VictorJuiz/thesis huggingface dataset:
Perceived coercion in mental health care

While decreasing coercion is an important objective of mental health policy and clinical practice, empirical research investigating perceptions of coercion has been limited. This thesis investigated patients’ and clinicians’ perceptions of coercion in mental health care. It aimed to: determine the levels of perceived coercion experienced by patients and clinicians during psychiatric hospital admissions; investigate the perceptions of coercion in patients receiving care from community mental health teams; and use qualitative thematic analysis to gain a better understanding of patients’ experiences during the hospitalization process.
The results indicated that there was great variation in the levels of coercion perceived by patients and clinicians. Perceptions of coercion were not associated with sociodemographic characteristics. Instead, they were most influenced by individuals’ experiences during the process. In all of the situations studied, high levels of perceived coercion were associated with either the experience of negative pressure or with the experience of little procedural justice. Both patient and clinician perceptions of coercion may be reduced by improving communication during the psychiatric decision making process.
Further quantitative and qualitative research is required to aid in the development of interventions for reducing high levels of perceived coercion and to determine the consequences of feeling coerced into mental health care.

Advisor: Burns, T
The role of microglia in activity-dependent neuronal network maturation and maintenance

Neurons comprise only less than half of the nervous system, yet some of all those other cells have been largely ignored. Microglia are the tissue resident macrophages of the brain. These cells play a key role in shaping neuronal network formation during development and subsequently help to maintain a stable and healthy brain. After birth our brain contains overabundant neuronal connections and some of these must be refined and eliminated. Microglia scavenge the unnecessary connections via synaptic pruning and shape the neuronal network. Any abnormality in this interaction during neuronal network formation and maintenance can lead to a variety of neurodevelopmental disorders such as autism or schizophrenia. Yet, neither the risk factors underlying these disorders nor the mechanisms that regulate synaptic pruning in the developing brain are well understood.
My DPhil project tested the hypothesis that excitation or inhibition of specific neurons in a neuronal network changes microglial behaviour and dynamics leading to altered communication between microglia and neurons. Using a mouse model, I selectively removed parts of the Snap25 gene, and it produced a non-functioning protein in a subset of cortical layer 5 projection neurons and some hippocampal dentate gyrus neurons and thus also eradicated their ability to release synaptic vesicles in a regulated manner from around the time of birth in a chronic fashion. I observed that abolition of Snap25 expression reduced microglial activity and altered synaptic maturation. Also, it affected microglia-neuron communication by disrupting normal chemokine and phagocytic signalling. Lastly, I observed sex-specific changes in microglia-neuron communications, and this indicated that male mice were more sensitive to abolished Snap25-mediated release of synaptic vesicles during brain development. To test whether the same changes would apply for more acute silencing, I used chemogenetic manipulation to increase or reduce network activity of the same subpopulation of layer 5 and hippocampal neurons for hours rather than weeks. I observed that chronic synaptic and acute chemogenetic ‘silencing’ affects microglia in the same manner. Moreover, acute chemogenetic activation alters microglial morphology leading to retraction of processes and shift to a highly phagocytic active amoeboid form. Findings from my doctoral project suggest that interaction between microglia and neurons is bidirectional in an activity- dependent and sex-specific manner. Given the differential effects of synaptic ‘silencing’ on microglial cell morphology and activity in males and females, it would be interesting to speculate that microglia may contribute to the sex-specific effects of synaptic ‘silencing’ on microglia-neuron communications and synaptic maturation during development.

Keywords: neuronal activity
brain development
Snap25
DREADD
microglia
sexual dimorphism
Advisor: Hoerder-Suabedissen, A
Molnár, Z
Violent reoffending in people released from prison: psychiatric epidemiology, risk assessment and psychological interventions

Violence was identified as a global public health concern by the World Health Assembly nearly three decades ago. Despite reported decreases in violent crime in many countries, reoffending rates worldwide remain high. Amongst people released from prison, there are some at high-risk of perpetrating interpersonal violence. Identifying these key individuals, who are most in need of effective interventions to prevent future criminality, is crucial to reducing societal violence, as their contribution to this major problem is considerable. In this thesis, I focus on violence risk assessment and prevention of future violence in people released from prison by employing methods from psychiatric epidemiology, public mental health and prediction modelling. I start by estimating the prevalence of a modifiable risk factor for violence (i.e. treatable mental disorders) amongst adolescents in juvenile detention and correctional facilities. I select this subgroup of the global prison population as most severe mental disorders emerge in late adolescence, and thus this period provides a critical window to improve prognosis and intervention. My second and third studies externally validate a novel, scalable and transparent violence prediction model—the Oxford Risk of Recidivism (OxRec) tool—in two new countries. I investigate the predictive ability of OxRec in both lower middle-income and high-income settings using data from Tajikistan and England to identify individuals who could be targeted for empirically supported interventions in prison and on release. Lastly, I evaluate the effectiveness of widely implemented psychological interventions for people in prison to reduce offending after release. I synthesise the evidence by solely including randomised controlled trials to identify the current most effective treatments, and inform future evidence-based research and policy in this area.

