Digital Commons Network^™

Reflective Case Study: The Role Of Repeated Observations In Identifying Sepsis In Older Adults With Indwelling Catheters In The Community, Lia Baldock

South West Clinical School Journal

No abstract provided.

Rethinking Dual-Task Training In Parkinson’S Disease: Engaging And Innovating For Inclusive Access To Rehabilitation, Nesibe Cakmak, Jennifer Freeman, Lisa Bunn, Camille Carroll

School of Health Professions

Dual-task training helps improve balance and cognitive function in people with Parkinson’s disease, but existing clinician-led, clinic-based programmes lack standardization. This qualitative study aimed to inform new programme designs by exploring the experiences and needs of individuals with Parkinson’s disease, their supporters, and physiotherapists. Semi-structured interviews were conducted with ten participants–six with mild-to-moderate Parkinson’s disease, two supporters, and two physiotherapists. Interviews were recorded, transcribed, and independently analysed by two researchers using framework analysis. Three main themes emerged: what comprises “An Engaging Dual-task Training,” emphasizing enjoyment, daily life integration, and the need for a balance between challenge and reward as well …

The Experiences Of Systemic Invalidation In Chronic Pain Care Among Socioeconomically Disadvantaged Individuals: An Interpretative Phenomenological Study, Claira Moro, Stuart Spicer, Charley Hobson-Merrett

Peninsula Medical School

This study explored the lived experiences of individuals from socioeconomically disadvantaged communities living with chronic pain and prescribed pain-relief medication. Using Interpretative Phenomenological Analysis, eight participants were recruited from a single primary care network in England. Two Group Experiential Themes were developed. This paper reports one: From Dismissed to Disengaged: the trauma of seeking help, with three sub-themes: (1) “Being fobbed off” – dismissal across healthcare and benefit systems; (2) “It just seemed horrible to me, to take it off me” – pain relief as withdrawn, stigmatised, or conditional; and (3) “Do I want to poke the bear?” – disengagement …

An Exploration Of The Experiences Of Vulnerable Young People Participating In A Stand-Up Paddle-Boarding Therapy Course; A Phenomenological Study, Claire Hornsby, Alison Warren, Rosi Raine, Alun Morgan

School of Health Professions

Nature-based interventions have been advocated as an approach to support mental health and well-being in young people. The Wave Project, a United Kingdom–based charity, has an established surf therapy intervention for vulnerable children and adolescents which has been demonstrated to have a positive impact on mental health and well-being. However, this intervention provides challenges in terms of accessibility for young people located away from the coast. Stand-up paddle-boarding is an aquatic activity which can be conducted on inland waters, which therefore has the potential to address this barrier. Semistructured interviews (n = 6) utilizing video and photo elicitation were conducted …

From Street Level To Science: Advancing Methods For Climate Walks To Improve Human Thermal Comfort, Kevin Lau, Cho Kwong Charlie Lam, Eduardo Krüger, André Santos Nouri, Zhikai Peng, Daniele Santucci, Andreas Matzarakis

School of Geography, Earth and Environmental Sciences

Urban heat risk is increasing, while fixed monitoring networks remain too sparse and coarse to resolve the pedestrian-scale variability, especially radiative loads, that governs outdoor thermal stress. This short communication advances the concept of climate walks, defined as route-based, human-centred field campaigns that build on earlier work on “thermal walks”, and presents them as a practice-ready methodology for design-relevant evidence. We define climate walks as structured, route-based, georeferenced assessments that pair high-resolution mobile microclimate measurements with synchronous in-situ human responses to capture transient, spatially heterogeneous conditions along actual walks. We synthesize key methodological features, such as dynamic, stop-and-go protocols; human-centred …

Everyday Tracking And Extraordinary Harm: Item Finder Misuse In Digital Coercive Control, Vivian Hocking, Shirley Atkinson, Hai-Van Dang, Nathan Clarke

School of Engineering, Computing and Mathematics

PurposeWhere one in three women worldwide experience some form of intimate partner violence, the rise of technology facilitated abuse means that abusers have increased access and control over their victims. This extension paper aims to examine the threat potential for technology misuse as pertains to item finder devices that make up part of the Internet-of-Things. Item finders have increasingly become the weapon of choice for abusers leveraging technological advantages against their victims.Design/methodology/approachThis study uses a mixed-methods approach, combining digital ethnography with 12 individuals engaged in a participant study to evaluate the misuse potential of Apple AirTag, Chipolo …

