Kingston University London
  • London, United Kingdom
Recent publications
Using discourse analysis to examine exchanges between fraudsters and victims in telephone-mediated frauds, this research examines the interactional techniques used by perpetrators of fraud to gain and maintain compliance from their victims, without causing them alarm. It reveals how compliance is secured and maintained in a process of establishing the relationship, grooming the victim and setting expectations of follow-through. Reimagining traditional understandings of fraud victimization and vulnerability, this work exposes how social and interactional norms are replicated and manipulated by fraudsters in order to compel individuals to be drawn into participating in an alternate, exploitative reality that is indistinguishable from safety; quashing a victim’s ability to recognize the situation as harmful and rendering any motivation to escape as nonsensical. In doing so, this paper questions the efficacy of public fraud protection guidance strategies and delivers evidence for the need to change the present approach to understanding and tackling fraud victimization and complicity.
Problem: There is a paucity of research on experiences and views of women at higher risk of preterm birth of midwifery continuity of care. Background: Midwifery continuity of care (MCoC) has been associated with improved maternal outcomes and with lower levels of preterm births and stillbirths. The majority of MCoC studies have focused on women without risk factors and little has been published on women with obstetric complexities. The aim of this study is to explore the views and experiences of women identified as a higher risk of preterm birth who have had continuity of care from midwives. Design: Face-to-face, semi-structured interviews with 16 women identified as at increased risk of preterm birth and experienced continuity of midwifery care across pregnancy, birth and the postnatal period. Care had been provided by the pilot intervention group for the pilot study of midwifery practice in preterm birth including women's experiences (POPPIE) trial. Findings: Women valued continuity of midwifery care across the care pathway and described the reassurance provided by having 24 h a day, seven days a week access to known midwives. Consistency of care, advocacy and accessibility to the team were described as the main factors contributing to their feelings of safety and control. Key conclusions: Recognising that known midwives were 'there all the time' made women feel listened to and actively involved in clinical decision making, which contributed to women feeling less stressed and anxious during their pregnancy, birth and early parenthood. When developing MCoC models for women with obstetric complexities: access, advocacy and time should be embedded to ensure women can build trusting relationships and reduce anxiety levels.
Background Advances in artificial intelligence (AI) technologies, together with the availability of big data in society, creates uncertainties about how these developments will affect healthcare systems worldwide. Compassion is essential for high-quality healthcare and research shows how prosocial caring behaviors benefit human health and societies. However, the possible association between AI technologies and compassion is under conceptualized and underexplored. Objectives The aim of this scoping review is to provide a comprehensive depth and a balanced perspective of the emerging topic of AI technologies and compassion, to inform future research and practice. The review questions were: How is compassion discussed in relation to AI technologies in healthcare? How are AI technologies being used to enhance compassion in healthcare? What are the gaps in current knowledge and unexplored potential? What are the key areas where AI technologies could support compassion in healthcare? Materials and methods A systematic scoping review following five steps of Joanna Briggs Institute methodology. Presentation of the scoping review conforms with PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews). Eligibility criteria were defined according to 3 concept constructs (AI technologies, compassion, healthcare) developed from the literature and informed by medical subject headings (MeSH) and key words for the electronic searches. Sources of evidence were Web of Science and PubMed databases, articles published in English language 2011–2022. Articles were screened by title/abstract using inclusion/exclusion criteria. Data extracted (author, date of publication, type of article, aim/context of healthcare, key relevant findings, country) was charted using data tables. Thematic analysis used an inductive-deductive approach to generate code categories from the review questions and the data. A multidisciplinary team assessed themes for resonance and relevance to research and practice. Results Searches identified 3,124 articles. A total of 197 were included after screening. The number of articles has increased over 10 years (2011, n = 1 to 2021, n = 47 and from Jan–Aug 2022 n = 35 articles). Overarching themes related to the review questions were: (1) Developments and debates (7 themes) Concerns about AI ethics, healthcare jobs, and loss of empathy; Human-centered design of AI technologies for healthcare; Optimistic speculation AI technologies will address care gaps; Interrogation of what it means to be human and to care; Recognition of future