Digital Commons Network^™

Heterogeneity Of Treatment Effect: The Case For Individualising Oxygen Therapy In Critically Ill Patients, Daniel S Martin, Michael P W Grocott

Peninsula Medical School

Oxygen therapy is ubiquitous in critical illness but oxygenation targets to guide therapy remain controversial despite several large randomised controlled trials (RCTs). Findings from RCTs evaluating different approaches to oxygen therapy in critical illness present a confused picture for several reasons. Differences in both oxygen target measures (e.g. oxygen saturation or partial pressure) and the numerical thresholds used to define lower and higher targets complicate comparisons between trials. The duration of and adherence to oxygenation targets is also variable with consequent substantial variation in both the dose and the dose separation. Finally, heterogeneity of treatment effects (HTE) may also be …

Bridging Classrooms And Communities: The Transformative Impact Of Community-Based Dental Education On The Learning Experiences Of Undergraduate Students, Kamran Ali, Sruthi Sunil, Nidhi Gupta, Rebecca Glanville, T. Vanishree, Sadeq Ali Al-Maweri, Asmaa Al Khtib

Peninsula Dental School

Aims: This study aimed to evaluate the impact of community-based dental education (CBDE) on the learning experiences of undergraduate dental students and recent dental graduates from two diverse geographical regions. Methods: The study followed a cross-sectional design, conducted online using Google Forms, with ethical approval from Qatar University. A non-probability purposive sampling method was used to recruit dental students and recent graduates from three institutions in India and one in Qatar. A questionnaire based on 20 closed-ended items and two open-ended questions, developed by a team of dental academics, was used for data collection. Data analysis involved descriptive statistics, analysis …

What Are Family Caregivers’ Experiences Of Coordinating End-Of-Life Care At Home: A Narrative Review, Harriet Nicholls, Matthew Carey, Kevin Hambridge

School of Nursing and Midwifery

Objectives People with life-limiting diseases, who are no longer receiving active or curable treatment, often state their preferred place of care and death as the home. This requires coordinating a multidisciplinary approach, using available health and social care services to synchronize care. Family caregivers are key to enabling home-based end-of-life support; however, the 2 elements that facilitate success - coordination and family caregiver - are not necessarily associated as being intertwined or one and the same. This narrative review explores family caregiver experiences of coordinating end-of-life care in the home setting. Methods Studies were identified systematically following the Preferred Reporting …

Developing A Citizen Science Approach To Monitor Stranded Marine Plastics On A Remote Small Island In Indonesia, Radisti A. Praptiwi, Carya Maharja, Fauzan Cholifatullah, Dwi Cj Subroto, Sainal Sainal, Peter I. Miller, Vikki Cheung, Tatang Mitra Setia, Nasruddin, Datu, Jito Sugardjito, Melanie Austen

School of Psychology

Marine plastics stranded on the coastlines of remote small islands threaten both the ecological integrity of local ecosystems and communities’ well-being. However, despite the growing quantities of stranded plastics in these locations, the remote nature of these sites renders monitoring and intervention efforts difficult to undertake. Within this context, we developed a citizen science approach to monitor stranded marine plastics in collaboration with villagers living on a remote small island in Indonesia. This study reports the co-development and application of an approach that can be used and maintained independently by remote coastal communities. In the monitoring stage, the participants quantified …

Salinity Does Not Affect Late-Stage In-Egg Embryonic Or Immediate Post-Hatch Development In An Ecologically Important Land Crab Species, Lucy M. Turner, Katharine A. Clayton, Linn Wiberg, Charlotte H. Wilson, Ziad Ibbini, Oliver Tills, John I. Spicer