Not Forgetting The Fathers: A Qualitative Narrative Review Exploring The Involvement And Psychological Well-Being Of Fathers In The Neonatal Intensive Care Unit., Kayleigh Gahagan, Kevin Hambridge, Matt Carey

School of Nursing and Midwifery

BackgroundDespite policy commitments to family-centred care, neonatal services often remain implicitly structured around maternal presence. Fathers, although increasingly acknowledged as vital to early child development, frequently experience feelings of exclusion throughout the neonatal journey, from antenatal care through to the neonatal intensive care unit.AimThis review explores how fathers experience involvement and psychological wellbeing during their infant’s admission to a neonatal intensive care unit.MethodsA narrative review of qualitative studies was conducted using the SPIDER framework to guide the search strategy. The nine included studies, which met the inclusion criteria were identified via searching the databases CINAHL, PubMed, and PsycINFO. Studies were …

Using Expert Elicitation And Systems Mapping To Support Social Innovation In The (Blue) Food System: The Case Of The Uk’S Plymouth Fish Finger, Clare Pettinger, Kelly Parsons, Yanaina Irazu Chavez-Ugalde, Louise Hunt, Carol Wagstaff

School of Health Professions

Background: The imperative for food system transformation is well known, yet to date there has been minimal emphasis on the blue food system [foods sourced from marine and freshwater environments]. Generally, a food systems approach should shift away from linear and move towards more systems thinking to embrace complexity. This paper focuses on a local social innovation project (Plymouth Fish Finger (PFF)) which has pioneered localising the blue food system. This study aimed to elicit how the (policy and practice) system around the PFF can be appraised to optimise social innovation practices for (blue) food system transformation. Methods: Expert elicitation …

Relational Practices Underpinning Person-Centred Care In Long-Term Residential Care Settings., Gary Hodge, Sam Ebden, Susie Pearce

School of Nursing and Midwifery

Recent figures indicate that there are just over 441,000 people living in long-term residential care homes across the United Kingdom (UK) (Berg, 2025), of which 70% are living with dementia or a severe cognitive impairment (Alzheimer’s Society, 2024). The percentage of people living in permanent residential aged care with dementia in Australia is slightly lower (54%) but still represents most residents and is rising (AIHW, 2025; Dementia Australia, 2025).This article is based on the findings and reflections of a qualitative multiple-case study exploring person-centred care across seven residential care homes in the United Kingdom (UK; Hodge et al., 2023). Findings …

Prioritising Follow-Up For People With Suspected Epilepsy Using A Digital Eeg Biomarker, Rohit Shankar, John Terry

Peninsula Medical School

Lengthy waits for follow-up testing are common for people with suspected epilepsy. This delays diagnosis, prolongs uncertainty and increases seizure risk. Initial EEGs are frequently inconclusive, yet follow-ups are often dictated by referral date, and there is no established method for risk-based prioritisation. Here, we tested whether an established digital EEG biomarker could help prioritise those most likely to have epilepsy for expedited follow-up EEG testing. We analysed 196 normal non-contributory (non-diagnostic) initial EEGs collected from six National Health Service (NHS) sites in England. From these recordings, we extracted eight previously validated computational features that quantify the likelihood that the …

Evaluating The Patient Journey Through Integrated Mental Health Services Using Routinely Collected Data: Utility Of The Dialog Patient-Reported Outcome And Experience Measure, Stuart G. Spicer, Rahul Bhattacharya, Katelyn Smalley, Akshith Shetty, Paul Sharpe, Richard Byng

Peninsula Medical School

Aims and method DIALOG is a patient-reported outcome and experience measure. We analysed anonymised DIALOG scores routinely collected from East London NHS Foundation Trust. We aimed to (a) examine changes in DIALOG scores through the patient journey (‘assessment’, ‘review’ and ‘discharge’); and (b) assess the impact of community mental health (CMH) transformation by comparing pre- and post-DIALOG scores. We analysed 11 198 DIALOG scores from 5007 patients in 2018–2019 and 2021–2022. Results DIALOG scores improved across treatment stages in both years. There was no clear difference pre- and post-CMH transformation, although in 2021–2022 there were lower satisfaction scores at referral. …

Sounding W. B. Yeats’S “Cuchulain Comforted”, David Sergeant

School of Law, Humanities and Social Sciences

No abstract provided.