Advisor: Fazel, S
Yu, R
Profiling the 'Triple Crusade', c.1233-c.1241

During the late 1230s, the Mediterranean saw crusades launched across its full breadth. From Muslim Valencia in the West, through Frankish Greece to the Holy Land, the Mediterranean saw redemptive war waged by Latin Christendom upon its neighbours, whether those neighbours be Muslims, as in Iberian or the Levant, or schismatics and heretics, as in the Balkans. Despite the success all three of these campaigns attained, they are often overlooked by crusade historians, perhaps due to the comparatively small sizes of the Greek and Outremer campaigns. This thesis contends all three campaigns warrant further investigation, both in order to reveal more about the campaigns themselves, and as exemplars from which to ground points of general resonance about crusading history. In undertaking this investigation, this thesis takes a broad approach to the expeditions using a wide range of sources, both chronicle and documentary, both Eastern and Western.
Tracing the expeditions thus from their inception in 1233 until their conclusion in 1241 achieves several distinct things. For one, given the special status of these three expeditions within the plethora of crusades called by Pope Gregory IX and the overlap in recruitment and participation witnessed between the three crusades, the connectivity between them is revealed. These were not simply coincidentally simultaneous events, but three equal parts of the same movement. That is why when approaching events, this thesis proposes the title “Triple Crusade”, replacing the heading of “Barons’ Crusade”. Secondly, taking a broad approach that includes oversight of all three campaigns allows fresh analysis of their preaching, financing and recruitment drives, advancing current knowledge on the subjects both in a specific and a general sense. Thirdly, taking a broad approach shows the actual expeditions took place within a much wider world than historians have previously allowed, with the influence of non-Latin agents key.

Keywords: Valencia
Barons' Crusade
Latin East
Constantinople
Crusades
Advisor: Tyerman, C
Interplay between oxygen sensing mechanisms and hepatitis B virus replication

Hepatitis B virus (HBV) preferentially replicates in the liver, a naturally hypoxic organ with an oxygen gradient from 8-4% in the periportal and pericentral regions, respectively. The hypoxia inducible factor (HIF) pathway is the most well studied mammalian oxygen sensing mechanism and is frequently perturbed by pathological states including infection and inflammation. However, the majority of in vitro studies have investigated HBV at atmospheric oxygen tensions (18%) where low oxygen sensing mechanisms are inactive and consequently their role in viral replication may be overlooked. Therefore, this thesis studied the interplay between HBV replication and oxygen sensing mechanisms.
Chronic hepatitis B (CHB) is associated with an increased expression of HIF gene transcripts. Further interrogation of a cohort of patients with CHB shows an association between inflammatory responses and HIF transcription. Importantly, this observation is not recapitulated in state-of-art in vitro, in vivo, and de novo HBV infection model systems.
HIF regulates target genes via HIF responsive elements (HREs), and the discovery of two evolutionarily conserved HREs in the HBV genome prompted experiments to understand the role of HIFs in viral replication. HIF siRNA silencing experiments in vitro and in vivo demonstrate a positive role for HIFs in regulating HBV replication.
As other oxygen sensing mechanisms have been identified in addition to the HIF pathway, further experiments assessed the role of hypoxia and HIF independent mechanisms in regulating HBV transcription. Data suggests that hypoxia positively regulates HBV transcription through both HIF dependent and independent mechanisms. Further investigations reveal that low oxygen downregulates the HBV host restriction factor Smc6 through HIF independent mechanisms. In addition, the cysteamine (2-aminoethanethol) dioxygenase oxygen sensing pathway regulated interleukin-32 may have anti-viral activities that are repressed under hypoxia.
Collectively, this thesis presents evidences demonstrating key regulatory interactions between HBV and hypoxia, revealing novel therapeutic directions.

Keywords: HBV
oxygen sensing
hypoxia
hepatitis B
hepatology
liver
Advisor: McKeating, J
Ratcliffe, P
Wing, P
Computer age sociology

