.
Participants often felt constrained from sharing their feelings with friends and families, who were perceived as unable to understand their experiences. They described a variety of forms of helpful informal social support, including social validation, which was a feature of support provided by others based on shared experience. For many participants, accessing groups based on shared experience was an important factor in their coping and recovery, and was a springboard to personal growth.
We recommend that people who respond to survivors’ psychosocial and mental healthcare needs after emergencies and major incidents should facilitate interventions for survivors and their social networks that maximise the benefits of shared experience and social validation.
Distress after major incidents is widespread among survivors. The great majority do not meet the criteria for mental health disorders and rely on psychosocial care provided by their informal networks and official response services. There is a need to better understand their experiences of distress and psychosocial care needs.
The aims of our study were to enhance understanding of the experience of distress among people present at the Manchester Arena bombing in 2017, identify their experiences of psychosocial care after the incident and learn how to better deliver and target effective psychosocial care following major incidents.
We conducted a thematic analysis of semi-structured interviews with 18 physically non-injured survivors of the Manchester Arena attack, who registered with the NHS Manchester Resilience Hub.
Distress was ubiquitous, with long-lasting health and social consequences. Initial reluctance to seek help from services was also common. Early and open access to authoritative sources of information and emotional support, and organised events for survivors, were viewed as helpful interventions. Inappropriate forms of psychosocial and mental healthcare were common and potent stressors that affected coping and recovery.
This paper extends our understanding of how people react to major events. Provision for the large group of people who are distressed and require psychosocial care may be inadequate after many incidents. There is a substantial agenda for developing awareness of people's needs for psychosocial interventions, and training practitioners to deliver them. The findings have substantial implications for policy and service design.
Terrorist attacks have increased globally since the late 1990s with clear evidence of psychological distress across both adults and children and young people (CYP). After the Manchester Arena terrorist attack, the Resilience Hub was established to identify people in need of psychological and psychosocial support.
To examine the severity of symptoms and impact of the programme.
The hub offers outreach, screening, clinical telephone triage and facilitation to access evidenced treatments. People were screened for trauma, depression, generalised anxiety and functioning who registered at 3, 6 and 9 months post-incident. Baseline scores were compared between screening groups (first screen at 3, 6 or 9 months) in each cohort (adult, CYP), and within groups to compare scores at 9 months.
There were significant differences in adults' baseline scores across screening groups on trauma, depression, anxiety and functioning. There were significant differences in the baseline scores of CYP across screening groups on trauma, depression, generalised anxiety and separation anxiety. Paired samples t-tests demonstrated significant differences between baseline and follow-up scores on all measures for adults in the 3-month screening group, and only depression and functioning measures for adults in the 6-month screening group. Data about CYP in the 3-month screening group, demonstrated significant differences between baseline and follow-up scores on trauma, generalised anxiety and separation anxiety.
These findings suggest people who register earlier are less symptomatic and demonstrate greater improvement across a range of psychological measures. Further longitudinal research is necessary to understand changes over time.
Obesity is a major challenge for people with schizophrenia.
We assessed whether STEPWISE, a theory-based, group structured lifestyle education programme could support weight reduction in people with schizophrenia.
In this randomised controlled trial (study registration: ISRCTN19447796), we recruited adults with schizophrenia, schizoaffective disorder or first-episode psychosis from ten mental health organisations in England. Participants were randomly allocated to the STEPWISE intervention or treatment as usual. The 12-month intervention comprised four 2.5 h weekly group sessions, followed by 2-weekly maintenance contact and group sessions at 4, 7 and 10 months. The primary outcome was weight change after 12 months. Key secondary outcomes included diet, physical activity, biomedical measures and patient-related outcome measures. Cost-effectiveness was assessed and a mixed-methods process evaluation was included.
Between 10 March 2015 and 31 March 2016, we recruited 414 people (intervention 208, usual care 206) with 341 (84.4%) participants completing the trial. At 12 months, weight reduction did not differ between groups (mean difference 0.0 kg, 95% CI −1.6 to 1.7, P = 0.963); physical activity, dietary intake and biochemical measures were unchanged. STEPWISE was well-received by participants and facilitators. The healthcare perspective incremental cost-effectiveness ratio was £246 921 per quality-adjusted life-year gained.