potential for patient monitoring, virtual proximity, and access to healthcare; Calls for curricula development and healthcare professional education; Implementation of AI applications to enhance health and wellbeing of the healthcare workforce. (2) How AI technologies enhance compassion (10 themes) Empathetic awareness; Empathetic response and relational behavior; Communication skills; Health coaching; Therapeutic interventions; Moral development learning; Clinical knowledge and clinical assessment; Healthcare quality assessment; Therapeutic bond and therapeutic alliance; Providing health information and advice. (3) Gaps in knowledge (4 themes) Educational effectiveness of AI-assisted learning; Patient diversity and AI technologies; Implementation of AI technologies in education and practice settings; Safety and clinical effectiveness of AI technologies. (4) Key areas for development (3 themes) Enriching education, learning and clinical practice; Extending healing spaces; Enhancing healing relationships. Conclusion There is an association between AI technologies and compassion in healthcare and interest in this association has grown internationally over the last decade. In a range of healthcare contexts, AI technologies are being used to enhance empathetic awareness; empathetic response and relational behavior; communication skills; health coaching; therapeutic interventions; moral development learning; clinical knowledge and clinical assessment; healthcare quality assessment; therapeutic bond and therapeutic alliance; and to provide health information and advice. The findings inform a reconceptualization of compassion as a human-AI system of intelligent caring comprising six elements: (1) Awareness of suffering (e.g., pain, distress, risk, disadvantage); (2) Understanding the suffering (significance, context, rights, responsibilities etc.); (3) Connecting with the suffering (e.g., verbal, physical, signs and symbols); (4) Making a judgment about the suffering (the need to act); (5) Responding with an intention to alleviate the suffering; (6) Attention to the effect and outcomes of the response. These elements can operate at an individual (human or machine) and collective systems level (healthcare organizations or systems) as a cyclical system to alleviate different types of suffering. New and novel approaches to human-AI intelligent caring could enrich education, learning, and clinical practice; extend healing spaces; and enhance healing relationships. Implications In a complex adaptive system such as healthcare, human-AI intelligent caring will need to be implemented, not as an ideology, but through strategic choices, incentives, regulation, professional education, and training, as well as through joined up thinking about human-AI intelligent caring. Research funders can encourage research and development into the topic of AI technologies and compassion as a system of human-AI intelligent caring. Educators, technologists, and health professionals can inform themselves about the system of human-AI intelligent caring.
Introduction: Using co-design processes, we aimed to develop an evidence-based decision guide for family carers and hospital professionals to support decision-making about eating and drinking for hospital patients with severe dementia. Methods: Following a systematic review, we interviewed people with mild dementia, family carers and hospital professionals in England. We then held co-design workshops with family carers and hospital professionals. In parallel with the workshops, we used a matrix to synthesize data from all studies and to develop a decision guide prototype. The prototype was iteratively refined through further co-design workshops and discussions among researchers and Patient and Public Involvement (PPI) representatives. We conducted user testing for final feedback and to finalize the decision guide. Results: Most participants acknowledged the limited benefits of tube feeding and would not use or want it for someone with severe dementia. However, they found decision-making processes and communication about nutrition and hydration were emotionally demanding and poorly supported in acute hospitals. The co-design groups developed the aims of the decision guide to support conversations and shared decision-making processes in acute hospitals, and help people reach evidence-based decisions. It was designed to clarify decision-making stages, provide information and elicit the values/preferences of everyone involved. It encouraged person-centred care, best-interests decision-making and multidisciplinary team working. From user testing, family carers and hospital professionals thought the decision guide could help initiate conversations and inform decisions. The final decision guide was disseminated and is being used in clinical practice in England. Conclusion: We used rigorous and transparent processes to co-design the decision guide with everyone involved. The decision guide may facilitate conversations about nutrition and hydration and help people reach shared decisions that meet the needs and preferences of people with severe dementia. Future evaluation is required to test its real-world impacts. Patient or public contribution: People with mild dementia, family carers and hospital professionals contributed to the design of the decision guide through the interviews and co-design workshops. PPI members helped design study procedures and materials and prepare this manuscript.
