Digital Commons Network^™

What Is The Volume, Quality And Characteristics Of Evidence Relating To The Effectiveness And Cost-Effectiveness Of Multi-Disciplinary Occupational Health Interventions Aiming To Improve Work-Related Outcomes For Employed Adults? An Evidence And Gap Map Of Systematic Reviews, Elizabeth Shaw, Michael Nunns, Stuart G. Spicer, Hassanat Lawal, Simon Briscoe, G. J. Melendez-Torres, Ruth Garside, Kristin Liabo, Jo Thompson Coon

Peninsula Medical School

Background: In the UK, tens of millions of working days are lost due to work-related ill health every year, costing billions of pounds. The role of Occupational Health (OH) services is vital in helping workers to maintain employment when they encounter injury or illness. OH providers traditionally rely on a clinical workforce to deliver these services, particularly doctors and nurses with OH qualifications. However, the increasing demand for OH services is unlikely to be met in the future using this traditional model, due to the declining number of OH-trained doctors and nurses in the UK. Multi-disciplinary models of OH delivery, …

Relationships Between Electronic Handgrip Dynamometer Derived Muscle Function And Purdue Pegboard Performance, Samantha Fitzsimmons

Health Nutrition and Exercise Science

Purpose: To examine the relationships of electronic handgrip dynamometer and accelerometer derived maximal handgrip strength (HGS), sub-maximal control, and neuromuscular steadiness on Purdue Pegboard Test (PPT) performance in older adults. Methods: The analytic sample included 30 generally healthy community-dwelling older adults (age 72.4±5.3). Participants squeezed the handgrip dynamometer with maximal effort on each hand to determine strength capacity. A 25% sub-maximal target was calculated from maximal HGS, and participants were asked to maintain this target for 10-seconds for sub-maximal control. The accelerometer, which was placed on top of the handgrip dynamometer, quantified neuromuscular steadiness. Standard protocols were used for PPT. …

The Effects Of An Acute Session Of Blood Flow Restriction Exercise On Autonomic Modulation, Andrew Garner

Health Nutrition and Exercise Science

PURPOSE: How an acute training session of blood flow restriction (BFR) exercise affects autonomic modulation during a unilateral knee extension exercise. METHODS: Fourteen physically active males completed three different sessions while performing a unilateral knee extension exercise. The dependent variables measured: Heart rate variability (HRV), muscle oxygen saturation (SmO2), and rating of perceived exertion (RPE). Repeated measures ANOVAs were used to analyze HRV and SmO2 data. A paired t-test was used to analyze RPE data. RESULTS: Significant time-effect differences were found in lnRMSSD, lnHF, and lnLF at baseline to 15 minutes post-exercise and 15 to 30 minutes post-exercise (P < 0.05). Time and group-effect differences were significant in SmO2%, oxygenated, and deoxygenated hemoglobin in the vastus lateralis (VL) muscle in BFR compared to control (P < 0.05). RPE increased when BFR was applied (P < 0.05). CONCLUSION: Exercise protocol may need to be altered to show autonomic modulation changes.

Associations Of Antioxidant Consumption From Food And Supplement Sources On Cognitive Function In Older Adults, Kelly Knoll

Health Nutrition and Exercise Science

Oxidative stress, the imbalance of prooxidants and antioxidants, has been recognized as a possible risk factor for cognitive impairment. We postulate that increased dietary antioxidant consumption could help preserve cognitive function during aging. Dietary intake and cognitive function of 50 adults aged ≥65-years (66% women; aged 71.5±5.1 years) was assessed using Cronometer, an electronic nutrition analysis application, and the Saint Louis University Mental Status examination. The fisher’s exact test (p < 0.01) identified a significantly lower percentage of cognitive dysfunction (31.6%; 6 of 19 participants) among participants that met the Recommended Daily Allowances (RDAs) for the antioxidants, vitamin C, vitamin E, selenium, and manganese, and a higher percentage of cognitive dysfunction among those that did not meet the antioxidant RDAs (74.2%; 23 of 31 participants). However, mean cognitive scores differed insignificantly between those meeting RDAs (26.2 ±4.2 points) and those that did not (24.9 ±2.9 points; p = 0.07).

