Jonathan Pinckney

What drives public perceptions of protests as peaceful - or violent - and how do such perceptions impact popular support for movements? Substantial literature has long held that disciplined nonviolence is essential for conveying a movement’s commitment to peaceful action and thereby eliciting popular support. Relatedly, scholars contend that violent state repression of nonviolent movements often backfires, triggering moral outrage from bystanders and increasing popular support for the activists. However, recent studies have complicated these expectations, finding that protester demographics condition whether observers see protests as peaceful and repression as warranted. Using conjoint survey experiments in Nigeria, South Africa, and the United States, we jointly examine these dimensions of protest movements to test how public audiences react to who protests, what protesters do, and how the state responds. Three prevailing patterns drive public perceptions of peacefulness and support for movements. First, some protester demographics (gender, race where salient, but not age) have modest effects on audience attitudes. Second, these effects are significantly overshadowed by the effects of protester behavior: audiences are extremely sensitive to perceived disorder and respond negatively to even the slightest deviation from narrowly conceived nonviolent discipline, interpreting property damage as equivalently violent to interpersonal violence. Third, violent state repression is assessed to the movement, decreasing audience support and perceptions of protester peacefulness, even when movements assiduously maintain nonviolent discipline.

Introduction: Pregnancy concurrent with incretin‐based medications is contraindicated due to unknown risk of teratogenicity, as is breastfeeding. The aim of this systematic scoping review was to investigate potential risks and benefits of incretin‐based medications in relation to preconception, pregnancy, and postnatal health, and to propose expert guidelines for clinical practice. Methods: An international expert multidisciplinary group was formed. Research questions relevant to women's reproductive health and incretin‐based medications were refined collaboratively, utilizing a lifecourse approach. A systematic search was undertaken on July 23, 2025, across several databases and grey literature sources. Primary data from human studies were prioritized above animal studies. Titles, abstracts, and full text articles were screened independently by two authors. Data were extracted by two people independently using a pre‐defined proforma and synthesized narratively. Consensus recommendations were made. Results: Thirty‐four articles were included in the evidence synthesis: 11 randomized trials, nine observational studies, two pharmacovigilance reviews, nine case reports/series, two animal studies, and one ex vivo study. No qualitative studies were identified. Evidence was found for 18/32 (56.3%) research questions. Most studies related to preconception or pregnancy usage; two addressed contraception, and one was about lactation. The sample size of exposed pregnancies ranged from 1 to 4267. Three studies reported exposure throughout pregnancy. Three studies investigated postpartum usage. One (animal) study had offspring data beyond birth. No studies reported an increase in congenital anomalies. Conclusion: Clinical practice and research recommendations were made based on current available evidence and evidence gaps, encompassing contraception, preconception, nutritional, pregnancy monitoring, lactation, and longer‐term outcomes.

Objectives To evaluate the early implementation of tirzepatide for the management of obesity in primary care in England, including variations in Integrated Care Board (ICB) service delivery models, access criteria, and initial prescribing activity following national policy introduction (June 2025). This paper reports the initial phase of a wider mixed methods national evaluation of tirzepatide delivery models for initial priority cohorts defined in NHS England interim commissioning guidance. Design National study combining 1) mapping of ICB implementation plans using a questionnaire, publicly available data and documents, and stakeholder discussions, and 2) analysis of English Prescribing Dataset (EPD) to investigate tirzepatide prescribing trends using interrupted time-series methods to compare monthly prescriptions before and after June 2025 (implementation start) against a synthetic control series based on semaglutide prescribing. Setting ICBs across England. Participants 23/42 ICBs (55%) responded, of which 13 also took part in stakeholder meetings. For 17 ICBs (40%), we additionally extracted information from publicly available documents. Main outcome measures Descriptions of service delivery models, access criteria, and ICB characteristics; stakeholder‑reported implementation challenges; and prescribing trends over time. Results We were able to categorise models of care for 40/42 ICBs. A general practice‑led delivery model was most commonly planned (18/40; 45%), followed by community/local‑based delivery (8; 20%), custom models (8; 20%), and specialist weight management service (SWMS) community outreach (6; 15%). Four ICBs (10%) planned to use more than one model of care. Most ICBs reported following national priority cohort eligibility criteria 31/39 (79%), while eight (21%) applied additional prioritisation criteria due to funding constraints. Stakeholder discussions highlighted variation in the interpretation of model definitions, variation in operationalisation, and challenges related to affordability, insufficient workforce capacity, and tight timelines, with some ICBs not yet prescribing at the time of stakeholder meetings (November 2025). Analyses of EPD showed a steady increase in tirzepatide prescribing over time, with no evidence that the June 2025 policy implementation date produced any additional increase beyond background diabetes‑related trends. Conclusions Early implementation of tirzepatide prescribing in primary care has been characterised by heterogeneous service models, local adaptations of access criteria, and slow implementation of obesity‑related prescribing. Findings highlight the challenges of implementing new pharmacological treatments including patient management within routine care and the need for clear guidance, realistic timelines, and system capacity. Ongoing evaluation is needed to understand how service models evolve and implications for access, equity, and outcomes.