School of Biological and Marine Sciences

Environmental drivers such as salinity can impact the timing and duration of developmental events in aquatic early life stages of crustaceans, including terrestrial crabs of the family Gecarcinidae. Low salinity delays larval development in land crabs, but nothing is known about its influence on the crucial late-stage encapsulated embryonic or immediate post-hatch development. Therefore, we exposed fertilised late-stage embryos of the Christmas Island red crab (Gecarcoidea natalis) to differing salinities (100%, 75%, 50% or 25% sea water) for 24 h during their spawning period and measured some key developmental and physiological traits. We found no effect of salinity on time …

Bringing Matter, To Matter: ‘Wild Ideas’ About ‘Readiness’ In The Transition From The Early Years Foundation Stage To The Key Stage 1 National Curriculum In England, Katherine Evans

School of Law, Humanities and Social Sciences

‘Readiness’ and transition are topics of ongoing debate in relation to early childhood education. Critiques of schoolification and the impact of a ‘school-readiness’ agenda on policy and practice point to a tendency for increased formalisation of learning as children progress through their early years of schooling. In England, these first years of school-based education involve a transition between different and distinct educational frameworks, from the Early Years Foundation Stage to the National Curriculum in Key Stage 1. This transition can be problematic as tensions emerge between different pedagogical traditions, thus creating a potentially challenging experience for children as they progress …

Assessing The Interrelationships Of Sustainability Drivers In The Liner Shipping Industry: A South Korean Perspective, Junseung Kim, Stavros Karamperidis, Lijun Tang, Saeyeon Roh

Plymouth Business School

Container shipping companies play a crucial role in global trade and bear significant social and environmental responsibilities. Given resource constraints, identifying key sustainable drivers is essential for guiding investments. This study explores sustainability drivers in South Korean liner shipping companies using stakeholder theory. Through literature reviews, expert interviews, and fuzzy Decision-Making Trial and Evaluation Laboratory (f-DEMATEL) method, six key drivers were identified. Sustainability performance improvement emerged as the most important driver. The study also reveals complex casual relationships among the drivers. These findings offer valuable academic and managerial insights.

Exploring Perceived Barriers To Palliative And End Of Life Care Provision In South-West England: Bringing Together The Perspectives Of Professionals, Patients, And Families, Gary Hodge, Gina Kallis, Tomasina Oh, Hannah Wheat, Susie Pearce

School of Nursing and Midwifery

INTRODUCTION: Palliative and End of Life care (PEoLC) in the United Kingdom (UK) is increasingly being reported as inadequate. This is occurring amidst a wider backdrop of health and social care systems facing unprecedented pressure, particularly as they recover from the long-term impact of the COVID-19 pandemic. This study aimed to explore the barriers to PEoLC faced by those providing and receiving care in South-West England (UK). This region of the UK brings its own set of unique challenges due to its rural and coastal location, an aging population, and a historical lack of research.

METHODS: An exploratory study was …

Introduction: From Broken Systems Towards Extended Possibilities Of Xr Technologies, Misha Myers, Victoria Duckett, Katy Morrison, Lienors Torre

School of Art, Design and Architecture

The ‘Extending Realities’ Special Issue originated out of the desire to open discussion between industry and academia around the status of extended reality (XR) in Australia today. Our intention is to generate a dialogue that is community-focused, speculative and reflective, engages a range of communities, and is both forward-moving and backwards-turning. Because of this, we explore critical language and perspectives that are emerging around XR so that we might mark a provisional location point, or at least a record of where some of us think we are–both within the XR community of makers, and within academic communities of scholars and …

Marketing With A Social Conscience: Strategic Windows For Aligning Societal Marketing With Corporate Identity, Christopher Agyapong Siaw

Plymouth Business School

PurposeThis study proposes a conceptual framework for strategically integrating societal marketing (SM) into corporate identity to effectively represent a firm’s SM programs to stakeholders. The framework is crucial for firms to align their SM efforts with their identity in a manner that minimizes, if not eliminating, the accusations of dishonesty, such as greenwashing, brownwashing, or greenhushing.Design/methodology/approachDrawing on corporate identity theory and synthesizing the literature on SM, the study identifies three levels of corporate identity (strategic, operational, and functional) and three dimensions of SM’s alignment with business objectives (direct, indirect, and remote). Subsequently, the study develops a conceptual framework based on …

