Digital Commons Network^™

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 …

Training Needs For Staff Providing Remote Services In General Practice: A Mixed-Methods Study, Trisha Greenhalgh, Rebecca Payne, Nina Hemmings, Helen Leach, Isabel Hanson, Anwar Khan, Lisa Miller, Emma Ladds, Aileen Clarke, Sara E. Shaw, Francesca Dakin, Sietse Wieringa, Sarah Rybczynska-Bunt, Stuart D. Faulkner, Richard Byng, Asli Kalin, Lucy Moore, Joseph Wherton, Laiba Husain, Rebecca Rosen

Peninsula Medical School

Background Contemporary general practice includes many kinds of remote encounter. The rise in telephone, video and online modalities for triage and clinical care requires clinicians and support staff to be trained, both individually and as teams, but evidence-based competencies have not previously been produced for general practice. Aim To identify training needs, core competencies, and learning methods for staff providing remote encounters. Design and setting Mixed-methods study in UK general practice. Method Data were collated from longitudinal ethnographic case studies of 12 general practices; a multi-stakeholder workshop; interviews with policymakers, training providers, and trainees; published research; and grey literature (such …

Psychosocial Factors Associated With Physical Activity In People With Dementia: A Pilot Cross-Sectional Study, Nicolas Farina, Uzma Niazi, Riona Mc Ardle, Johanna Eronen, Ruth Lowry, Sube Banerjee

Peninsula Medical School

Objectives: To understand how psychosocial factors associated with physical activity differ based on disease severity in people with dementia, and how these factors are associated with physical activity participation. Methods: Eighty-seven people with dementia, alongside their family carer were asked to complete a series of questions related to physical activity participation, including barriers, motivators, and facilitators. Regression models were developed to understand how psychosocial factors were associated with physical activity participation in the cohort. Results: In the final models, only the absence of intrapersonal barriers was associated with overall physical activity and regular moderate-to-vigorous physical activity. Feelings of relatedness were …

The Mini-Cog: A Community Screening Tool For Dementia In Indonesia, Yuda Turana, Nicolas Farina, Imelda Theresia, Tara Puspitarini Sani, Ika Suswanti, Fasihah Irfani Fitri, Emiliano Albanese, Adelina Comas-Herrera, Martin Knapp, Sube Banerjee

Peninsula Medical School

Background: Early detection of dementia enables more effective planning and can enable access to treatment and support. The Mini-Cog is a widely used screening instrument in Indonesia; however, this instrument has never undergone a translation and cultural adaptation process. Currently, there is no data on how accurate the tool is against diagnostic criteria, particularly in low-education. Methods: Embedded within the community-based dementia prevalence study was the Strengthening Responses to Dementia in Developing Countries (STRiDE) project; older adults (aged ≥ 65 years) were randomly recruited from sites in Jakarta and North Sumatra, Indonesia. All participants were asked to complete the Mini-Cog …

Collaborative Care Intervention For Individuals With Severe Mental Illness: The Partners2 Programme Including Complex Intervention Development And Cluster Rct, Humera Plappert, Richard Byng, Siobhan Theresa Reilly, Charley Hobson-Merrett, Jon Allard, Elina Baker, Nicky Britten, Melanie Calvert, Michael Clark, Siobhan Creanor, Linda Davies, Rebecca Denyer, Julia Frost, Linda Gask, Bliss Gibbons, John Gibson, Laura Gill, Ruth Gwernan-Jones, Joanne Hosking, Peter Huxley, Alison Jeffery, Benjamin Jones, Tom Keeley, Richard Laugharne, Steven Marwaha, Claire Planner, Tim Rawcliffe, Ameeta Retzer, Debra Richards, Ruth Sayers

Peninsula Medical School

Background and aims: Individuals living with severe mental illness such as schizophrenia and bipolar can have significant emotional, cognitive, physical and social challenges. Most people with severe mental illness in the United Kingdom do not receive specialist mental health care. Collaborative care is a system of support that combines clinical and organisational components to provide integrated and person-centred care. It has not been tested for severe mental illness in the United Kingdom. We aimed to develop and evaluate a primary care-based collaborative care model (PARTNERS) designed to improve quality of life for people with diagnoses of schizophrenia, bipolar or other …

Nature-Based Approaches: A Mixed Methods Study Of Facilitators And Barriers To Implementation In Camhs, Siobhan B. Mitchell, Beth Chapman, Rachel Hayes, Hélène Bonnici, Hazel Banks, Silvana Mareva, Rebecca Hardwick