Evidence Base To Inform Health Service Configuration For Abortion Provision: The Sacha (Shaping Abortion For Change) Multi-Component Study, Kaye Wellings, Rebecca S. French, Annette Aronsson, Paula Baraitser, Sharon Cameron, Caroline Free, Louise Keogh, Maria Lewandowska, Patricia Lohr, Rebecca Meiksin, Ona Mccarthy, Clare Murphy, Wendy Norman, Melissa Palmer, Jennifer Reiter, Natasha Salaria, Rachel Scott, Jill Shawe, Sally Sheldon, Geoff Wong

School of Nursing and Midwifery

Background: Significant changes to the nature and context of abortion provision are taking place in the United Kingdom. Empirical evidence is needed to guide efforts to respond to these changes. Objective(s): To provide an evidence base to inform optimal configuration of health services and systems in response to current and future changes in abortion provision in the UK. Design and methods: Observational study comprising five integrated components: (1) a realist review to generate evidence to guide optimal abortion provision and a scoping review of interventions aimed at preparing non-specialist health professionals to provide abortion care and support; (2) country-based case studies identifying transferable …

Exposing The Work Of The Market Through The Case Of Alternative Provision For English School Students, Nick Pratt, Elizabeth Done, Sam Morahan

School of Law, Humanities and Social Sciences

Pupils in England who for some reason are not able to attend school often find themselves in Alternative Provision (AP). These are special arrangements designed to address their specific needs and help them return to mainstream schooling. AP involves a financial agreement between the provider and the organisation that commissions the provision and thus operates as an explicit form of education market in which educational services are traded directly for financial recompense. We report on a case study of one AP provider in the South-West of England undertaken over a one-year period which generated data through individual, semi-structured interviews and …

Dementia Knowledge Levels Among Adolescents In England, Esra Hassan, Ben Hicks, Naji Tabet, Nicolas Farina

Peninsula Medical School

Objectives: Raising awareness of dementia in the general public is a key dementia policy. Adolescents are one population whose levels of dementia knowledge we have little understanding about. In this cross-sectional survey study, we aimed to capture the level of dementia knowledge in adolescents from different socio-demographic groups and to explore the factors associated with adolescents’ dementia knowledge. Method: We recruited 1,371 adolescents aged 11-18 years across England. Adoeslescents were asked to complete a survey that included dementia knowledge items from the The Northern Ireland Life and Times Survey. Descriptive statistics, a logistic regression, and cross-tabulations were used to explore …

Aberrant Recruitment Of The Striatum And Insula Is Associated With Recalling And Suppressing Fatigue- And Anger-Related Memories In People With Chronic Fatigue Syndrome/Myalgic Encephalomyelitis, Katharine Rimes, Vincent Giampietro, Trudie Chalder, Roland Zahn, Sean Fallon

School of Psychology

Research suggests that people with chronic fatigue syndrome tend to suppress emotions more than healthy individuals. However, whether there are also changes in the neural substrates of emotional regulation in people with chronic fatigue syndrome remain unexplored. Specifically, it is unclear whether there is a neural delineation in how fatigue and anger-related memories are recalled or supressed in people with chronic fatigue syndrome. This study investigated this hypothesis using functional magnetic resonance imaging. We compared blood oxygen level-dependent signal changes between people with chronic fatigue syndrome (N=20) and matched controls (N= 20) during a novel task that involved the recall …

What Is The Contribution Of Thermal Selection To The Maintenance Of A Shell Color Cline In Littorina Saxatilis?, Ramón Vigo, Sarah L.Y. Lau, Juan Gefaell, Juan Galindo, Gray A. Williams, Manuela Truebano, Emilio Rolán-Alvarez