The Cost Of Providing Care By Family And Friends (Informal Care) In The Last Year Of Life: A Population Observational Study, Miriam J. Johnson, David C. Currow, Jade Chynoweth, Helen Weatherly, Gamze Keser, Ann Hutchinson, Annie Jones, Laurie Dunn, Victoria Allgar

Peninsula Medical School

Introduction: Little is known about replacement costs of care provided by informal carers during the last year of life for people dying of cancer and non-cancer diseases. Aim: To estimate informal caregiving costs and explore the relationship with carer and decedent characteristics. Design: National observational study of bereaved carers. Questions included informal end-of-life caregiving into the 2017 Health Survey for England including estimated recalled frequency, duration and intensity of care provision. We estimated replacement costs for a decedent’s last year of life valuing time at the price of a substitutable activity. Spearman rank correlations and multivariable linear regression were used …

Improved Structure And Function In Early-Detected Second-Eye Neovascular Age-Related Macular Degeneration: Fasbat/Early Detection Of Neovascular Age-Related Macular Degeneration Report 1, Fasbat Study Group, Richard P Gale, Archana Airody, Sobha Sivaprasad, Rachel L W Hanson, Victoria Allgar, Martin Mckibbin, Antony B Morland, Tunde Peto, Mia Porteous, Usha Chakravarthy

Peninsula Medical School

PURPOSE: Visual acuity (VA) and structural biomarker assessment before and 24-months after early detection and routine treatment of second-eye involvement with neovascular age-related macular degeneration (nAMD) and additional comparison with the first eye affected.

DESIGN: Prospective, 22-center observational study of participants with unilateral nAMD in the Early Detection of Neovascular AMD (EDNA) study, coenrolled into the Observing Fibrosis, Macular Atrophy and Subretinal Highly Reflective Material, Before and After Intervention with anti-VEGF Treatment (FASBAT) study for an additional 2-year follow-up.

PARTICIPANTS: Older adults (> 50 years) with new onset nAMD in the first eye.

METHODS: Assessment of both eyes with OCT, …

Transformation Of Autophagic Sqstm1 Droplets To Sqstm1-Dependent P-Bodies, Evelina Valionyte, Elizabeth R. Barrow, Chris R. Baxter, Sharon Herath, Shouqing Luo

Peninsula Medical School

SQSTM1/p62 droplets play crucial roles in droplets-based macroautophagy/autophagy including selective autophagy and bulk autophagy. We observed that under several stress milieus, SQSTM1 droplets entirely colocalize with P-body markers, and these stress-induced SQSTM1 droplets contain mRNAs. We thus determined that under certain stress conditions, autophagic SQSTM1 droplets are converted to a type of enlarged P-bodies, designated SQSTM1/p62-dependent P-bodies (pd-PBs). Stress-enhanced SQSTM1 droplet formation drives the nucleation of pd-PBs through the interaction between SQSTM1 and the RNA-binding protein DDX6. Furthermore, pd-PBs sequester PYCARD, facilitating the assembly of NLRP3 inflammasomes, and in turn induce inflammation-related cytotoxicity. Our study suggests that under stress settings, …

Effect Of Skin Tone On The Accuracy Of The Estimation Of Arterial Oxygen Saturation By Pulse Oximetry: A Systematic Review, Daniel Martin, Chris Johns, Lexy Sorrell, Eugene Healy, Mandeep Phull, Segun Olusanya, Mark Peters, Jeremy Fabes

Peninsula Medical School

Background: Pulse oximetry-derived oxygen saturation (SpO₂) is an estimate of true arterial oxygen saturation (SaO₂). The aim of this review was to evaluate available evidence determining the effect of skin tone on the ability of pulse oximeters to accurately estimate SaO₂. Methods: Published literature was screened to identify clinical and non-clinical studies enrolling adults and children when SpO₂ was compared with a paired co-oximetry SaO₂ value. We searched literature databases from their inception to March 20, 2023. Risk of bias (RoB) was assessed using the QUADAS-2 tool. Certainty of assessment was evaluated …

