Wolverhampton Intellectual Repository and E-Theses
WIRE is the open access repository for research publications and outputs by researchers based at the University of Wolverhampton.
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Item Fracture-related hospitalisations in newly diagnosed high-risk localised or metastatic hormone-sensitive prostate cancer: secondary analysis of the STAMPEDE phase III trials of docetaxel and zoledronic acid using healthcare systems data(Elsevier, 2025-07-16)Background Androgen deprivation therapy (ADT), the mainstay systemic treatment for high risk non-metastatic (M0) and metastatic (M1) prostate cancer is associated with bone loss and increased fracture risk. The STAMPEDE trial tested the addition of zoledronic acid (ZA) ± docetaxel (with prednisolone) to ADT. Both regimens may impact bone health. However, long-term fracture incidence remains uncertain. Patients and methods Health systems data were obtained for patients recruited from England and randomised to standard-of-care (SOC) ADT compared with SOC plus ZA or docetaxel or both docetaxel and ZA. ICD10 diagnosis and OPCS procedure codes from inpatient hospital admissions were used to identify fracture-related hospitalisations. Flexible parametric competing risks models were used to estimate 5- and 10-year cumulative incidence and sub-distribution hazard ratios (SDHR). Results 2140 of 2705 (79%) patients recruited from trial sites in England were eligible for this secondary analysis. Linked data were available for 2042/2140 (96%) pts (734 M0, 1308 M1). 5-year cumulative incidence of fracture for M0 and M1 patients treated with SOC only was 11% [95% confidence interval (CI), 8% to 15%] and 23% (95% CI, 19% to 28%), respectively. 10-year cumulative incidence in M0 patients was 26% (95% CI, 20% to 33%). Allocation to ZA significantly reduced the risk of fracture in M1 patients (SDHR 0.73, 95% CI 0.55-0.97; P = 0.015) but not M0 patients (SDHR 0.88, 95% CI 0.59-1.32; P = 0.549). Docetaxel had no clear effect on the risk of fracture in M0 (P = 0.570) or M1 (P = 0.264) patients. Conclusions High cumulative incidence of fracture was observed in both M0 and M1 prostate cancer patients receiving ADT. The addition of ZA to ADT ± docetaxel significantly reduced long-term fracture risk in M1 participants but had no clear effect in M0 disease. These data support the use of bone protective agents to reduce fracture risk in men with M1 prostate cancer undergoing ADT.Item Why is autism a disability? Examining an argument for intersectional neurodiversity(University of Wolverhampton, 2025)This thesis questions why autism is seen as a disability when many autistic people perceive autism as a natural difference that relates to the way their mind works. Autistic people struggle to find academic information to explain their experiences and often turn to online resources for validation. To create the conditions for the emergence of adequate explanations of autistic conscious experience, this thesis begins by challenging some dominant explanations for autism. An epistemological approach, utilising first-person perspectives on the experience of autism, is suggested as a corrective. Feminist standpoint epistemology is adapted to demonstrate that autistic perception is valuable in remedying the prevailing distorted image of autism caused by the lack of autistic representation. I critically analyse Theory of Mind to suggest an alternative more suited to explain the autistic experience. In the preferred version of neurodiversity, not the brain itself, but the interaction of the brain with the environment explains autism. To challenge the brain-based explanation of autism, a small section of the available neurological data mapping the human brain is statistically analysed to demonstrate the possibility that the diversity of brain structure found could be a part of natural variation and not specific to autism. The element of interaction with the environment is developed through sharing autoethnographic data, followed by an engagement with the reported life experiences of self-identified autistic people to counter likely biases in the use of the method of autoethnography. I conduct a thematic analysis on online expressions of autistic experience to highlight concerns such as the use of Applied Behavioural Analysis, Identity and the experience of Discrimination, and the differences in Sensory Experience, which currently lack adequate representation in information about autism generated by academic research and adopted for wider public consumption. This thesis shows that from the autistic perspective, the environment determines whether autism is experienced as a disability. The negative judgement of the traits associated with autism coming from other people is often the reason why autistic people experience discrimination and burnout. An understanding of autistic people, as Neurodivergent suggested here, could lead to changing negative judgements and hence improve experiences for autistic people.Item The Systematics, Biogeography, and Natural History of the Endemic Papuan Snake Genus Toxicocalamus (Elapidae: Hydrophiinae)(University of Wolverhampton, 2025)Toxicocalamus Boulenger 1896, is a genus of front-fanged venomous snakes belonging to the Australo-Melanesian subfamily Hydrophiinae, in the near-global family Elapidae. It is endemic to the island of New Guinea, and its satellites, the d’Entrecasteaux and Louisiade Archipelagos, in Milne Bay Province, Papua New Guinea (PNG), off the southeastern tip of the Papuan Peninsula, and four small islands along the northern coast of Madang, East Sepik, and Sandaun Provinces, PNG. Currently twenty-four species are recognised, twelve of which have been described since 2009 (five involving this author as first or last author), with three species resurrected from synonymy, making