Introduction: Advances in information and communication technology (ICT) and post-COVID-19 tectonic changes in healthcare delivery have made it possible for cancer survivors to obtain disease-related information for remote management online rather than through healthcare providers. To comprehend and evaluate health information, digital literacy is crucial. Objectives: This study examined cancer survivors' information-seeking behaviour, information sources, digital health literacy, and digital trends, as well as potential determinants of e-health information receptivity and online resource use. Methods: A national 30-item cross-sectional survey using a representative random sample of cancer survivors from Jordan's cancer registry was conducted. Chi-square tests established categorical variable relationships. Using the mean and standard deviation, we calculated the Likert scale's ordinal data average. A p-value < 0.05 was statistically significant. Logistic regression identified predictors of interest in late-trajectory information acquisition and use of e-health platforms (apps, portals) for cancer self-management. Results: Lower digital literacy and electronic searching were associated with older age and lower income, education, and employment status (p ≤ 0.001). Digital literacy independently predicted m-health app use for remote management and interest in cancer supportive care information. Digitally literate survivors preferred the use of digital platforms (p ≤ 0.001). Information acquisition barriers included "reliability" (26%, n = 25) and "health information trustworthiness" (16.2%, n = 25). Following treatment completion, Internet-seeking behaviour decreased significantly when compared to the early cancer trajectory. Conclusion: Our findings imply that Jordanian cancer survivors' low digital literacy may hinder information acquisition and technology-enabled cancer care. Digital interventions for cancer survivors should be adaptable to varying levels of digital health literacy. Healthcare policymakers should recognise digital inequities and devise focused initiatives to bridge the digital divide while responding to the urgent need to digitalise cancer care delivery.
This paper describes the process of developing a classification model for the effective detection of malignant melanoma, an aggressive type of cancer in skin lesions. Primary focus is given on fine-tuning and improving a state-of-the-art convolutional neural network (CNN) to obtain the optimal ROC-AUC score. The study investigates a variety of artificial intelligence (AI) clustering techniques to train the developed models on a combined dataset of images across data from the 2019 and 2020 IIM-ISIC Melanoma Classification Challenges. The models were evaluated using varying cross-fold validations, with the highest ROC-AUC reaching a score of 99.48%.
Promethazine hydrochloride (PMZ), a potent H1-histamine blocker widely used to prevent motion sickness, dizziness, nausea, and vomiting, has a bitter taste. In the present study, taste masked PMZ nanocapsules (NCs) were prepared using an interfacial polycondensation technique. A one-step approach was used to expedite the synthesis of NCs made from a biocompatible and biodegradable polyamide based on l -arginine. The produced NCs had an average particle size of 193.63 ± 39.1 nm and a zeta potential of −31.7 ± 1.25 mV, indicating their stability. The NCs were characterized using differential scanning calorimetric analysis and X-ray diffraction, as well as transmission electron microscopy that demonstrated the formation of the NCs and the incorporation of PMZ within the polymer. The in vitro release study of the PMZ-loaded NCs displayed a 0.91 ± 0.02% release of PMZ after 10 min using artificial saliva as the dissolution media, indicating excellent taste masked particles. The in vivo study using mice revealed that the amount of fluid consumed by the PMZ-NCs group was significantly higher than that consumed by the free PMZ group (p < 0.05). This study confirmed that NCs using polyamides based on l -arginine and interfacial polycondensation can serve as a good platform for the effective taste masking of bitter actives.
High-temporal-frequency monitoring of transport infrastructure is crucial to facilitate maintenance and prevent major service disruption or structural failures. Ground-based non-destructive testing (NDT) methods have been successfully applied for decades, reaching very high standards for data quality and accuracy. However, routine campaigns and long inspection times are required for data collection and their implementation into reliable infrastructure management systems (IMSs). On the other hand, satellite remote sensing techniques, such as the Multi-Temporal Interferometric Synthetic Aperture Radar (MT-InSAR) method, have proven effective in monitoring ground displacements of transport infrastructure (roads, railways and airfields) with a much higher temporal frequency of investigation and the capability to cover wider areas. Nevertheless, the integration of information from (i) satellite remote sensing and (ii) ground-based NDT methods is a subject that is still to be fully explored in civil engineering. This paper aims to review significant stand-alone and combined applications in these two areas of endeavour for transport infrastructure monitoring. The recent advances, main challenges and future perspectives arising from their mutual integration are also discussed.
