18918 research outputs found
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Volumetric Video With Skateboarders: Creative Opportunities of Working With an Emerging Screen Technology Beyond the Studio
No full textVolumetric video is an emerging moving image technology in which each pixel is recorded witha location in three dimensions. Volumetric videos are normally created in studios using rigs made upof multiple cameras with LiDAR sensors and computers that combine the moving images. We tookthis technology out of the studio to explore variations of this technique in public skateparks. We foundthat as the technology is still in developing stages it has creative constraints: it can records at a limiteddistance to the subject, the image is of a relatively low resolution, and there are often glitches in theimage. In our creative experiments with the skateboard community, we found we could use thesequalities to our advantage. For example, we could create images that emphasise movement oversurface texture. In this paper we explore this emerging screen technology through the theoretical lensof Modes of Existence of Technical Objects by Gilbert Simondon (2017/1958). Simondon articulates theindividuation of novel technologies from abstract phases, which are multiple and emergent, towardsa metastable phase of concretisation when they become consistent and coherent. This paper arguesfor the valorisation of working with screen technologies in their abstract phases. In this phase andthe situation in which the technology is employed can easily shape the techniques, the means ofproduction becomes more readily visible to the viewer, and unintended functionality may be exploredfor creative outcomes
Towards a typology of mental health crisis care services for children and young people in England and Wales: a cross-sectional survey and analysis of implementation practices
No full textBackground: The mental health and wellbeing of children and young people is a global concern. Alongside approaches emphasising mental health promotion in schools, communities and in the home, many countries are also investing in crisis services. These aim to meet the needs of young people experiencing acute psychosocial distress. A recent synthesis of the international evidence found a paucity of research in this area. This study sought to address this gap while simultaneously situating the findings within the international context and drawing out implications for policymakers and practitioners. Methods: A cross-sectional study aiming to describe and map approaches to the implementation and organisation of crisis care for children and young people was conducted across England and Wales. Complexity ideas, systems thinking and normalisation process theory conceptually underpinned the study. A bespoke survey captured service characteristics, service organisation and service user characteristics. It also incorporated the NoMAD tool to gather data on implementation. Usable data were received from 124 services. We used descriptive statistics and thematic analysis to summarise service characteristics and to develop a logic model. Typological analysis was used to develop a typology of service responses. NoMAD data were analysed using frequency analysis, item means and mean scale scores for each construct. Results: The ‘community in-person rapid response’ is the most common approach to provision. However, our analysis captured a patchwork of diverse provision across the system, typified by an absence of consensus regarding definitions of ‘mental health crisis’, lack of common agreement relating to the goals of care, and multiplication of approaches to the organisation and provision of services. Despite this, high levels of within-service coherence, cognitive participation and reflexive monitoring were observed. Conclusions: There is significant variation in the organisation and provision of crisis services for children and young people. Through situating our findings in a prevailing international policy context, we suggest that the variation we observe reflects an absence of a developed evidence base and a proliferation of strategies and frameworks which fail to provide clear guidance on how crisis care might best be organised and provided. Project registration: This project is registered with Research Registry (unique identifier: researchregistry8660)
The Impact of Patient-Generated Health Data From Mobile Health Technologies on Health Care Management and Clinical Decision-Making: Narrative Scoping Review
No full textBackground: Long-term health conditions and multimorbidity are increasing globally, placing an unsustainable pressure on health care systems. Mobile health (mHealth) technologies enable the collection of patient-generated health data outside clinical settings, offering the potential to support personalized care and inform clinical decision-making. However, the ways in which mHealth patient data are being used in clinical practice remain unclear. Objective: This study aimed to map and synthesize the existing literature on how patient-generated mHealth data are reportedly being used and influencing clinical decision-making for adults with long-term conditions in an outpatient care setting. Methods: A narrative scoping review was conducted on studies published between 2014 and 2025. Studies were eligible for inclusion if they were in English, had data on the use of