Preoperative Aerobic Fitness And Perioperative Outcomes In Patients Undergoing Cystectomy Before And After Implementation Of A National Lockdown, Nicholas Tetlow, Amy Dewar, Pietro Arina, Melanie Tan, Ashwin N. Sridhar, John D. Kelly, Nishkantha Arulkumaran, Robert C.M. Stephens, Daniel S. Martin, Suneetha R. Moonesinghe, John Whittle

Peninsula Medical School

Background: Lower fitness is a predictor of adverse outcomes after radical cystectomy. Lockdown measures during the COVID-19 pandemic affected daily physical activity. We hypothesised that lockdown during the pandemic was associated with a reduction in preoperative aerobic fitness and an increase in postoperative complications in patients undergoing radical cystectomy. Methods: We reviewed routine preoperative cardiopulmonary exercise testing (CPET) data collected prior to the pandemic (September 2018 to March 2020) and after lockdown (March 2020 to July 2021) in patients undergoing radical cystectomy. Differences in CPET variables, Postoperative Morbidity Survey (POMS) data, and length of hospital stay were compared. Results: We …

Perioperative Oxygenation—What's The Stress?, Joseph Larvin, Mark Edwards, Daniel S. Martin, Martin Feelisch, Michael P.W. Grocott, Andrew F. Cumpstey

Peninsula Medical School

Oxygen is the most used drug in anaesthesia. Despite such widespread use, optimal perioperative oxygen administration remains highly controversial because of concerns about the competing harms of both hyperoxia and hypoxia. Notwithstanding a Cochrane review concluding that routinely administering a fractional inspired oxygen concentration (FiO₂) >0.6 intraoperatively might increase postoperative morbidity and mortality, the World Health Organization (WHO) currently recommends all anaesthetised patients receive 0.8 FiO₂ during and immediately after surgery to reduce surgical site infections. Results from the largest trial available at the time of these two reviews (suggesting long-term survival may be worse with high …

Optimizing Group Work Strategies In Virtual Dissection, Lily Evans, Lauren Singer, Daniel Zahra, Ifeoluwa Agbeja, Siobhan M. Moyes

Peninsula Medical School

Due to its haptic and interactive nature, virtual anatomy provides an opportunity for small-group learning, enabling students to develop their group work skills before they graduate. However, there is currently little practical guidance supported by pedagogic principles detailing how to incorporate it into curricula. Anatomy educators at the University of Plymouth conducted action research aiming to capture students' overall perceptions of the virtual anatomy platform Anatomage. Questioning the benefits and challenges students face while interacting with Anatomage prompted the creation of evidence-based interventions to be later evaluated. Although a plethora of themes were identified, this report specifically examines those relating …

Protecting The Mental Health Of People Seeking Sanctuary In The Uk's Evolving Legislative Landscape, Rohit Shankar

Peninsula Medical School

No abstract provided.

Ship Recycling In Developing Economies Of South Asia: Changing Liability To A Commodity, Bisma Mannan, Md Jahir Rizvi, Yong Ming Dai

School of Engineering, Computing and Mathematics

The end-of-life (EOL) of ships which is neglected and considered a liability by developed economies of the western world. However, it has become a commodity in the developing economies of South Asian countries. Ship recycling activities are considered extremely dangerous by the International Labour Organization (ILO); however, if ship recycling operations are well-managed then they can play a vital role in achieving circular economy and UN sustainable development goals. This study critically examines recent developments in key ship recycling nations, shedding light on both opportunities and challenges faced by this evolving industry. By delving into the socio-economic benefits and presenting …

Incidence Of Diabetes After Sars-Cov-2 Infection In England And The Implications Of Covid-19 Vaccination: A Retrospective Cohort Study Of 16 Million People, Kurt Taylor, Sophie Eastwood, Venexia M. Walker, Genevieve Cezard, Rochelle Knight, Marwa Al Arab, Yinghui Wei, Elsie M.F. Horne, Lucy Teece, Harriet Forbes, Alex Walker, Louis Fisher, Jon Massey, Lisa Hopcraft, Tom Palmer, Jose Ignacio Cuitun Coronado, Samantha Ip, Simon Davy, Iain Dillingham, Caroline Morton, Felix Greaves, John Macleod, Ben Goldacre, Angela Wood, Nishi Chaturvedi, Jonathan A.C. Sterne, Rachel Denholm, The Opensafely Collaborative