A Five-Year Retrospective Analysis (2017-2022) Of Reported Incidents From A Primary Care-Based Education Provider, Afsha Musa, Robert Witton, Kamran Ali, Ewen Mccoll

Peninsula Dental School

Background Patient safety incident reporting and analysis are often confined to secondary care, despite 95% of dentistry occurring in primary care. Peninsula Dental Social Enterprise (PDSE) delivers primary care dentistry in education-based settings and uses a report-review-action process to underpin its patient safety framework. Aim This article analyses trends in clinical incident data, reflecting on learning to improve overall patient safety. Methods A retrospective observational study was employed to analyse incidents over a five-year period (2017-2022) using anonymised data from the PDSE reporting system. Results Over the five-year reporting period, there were an average of 13.1 total incidents per 1,000 …

The Simca Study Protocol: Factors Influencing The Implementation Of The Midwifery Continuity Of Carer (Mcoc) Model Of Care In Nhs Maternity Care In England: A Mixed Methods Cross Case Analysis Involving Clinicians, Women And Policy Makers, Rebecca Milton, Susan Channon, Julia Sanders, Sara Kenyon, Aimee Middlemiss, Heather Strange, Kate Davies, Lena Choudary-Salter, Susan Barry, Tina Prendeville, Aled Jones

School of Nursing and Midwifery

Background: During pregnancy, labour and early motherhood, most women in the UK receive care from different midwives. NHS policy change in England sought to introduce a model of care whereby each woman is cared for by the same midwife throughout antenatal, intrapartum and postnatal periods, supported by a small team of midwives to cover off-duty periods. This model is called the Midwifery Continuity of Carer (MCoC). This study proposes to evaluate the implementation and delivery of MCoC across England, aiming to better understand the factors that result in different rates of progress with MCoC implementation. Aim: To identify the local, …

A Pilot And Feasibility Study Investigating The Abundance And Activity Of Nitrate-Reducing Bacteria In Women With Pre-Eclampsia, Lisa Du Toit, Ifeoma Offiah, Alvaro Redondo-Rio, Tanya Kahawita, Michele Kiernan, Yen Ming Lin, Louise A. Belfield, Gemma Montagut, Alicia Benavente, Tomas Nicholas, Amazon Doble, Renske Dikkers, Robert Freeman, Toni Gabaldón, Zoe Brookes, Raul Bescos Garcia

Peninsula Dental School

BackgroundOral health may influence blood pressure control by modulating the abundance and activity of nitrate-reducing bacteria, which are essential for enhancing nitrite and nitric oxide (NO) bioavailability. This study aimed to investigate the oral health and microbiome composition of women with pre-eclampsia (PET) compared to healthy controls (CN).MethodsTen PET and eleven CN women participated in this study, respectively. An oral health examination was conducted in all the participants. Saliva and blood samples were collected for analysis of the oral microbiome and NO biomarkers.ResultsHigher plaque levels were observed in the PET group compared to the CN group (P = 0.038). The …

An Evaluation Of A Community Dementia Screening Program In Rural Kenya: Dem-Sky, Nicolas Farina, Christine W. Musyimi, Kevin Onuonga, David M. Ndetei

Peninsula Medical School

INTRODUCTION: This study describes the implementation outcomes and evaluation of DEM-SKY, a community-based dementia screening program developed in rural Kenya with the support of community health care workers (CHWs). METHODS: DEM-SKY was delivered to 3546 older adults in Makueni County, Kenya, over a 6-month period. Using a mixed-methods design, we explored implementation outcomes with stakeholders through surveys and interviews. RESULTS: The program demonstrated good acceptability, adoption, and fidelity and was effective in instigating behavior change. Individuals who screened positive for dementia were 28.7 times more likely to intend to speak to a doctor. Qualitative data showed that participants valued the …