School of Biological and Marine Sciences

The study of clines, or geographical variations of a given trait, can help understand how the interactions of genetics and local environments determine phenotypic diversity. The marine snail Littorina saxatilis (Olivi, 1792) exhibits a gradual change in the relative frequencies of shell color morphs across populations in the estuary system of the Rias Baixas (Galicia, NW Iberian Peninsula). A consistent pattern of distribution occurs across these four Rias, with the interior, sheltered regions dominated by a light fawn-like morph (fulva), and the exterior, wave-exposed locations by a darker lineated morph (lineata). Measurements of rock surface temperature along one of the …

Logic Model Development Through A Feasibility Rct For A Group-Based Weight Management Programme, Rod Sheaff, Shokraneh Moghadam, Laura Hollands, Lily Hawkins, Dawn Swancutt, Jenny Lloyd, Jonathan Pinkney, Mark Tarrant

School of Psychology

ObjectivesClinical psychology interventions for reducing obesity have developed alongside pharmacological and surgical treatments, but usually as interventions for individual patients. Any healthcare intervention rests on a logic model: assumptions that through specific physical and social mechanisms, it will produce certain intended outcomes, provided that conducive background conditions (‘contexts’) exist. Using evidence from the feasibility trial preceding a full randomised controlled trial (RCT), this paper assesses the empirical validity of the initial logic model of a new group-based weight management intervention: PROGROUP, designed for patients with body mass index (BMI) ≥40 kg/m2 or ≥35 kg/m2 with comorbidities. We aimed to test …

Autistic Traits And Mind Wandering: A Correlational Study Of Themes, Intentionality, And Temporal Focus, Leilani Forby, Farid Pazhoohi, Alan Kingstone

School of Psychology

There is abundant research on the nature and content of mind wandering (MW) in neurotypical individuals, yet little research in these areas on individuals high in autistic traits. The current study explored the relationship between autistic traits and several aspects of MW: themes, intentionality, temporal dimensions, and attitudes towards MW. A total of 1,477 participants completed measures of autistic traits, MW, and stress. Autistic trait level was positively correlated with the MW theme of guilt and fear of failure (GFF), spontaneous MW (MW-S), poor attentional control (PAC), and stress, and negatively correlated with appreciation for MW’s benefits. Participants were then …

Modelling Enablers And Barriers To Improve Uptake Of A Fruit And Vegetable Voucher Scheme (The Fresh Street Community) In England:: A Tism-Micmac Approach, Jiang Pan, Clare Relton, Lisa Howard, Lisa Howard, Aira Ong, Louise Hunt, Paridhi Garg, Jane Bradbeer, Manik Puranik, Rachel Sutton, Carol Wagstaff, Clare Pettinger

School of Health Professions

Background: Improving equitable access to fresh fruit and vegetables (FV) remains a critical public health priority in the UK, particularly in low-income communities where affordability, accessibility, and social barriers limit healthy food choices. The Fresh Street Community scheme, a place-based FV voucher initiative in England, aims to enhance dietary equity by enabling households to purchase fresh produce from local community centres. Building on prior feasibility research, this study applies a systems-modelling approach to explore how multiple enablers and barriers interact to influence scheme uptake and sustainability.Methods: Using Total Interpretive Structural Modelling (TISM) combined with MICMAC analysis, we engaged research team …

Science Challenges And Solutions To Support Implementation Of The Biodiversity Beyond National Jurisdiction Agreement, Claire L. Szostek, Angus Atkinson, Victor Martinez-Vicente, Ana M. Queirós, Peter I. Miller, Kerry L. Howell, Rebecca C. Millington, Susan Kay, Matthew Faith, Karen Tait, Elizabeth Talbot, Andrew Rees, Chris Lyal, Jeff Ardron, Matthew Frost

School of Biological and Marine Sciences

The Biodiversity Beyond National Jurisdiction (BBNJ) Agreement provides a new opportunity to consolidate and achieve global marine environmental goals. Here we focus on how science and technology will support its implementation. We provide an overview of existing scientific knowledge and methods that are scalable to Areas Beyond National Jurisdiction (ABNJ). Reviewing data gaps, challenges and opportunities, we outline solutions and a roadmap focused on enhancing resources and capacity.