Peninsula Medical School

Background: There is growing evidence that spending time with or in nature can be beneficial for health and wellbeing. Emerging evidence suggests potential benefits for staff and service users in healthcare settings, yet little is known about how to put Nature-based approaches (NBAs) into practice within the Child and Adolescent Mental Health Services (CAMHS) setting. The CAMHS Goes Wild project in Southwest England aimed to explore the implementation of NBAs within CAMHS, examining staff attitudes and understanding to identify potential benefits and challenges through a mixed methods study. Methods: The study involved three phases of data collection: an online survey …

Child Protection And Family Support: Experiences In A Seaside Resort, Thomas El-Hoss, Felicity Thomas, Felix Gradinger, Ms Susanne Hughes

Peninsula Medical School

Effective Early Help services are key to halting rising rates of children in care in the UK. Yet despite family support and child welfare interventions being unequally distributed across the country, the role of ‘place’ has received limited attention in the children's social care arena. This paper examines the connections between coastal challenges, Early Help and child welfare interventions, drawing on embedded research undertaken within a Local Authority on England's coast with elevated levels of children in care. We focus on families’ experiences raising children in a seaside resort area as well as professionals’ perspectives on the place-based challenges faced …

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, …

A Study Of Referral Bias In Nmosd And Mogad Cohorts, Miguel Leal Rato, Bo Chen, Anna Francis, Silvia Messina, Madalina Miron, Yvonne Sharawakanda, Eoin O'Sullivan, Sarah Cooper, Leonora Fisniku, Christopher Halfpenny, Roswell Martin, Jeremy Hobart, Waqar Rashid, Cheryl Hemingway, Victoria Williams, Yael Hacohen, Ruth Dobson, Sithara Ramdas, Maria Isabel Leite, Jacqueline Palace, Ruth Geraldes

Peninsula Medical School

Background: Neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody–associated disease (MOGAD) are rare disorders often seen in highly specialized services or tertiary centres. We aimed to assess if cohort characteristics depend on the origin of the referral catchment areas serviced by our centre (i.e. local, regional or national). Methods: Retrospective cohort study using a national referral service database including local (Oxfordshire), regional (Oxfordshire and neighbouring counties), and national patients. We included patients with the diagnosis of NMOSD, seronegative NMOSD or MOGAD, followed at the Oxford Neuromyelitis Optica Service. Results: We included 720 patients (331 with MOGAD, 333 with …

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 …

Workshop: Active Learning Teaching Methods For Engineering Ethics Education, Shannon M. Chance

Research Outputs: 2025-Present

This workshop, conducted by the lead editor of the forthcoming Routledge International Handbook of Engineering Ethics Education, focuses on exploring active learning teaching methods in engineering ethics education. Beginning with a whole-group discussion to define ethics in engineering education, facilitators will present an overview of trends and teaching methods outlined in the handbook. These methods include case studies, project-based learning (PB), value-sensitive design, service-learning, arts-based methods, and reflective and dialogical approaches. Participants will then engage in hands-on activities, selecting one ethics topic (e.g., environmental sustainability, social justice, equity, diversity, and inclusion) and one active learning pedagogy (case studies and dilemmas, …

Leading The Development Of Eer Books And Special Issues, S. M. Chance, A. Johri, T. H. Børsen, D. A. Martin, K. Edström, J. E. Mitchell, S. A. Male, I. Direito

Research Outputs: 2025-Present

This workshop was created for researchers seeking to elevate awareness of specific engineering education research (EER) issues or sub-domains and expand their readership and authorship base within these areas.Drawing from the experience of developing book and journal publications in EER, the facilitators shared insights into the publication process, highlighting the primary considerations involved.The discussion helped participants identify publication formats and understand the usefulness of special-focus journal issues as well as how to conceptualise publication projects, set up editorial teams, select and approach publishers, and prepare proposal documents.The open discussion format allowed participants to query the facilitators.

Guest Editorial Special Issue On Conceptual Learning Of Mathematics-Intensive Concepts In Engineering, Shannon Chance, Farrah Fayyaz, Anita L. Campbell, Nicole P. Pitterson, Sadia Nawaz

Research Outputs: 2025-Present

No abstract provided.