Toxicocalamus the largest terrestrial, alethinophidian genus in the entire Australia-Pacific region. Yet, many species are poorly known, five species being only known from their holotypes, four from just two specimens, and a further five from fewer than ten specimens. Conversely, 189 specimens have been collected belonging to a single species in one relatively small area, accounting for 36% of all known Toxicocalamus specimens (520) in thirty collections worldwide. The diversity of this genus is set to increase still further over the next 1–3 years, as between four and six new species are awaiting description and the only subspecies will be elevated to specific status. Snakes in the genus Toxicocalamus vary greatly in size (less than 250 mm to 1.2 m), physique (bootlace slender to stout and robust), and even activity (diurnal and terrestrial to secretive and semi-fossorial/fossorial). They also exhibit a wide range of scale counts and scalation characteristics, which are useful in determining their identification: varying degrees of head scute fusion; dorsal, ventral and subcaudal counts; subcaudal and cloacal plate condition, and colouration or patterning. All species also share several biological or behavioural characteristics, i.e., all members are venomous (although the venom composition of only one species has been analysed) and some species exhibit extremely elongate venom glands that run into the body cavity, all species are believed to be vermivorous (worm-eating) and all are oviparous. Toxicocalamus is believed to occupy a basal position in the subfamily Hydrophiinae and its distribution across northern and central New Guinea, and on the southeastern and northern coast islands mirrors the underlying geology. Snakes in this genus are found primarily in those parts of New Guinea that originated as Pacific or Southeast Asian oceanic arcs and terranes, rather than the rump of southern New Guinea, which formed the vanguard of the Australian Craton, and therefore to understand the distribution of Toxicocalamus it is necessary to understand the geological and biogeographical history of the island of New Guinea itself.Item The effect of LED light on plant growth and phenolic compounds present in three species of mentha(Springer Nature, 2025-07-26)Exposure to different light spectra results in a variety of physiological responses. The present study focused on the responses of three species of Mentha (Mentha piperita, Mentha spicata and Mentha longifolia) to artificial light of selected wavelengths (including red, blue, red + blue, and white LED light and natural light). The study was performed as a factorial (Mentha species and light spectra) pot experiment in the form of a randomized complete block design with four replications. The results demonstrated that the quality of light had a statistically significant effect upon all the measured traits. Blue light was shown to produce the highest number of shoots in Mentha longifolia, and the longest shoots were also observed under blue light conditions in Mentha longifolia. A combination of red + blue light produced the highest shoot weight in Mentha piperita, which was significantly different from other treatments. The highest amount of rosmaric acid was found in Mentha spicata grown under red + blue light conditions which was approximately 425% more than in plants grown under natural light. In Mentha piperita, cultivation under blue light produced the highest concentration of luteolin (37 times compared to natural light) and red light produced the highest concentration of ellagic acid (3 times compared to natural light). This study deals with how differences in light quality affected the growth traits and phenolic compound accumulation of Mentha species, under controlled environmental conditions. The results obtained, are of application for the commercial production of these agronomically important mint species.Item Attitudes to brain health and dementia amongst the Chinese population living in the UK(SAGE, 2025-06-29)Background: Just under half a million people who identify as Chinese or Chinese-British are living in the UK. Chinese migrants have a distinctive linguistic and cultural heritage and are likely to differ from the wider UK population in their attitudes to dementia care. However, to date no studies have explored this area. This study aimed to compare attitudes to dementia amongst Chinese people and the wider UK population using a translated version of the 2023 Dementia Attitudes Monitor survey (DAM). Methods: We translated the DAM into Simplified and Traditional Chinese and distributed this through an online survey. In total 84 UK based participants (65 women and 19 men) completed the survey. We weighted data by age and sex. Results: We identified important differences between Chinese participants and the wider UK population. Chinese participants were more likely to report that they would find it hard to talk to someone with dementia and that they would not feel comfortable telling people outside their close family if they were to be diagnosed. Higher levels of knowledge about dementia were associated with increased reluctance to tell people outside their family. Chinese participants were equally willing to take a test that could tell them whether they were in the early stages of dementia, even before symptoms showed. They were also more likely to report that they would want to know information in midlife about their risk of developing dementia later on. Conclusion: This paper is the first to report knowledge about brain functioning and dementia within the UK-based Chinese community. Chinese people are highly motivated to reduce their dementia risk – but to do so requires specific public health programmes that are adapted to meet the specific needs of Chinese communities.
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