Abandoning Young People To The Dark Places They Can Find Elsewhere’: The Implications Of The Anti-Radicalisation Policies In Uk Secondary Schools, Freya Cooper

Plymouth Interdisciplinary Education Open Journal

The rise of extremist groups in the United Kingdom has led to the introduction of new policies, created by the Home Office, Home Department and Department for Education. These policies are designed to reduce the risk of radicalisation in young people and schools are required to adhere and promote these policies within their educational institutions. This means that both staff and students are to be protected from the risk of radicalisation, with potential threats being identified and escalated. The legislation covers all types of radicalisation; however, this research is focussing on the way in which it has been used to …

Understanding Pathways To Radicalisation: Examining The Risk Factors Among Uk Secondary School Students, Freya Cooper

Plymouth Interdisciplinary Education Open Journal

With the rise of social media usage, adolescents are becoming easier targets for far-right extremist groups on the internet. There are specific factors that make young people, specifically those of secondary school age, more likely to be at risk of becoming radicalised. The factors explored in this analysis include: developmental stage of youth, gender, and social media. This analysis looks at the patterns of radicalisation and the risk factors that contribute to susceptibility of extremist thoughts, beliefs and occasionally actions. Through placing this investigation within the secondary school setting, this opinion piece explores the implication of this stage of a …

Transforming Higher Education Through Systematic Inclusive Design: Virna Rossi’S Practical Guide To Equitable Learning, Alicja Syska

Plymouth Interdisciplinary Education Open Journal

No abstract provided.

Exploring The Experiences Of Autistic Girls Within Mainstream Primary Education In England, Olivia Jones

Plymouth Interdisciplinary Education Open Journal

Autism Spectrum Disorder (ASD) is a developmental disability that causes social difficulties such as making and maintaining friendships and sensory difficulties that cause distress triggered by light, sound or smell stimuli that significantly impact daily life. Roughly 1 in every 100 children are diagnosed with ASD (NHS Inform, 2023). However, females are notably less likely to receive a formal diagnosis than males, which leads to higher rates of poor mental health and lack of self-acceptance. Females with ASD are likely not to receive their diagnosis or support for their difficulties until late teens or early adulthood. Those diagnosed with ASD …

Opening Doors, Reimagining Publishing: A New Chapter For Pieoj, Alicja Syska, Cara Baer, Claudia Blandon, Katherine Gulliver, Mandy Andrews, James Tarling

Plymouth Interdisciplinary Education Open Journal

This editorial announces the relaunch of the Plymouth Institute of Education Open Journal (PIEOJ), marking its transformation from ‘Online’ to ‘Open’ to reflect its commitment to accessibility and inclusivity in writing and publishing. The issue features five publications related to different facets of Equality, Diversity, and Inclusion (EDI) themes, including research on autistic girls in primary education, case studies and opinion pieces on the radicalisation of secondary school pupils and the anti-radicalisation policies designed to combat it, discussions of research methodology and its ethical aspects, and a book review on inclusive learning design. The editorial emphasises PIEOJ’s role as a …

Soluble Herpes Virus Entry Mediator And Type Ii/Iii Interferons Are Upregulated In Primary Biliary Cholangitis, Yooyun Chung, Hio Lam Phoebe Tsou, Michael A Heneghan, Shilpa Chokshi, Antonio Riva

Peninsula Medical School

Bacterial translocation-induced inflammation and immune dysfunction are recognised factors contributing to the pathogenesis of primary biliary cholangitis (PBC). However, the specific involvement of interferons (IFNs) and soluble checkpoints (sol-CRs) in shaping the immune landscape in PBC patients remains unexplored. Furthermore, the influence of ursodeoxycholic acid (UDC) on these immune mediators is unknown. Twenty-eight cytokines and 14 sol-CRs were quantified by Luminex assays in plasma samples from 64 PBC patients and 10 healthy controls (HCs). D-lactate was measured as a marker of bacterial translocation. The PBC subgroups were: 24 UDC responders (UDCRs), 18 UDC non-responders (UDCNRs) and 22 patients with end-stage …