The Harms Associated With Simplifying Our Language Choices, And The Need For A New Typology For Dog Breeders And Consumers, Rebekah Gregory

School of Law, Humanities and Social Sciences

‘Animal’ exploitation is not a new phenomenon. Whilst categorising ‘animals’ by broader groups rather than species helps us understand their experiences, our language still limits our ability to capture the nuances of their treatment. Dogs appointed as domesticated companions are subjected to a variety of experiences. Some are fed gourmet meals and taken to privately rented parks; and others suffer from the consequences of impulsive purchasing and physical abuse. This diversity in treatment is significantly determined by the intentions of the dog’s breeder and consumer. Subsequently, referring to all breeders and consumers with the same terminology instead of highlighting the …

Conquering Today's Health Paradox With The Power Of Heal - An Expert Consensus Report Plus Research Priorities And Policymaker Roadmap, Katharina C Wirnitzer, Mohamad Motevalli, Derrick R Tanous, Clemens Drenowatz, Maximilian Moser, Holger Cramer, Thomas Rosemann, Karl-Heinz Wagner, Andreas Michalsen, Beat Knechtle, Zlatko Fras, Adilson Marques, Nataša Fidler Mis, Fatima C Stanford, Christian Schubert, Nandu Goswami, Claus Leitzmann, Per Morten Fredriksen, Gerhard Ruedl, Rodrigo A Lima, Christian Kessler, Michael Jeitler, Naim A Khan, Hassan Joulaei, Maryam Fatemi, Karl W Kratky, Kara K Palmer, Bernd Haditsch, Boštjan Jakše, Walter Kofler

School of Health Professions

BACKGROUND: Despite growing scientific evidence and health guidelines, the global health paradox persists, with rising lifestyle-related diseases and escalating healthcare costs exposing the inadequacy of current efforts.

OBJECTIVE: Three multidisciplinary congresses were held to generate evidence-based conclusions aimed at addressing the global health paradox.

METHODS: A total of 58 experts from 62 entities participated in the international research and knowledge-exchange panels. Experts reviewed the latest findings to develop practical strategies and identify key research and policy priorities, focusing on the Healthy Eating & Active Living (HEAL) approach.

RESULTS CONCLUSION AND RELEVANCE: The expert consortium endorsed a 33 evidence-based consensual-statement policy …

Assessment Of Enforcement Strategy Highlights Opportunities For More Effective Deterrence In A Large-Scale No-Take Mpa, Chris Kerry, Claire Collins, Lasuni Gule Godage, Oliver S. Ashford, Kristian Metcalfe, Sam B. Weber, Tom B. Letessier

School of Biological and Marine Sciences

Illegal, unreported, and unregulated (IUU) fishing poses a significant threat to fisheries sustainability, global food security, and biodiversity conservation. Many regions rely on patrol-based enforcement to promote compliance, yet the effectiveness of such strategies in deterring IUU activity remains underexplored. In this study, we employed a mixed-methods approach to assess the impact of management and policy decisions on illegal fishing within the Chagos Archipelago marine protected area (MPA). This MPA has maintained near-continuous patrols since its implementation in 2010, providing a unique opportunity to evaluate the influence of patrolling on illegal fishing deterrence. First, we analyzed semi-structured interviews with fishers …

Achieving High Terminal Performance: A Case Study Of Korean Steel Terminals Using Fsqca, Hae Chan Lee, Saeyeon Roh, Inhyeok Yeo, Jinwoong Yoo

Plymouth Business School

Steel-dedicated terminals play a critical role in the facilitation of the Korean steel industry. Due to the nature of steel production and handling, Korean steel-dedicated terminals are heavily utilized in the transportation of steel products both domestically and internationally. Despite the importance of steel terminals, there is limited research exploring factors that drive high terminal performance for bulk terminals, let alone steel terminals. Thus, this study examines factors that lead to high terminal performance for Korean steel terminals. A configurational approach was taken using fuzzy-set Qualitative Comparative Analysis (fsQCA) to yield different combinations of factors that drive high terminal performance. …

Individual Differences In Alexithymia Modulate Cognition-Emotion Interactions In Daily Life Ongoing Experiences, Anqi Lei, Md Faysal, Louis Chitiz, Raven Wallace, Samyogita Hardikar, Brontë Mckeown, Jonathan Smallwood, Elizabeth Jefferies, Robert Leech, Nerissa Ho