Quantitative sociology is dominated by 'beta hat'-questions, which refer to the process of defining a model of the world and interpreting its estimated coefficients when fit to data. Unfortunately, the situations where we actually know how this model should look are few and far between, yet a monolithic focus on 'beta hat' remains. This leads to a number of issues, ranging from i) a lack of appreciation of our social theories' ability to reflect the actual world, ii) misrepresentation of the actual patterns of interest resulting in biased findings, and iii) free range for researcher degrees of freedom to muddy findings. Instead, we can learn much from 'y hat'-questions that embrace the fact that we do not know the true model of the world, and should approach sociological questions accordingly. In this state of the world, there is great benefit in exploiting ever more powerful computers to assist us in making sense of social life. In this thesis, I explore how two simple ideas from fields that embrace computational power can be used to assist sociologists in their empirical workflow. First, that prediction can be used as a broad model analysis tool that can help sociologists estimate and interpret their models in a better way. Second, that methods from the machine learning domain that excel in finding patterns in data can be used to improve sociological model-building. I illustrate both ideas throughout this thesis with a range of empirical examples and case studies. The goal throughout is to complement --- rather than replace --- the standard empirical workflow of sociologists with computational ideas and methods. Accordingly, the aim remains to distill interpretable findings about the social world from data. However, I propose we do so without shying away from the computational riches and associated exciting methodological developments that characterize this day and age.

Keywords: machine Learning
data science
computational social sciences
reproducibility
prediction
Preterm birth screening, prevention and management: a cross-sectional online survey of practice in the Oxford Academic Health Science Network (The AHSN Network)

Background: A survey in the six hospitals of the Oxford Academic Health Science Network (The AHSN Network) with the aim of establishing current practice for screening, prevention and management of preterm labour and assessing variation in practice.
Methods: A cross-sectional web-based survey was piloted then administered via an online survey software to sixty (60) participants drawn from practitioners involved in the screening, prevention and management of preterm birth in the Oxford Academic Health Science Network.
Results: The survey received responses from all the 6 hospitals in the network. It had a 38.3% response rate and a 73.9% completion rate. The key interesting findings from the survey are summarised as: practice; 94.12% of obstetricians are in favour of selective screening in favour of high-risk women; 18.75% are not offering progesterone, the best evidence-based treatment at the moment; rescue and abdominal cerclages are being performed at district general hospitals instead of tertiary referral centres; a 100% use of diagnostic aids; majority use nifedipine for tocolysis; magnesium sulphate is commonly prescribed but not supported by a recent place of birth audit, and there is use of routine antenatal corticosteroids against NICE guidance. About half of obstetricians are in favour of universal screening and the establishment of a preterm labour service across the network supported by individual units in their hospitals. Patient decision support aids, support groups and patient-reported outcomes were noted as weak areas across the network.
Conclusions: Development of Strategies for improving adherence to the network guidelines are necessary so as to ensure uniformity in practice especially for interventions that are conclusively backed by evidence. It is necessary to further establish the effectiveness of establishment of a preterm birth service and dedicated preterm birth units in each of the hospitals. There is a need to develop decision support aids, establish support groups and patient reported goals and outcomes.

Keywords: management
prevention
preterm
United Kingdom
practice
screening
variation
Advisor: Hinton, L
Rees, S
Impey, L
Evolution of the volatile inventory of rocky exoplanets in a runaway greenhouse state with the General Circulation Model ExoFMS-SOCRATES

The runaway greenhouse represents the ultimate climate catastrophe for rocky, Earth-like worlds: when the incoming stellar flux cannot be balanced by radiation to space, the oceans evaporate and exacerbate heating, turning the planet into a hot wasteland with a steam atmosphere overlying a possibly molten magma surface. The equilibrium state beyond the runaway greenhouse instellation limit depends on the radiative properties of the atmosphere and its temperature structure. Here, we use 1-D and 3-D radiative-convective models of steam atmospheres to explore the transition from the tropospheric radiation limit to the post-runaway climate state. To facilitate simulations with 3-D global circulation models, a computationally efficient band-grey model is developed, which is capable of reproducing the key features of the more comprehensive calculations. We analyse two factors that determine the equilibrated surface temperature of post-runaway planets. The infrared cooling of the planet is strongly enhanced by the penetration of the dry adiabat into the optically thin upper regions of the atmosphere. In addition, thermal emission of both shortwave and near-IR fluxes from the hot lower atmospheric layers, which can radiate through window regions of the spectrum, is quantified. 3-D GCM simulations were performed, indicating that the runaway greenhouse effect necessarily ends with a thin condensing region located at the uppermost layers of the atmosphere, mostly on the nightside, while dayside condensation is prevented by heating coming from the absorption of incoming stellar radiation caused by the opacity of water vapour. Surface pressures higher than 10 bar feature non-convective regions in the deep layers, whereas the surface temperature of post-runaway atmospheres seem only weakly sensitive to instellation. Combining five secondary eclipse observations of TRAPPIST-1b with JWST/MIRI could yield a 4.5 sigma detection if it has an atmosphere made out of 1 bar of water vapour. The maximum confidence level in the cases explored for TRAPPIST-1d is 2 sigma, making it unsuitable for thermal emission observations with JWST. Astronomical surveys of rocky exoplanets in the runaway greenhouse state may discriminate some of these features using multi-wavelength observations. Further understanding of runaway greenhouse climates will come from more holistic models, more spectroscopic measurements outside Earth-like conditions, and future observatories.

