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In August, 2015, Serena Williams, one of the most successful female athletes of all time, was body shamed in a New York Times article. The incident highlights the issue of unequal treatment of male and female athletes – while a muscular frame enhances masculinity for male athletes, a muscular physique invites body shaming for female athletes. In this study, symbolic interactionist theories regarding the generalized other are called into question. While George Mead's theorizing exhibits a nonproblematic role taking of the generalized other in a cooperative manner, this study reports the presence of paradoxical generalized others, and consequently, the incongruent role taking of a latent generalized other by individuals. This study investigates if the issue of body image exists among college female athletes, if college female athletes experience the dilemma of choosing between outstanding performance with a muscular frame or maintaining traditional female appearance. To provide answers to the question, female athletes in a midwest university were invited to fill out a survey. The survey results confirm the existence of a paradox between performance and appearance among some college female athletes.

This study aims to evaluate the effect of Alpha-Stim Anxiety, Insomnia and Depression (AID) cranial electrotherapy stimulation (CES) on anxiety, depression and health-related quality of life for primary care social prescribing service patients with anxiety symptoms.

Open-label patient cohort design with no control group. A total of 33 adult patients (average age 42 years) completed six weeks of Alpha-Stim AID use. Pre- and post-intervention assessment with participant self-report measures: Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder (GAD-7) and European Quality of Life Five Dimension (EQ-5D-5L).

Reliable improvement and remission rates, respectively, were 53.39% and 33.3% for GAD-7; 46.7% and 29.5% for PHQ-9. There was a significant improvement in GAD-7 and PHQ-9 with large effect sizes. EQ-5D-5L results showed significant improvements in health-related quality of life. Perceived quality of life increased by 0.17 on the health index score, with the intervention adding 1.68 quality-adjusted life years (QALYs).

Alpha-Stim AID can be delivered through a primary health-care social prescribing service and most patients will use as prescribed and complete treatment course. Alpha-Stim AID CES may be an effective anxiety and depression treatment for people with anxiety symptoms. The widespread roll-out of Alpha-Stim AID in health-care systems should be considered.

To the best of the authors’ knowledge, this is the first study to respond to the UK’s National Institute for Health and Care (NICE) request for the collection of real-world data to understand better Alpha-Stim AID in relation to people’s treatment uptake, response rates and treatment completion rates (NICE, 2021).

Megaprojects are seen as vehicles for delivering significant social value. However, megaproject decision-making, which is deeply embedded in networks comprising formal and informal practices involving the exercise of power, can facilitate or hinder social value delivery. Moreover, these decision-making practices are often intentionally designed and executed to remain hidden and so are not easily identifiable but have implications for maximising social value. This paper aims to identify the hidden barriers to social value delivery on megaprojects resulting from the decision-making environment.

Governmentality theory was used to deconstruct the megaproject decision-making environment. The critical realism philosophy was merged with a narrative inquiry approach to analyse the everyday, taken-for-granted practices that resulted in the decision-making outcomes. Data were collected through 22 in-depth semi-structured interviews to uncover stories highlighting the nature of power relations underpinning the decision-making environment of one megaproject in the Asia Pacific region.

Governmentality theory as a lens showed that emergent, informal governing practices blend with formal governance mechanisms, creating a complex mix of overt and covert power dynamics. The findings suggest that the exercise of covert power by project team members through deviant tactics hinders social value delivery. Therefore, understanding the power dynamics that influence the decision-making of project team members is key for maximising social value delivery.

Originality stems from the use of governmentality theory and critical realism to deconstruct and explain the megaproject decision-making environment, enabling observation of otherwise challenging-to-understand, complex and hidden barriers to the delivery of social value. This paper offers a novel way of explaining social value delivery through megaproject decision-making.