Who attempts to overturn nonviolent revolutions? And when do they succeed? There is a strong correlation between transitions initiated through primarily nonviolent civil resistance and democratization. However, in several prominent cases, civil resistance transitions have been overturned, resulting in new authoritarian regimes. Little research has examined when and how overturning occurs, and which organizations perpetrate it, in part because no data exists that comprehensively examines overturning in civil resistance transitions. In this article we present the Resistance Overturning Attempts Dataset (ROAD), a dataset of overturning attempts and the organizations participating in and resisting them in every civil resistance transition from the beginning of the Third Wave of democratization to the present. We describe the variables and data collection process, and present descriptive statistics to illustrate the data’s utility. These descriptives reveal several important areas for future research, perhaps most surprisingly that the most effective tactic for safeguarding civil resistance transitions appears to be armed violence.

How does protests’ size shape their electoral impact? Recent years have seen frequent, loosely coordinated public days of protest with historically unprecedented participation. Yet scholars and activists debate whether even massive protest size translates into electoral outcomes. Resolving this debate is difficult because protest participation is influenced by underlying political conditions, and thus any correlation between protest size and electoral results may be due to unobservable omitted variables. In this article, I conduct a rigorous test of the electoral impact of protest participation in a case that also allows for further insight into the mechanisms for protest’s impact: the 2017 Women’s March. I test the impact of the Women’s March on 2018 county-level election results using detailed geo-coded data on local marches’ location and participation. To address omitted variable bias, I employ an instrumental variables analysis, instrumenting march size with precipitation and temperature data. I find that the number of Women’s March participants had a significant positive effect on the 2018 Democratic party vote share. To understand why, I further test the impact of instrumented march participation on two other variables: the creation of “Indivisible” groups and donations to Democratic politicians. This analysis shows that larger Women’s Marches led to higher levels of sustained organizing and political donations. Rapidly organized, social media–based days of protest can impact elections through activating participants for future political action.

How do nonviolent alternatives affect international support for violent rebel groups? Armed rebellions are often sustained by outside sympathy and support, which conditions global coordination to end intrastate conflict. Studies on reducing such support largely neglect how the emergence of alternative, nonviolent resistance groups impacts international support for violent resistance. Nonviolent alternatives could plausibly increase support for armed rebellion by legitimizing the cause of resistance or reduce support by delegitimizing the means of violent rebellion relative to nonviolent alternatives. To examine this puzzle, we conducted two online survey experiments across more than 30 countries using a pre-post design to capture changes in attitudes toward a hypothetical violent rebel group before and after the emergence of an alternative resistance group. We randomly vary both the presence and features of the alternative group, including explicitly nonviolent rhetoric, government repression and concessions, and short descriptors meant to signal the alternative group’s capacity to fill psychological needs for agency, justice, and belonging. We find that alternative resistance options consistently reduce support for armed rebellion, including among those originally most supportive of it, and that respondents strongly prefer explicitly nonviolent alternatives, yet neither the material efficacy nor the emotional resonance of those alternatives have a substantial additional effect.

When do political transitions lead to greater inclusion for groups historically excluded from power? Scholars and policymakers often assume the answer is simple: a transition will result in more inclusion when it ends in democracy. Yet this answer is incomplete at best, since many democracies systematically exclude women, particular ethnic groups, or lower economic classes from power. Using data on political transitions around the world from 1945 to 2014, this study shows that a political transition’s initiating force critically shapes post-transition political inclusion. When transitions are initiated through unarmed civil resistance campaigns they achieve greater advances in inclusion relative to other types of transition. We propose three mechanisms to explain this effect: civil resistance leads to greater continued mobilization and civic activism among the historically excluded, provides greater opportunities for elites from historically excluded groups to rise to positions of leadership in new regimes, and forges more pluralistic norms of political behavior.