Iqgo: Iterative Quantum Gate Optimiser For Quantum Data Embedding, Tautvydas Lisas, Ruairí De Fréin

Research Outputs: 2025-Present

Quantum kernel methods and Variational Quantum Classifiers (VQCs) have recently gained significant interest in the field of Machine Learning (ML). They have the potential to achieve superior generalisation whilst using smaller datasets and fewer parameters compared to their classical counterparts. However, kernel methods which leverage feature map embedding, often struggle with overfitting, which compromises their generalisation performance on unseen data. VQCs which utilise Parameterised Quantum Circuits (PQCs) to model the relationship between input data and the output, are susceptible to the Barren Plateau (BP) problem. To address these challenges, we introduce an adaptive quantum embedding optimisation algorithm, namely the Iterative …

Securing Fellowships For Engineering Education Research, S. M. Chance, A. Johri, S. I.Cruz Moreno, I. Direito, M. Polmear, H. Kovacs, R. Joshi

Research Outputs: 2025-Present

This workshop was geared toward educators seeking to enhance their research capabilities, explore new areas of inquiry, and expand their professional networks through collaborations with colleagues from institutions beyond their national borders.The facilitators introduced the topic and described various pathways to securing fellowships for engineering education research (EER), including prestigious Fulbright, Marie Curie, and EU-funded fellowships.Via practical demonstrations, participants learned how to navigate relevant databases, identify suitable fellowship opportunities, and strategically align their research interests with funding priorities.Participants interacted with previous recipients of grants and fellowships awarded to individuals for research and/or professional development.Overall, the workshop leveraged collective expertise to …

Sefi Sig Workshop: Eager To Further Develop The Field Of Engineering Ethics Education?, D. A. Martin, S. Chance, T. Boersen, R. Tormey, T. Lennersfors, G. Bombaerts, M. Tobosaru, H. Kovacs

Research Outputs: 2025-Present

No abstract provided.

Explorando Dinámicas De Género En El Aprendizaje Colaborativo En La Enseñanza De Ingeniería, S I Cruz-Moreno, Shannon M. Chance, B Bowe

Research Outputs: 2025-Present

A fundamental skill sought to be strengthened in engineering professionals is the ability to work in a team. Gradually, pedagogies centered on problem-based or project based learning (PBL) have been incorporated into the curricula of engineering programs with the aim of promoting collaboration and critical thinking. Although PBL can be a beneficial approach to foster students' cognitive abilities and promote their group integration, its implementation may pose challenges for female students due to their minority status in the engineering field and the persistence of gender stereotypes.This article describes part of an ongoing research project that examines the experiences of female …

Crystal Phase Ionic Liquids For Energy Applications: Heat Capacity Prediction Via A Hybrid Group Contribution Approach, Moh’D Basel Shahin, Shehzad Liaqat, Paul Nancarrow, Sarah J. Mccormack

Research Outputs: 2025-Present

In the selection and design of ionic liquids (ILs) for various applications, including heat transfer fluids, thermal energy storage materials, fuel cells, and solvents for chemical processes, heat capacity is a key thermodynamic property. While several attempts have been made to develop predictive models for the estimation of the heat capacity of ILs in their liquid phase, none so far have been reported for the ILs’ solid crystal phase. This is particularly important for applications where ILs will be used for thermal energy storage in the solid phase. For the first time, a model has been developed and used for …

Evaluation Of Ion Chamber Response For Applications In Electron Flash Radiotherapy, Kevin Liu, Shannon Holmes, Brian Hooten, Emil Schüler, Sam Beddar

Faculty, Staff and Student Publications

Ion chambers are required for calibration and reference dosimetry applications in radiation therapy (RT). However, exposure of ion chambers in ultra-high dose rate (UHDR) conditions pertinent to FLASH-RT leads to severe saturation and ion recombination, which limits their performance and usability. The purpose of this study was to comprehensively evaluate a set of commonly used commercially available ion chambers in RT, all with different design characteristics, and use this information to produce a prototype ion chamber with improved performance in UHDR conditions as a first step toward ion chambers specific for FLASH-RT. The Advanced Markus and Exradin A10, A26, and …

Gut Microbiome And Hepatic Transcriptomic Determinants Of Hcc Development In Mice With Metabolic Dysfunction-Associated Steatohepatitis, Lillian I Dolapchiev, Kristyn A Gonzales, Lorenzo R Cruz, Mihai Gagea, Heather L Stevenson, Suet-Ying Kwan, Laura Beretta

Faculty, Staff and Student Publications

Purpose: Hepatocellular carcinoma (HCC) related to metabolic dysfunction-associated steatotic liver disease (MASLD) is often diagnosed at a late stage, and its incidence is increasing. Predictive biomarkers are therefore needed to identify individuals at high risk of HCC. We aimed to characterize the gut microbiome and hepatic transcriptome associated with HCC development in female mice with hepatocyte-deletion of Pten (HepPten -). These mice present with large variations in HCC development, making them a powerful model for biomarker discovery.