patient-generated mHealth data, went beyond feasibility testing, and had reference to clinician behavior or patient interactions. Gray literature was not used to maintain a focus on peer-reviewed and published evidence. Studies involving pediatric or adolescent populations were excluded. Searches were conducted across the following databases between 2014 and 2025: Embase, MEDLINE, Knowledge and Library Hub, British Nursing Index, and ProQuest Health Research Premium Collection. Data were charted systematically and synthesized narratively. Key data included study characteristics, mHealth use, data types and visualizations, patient demographics, and the ways the data informed clinical decision-making. Results: A total of 16 studies met the inclusion requirements, which were primarily high-income countries focusing on rheumatoid arthritis and diabetes. The studies reported on how mHealth data were integrated into workflows, influenced health care decisions, and shaped patient-provider interactions. mHealth patient data were found to support patient-centered care and facilitate proactive holistic care, though in some instances, the data were shown to reinforce medical agendas removing agency from patients. There is also a gap between the intended use of the data and their implementation in clinical practice. The reported barriers included professional skepticism, integration challenges, and concerns about data accuracy. Evidence was focused on feasibility rather than long-term outcomes, with limited evidence on the impacts of mHealth. Conclusions: Patient-generated health data have the potential to enhance clinical decision-making and person-centered practices. However, integration into routine practice is hindered by technological challenges, professional hesitancy, and a lack of standardization. Future research should prioritize supporting integration, improve data presentation, and evaluate the long-term effects on clinical workflows. Addressing these barriers and establishing clear policy frameworks will be crucial for realizing the potential of mHealth in health care delivery
Towards a typology of mental health crisis care services for children and young people in England and Wales: a cross-sectional survey and analysis of implementation practices
No full textBackground: The mental health and wellbeing of children and young people is a global concern. Alongside approaches emphasising mental health promotion in schools, communities and in the home, many countries are also investing in crisis services. These aim to meet the needs of young people experiencing acute psychosocial distress. A recent synthesis of the international evidence found a paucity of research in this area. This study sought to address this gap while simultaneously situating the findings within the international context and drawing out implications for policymakers and practitioners. Methods: A cross-sectional study aiming to describe and map approaches to the implementation and organisation of crisis care for children and young people was conducted across England and Wales. Complexity ideas, systems thinking and normalisation process theory conceptually underpinned the study. A bespoke survey captured service characteristics, service organisation and service user characteristics. It also incorporated the NoMAD tool to gather data on implementation. Usable data were received from 124 services. We used descriptive statistics and thematic analysis to summarise service characteristics and to develop a logic model. Typological analysis was used to develop a typology of service responses. NoMAD data were analysed using frequency analysis, item means and mean scale scores for each construct. Results: The ‘community in-person rapid response’ is the most common approach to provision. However, our analysis captured a patchwork of diverse provision across the system, typified by an absence of consensus regarding definitions of ‘mental health crisis’, lack of common agreement relating to the goals of care, and multiplication of approaches to the organisation and provision of services. Despite this, high levels of within-service coherence, cognitive participation and reflexive monitoring were observed. Conclusions: There is significant variation in the organisation and provision of crisis services for children and young people. Through situating our findings in a prevailing international policy context, we suggest that the variation we observe reflects an absence of a developed evidence base and a proliferation of strategies and frameworks which fail to provide clear guidance on how crisis care might best be organised and provided. Project registration: This project is registered with Research Registry (unique identifier: researchregistry8660)
There’s No Magic Pill: A Multimethods Qualitative Study Exploring Routine Fatigue Care in People With Multiple Sclerosis