Keywords: extrasolar rocky planets
exoplanet atmospheres
habitable planets
greenhouse gases
Advisor: Pierrehumbert, R
An aptamer-based sensor for the detection of antimalarial drugs

Artemisinin-based combination therapies (ACTs) have begun to fail as first-line therapies for the treatment of Plasmodium falciparum malaria in Southeast Asia. Preventing the further spread of drug-resistant parasites is a top priority for global malaria elimination campaigns. A low-cost, field-based assay to detect slow clearing ACT compounds from patient samples could allow for improved tracking of antimalarial drug use, monitoring of treatment adherence, and evaluation of therapeutic efficacy and resistance. It could also provide sensitive detection of active components in assessments of tablet quality. This research reports the development of a low-cost, rapid, fluorescent sensor for the specific detection of piperaquine and mefloquine. In order to do this, DNA aptamers were identified that bind and differentiate between small molecule partner drugs. These aptamers were selected from a library of single-stranded DNA molecules for their selectivity and binding affinity. Following their isolation by a capture-SELEX method, a structure-switching aptamer fluorescent sensor was developed. The sensor performance was optimized for the detection of drug from crushed tablets and from human serum, resulting in two fluorescent sensing platforms. The sensors were evaluated for their sensitivity and specificity in relevant sample matrices and the serum sensor was validated against an LC-MS gold standard drug detection method. Feedback from potential assay end-users was collected to inform the assay development and it is believed that these aptamer sensors will be useful tools for monitoring antimalarial drug quality and studying antimalarial drug use.

Keywords: malaria
drug detection
drug resistance
aptamer
Advisor: Long, C
De Vos, M
Tarning, J
The dehybridization of social enterprises

In the world of hybrid organizations, an important and under-examined phenomenon is the process of transforming from a hybrid structure to an organizational form with fewer logics. This research introduces the concept of dehybridization, which I define as a process through which an organization transforms in a way that integrates fewer institutional logics than previously. To examine the phenomenon of dehybridization in the context of social enterprises, I draw on the hybridity and hybrid organizations literatures. These literatures are integral in gaining a conceptual understanding of the challenges of hybrids and their transformations. Building upon this theory, I propose a conceptual framework that describes how dehybridization occurs in hybrid organizations and empirically study this phenomenon in a three-paper dissertation. The first paper introduces and defines the concept of dehybridization and illustrates the potential process for hybrid organizations. The second paper draws on a dataset of 33,350 Community Interest Companies in the United Kingdom from 2006-2020 to examine the relationship between organizational governance and dehybridization. The third paper draws on the same dataset and examines how three exogenous shocks (2007-2008 Financial Crisis, Brexit Vote, and Covid-19 Lockdown) affected the management of hybrid tensions in social enterprises.

Keywords: board heterogeneity
hybrid organizations
dehybridization
hybrids
financial crisis
Brexit
social entrepreneurship
community interest companies
COVID-19
exogenous shocks
social enterprise
hybridity
governance
Advisor: Nicholls, A
Lawrence, T
Workplace mindfulness-based programmes for stress and wellbeing: a realist review and evaluation

Mindfulness-based programs (MBPs) are increasingly offered in the workplace to reduce stress and enhance wellbeing. A growing body of evidence suggests that these programmes can be beneficial; however, dropout rates are often high, and there is great heterogeneity in both programme content and strength of effects between studies. This thesis contributes to a better understanding of what makes these programmes successful, under what circumstances, for whom, and why. A realist approach was employed that is theory-driven and well-suited to make sense of complex interventions, such as MBPs.
First, I conducted a realist review where I analysed and synthesised data from 75 existing studies of workplace MBPs to identify the mechanisms through which these programmes work or do not work and discover how particular contexts impact these mechanisms and, consequently, outcomes. The findings were consolidated into a programme theory augmented by theories from organisational literature, such as conservation of resources (COR) theory and psychological safety. I then tested and refined parts of that programme theory with realist evaluation methodology. The evaluation consisted of five workplace MBPs and included quantitative and qualitative data collection methods.
The research results show that for managers and employees to invest in an MBP and benefit from it, it is crucial that they feel safe to engage with selfcare at work and show vulnerability to each other. The more participants feel that they are not at work, the safer they feel. To be beneficial, it is also important that managers and employees link the programme and its activities to existing goals and practices. If these conditions are not met, the costs of investing in an MBP may be too high and lead to the strategic use of brief mindfulness exercises, non-adherence, or dropout. These findings should be of value to decision makers and practitioners wishing to offer and implement effective and sustainable workplace MBPs.

Keywords: wellbeing
stress
realist evaluation
workplace
realist review
programme
mindfulness
Advisor: Wong, G
Howick, J