Digital Commons Network^™

Editorial: Publishing Impact Awarded, Frazer Underwood

South West Clinical School Journal

No abstract provided.

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.

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across healthcare and benefit systems; (2) “It just seemed horrible to me, to take it off me” – pain relief as withdrawn, stigmatised, or conditional; and (3) “Do I want to poke the bear?”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 …

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 …

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 …

Implementation Of An Occupational Therapy-Led, Sensory-Based Intervention In A Secure Children’S Home: A Qualitative Study Of Staff Experiences, Kevin Steede, Alison Warren

School of Health Professions

The Just Right State program (JRSP) is an occupational therapy-based, sensory intervention designed to support self-regulation. Qualitative methodology was used to explore the experiences of five members of staff working in a secure children’s home in training in and implementing the JRSP under the guidance of occupational therapy staff. Using thematic analysis four themes emerged: Sensory regulation training enhanced staff wellbeing, Sensory regulation as a new lens in a unique environment, Embedding theory in practice, and Considerations for the experiential JRSP training. The findings provide insights into effective training and implementation of sensory modulation interventions.

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 …

Partisan Differences In Risk-Taking In A Simulated Pandemic, Jan K. Woike, Sebastian Hafenbrädl, Patricia Kanngiesser, Ralph Hertwig

School of Psychology

Responses to COVID-19 in the United States were split along partisan political lines throughout the pandemic. People on the political left tended to take the medical threat more seriously and were more likely to adopt preventive health behaviors than those on the political right, resulting in clear differences in state-level policies and health consequences. Here, we examine the origins of these differences, investigating whether they are based on interindividual differences or in party dynamics. Two groups of participants (N=819), who had voted either for Donald Trump or Hillary Clinton in 2016, played the Transmission Game. Players made repeated decisions in …

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 …

Variation In Corneal Biomechanical Properties Following Continuous Cross-Linking Treatment, Chenhao Zhao, Xinyu Yao, Yewei Zhao, Hongjiang Wu, Xuanya Tong, Daniela Oehring, Lan Yang, Xiaofei Zhou, Ying Li, Yanjie Shen, Yufeng Ye, Shihao Chen, Jia Qu, Qinmei Wang, Ahmed Elsheikh, Fangjun Bao

School of Health Professions

Background: This retrospective study aimed to evaluate the efficacy of transepithelial accelerated corneal cross-linking (transEpi ACXL) when applied separately or combined with phototherapeutic keratectomy (transPTK ACXL) in keratoconic eyes using biomechanical parameters. Methods: The study included eyes with progressive keratoconus treated with either continuous transEpi ACXL or transPTK ACXL with 6 months follow-up. The following parameters were assessed preoperatively and 6 months postoperatively: biomechanically corrected intraocular pressure (bIOP), maximum and mean keratometry (K _max and K _m), minimum and central corneal thickness (MCT and CCT), corneal coma, best-corrected visual acuity (BCVA), deformation amplitude ratio at 2 mm nasal/temporal (DAR2), …

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

School of Law, Humanities and Social Sciences

No abstract provided.

The Case For The Retrospective Phd By Publication In Dental Academia, James Puryer

Peninsula Dental School

For many mid-career clinicians, the traditional PhD is impractical. We assess how a retrospective PhD by publication provides a flexible, credible model aligned with academic and professional realities.

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 …

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 …

Advancing Fish Tissue Reference Material Development For Ag Nanoparticles Through A Perfusion Approach, Nathaniel J. Clark, Robert Clough, Adam Laycock, Rachel Smith, Richard D. Handy

School of Biological and Marine Sciences

There is a regulatory need for reliable methods to quantify nanoparticles in biological samples for the hazard assessment and bioaccumulation potential of engineered nanomaterials (ENMs). Single particle inductively coupled plasma mass spectrometry (SP-ICP-MS) is a promising technique, but its application is hindered by the lack of validated sample preparation procedures (e.g., solubilisation) and suitable biological reference materials. This study aimed to develop an in-house biological reference material for ENMs to support analytical method validation. Silver nanoparticles (Ag NPs) were introduced into rainbow trout via cardiac perfusion, with the gills and liver collected as target tissues. Tissues were homogenised using a …

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 …

Promoting Positive Youth Development With Adolescent Boys In Uk Schools: A Theory-Driven Evaluation Of The “Becoming A Man” Programme, Finlay Green, Cristina Preece, Kate Allen, Sean Manzi, Julia Mannes, Lynne Callaghan, Vashti Berry, Ediane Santana De Lima, Amy Woodburn, Tim Hobbs, Julie Harris, Nick Axford