Methods & results: Sequencing of stool 16S and hepatic RNA was performed on a first set of mice. Among all liver histology …

Protection Against Fibrosis By A Bacterial Consortium In Metabolic Dysfunction-Associated Steatohepatitis And The Role Of Amino Acid Metabolism, Suet-Ying Kwan, Kristyn A Gonzales, Mohamed A Jamal, Heather L Stevenson, Lin Tan, Philip L Lorenzi, P Andrew Futreal, Ernest T Hawk, Joseph B Mccormick, Susan P Fisher-Hoch, Robert R Jenq, Laura Beretta

Faculty, Staff and Student Publications

The gut microbiota drives progression to liver fibrosis, the main determinant of mortality in metabolic dysfunction-associated steatohepatitis (MASH). In this study, we aimed to identify bacterial species associated with protection against liver fibrosis in a high-risk population, and test their potential to protect against liver fibrosis in vivo. Based on stool shotgun metagenomic sequencing of 340 subjects from a population cohort disproportionally affected by MASH, we identified bacterial species from the Bacteroidales and Clostridiales orders associated with reduced risk of liver fibrosis. A bacterial consortium was subsequently tested in a mouse model of MASH, which demonstrated protective effects against …

Quantifying The Effect Of 4-Dimensional Computed Tomography-Based Deformable Dose Accumulation On Representing Radiation Damage For Patients With Locally Advanced Non-Small Cell Lung Cancer Treated With Standard-Fractionated Intensity-Modulated Radiation Therapy, Yulun He, Guillaume Cazoulat, Carol Wu, Stina Svensson, Lusmeralis Almodovar-Abreu, Bastien Rigaud, Emma Mccollum, Christine Peterson, Zachary Wooten, Dong Joo Rhee, Peter Balter, Julianne Pollard-Larkin, Carlos Cardenas, Laurence Court, Zhongxing Liao, Radhe Mohan, Kristy Brock

Faculty, Staff and Student Publications

Purpose: The aim of this study was to investigate the dosimetric and clinical effects of 4-dimensional computed tomography (4DCT)-based longitudinal dose accumulation in patients with locally advanced non-small cell lung cancer treated with standard-fractionated intensity-modulated radiation therapy (IMRT).

Methods and materials: Sixty-seven patients were retrospectively selected from a randomized clinical trial. Their original IMRT plan, planning and verification 4DCTs, and ∼4-month posttreatment follow-up CTs were imported into a commercial treatment planning system. Two deformable image registration algorithms were implemented for dose accumulation, and their accuracies were assessed. The planned and accumulated doses computed using average-intensity images or phase images were …

Predicting Suicidality In Late-Life Depression By 3d Convolutional Neural Network And Cross-Sample Entropy Analysis Of Resting-State Fmri, Chemin Lin, Chih-Mao Huang, Wei Chang, You-Xun Chang, Ho-Ling Liu, Shu-Hang Ng, Huang-Li Lin, Tatia Mei-Chun Lee, Shwu-Hua Lee, Shun-Chi Wu

Faculty, Staff and Student Publications

BACKGROUND: Predicting suicide is a pressing issue among older adults; however, predicting its risk is difficult. Capitalizing on the recent development of machine learning, considerable progress has been made in predicting complex behavior such as suicide. As depression remained the strongest risk for suicide, we aimed to apply deep learning algorithms to identify suicidality in a group with late-life depression (LLD).

METHODS: We enrolled 83 patients with LLD, 35 of which were non-suicidal and 48 were suicidal, including 26 with only suicidal ideation and 22 with past suicide attempts, for resting-state functional magnetic resonance imaging (MRI). Cross-sample entropy (CSE) analysis …

Jointtracker: Real-Time Inertial Kinematic Chain Tracking With Joint Position Estimation, Bertram Taetz, Michael Lorenz, Markus Miezal, Didier Stricker, Gabriele Bleser-Taetz

Faculty, Staff and Student Publications

In-field human motion capture (HMC) is drawing increasing attention due to the multitude of application areas. Plenty of research is currently invested in camera-based (markerless) HMC, with the advantage of no infrastructure being required on the body, and additional context information being available from the surroundings. However, the inherent drawbacks of camera-based approaches are the limited field of view and occlusions. In contrast, inertial HMC (IHMC) does not suffer from occlusions, thus being a promising approach for capturing human motion outside the laboratory. However, one major challenge of such methods is the necessity of spatial registration. Typically, during a predefined …