School of Psychology

Individual differences modulate our thoughts and emotional experiences, yet how thought and emotion interact in daily life remains largely unclear. We leverage alexithymia, a trait reflecting atypical emotional awareness, to reveal these interactions in naturalistic settings. Using multi-dimensional experiencesampling via smartphones, we captured moment-to-moment thought patterns and concurrent affective states (valence, arousal, stress) in people’s daily life (N = 190 undergraduate students, age range = 18 to 36, 159 females). Using Principal Component Analysis and Linear Mixed Models, we identified four thought dimensions that relate differently to these affective states: future-self orientation, intrusive distraction, sensory engagement, and task-focus. Alexithymia modulated …

Exploring Factors Influencing Autistic Children And Young People’S Access To Dental Care In Southwest England: A Qualitative Study Of Children, Parents, And Dental Professionals, Jo Erwin, Sarah Neill, Tara Vassallo, Robert Witton, Louise Peters, Isaac Vassallo, Abigail Nelder, Martha Paisi

Peninsula Dental School

Background: Autistic children and young people (CYP) experience inequalities in oral health. They are at higher risk of dental caries and periodontal disease and are more likely to have teeth extracted under general anaesthetic than their non-autistic peers. Poor oral health among autistic CYP results from multiple factors, including sensory sensitivities, communication differences, and difficulties accessing appropriate dental care. This qualitative study explored factors influencing autistic CYP’s access to dental care from the perspective of CYP, parents/carers, and dental health professionals (DHPs). Methods: A qualitative design using semi-structured interviews was adopted. Purposive sampling was used to recruit autistic CYP, parents/carers, …

Widening Participation In Dentistry: A Quantitative Study Of Changing Demographics At A South West Uk Dental School (2014-2021)., Sally Hanks, Ian Mills, Marie Bryce, Daniel Zahra, Rebecca Glanville

Peninsula Dental School

Introduction: Access to National Health Service (NHS) dental care in the UK, particularly in rural and coastal regions such as the South West, remains a significant concern. Increasing socio-economic diversity in the dental workforce has previously been reported to improve access to care in underserved areas. Widening Participation (WP) initiatives aim to address this by encouraging applications from underrepresented groups. Methods: This study analysed admissions data from the University of Plymouth's Bachelor of Dental Surgery (BDS) programme for cohorts between 2014 and 2021. Metrics included entry qualifications, age, gender, ethnicity, disability and socio-economic markers. Statistical analyses included chi-squared tests and …

Home-Based Dual-Task Balance Training For Parkinson’S Disease: A Feasibility Study Of A Randomized Controlled Trial, Nesibe Cakmak, Jennifer Freeman, Camille Carroll, Lisa Bunn

School of Health Professions

Purpose: Dual-task training, incorporating both motor-motor and/or motor-cognitive elements, is recognized as a safe and effective strategy for enhancing balance in individuals with Parkinson’s disease. Despite this, limited research has explored the implementation of dual-task training within a home-based context or superiority of task types. This study aims to investigate the feasibility and acceptability of two novel, unsupervised home-based programmes; each adopting a comparable procedure yet with a focus on motor-motor and motor-cognitive dual-task training.Methods: Six participants with mild to moderate stage Parkinson’s disease wererandomized to group (M-DTT/C-DTT). Each engaged in 30-minute training sessions three times per week over six …

Finding Our Tempo: Exploring Embodied Synchrony Through Full-Body Play In Children, Sena Beste Ercan, Belén González Mateo, Olga Galí Pérez, Gray Atherton, Liam Cross, Narcís Parés

School of Psychology

This study advances the design of timing-sensitive, full-body interactive experiences supporting both collaboration and individual agency in children’s group play. We investigate how temporal structuring within an improved version of a full-body interactive system influences behavioral and perceived synchrony among children aged 9–10. Prior research has often focused on dyads, required human facilitation, or neglected relationship between perceived and actual synchrony. Addressing these gaps, we conducted a multi-user study comparing synchronous and asynchronous interaction modes using system-logged behavioral data and self-reports. Results demonstrate the synchronous condition fosters higher user performance, tighter temporal coordination, and stronger perceptions of shared movement. In …