Participants were successfully recruited and retained, indicating a strong interest in weight interventions; however, the STEPWISE intervention was neither clinically nor cost-effective. Further research is needed to determine how to manage overweight and obesity in people with schizophrenia.
Declaration of interest
R.I.G.H. received fees for lecturing, consultancy work and attendance at conferences from the following: Boehringer Ingelheim, Eli Lilly, Janssen, Lundbeck, Novo Nordisk, Novartis, Otsuka, Sanofi, Sunovion, Takeda, MSD. M.J.D. reports personal fees from Novo Nordisk, Sanofi-Aventis, Lilly, Merck Sharp & Dohme, Boehringer Ingelheim, AstraZeneca, Janssen, Servier, Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceuticals International Inc.; and, grants from Novo Nordisk, Sanofi-Aventis, Lilly, Boehringer Ingelheim, Janssen. K.K. has received fees for consultancy and speaker for Novartis, Novo Nordisk, Sanofi-Aventis, Lilly, Servier and Merck Sharp & Dohme. He has received grants in support of investigator and investigator-initiated trials from Novartis, Novo Nordisk, Sanofi-Aventis, Lilly, Pfizer, Boehringer Ingelheim and Merck Sharp & Dohme. K.K. has received funds for research, honoraria for speaking at meetings and has served on advisory boards for Lilly, Sanofi-Aventis, Merck Sharp & Dohme and Novo Nordisk. D.Sh. is expert advisor to the NICE Centre for guidelines; board member of the National Collaborating Centre for Mental Health (NCCMH); clinical advisor (paid consultancy basis) to National Clinical Audit of Psychosis (NCAP); views are personal and not those of NICE, NCCMH or NCAP. J.P. received personal fees for involvement in the study from a National Institute for Health Research (NIHR) grant. M.E.C. and Y.D. report grants from NIHR Health Technology Assessment, during the conduct of the study; and The Leicester Diabetes Centre, an organisation (employer) jointly hosted by an NHS Hospital Trust and the University of Leicester and who is holder (through the University of Leicester) of the copyright of the STEPWISE programme and of the DESMOND suite of programmes, training and intervention fidelity framework that were used in this study. S.R. has received honorarium from Lundbeck for lecturing. F.G. reports personal fees from Otsuka and Lundbeck, personal fees and non-financial support from Sunovion, outside the submitted work; and has a family member with professional links to Lilly and GSK, including shares. F.G. is in part funded by the National Institute for Health Research Collaboration for Leadership in Applied Health Research & Care Funding scheme, by the Maudsley Charity and by the Stanley Medical Research Institute and is supported by the by the Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London.
Background: Cognitive Behavioural Therapy (CBT) aims to teach people skills to help them self-manage their depression. Trial evidence shows that CBT is an effective treatment for depression and individuals may experience benefits long-term. However, there is little research about individuals’ continued use of CBT skills once treatment has finished. Aims: To explore whether individuals who had attended at least 12 sessions of CBT continued to use and value the CBT skills they had learnt during therapy. Method: Semi-structured interviews were held with participants from the CoBalT trial who had received CBT, approximately 4 years earlier. Interviews were audio-recorded, transcribed and analysed thematically. Results: 20 participants were interviewed. Analysis of the interviews suggested that individuals who viewed CBT as a learning process, at the time of treatment, recalled and used specific skills to manage their depression once treatment had finished. In contrast, individuals who viewed CBT only as an opportunity to talk about their problems did not appear to utilize any of the CBT skills they had been taught and reported struggling to manage their depression once treatment had ended. Conclusions: Our findings suggest individuals may value and use CBT skills if they engage with CBT as a learning opportunity at the time of treatment. Our findings underline the importance of the educational model in CBT and the need to emphasize this to individuals receiving treatment.