Peninsula Medical School

Youth violence, including gender-based violence, is a major public health issue in the UK, yet evidence on effective interventions in the UK remains limited. Becoming a Man (BAM) is a two-year school-based positive youth development programme for adolescent boys, developed in Chicago, US, where two RCTs found reduced violent crime arrests and improved academic engagement. This study evaluated BAM’s potential in the UK using a theory-driven design (no comparison group). 97 boys aged 12–14 years (66% Black/Black British) in three London schools enrolled in BAM. Data sources included: implementation records (recruitment, attendance, adherence, quality, youth socio-demographics); school data (attendance, exclusions, …

Exploration Of Radiotherapy-Related Insufficiency Fractures In Gynaecological Cancer: A Service Evaluation Report, Vicki Hands

South West Clinical School Journal

No abstract provided.

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 …

Barriers And Facilitators To Accessing Addiction Treatment Services For Sexual Minority (Lgbq+) People: Systematic Review, Miriam Hillyard, Beatrice Cockbain, Colin Drummond, Katharine Rimes, Emmert Roberts

School of Psychology

Background Sexual minority (lesbian, gay, bisexual, queer and other non-heterosexual) people experience significant disparities in addiction problems compared with heterosexual people.  Aims We aimed to answer the question, what are the barriers and facilitators to accessing drug/alcohol addiction treatment services for sexual minority adults?’.  Method A systematic review was conducted by searching Medline, PsycINFO, CINAHL, Web of Science, and Sociological Abstracts for any English-language primary research article (qualitative, quantitative or mixed methods) relevant to the study aims, from inception up to 18 April 2025. Quality of included studies was assessed using the Mixed-Methods Appraisal Tool (MMAT-2018). Barriers and facilitators were …

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 …

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 …

Sex And Gender Bias In Major Trauma Care: A Scoping Review, A. Ghika-Nanchen, L. Marzorati, A. Merra, C. Girardello, P. Truong, P. N. Carron, T. Nutbeam, C. Clair, F. X. Ageron

Peninsula Medical School

Background: Sex/gender bias have been well-documented in clinical medicine. However, few studies have assessed sex/gender disparities specifically in major trauma care. This scoping review aims to explore sex and gender-based differences in the emergency management of severely injured patients. Methods: A systematic literature review was conducted in the following electronic databases: Medline Ovid ALL, Embase, CINAHL with Full Text, Web of Science Core Collection, Cochrane Central Register of Controlled Trials with search criteria including keywords and mesh terms: gender, sex, major trauma, wounds and injuries. Three reviewers conducted the article selection. Results: Seventy-four full-text articles were included in the study. …

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 …

Sars-Cov-2 Nonspike Structural Proteins Hijack Mucosa Epithelial Cell Fate, Yan Gao, Lucas Lacerda Souza, Hong Soon Kang, Zehan Li, Juan Carlos Hernandez-Guerrero, Fábio Abreu Alves, Wei Zhang, Vikram Sharma, Sally Hanks, Jinhua Yu, Christopher Tredwin, Anton M. Jetten, Ciro Dantas Soares, Bing Hu

Peninsula Dental School

COVID-19 patients readily present with severe epithelial damage, such as tissue ulceration and erosion, along with disrupted tissue repair, in multiple organs. The mucous membranes of the lung alveoli [1, 2], gastrointestinal tract [3, 4], nasal [5] and oral cavity [6, 7] are the primary targets of the SARS-CoV-2 virus. The infected epithelium triggers a dysregulated immune response that further damages tissues and organs [8, 9–10]. Increasing evidence suggests that the SARS-CoV-2 virus can cause direct damage to epithelial cells and fibroblasts [11, 12–13]. Here, we report that the mucosa epithelia of COVID-19 patients can undergo cellular dedifferentiation before any …

The Difficulty With Setting A Standard Based On Difficulty: The Role Of Validity In Determining Assessment Standards., Steven Burr, Daniel Zahra, Iain M Robinson

Peninsula Medical School

When setting standards for high-stakes assessments, it is necessary to be clear whether the primary criterion should be importance or difficulty. While standard setting practices frequently rely on the difficulty to determine passing or failing thresholds, this can undermine the intended inferences and uses of assessments. Standard setting based on difficulty conflates importance with subjective perceptions of difficulty, misguiding decisions about what candidates need to demonstrate for safe and effective practice. We explore several reasons why difficulty does not align with the aims of assessment and how prioritising importance can better reflect the intended uses and inferences of a test. …

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 …