No full textBACKGROUND: Fatigue is a common and debilitating symptom for people with multiple sclerosis (MS). Evidence suggests that behavioral treatments, particularly cognitive behavioral therapy and some exercise therapies, are effective in reducing MS fatigue. However, few people are offered these treatments in routine care, and little is known about the reasons for this research-to-practice gap. The aim of this study was to explore how routine care is currently delivered for MS fatigue. METHODS: Health care professionals (n = 28) took part in 6 focus groups and 6 one-to-one interviews exploring experiences with assessing, managing, and treating fatigue. How health care professionals (n = 10) delivered MS fatigue management was observed across 19 patient-clinician consultations in 4 National Health Service clinics in London, the North East, and the South West of England. All data were analyzed using reflexive thematic analysis. RESULTS: Three key themes with subthemes were generated: (1) MS fatigue is not formally screened, (2) promoting self-management for MS fatigue, and (3) MS fatigue cannot be treated in isolation. Key findings included relying on people who have MS to recognize and report their experience of fatigue, the use of the multidisciplinary team to trickle fatigue management through their practice, and the tendency for professionals to sometimes differ in their interpretations of fatigue management advice. CONCLUSIONS: The findings indicate that introducing a formal screening measure and developing a standardized, evidence-based behavioral treatment that can be implemented into routine care may allow for improved treatment of MS fatigue
Characterisation of tyre wear particle transport from road runoff to sea in coastal environments
No full textData on the fate of tyre wear particles (TWPs) within aquatic environments is limited. This study quantified TWPs entering estuaries in stormwater drainage and atmospheric fallout, and once they have reached the marine environment, within surface waters and sediments. TWPs were found at concentrations of 0.4 mg/L, 2.55 mg/m2/d, 0.00063 mg/L, and 0.96 g/kg respectively. Samples were partitioned by size to examine the distribution of TWP mass. 80-90% of TWP mass entering marine systems (stormwater and atmospheric fallout) lay between 31-125 µm. Larger particles preferentially accumulated in sediments where ∼50 % of TWP mass was \u3e250 μm, compared to surface waters where the size class 15-63 μm accounted for ∼80 %. This study provides novel data on the sizes and concentrations of TWP pollution in coastal environments. Such data are of importance in determining biological exposures. Notably, the presence of TWPs in surface waters demonstrates their potential for transport over longer distances
A qualitative exploration of the potential benefits of Nature-based Approaches for staff and Children and Young People in Child and Adolescent Mental Health Services
No full textAcross the UK there are concerns about young people’s mental health, with rates of ill health increasing and referrals to Child and Adolescent Mental Health services (CAMHS) doubling. This study explores the potential benefits of incorporating Nature-Based Approaches (NBAs) within CAMHS. Providers are understaffed, under-resourced and under pressure. NBAs offer a way of working which could address some of these challenges, yet little is known about the potential benefits of NBAs in the context of CAMHS. The project aimed to explore staff understanding of NBAs, and to identify potential benefits of integrating NBAs into practice. Staff within a South of England CAMHS service were asked to complete a survey and qualitative interview to explore staff perspectives on using NBAs in their practice. Staff were also given the opportunity to attend a nature-based training course. All participants were sampled from one NHS Trust and the study was open to all staff whether or not they had attended the training. Data were synthesised to produce an understanding of staff attitudes towards NBAs and the potential benefits of this approach. Ninety-seven staff responded to the survey, and fourteen staff members were interviewed. Data synthesis generated three themes: Tension between the culture of CAMHS and NBAs (Theme 1) and the need for buy-in and governance support (Theme 2), whilst Theme 3 describes the potential benefits of NBAs for staff and service users in CAMHS and is the focus of this paper. This study highlights the perceived benefits of adopting NBAs for both CAMHS service users and staff. Participants noted advantages including increased choice, individualisation, enhanced therapeutic quality, and new ways of working that offer greater autonomy, creativity, and flexibility at individual and service level. Further research is recommended to explore the full potential of NBAs to enhance service user and staff experiences in CAMHS
Advanced practitioner’s skills in communicating bad news to patients: a service evaluation project proposal
No full textCore GRADE 2: choosing the target of certainty rating and assessing imprecision
Get PDFThis second article in a seven part series presents the Core GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to deciding on the target of the certainty rating, and decisions about rating down certainty of evidence due to imprecision. Core GRADE users assess if the true underlying treatment effect is important or not in relation to the minimal important difference (MID) or, alternatively, if a true underlying treatment effect exists. The location of the point estimate of effect in relation to the chosen threshold determines the target. For instance, using the MID thresholds, a point estimate greater than the MID suggests an important effect and less than the MID, an unimportant or little to no effect. Users then rate down for imprecision if the 95% confidence interval crosses the MID for benefit or harm