Summary: Pregnancy during or soon after treatment with weight loss medication, particularly glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs), is contraindicated due to potential teratogenicity. The aim of this scoping review is to investigate what is known about the use of weight loss medication in women of childbearing age in relation to reproductive health outcomes, focusing on the three medications licenced in the United Kingdom at the time of the search. A systematic search of studies that assessed reproductive health outcomes in women taking either orlistat, liraglutide or semaglutide was undertaken in July 2023 and updated in January 2024 across MEDLINE, Embase, CINAHL, Scopus, ClinicalTrials.gov, PROSPERO, Epistemonikos and OpenGrey. Studies focused on polycystic ovarian syndrome, diabetes or animals were excluded. Titles and abstracts were screened, and data from included articles were extracted. After removal of duplicates, 341 titles remained, of which 318 were excluded. Of the final 18 articles included, there were five interventional trials, one retrospective case‐control study, six narrative reviews, two systematic reviews, three systematic review protocols and one registry protocol yet to start recruitment. All five interventional trials involved orlistat given preconceptionally, showing no improvement in live birth rate, despite improvement in reproductive hormone levels. There were no studies with primary data about GLP‐1 RAs. There were no qualitative studies. There is an absence of primary data about the role of GLP‐1 RAs on the reproductive health of women of childbearing age without polycystic ovarian syndrome. Future research should explore short‐ and long‐term effects on reproductive health, pregnancy outcomes and experiences.

Summary: The optimal treatment and organization of care for people with obesity is one of the greatest challenges facing today's health services. While surgery and pharmacotherapy offer effective treatment options for some people with obesity, behavioral interventions are important to support long‐term behavioral change. However, little is known about the most effective components of behavioral interventions, and this is especially the case for people with complex or severe obesity (i.e. body mass index [BMI] > 35 kg/m²). Accordingly, the current rapid review aimed to identify which behavior change techniques (BCTs) are effective for weight loss in adults with (severe) obesity. A secondary aim was to review the effects of BCTs on dietary behaviors and physical activity, and psychological outcomes, recognizing that behavioral interventions commonly target these. A search of Scopus, Ovid Medline, and Web of Science resulted in 1227 results, with 22 reviews eligible for inclusion. The most commonly reported BCTs were self‐monitoring and goal setting, but these had variable effects on weight in adults with obesity. Combining these BCTs with other self‐regulatory techniques led to increased weight loss. Further, for adults with severe obesity, so‐called ‘nudge’ techniques and self‐regulatory techniques were associated with greater weight loss. Three reviews also found that while self‐monitoring increased physical activity, behavioral commitments increased changes to dietary behaviors. BCTs were not associated with psychological well‐being. The review confirms that behavioral interventions have an impact in weight management, including for individuals with more complex or severe obesity, but highlights the need for further investigation of their use within clinical settings.

Background: Current treatments for people with obesity emphasise the need for person-centred approaches that consider complex biopsychosocial factors and value the lived experience of people when attempting to lose weight. Methods: Narrative interviews (n = 20) were conducted with people living with obesity to explore the causes of their weight gain and their expectations and engagement with treatment at a Weight Management Clinic. A mixed inductive and deductive qualitative analysis identified utterances that represented psychological constructs used to understand self-appraisal and health behaviour. A narrative analysis was used to situate these findings in the context of a participant’s life story. Results: Locus of control was a dominant construct evidenced through a person’s attributional style and self-efficacy. Transcripts represented a heightened sense of self-understanding and shifts in control, and styles of attribution and efficacy resulted in either stasis or self-actualisation. The Stages of Change model could be applied to narratives to ascertain a patient’s motivation to access treatment. Importantly, narrative interviews also allowed for the consideration of how a person’s systemic context influenced their weight. Conclusion: Narrative interaction supports both self- and shared understandings of the causes and consequences of obesity for individuals, in a non-blaming or shaming manner. It provides an opportunity to enhance engagement through tailored, person-centred treatments.