Insights Into The Assembly And Regulation Of The Bacterial Divisome, Todd A Cameron, William Margolin

Faculty, Staff and Student Publications

The ability to split one cell into two is fundamental to all life, and many bacteria can accomplish this feat several times per hour with high accuracy. Most bacteria call on an ancient homologue of tubulin, called FtsZ, to localize and organize the cell division machinery, the divisome, into a ring-like structure at the cell midpoint. The divisome includes numerous other proteins, often including an actin homologue (FtsA), that interact with each other at the cytoplasmic membrane. Once assembled, the protein complexes that comprise the dynamic divisome coordinate membrane constriction with synthesis of a division septum, but only after overcoming …

Probing Membrane-Associated Cytoskeletal Oligomers Of The Bacterial Divisome By Electron Microscopy And Tomography, Bo Hu, William Margolin

Faculty, Staff and Student Publications

The cell division machinery or "divisome" of many bacteria, including Escherichia coli, contains homologs of tubulin (FtsZ) and actin (FtsA) that interact with each other to promote the synthesis of septal peptidoglycan. FtsA oligomers have an essential role as a track for tethering dynamically treadmilling FtsZ protofilaments to the cytoplasmic membrane. Other bacterial cytoskeletal oligomers such as MreB also assemble on and move along the membrane. Structures of these oligomers on membranes in vitro may mimic their behavior in the cell. Here, we describe a protocol to visualize FtsA oligomeric structures on membranes and their interactions with FtsZ protofilaments using …

Identification Of Druggable Regulators Of Cell Secretion Via A Kinome-Wide Screen And High-Throughput Immunomagnetic Cell Sorting, Mahmoud Labib, Zongjie Wang, Yunhye Kim, Sichun Lin, Abdalla Abdrabou, Hanie Yousefi, Pei Ying Lo, Stéphane Angers, Edward H. Sargent, Shana O. Kelley

Peninsula Medical School

The identification of genetic regulators of cell secretions is challenging because it requires the sorting of a large number of cells according to their secretion patterns. Here we report the development and applicability of a high-throughput microfluidic method for the analysis of the secretion levels of large populations of immune cells. The method is linked with a kinome-wide loss-of-function CRISPR screen, immunomagnetically sorting the cells according to their secretion levels, and the sequencing of their genomes to identify key genetic modifiers of cell secretion. We used the method, which we validated against flow cytometry for cytokines secreted from primary mouse …

A Signal Injection Attack Against Zero Involvement Pairing And Authentication For The Internet Of Things, Isaac Ahlgren, Jack West, Kyuin Lee, George K. Thiruvathukal, Neil Klingensmith

Computer Science: Faculty Publications and Other Works

Zero Involvement Pairing and Authentication (ZIPA) is a promising technique for auto-provisioning large networks of Internet-of-Things (IoT) devices. In this work, we present the first successful signal injection attack on a ZIPA system. Most existing ZIPA systems assume there is a negligible amount of influence from the unsecured outside space on the secured inside space. In reality, environmental signals do leak from adjacent unsecured spaces and influence the environment of the secured space. Our attack takes advantage of this fact to perform a signal injection attack on the popular Schurmann & Sigg algorithm. The keys generated by the adversary with …

Exploring Analytical Frameworks To Investigate Power Dynamics In Collaborative Learning In Engineering Education, S. I.Cruz Moreno, S. Chance

Research Outputs: 2025-Present

Previous research has examined patterns in women's team interactions within collaborative learning environments, highlighting potential barriers that hinder their full participation. This paper explores two analytical frameworks that could be beneficial in investigating power dynamics in such settings. Through a narrative literature review, we establish links between individuals' experiences and broader social or institutional practices, revealing underlying discourses and power relations. We identify a lack of evidence regarding discourses shaping attitudes and behaviours that perpetuate power inequities. Awareness of these dynamics could facilitate the provision of support and empathy to a more diverse group of students in engineering education.

Engineering Education Research: Writing For Publication, J. Bernhard, M. Van Den Bogaard, R. Broadbent, S. Chance, S. Daniel, I. Direito, X. Du, K. Edström, D. Knight, S. Male, D. May, J. E. Mitchell, N. Wint

Research Outputs: 2025-Present

This interactive workshop, facilitated by a team of editors, associate editors and experienced reviewers from a number of leading journals in engineering education, allowed participants the opportunity to network with other researchers and to learn about the journal publication process and how best to navigate it as an author.It provided an informal opportunity for both early-stage scholars, as well as those with more experience, to share their publication journeys and experiences, both positive and negative, directly with each other and journal editors.