School of Engineering, Computing and Mathematics

Background: Some studies have shown that the incidence of type 2 diabetes increases after a diagnosis of COVID-19, although the evidence is not conclusive. However, the effects of the COVID-19 vaccine on this association, or the effect on other diabetes subtypes, are not clear. We aimed to investigate the association between COVID-19 and incidence of type 2, type 1, gestational and non-specific diabetes, and the effect of COVID- 19 vaccination, up to 52 weeks after diagnosis. Methods: In this retrospective cohort study, we investigated the diagnoses of incident diabetes following COVID-19 diagnosis in England in a pre-vaccination, vaccinated, and unvaccinated …

Social Connections And Social Identity As A Basis For Learning And Support: Experiences Of Medical Students With Minoritised And Non-Minoritised Ethnic Identities, Stephanie Bull, Rohini Terry, Neil Rice, Daniele Carrieri, Mark Tarrant, Gerens Curnow

School of Psychology

Background: Social connections between medical students provide a key basis for learning and support. These connections, and associated social identity, may be patterned by ethnicity, and students often perform similarly academically to those they connect with. The mechanisms that underpin the formation of these connections and the role that they play are not fully understood. This study explored how medical students connect with each other, and the potential impact of this on their academic attainment and well-being, with a focus on students with minoritised ethnic identities. Methods: A mixed methods study combining (1) a survey to establish the number and …

Hermit Crabs As Model Species For Investigating The Behavioural Responses To Pollution, Mark Briffa, Gareth Arnott, Jörg D. Hardege

School of Biological and Marine Sciences

Human impacts on the environment affect organisms at all levels of biological organisation and ultimately can change their phenotype. Over time, phenotypic change may arise due to selection but individual phenotypes are also subject to change via genotype × environment interactions. In animals, behaviour is the most flexible aspect of phenotype, and hence the most liable to change across environmental gradients including exposure to pollution. Here we review current knowledge on the impacts of pollution, broadly defined to include the release of substances, energy, and the effects of carbon emissions, on the behaviour of a highly studied group, the globally …

Co-Producing Ethics Guidelines Together With People With Learning Disabilities, Mary Bottomley, Jodie Bradley, Lisa Clark, Bryan Collis, Bojana Daw Srdanovic, Victoria Farnsworth, Annie Ferguson, Dan Goodley, Andrew Fox, Nikita K. Hayden, Charlotte Lawthom, Rebecca Lawthom, Claudia Magwood, Robert Mclean, Ian Middleton, Alison Owen, Matty Prothero, Simon Rice, Simon Richards, Katherine Runswick-Cole, Kelly Scargill, Rohit Shankar, Toni Ann Wood

Peninsula Medical School

Background: We are a research team of clinical, academic and advocacy-based researchers with and without learning disabilities, working on the Humanising Healthcare (for people with learning disabilities) project. The project is dedicated to finding and sharing healthcare practices that enhance the lives of people with learning disabilities. As part of our ethics applications to access National Health Service study sites for fieldwork, we worked together to write guiding principles for co-producing research ethics with researchers with learning disabilities. In this paper, we introduce these Participatory Ethics Good Practice Guidelines and reflect on our collaboration. Methods: We reflect on developing the …

Mapping Patients’ Online Record Access Worldwide: Preliminary Results From An International Survey Of Healthcare Experts, A Kharko, C Blease, M Johansen, A Moen, Et Al

Peninsula Medical School

While research on the effects of patient access to health records is increasing, a basic understanding of the spread of patient-accessible electronic health records worldwide is lacking. In this survey of healthcare experts with professional and personal experience from 29 countries, we explored the state of patient online record access (ORA). We asked participants whether ORA exists in their country and which information is available through it. Experts in all polled countries reported having some national access to health records, with 6 (21%) countries providing exclusively paper-based records and 23 (79%) countries having ORA. Overview of test/lab results and prescription/medication …

Do I Sound Anxious? Emotional Arousal Is Linked To Changes In Vocalisations In Domestic Chicks (Gallus Gallus Dom.), Sarah A. Collins, Katherine Herborn, Kenneth J. Sufka, Lucy Asher, Ben Brilot

