17390 research outputs found
Sort by
A co-designed patient reported experience measure for understanding the patient's and public experience of receiving X-ray results
No full textIntroduction: The National Health Service England (NHSE) General Practitioner (GP) contract mandates the implementation of electronic health records (EHR) to improve patient access to medical results. However, access to complex X-ray reports can lead to patient anxiety and misunderstanding, necessitating the requirement for clear communication. This paper reports an example of a good practice approach to research co-design and co-production with Patient and Public Involvement (PPI) experts to develop a Patient Reported Experience Measure (PREM) to explore accessing X-ray reports through EHR.
Method: A participatory method of a modified e-Delphi (iterative process) utilising PPI focus groups followed by two rounds of reviewing online survey questions to gain consensus. The PREM used Likert scoring, data analysis of each subscale score, and distributions, including face, construct, and content validity, reliability coefficient, principal component and factor analysis, and dimension reduction.
Results: The phase one PPI focus groups (n=28 participants) co-produced n=16 themes related to the experience of receiving X-ray results. Key themes emphasised the need for patient-friendly language to reduce anxiety and misunderstanding of complex language and terminology. The PREM tool was refined through two rounds of iterative feedback. The phase two survey included n=57 questions, while the phase three survey pared down questions to n=27.
Conclusion: It is critical to involve patients in the co-design and co-production of PREM tools to ensure they appropriately capture patient and public lived experiences. Implementing clear, patient-friendly communication within EHR X-ray reports could reduce anxiety and empower patients’ decision-making.
Implications for Practice: National testing of the PREM involving a large sample of diverse participant demographics is recommended. Future PREM findings will assist in recommending and developing strategies to improve EHR communication of X-ray report wording, structure, and content
Understanding travel behaviour change: Insights paper
No full textCanterbury City Council commissioned Dr Susan Kenyon to write a Travel Behaviour Insights paper.
The objectives of the Insights paper are to:
• Provide an overview of theories of travel behaviour and travel behaviour change; and
• Consider how the Canterbury City Council Draft Transport Strategy 2024 aligns with these theoretical insights.
The paper was prepared in May, 2025
Comparative analysis of large language models in dermatological diagnosis: An evaluation of diagnostic accuracy
No full textBackground: The diagnostic process in dermatology often hinges on visual recognition and clinical pattern matching, making it an attractive field for the application of artificial intelligence (AI). Large language models (LLMs) like ChatGPT-4o, Claude 3.7 Sonnet, and Gemini 2.0 Flash offer new possibilities for augmenting diagnostic reasoning, particularly in rare or diagnostically challenging cases. This study evaluates and compares the diagnostic capabilities of these LLMs based solely on clinical presentations extracted from rare dermatological case reports.
Methodology: Fifteen published case reports of rare dermatological conditions were retrospectively selected. Key clinical features, excluding laboratory or histopathological findings, were input into each of the three LLMs using standardized prompts. Each model produced a most probable diagnosis and a list of differential diagnoses. The outputs were evaluated for top-match accuracy and whether the correct diagnosis was included in the differential list. Performance was analyzed descriptively, with visual aids (heatmaps, bar charts) illustrating comparative outcomes.
Results: ChatGPT-4o and Claude 3.7 Sonnet each correctly identified the top diagnosis in 10 (66.7%) out of 15 cases, compared to 8 (53.3%) out of 15 for Gemini 2.0 Flash. When differential-only matches were included, both ChatGPT-4o and Claude 3.7 achieved a total coverage of 86.7%, while Gemini 2.0 reached 60.0%. Notably, all models failed to identify certain diagnoses, including blastic plasmacytoid dendritic cell neoplasm and amelanotic melanoma, underscoring the potential risks associated with plausible but incorrect outputs.