Cross-Domain Transfer Learning For Domain Adaptation In Autism Spectrum Disorder Diagnosis, Kush Gupta, Amir Aly, Emmanuel Ifeachor

School of Engineering, Computing and Mathematics

A cross-domain transfer learning approach is introduced to address the challenges of diagnosing individuals with Autism Spectrum Disorder (ASD) using small-scale fMRI datasets. Vision Transformer (ViT) and TinyViT models pre-trained on the ImageNet, were employed to transfer knowledge from the natural image domain to the brain imaging domain. The models were fine-tuned on ABIDE and CMI-HBN, using a teacher student framework with knowledge distillation loss. Experimental results demonstrated that our method outperformed previous studies, ViT models, and CNN-based models. Our approach achieved competitive performance (F-1 score 78.72%) with a much smaller parameter size. This study highlights the effectiveness of cross-domain …

Fine Sediment-Associated Contaminants In Gravel Bed Rivers: Evaluating Storage Times And Turnover Using Fallout Radionuclides (Frns), Enrique G. Muñoz-Arcos, Geoffrey E. Millward, Caroline C. Clason, Claudio M. Bravo-Linares, William H. Blake

School of Geography, Earth and Environmental Sciences

Excess fine sediment supply and its associated contaminants can have detrimental effects on water quality and river ecology with sediment deposition on, and subsequent infiltration in, streambeds impacting riverine habitats. Fallout radionuclides (FRNs) are used as tracers in aquatic systems, and the ⁷Be/²¹⁰Pb_ex ratio is a useful indicator for sediment residence/storage time. Suspended and submerged mid-channel bar sediments were collected during five surveys within a 5 km reach of a typical temperate lowland agricultural river system. Solids were analysed by gamma (⁷Be and ²¹⁰Pb_ex) and inductively coupled plasma (ICP, trace metals …

Extremism And The Potential Dismantling Of Special Education: Or Moving Forward With Inclusive Special Education., Garry Hornby, James M. Kauffman

More Faculty of Arts, Humanities and Business Research

Extremism in special education has been an endemic feature for decades but its most recent iteration, the full inclusion movement (FIM), is pushing special education toward a radical ideology in which placement in mainstream schools, rather than providing effective instruction, is becoming the main focus of efforts to meet the needs of students with special educational needs and disabilities (SEND). We first review some realities that we believe are basic to special education as it has been conceptualised and practiced. Second, we provide examples of the rhetoric of supporters of the full inclusion movement that do not conform to those …

Exploring The Challenges Which Influence General Dental Practitioners' Participation As Educational Supervisors In Dental Foundation Training In The South West Of England, Hesham Matabdin, Ian Mills, Amy Rathbone, Laura Clarry, Sally Hanks

Peninsula Dental School

Introduction The challenges of recruitment and retention of dentists within the NHS are a major contributory factor in delivering dental access. Availability and geographical location of dental foundation training (DFT) placements is considered to be an important element in recruiting new dental graduates to poorly served areas. A recent decline in the number of dentists applying to act as educational supervisors (ESs) for DFT has been observed, which could have a direct impact on the future sustainability of NHS services.Aims This study aimed to explore the challenges faced by ESs which influence participation in DFT in South West England.Design A …

Saying Hello Again Rather Than A Long Goodbye: A Novel Way Of Addressing Pre-Death Grief And Facilitating Continuing Bonds For Dementia Caregivers, Elizabeth Gilmour, Edith Steffen