School of Biological and Marine Sciences

A major goal in animal welfare science is the development of methods that quantify or ‘read-out’ current affective states in freely behaving animals. In mammalian models, changes in acoustic parameters within vocalisations have been linked to differences in emotional arousal, although there are very few studies showing changes in vocalisations that act as indicators of valence (positive or negative affect). Currently, there are very few studies on vocal indicators of emotion in birds. To determine the link between acoustic parameters within vocalisations and emotion in domestic chicks (Gallus gallus dom.), we used a well-validated paradigm that purports to elicit two …

Victim Of Changes? Marine Macroalgae In A Changing World, Mick E. Hanley, Louise B. Firth, Andy Foggo

School of Biological and Marine Sciences

Background Marine macroalgae (‘seaweeds’) are a diverse and globally distributed group of photosynthetic organisms that together generate considerable primary productivity, provide an array of different habitats for other organisms, and contribute many important ecosystem functions and services. As a result of continued anthropogenic stress on marine systems, many macroalgal species and habitats face an uncertain future, risking their vital contribution to global productivity and ecosystem service provision. Scope After briefly considering the remarkable taxonomy and ecological distribution of marine macroalgae, we review how the threats posed by a combination of anthropogenically induced stressors affect seaweed species and communities. From there …

The Policy And Politics Of Healthcare Corporatisation: The Case Of The English Nhs, Rod Sheaff, Pauline Allen, Mark Exworthy, Russell Mannion

Peninsula Medical School

Rationale: Few accounts of healthcare corporatisation examine the effects of the 2008 financial crisis. New Politics of the Welfare State (NPWS) theories recognise the relevance of crises but give more attention to programmatic than systemic (structural) retrenchment, and little to healthcare corporatisation. Objective: To examine what changes the 2008 financial crisis produced in the pattern of healthcare corporatisation, and the implications for NPWS theories. Methods: Using administrative data from the English NHS during 1995–2019 we formulated a multi-dimensional index of corporatisation, tested its validity, and used it to analyse longitudinally how the financial crisis affected the balance between the responsibilization …

Practical Actions To Strengthen Capacity For Deep-Water Research In Africa, Kirsty A Mcquaid, Kerry Howell, Agnes W.N. Muthumbi, Olusola Adeoye, Isa Elegbede, Luther Adams, Blessing Charuka, Ana Hilário, Hendrina Kadila, Sophia Laarissa, Randa Mejri, Sidi Mohamed, Damaris Mutia, Angela Nyangwe, Angus Paterson, Sinothando Shibe, Kerry Sink, Sheena Talma, Urias Taylor, Arthur Tuda

School of Biological and Marine Sciences

While Africa's deep marine biodiversity offers economic prospects it also supports crucial ecosystem services and sustainable development is dependent on knowledge of these systems. Building understanding of deep-water ecosystems is key, but there are substantial discrepancies in countries' abilities to achieve this. Coinciding with the 2024 Ocean Decade Conference, the Challenger 150 African Network of Deep-water Researchers is pleased to release a report on “Practical Actions to Strengthen Capacity for Deep-water Research in Africa”. Through a series of online workshops, the ANDR brought together 98 individuals from 19 African nations to discuss challenges for deep-water research in Africa, identify solutions …

Amplifying Pcr Productivity And Environmental Sustainability Through Shortened Cycling Protocols, Matthew Pedlar, Matthew J. Emery, Philip J. Warburton

School of Biological and Marine Sciences

Since its inception in the 1980s, advancements in PCR technology using improved thermal cyclers, engineered DNA polymerases and commercial master mixes, have led to increased PCR productivity. Despite these advancements, PCR cycling protocols have largely remained unchanged over the same period. This study aimed to systemically evaluate the effect of reduced PCR cycling parameters on amplicon production. The 1466bp fragment from the 16S rRNA gene present in low-, medium- and high-CG bacteria was amplified using three commercially available PCR master mixes. The shortest cycling parameters required to successfully amplify the 16S fragment from all bacteria and master mixes comprised 30-cycles …