Conclusions: This study demonstrates that ChatGPT-4o and Claude 3.7 Sonnet show promising diagnostic potential in rare dermatologic cases, outperforming Gemini 2.0 Flash in both accuracy and diagnostic breadth. While LLMs may assist in clinical reasoning, particularly in settings with limited dermatology expertise, they should be used as adjunctive tools, not substitutes, for clinician judgment. Further refinement, validation, and integration into clinical workflows are warranted
The deeper context of coercive control: New insights into behavioural patterns in coercive controllers to support greater precision in social worker assessments of critical risk
No full textThis research aimed to provide new insights into the behaviours and tactics of people who engage in coercive control. The research drew on the knowledge and experiences of a wide range of professionals working with people who actively violate social norms and harm and disadvantage others by conscious choice both inside and outside of forensic settings. The results provide a framework to inform social work practice, policy, and training requirements to support the assessment and management of risk to both vulnerable adults and children when they are targeted by people who perpetrate coercive control
Scott Holland and the needs of 2025: integrated nature and grace
No full textDonald MacKinnon once argued that the Victorian and Edwardian sermons of Henry Scott Holland (1847–1918) remained theologically relevant during the nuclear age of the 1950s. Following his lead, I argue that Scott Holland’s theological message continues to remain relevant to the political situation of 2025. Examining the theological responses of John Milbank and David Bentley Hart to the recent renewal of Neo-Thomist integralism in some US postliberal circles, I explore how Scott Holland’s theology adumbrated, anticipated and prepared the way for today’s critiques of right-wing and separatist Catholic integralist communitarianism. Particular focus is placed on Scott Holland’s theology of the supernatural, and how this enabled him to develop, via the Incarnationalism of Lux Mundi, a theology of radically inclusive Christian socialism
Consolation and hope in a time of crisis extension project: Research Digest: Sepetmber 2024
No full textThis Research Digest is from the Consolation and Hope in a Time of Crisis, Phase 2 project. The Project surveyed school students in three secondary schools, whose transition from primary to secondary schools was impacted by COVID 19. We held focus groups with selected groups from those schools as well as informal conversations with some senior members of staff. More information is available from the NICER website: nicer.org.uk
The digests produced are intended for education professionals, including chaplains, pastoral leaders and school leaders, advisors, and anyone interested and concerned about the spiritual flourishing of young people.
This digest outlines qualitative findings from the research with some preliminary analysis for early dissemination, prior to formal peer reviewed research publication. Findings from the survey which includes a focus on the role of the chaplain will be made available in due course. This digest details qualitative findings from the research
IoT-enabled headband for real-time concussion monitoring in amateur rugby
No full textGiven the growing concern around chronic traumatic encephalopathy (CTE) and repeated mild traumatic brain injuries (mTBIs), particularly in non-helmeted contact sports, this paper introduces the development and evaluation of an affordable concussion detection device specifically designed for amateur rugby players. While existing helmet-mounted devices focus primarily on head motion tracking, primarily in professional sports and defense applications, there remains a gap in accessible solutions for non-helmeted athletes. The proposed system incorporates an Inertial Measurement Unit (IMU) and an IoT-enabled microcontroller into a compact, wearable headband capable of monitoring real-time head impacts. The IMU is positioned at the back of the head near the external occipital protuberance for measuring concussion and a force resistive sensor (FSR) near the temporal region (right side) of the skull to measure direct impact force. This location is chosen to minimise damage to both the sensors and the players since the nature of most tackles in rugby involves connecting the temporal region of the skull. The device will continuously monitor linear and angular acceleration, as well as force data, through a mobile application using IoT capabilities. To assist with early medical intervention, the device categorises impacts into three severity levels: low, medium, and high, indicating the
potential need for prompt medical evaluation
Grounding ethical governance: Co-produced, community-based research ethics in qualitative and oral history practice with vulnerable groups
No full textThis article examines an embedded model of ethical governance, as practised by the Mind in Bexley Research and Ethics Advisory Board, in overseeing the Unpaid Mental Health Carers in Bexley oral history project. Unlike conventional university-based research ethics committees (RECs), this Board was rooted in the local community, comprising unpaid carers, mental health service users, clinicians, safeguarding leads and qualitative/oral history researchers. Its deep contextual knowledge, direct links to support and safeguarding pathways, and procedural rigour enabled ethical deliberations grounded in lived realities and local service infrastructures. The Board’s design transformed ethics from a pre-approval checkpoint into an active safeguarding partner, exemplified by real-time crisis interventions during fieldwork. Meetings in accessible community venues, the use of plain-language documentation, and a collaborative approach fostered trust and transparency, aligning with the concept of “everyday ethics.” Drawing on this case, the article argues that de-centralised, co-produced ethics governance can enhance contextual sensitivity, strengthen lived experience participation, and mitigate participant risk more effectively than standard institutional models. It concludes by considering implications for research governance frameworks seeking to embed ethical oversight within the relational and place-based contexts in which research unfolds, while recognising that statutory research ethics committees remain essential in biomedical and NHS-facing domains
Towards a cost-rffective simplified mechanical fuse: A feasibility study
No full textConventional fuses rely on electrical and thermal overload to function, however, there is a gap in the market for a single-use mechanical fuse [1, 2] that fails under controlled shear force and is easy to actuate. This type of fuse can be used in switching circuits for braking systems. In this abstract, the mechanical formation of the fuse is explored along with a comparative analysis of structural material supported by finite element analysis (FEA). Physical testing of the fuse is evaluated using a custom rig breakage force, notch design, and actuator geometry. Results confirm the fuse's viability for applications requiring electrical safety and anti-tampering