School of Psychology

The ‘Hello Again’ letter-writing intervention is sometimes used in grief counselling to facilitate continuing bonds with the deceased. Family member caregivers of those with dementia often experience a ‘long goodbye’, as the relationship with their loved one gradually changes through serial losses before they have physically died, making the relationship markedly different than the one before the dementia. There are limited interventions to support caregivers with this pre-death grief. This study aimed to address this lack by offering the ‘Hello Again’ intervention to dementia family caregivers, exploring the perceived helpfulness of the task, and attempting to understand the meanings of …

How Research Into Citizenship Education At University Might Enable Transformative Human Rights Education, Piers Von Berg

School of Law, Humanities and Social Sciences

This article presents a new research design for pedagogical research at university. The design demonstrates how personal and cultural citizenship education can be a form of transformative human rights education by nurturing citizens who challenge patterns of exclusion. It draws on shared traditions of citizenship and human rights education that have focused on lived experiences of injustice and uses spaces that mitigate prevailing power structures. These ideas have shaped a new pedagogical action research design that uses theories and practices of transformational learning, authentic reflection, and participatory theatre to stimulate ‘becomings’ in civic identity and agency. ‘Becoming’ is a form …

Extrication Following A Motor Vehicle Collision: A Consensus Statement On Behalf Of The Faculty Of Pre-Hospital Care, Royal College Of Surgeons Of Edinburgh, Tim Nutbeam, Rob Fenwick, Charlotte Haldane, Caroline Leech, Emily Foote, Simon Todd, David Lockey

Peninsula Medical School

Background: Road traffic injury is the leading cause of death among young people globally, with motor vehicle collisions often resulting in severe injuries and entrapment. Traditional extrication techniques focus on limiting movement to prevent spinal cord injuries, but recent findings from the EXIT project challenge this approach. This paper presents updated recommendations from the Faculty of Pre-Hospital Care (FPHC) that reflect the latest evidence on extrication practices. Methods: A systematic scoping review identified 170 relevant articles from 7083 records. Findings, together with EXIT project data, informed the development of 12 core and supplemental statements on extrication. In April 2024, 43 …

A New Approach: Using Biometric Technology To Explore The Physiological Stress Of Working In Child Welfare, Austin Griffiths, Kim Link, Kara Haughtigan, Oliver Beer, Lindsey Powell, David Royse

School of Health Professions

Job stress among child welfare professionals affects their mental and physical health and is associated with negative outcomes. Researchers have used self-report measures to document the stress experienced by those in the child welfare field, and this is the first study to use biometric technology across 72 h to identify physiological indicators of stress, recovery, and sleep in frontline child welfare workers in mostly rural areas (n = 32). A stress profile of the participants is presented on their heart rates, mean time-stressed, percent of time stressed, mean time relaxed, percent of time relaxed, mean sleep time, mean RMSSD in …

How Confident Are Final Year Students With The Speech And Language Interventions Utilised For The Educational And Social Development Of Children With Autism In One Mainstream School In South Devon?, Sadie Spira

Plymouth Interdisciplinary Education Open Journal

The aim of my research was to discover what speech and language intervention strategies are used in a mainstream school to assist children with autism, and how confident student teachers feel about these particular strategies. My method was to conduct semi-structured interviews with teachers from a mainstream school and online questionnaires for final year student teachers. This approach was adopted in order to position questionnaires for student teachers into a real context and compare their ideas about interventions to the strategies actually used in a school. After completing my research, a significant conclusion reached is that student teachers need more …

Childhood And Well-Being In Bangladesh: A Focus On Gender Inequalities, Child Marriage And Climate Change Issues, Zoe Durston

Plymouth Interdisciplinary Education Open Journal

This paper uses literature to explore the gender inequalities, the issues of child marriage, and the struggles being faced as a result of climate change in Bangladesh. It highlights the key issues of each topic, and how these issues are linked; and examines how they are being exacerbated by climate change. The paper then focuses on the work that is being done by Non-Governmental Organisations in order to address the Sustainable Development Goals, and highlights what work still needs to be done. It is concluded that education is key to making progress in terms of gender equality, reducing rates of …