Unfit: Eugenics On The Northern Great Plains, Levi Magnuson

History, Philosophy, and Religious Studies

The early twenty-first century saw the emergence of the eugenics movement in the United States, which culminated in the sterilization of people with mental or physical disabilities. State institutions across the country were weaponized against these citizens due to the perception that they were “unfit” to be parents. Recent scholarship on the topic has sought to uncover this history. This study seeks to uncover this past in both North and South Dakota as well as offer an alternative avenue for examining the topic with Canton Hiawatha Asylum for Insane Indians. Both states provide instances that confirm the current scholarship on …

Digital Seascapes: Can We Use Digital Technologies To Engage Coastal Communities In Building Marine Citizenship?: Resilience And Adaptation: Parallel Workshop (6), Ashita Gupta, Katharine Willis

School of Art, Design and Architecture

No abstract provided.

Enhancing The Student Nurse Clinical Experience Through Collaborative Academic-Hospital Partnerships: The Piloting And Psychometric Testing Of A New Instrument To Measure Nursing Student Perceptions Of Nursing Staff During Clinical Learning Experiences, Charys Kunkel

Education

There is a critical national nursing workforce shortage, with estimates of over 200,000 new job openings for Registered Nurses (RNs) annually through 2031 (AACN, 2022). These forecasted workforce needs challenge nursing programs to increase student enrollment (Dowling et al., 2021) while maintaining high-quality education standards. Student learning is facilitated by collaborative academic healthcare practices that provide active learning environments for students to engage in direct patient care under the direct supervision of a licensed nurse. The interactions between students and mentors within the clinical environment are essential for cultivating a sense of belonging while fostering the development of the professional …

Drug-Resistant Epilepsy And Ketogenic Diet Therapy – A Qualitative Study Of Families’ Experiences, Jennifer H. Carroll, Tracey Parkin, J. Helen Cross, Mary Hickson, Emma Williams, Val Aldridge, Avril Collinson

School of Health Professions

Background: A diagnosis of drug-resistant epilepsy is life changing for a family. Ketogenic diet therapy (KDT) can offer hope when other treatments have failed. However, it often requires a significant change in daily routine and dietary habits. This qualitative descriptive study aimed to explore families’ experiences of epilepsy and KDT. Methods: Parents of a child aged ≤18 years with epilepsy, currently or recently treated with KDT, were recruited from the UK and internationally via UK Ketogenic Diet (KD) centres, charities, and social media. Semi-structured interviews were audio recorded, transcribed verbatim, anonymised, coded using Nvivo (V12), and inductive thematic analysis undertaken. …

The Effectiveness Of Motor-Motor And Motor-Cognitive Dual-Task Training Interventions On Balance In People With Parkinson’S Disease: Rct Design, Feasibility, And Acceptability Testing, Nesibe Cakmak

School of Health Professions Theses

Background: Dual-task training (DTT), utilized in motor-motor (M-DTT) and/or cognitive-motor (C-DTT) forms, has been identified as an effective and safe approach to improve balance in people with Parkinson’s disease (pwPD). Studies which investigate the superiority of the effectiveness of M-DTT and CDTT interventions, however, are lacking. To determine superiority there is a need to design a randomized control trial (RCT). This PhD study, therefore, had two aims. Firstly, to design home-based M-DTT and C-DTT interventions for improving upright balance in people with mild to moderate PD. Secondly to test the feasibility and acceptability of the interventions, outcome measures, and the …

Shape Discrimination In Central And Peripheral Vision And Its Potential For Vision Screening, Anna Zolubak

School of Health Professions Theses

Background and aims: Radial frequency (RF) shape discrimination with small central and achromatic stimuli has been successfully used in vision monitoring tests for age related macular degeneration (AMD). This thesis aims to provide basic vision research in the peripheral visual field (VF) that can expand the versatility and sensitivity of the current tests. Methods: The research described herein used visual psychophysics to explore RF shape discrimination under different conditions in normal vision. Aspects explored included chromatic and luminance mechanisms, retinal location, size and scaling, binocular interactions and effects of simulated scotoma, concentric and eccentric presentation, and interval and spatial methods. …

The Importance Of Acoustic Output Measurement And Monitoring For The Replicability Of Transcranial Ultrasonic Stimulation Studies, Miriam C. Klein-Flügge, Elsa F. Fouragnan, Eleanor Martin

School of Psychology

No abstract provided.