Avian diet selection is hypothesized to be sensitive to seasonal changes in breeding status, but few tests exist for frugivorous tropical birds. Frugivorous birds provide an interesting test case because fruits are relatively deficient in minerals critical for reproduction. Here, we quantify annual patterns of fruit availability and diet for two frugivorous hornbill (Bucerotidae) species over a 5.5-y period to test for patterns of diet selection. Data from the lowland tropical rain forest of the Dja Reserve, Cameroon, are used to generate two nutritional indices. One index estimates the nutrient concentration of the diet chosen by Ceratogymna atrata and Bycanistes albotibialis on a monthly basis using 3165 feeding observations combined with fruit pulp sample data. The second index is an estimate of nutrient concentration of a non-selective or neutral diet across the study area based on tree fruiting phenology, vegetation survey and fruit-pulp sample data. Fifty-nine fruit pulp samples representing 40 species were analysed for 16 nutrient categories to contribute to both indices. Pulp samples accounted for approximately 75% of the observed diets. The results support expected patterns of nutrient selection. The two hornbill species selected a diet rich in calcium during the early breeding season (significantly so for B. albotibialis in July and August). Through the brooding and fledging periods, they switched from a calcium-rich diet to one rich in iron and caloric content as well as supplemental protein in the form of invertebrates. Calcium, the calcium to phosphorus ratio and fat concentration were the strongest predictors of breeding success (significant for calcium and Ca:P for B. albotibialis in June). We conclude that hornbills actively select fruit based on nutritional concentration and mineral concentration and that the indices developed here are useful for assessing frugivore diet over time.
We present an update of the ‘key points’ from the Antarctic Climate Change and the Environment (ACCE) report that was published by the Scientific Committee on Antarctic Research (SCAR) in 2009. We summarise subsequent advances in knowledge concerning how the climates of the Antarctic and Southern Ocean have changed in the past, how they might change in the future, and examine the associated impacts on the marine and terrestrial biota. We also incorporate relevant material presented by SCAR to the Antarctic Treaty Consultative Meetings, and make use of emerging results that will form part of the Intergovernmental Panel on Climate Change (IPCC) Fifth Assessment Report.
Those with a sharp tongue might say that labor historians in contemporary Brazil operate in the shadows or, to be more accurate, the shadow cast by the success of Latin America's most famous trade unionist, who served as president from 2002–2010. The field's growth in the number and quality of practitioners, as well as the breadth of their ambitions, cannot be separated from the memorable metalworkers' strikes of 1979 and 1980, the subsequent defeat of the military dictatorship in 1985, and the construction of a militant trade unionism and the radical Workers' Party that ran Luiz Inácio Lula da Silva for president in five successive elections between 1989 and 2006.
The surface brightness fluctuation (SBF) method at near-infrared (NIR) wavelengths is a powerful tool for estimating distances to unresolved stellar systems with high precision. The IR channel of the Wide Field Camera 3 (WFC3), installed on board the Hubble Space Telescope (HST) in 2009, has a greater sensitivity and a wider field of view than the previous generation of HST IR instruments, making it much more efficient for measuring distances to early-type galaxies in the Local Volume. To take full advantage of its capabilities, we need to empirically calibrate the SBF distance method for WFC3's NIR passbands. We present the SBF measurements for the WFC3/IR F160W bandpass filter using observations of 16 early-type galaxies in the Fornax and Virgo Clusters. These have been combined with existing (g475–z850) color measurements from the Advanced Camera for Surveys Virgo and Fornax Cluster Surveys to derive a space-based H160-band SBF relation as a function of color. We have also compared the absolute SBF magnitudes to those predicted by evolutionary population synthesis models in order to study stellar population properties in the target galaxies.
A simple method for separating and surface sterilizing spruce budworm eggs is described. The egg masses are incubated with constant agitation in a 1% solution of NaOH for 10 minutes at 35 °C. The separated eggs are rinsed serially in distilled water, 1% bovine albumen solution, and 70% ethanol, and placed on a moist, sterile filter paper in a petri dish. When surface sterilized eggs are not required the 70% ethanol wash can be omitted.