The intermittent nature of renewable energy resources creates extra challenges for the operation and control of the electricity grid. Demand flexibility markets can help in dealing with these challenges by introducing incentives for customers to modify their demand. Market-based demand-side management (DSM) have garnered serious attention lately due to its promising capability of maintaining the balance between supply and demand, while also taking customers’ preferences into consideration. Many researchers have proposed using concepts from mechanism design theory in their approaches to market-based DSM. In this work, we provide a review of the advances in market-based DSM using mechanism design. We provide a categorisation of the reviewed literature and evaluate the strengths and weaknesses of each design criteria. We also study the utility function formulations used in the reviewed literature and provide a critique of the proposed indirect mechanisms. We show that despite the extensiveness of the literature on this subject, there remains concerns and challenges that should be addressed for the realistic implementation of such DSM approaches. These include privacy concerns, market efficiency, scalability, convergence speed, and modelling the intertemporal dependence of electricity consumption. We draw conclusions from our review and discuss possible future research directions.
Thirty sediment samples were collected from the Gohar Rood River (Iran) to assess the elemental concentrations, origins, and probable environmental risks in the riverine system. In this study, fifteen elements were analyzed by inductively coupled plasma mass spectrometry (ICP-MS). Cr at all sites were exceeded the SEL (Severe Effect Level) value. Zn, Mn, Co, and Cr showed a moderate level of contamination, based on pollution index (PI), modified pollution index (MPI), and enrichment factor (EF). The modified hazard quotient (mHQ) represented low to extreme severity of pollution for some elements. The multi-linear regression of the absolute principal component score model indicated that largest contributors of Zn, Cu, Pb, Sb, and Mo to the riverine sediment were from agricultural runoff, domestic, and municipal sewage. Based on the modified BCR (the European Community Bureau of Reference) fractionation scheme, Mn, Co, and Zn indicated a medium to high risk to the local environment.
The study aims to examine the formation of and interrelationship between career importance, decisiveness, and aspirations among students. The data used in the study came from the ‘School experience, educational aspirations and scholastic achievement in Qatar’ survey 2018-2020 (SEEASAP). A sample of 841 students aged 12–14 was used for the analysis. The results of this study showed that the future career orientation among young people tends to be fragmented and incoherent. Believing in the centrality of work and employment in one’s life does not necessarily help young people become more certain about their future career or boost their career aspirations. The results also showed that career importance, decidedness and aspirations are shaped by different factors providing further evidence for the incoherence of young people’s future career orientation in times of greater insecurity and instability. The theoretical implications and limitations of this study are further discussed throughout.
Purpose Thermosensitive in situ gels have been around for decades but only a few have been translated into ophthalmic pharmaceuticals. The aim of this study was to combine the thermo-gelling polymer poloxamer 407 and mucoadhesive polymers chitosan (CS) and methyl cellulose (MC) for developing effective and long-acting ophthalmic delivery systems for L-carnosine (a natural dipeptide drug) for corneal wound healing. Methods The effect of different polymer combinations on parameters like gelation time and temperature, rheological properties, texture, spreading coefficients, mucoadhesion, conjunctival irritation potential, in vitro release, and ex vivo permeation were studied. Healing of corneal epithelium ulcers was investigated in a rabbit’s eye model. Results Both gelation time and temperature were significantly dependent on the concentrations of poloxamer 407 and additive polymers (chitosan and methyl cellulose), where it ranged from <10 s to several minutes. Mechanical properties investigated through texture analysis (hardness, adhesiveness, and cohesiveness) were dependent on composition. Promising spreading-ability, mucoadhesion, transcorneal permeation of L-carnosine, high ocular tolerability, and enhanced corneal epithelium wound healing were recorded for poloxamer 407/chitosan systems. Conclusion In situ gelling systems comprising combinations of poloxamer-chitosan exhibited superior gelation time and temperature, mucoadhesion, and rheological characteristics suitable for effective long-acting drug delivery systems for corneal wounds.
The Extended Crosswise Model (ECWM) is a randomized response model with neutral response categories, relatively simple instructions, and the availability of a goodness-of-fit test. This paper refines this model with a number sequence randomizer that virtually precludes the possibility to give evasive responses. The motivation for developing this model stems from a strategic priority of WADA (World Anti-Doping Agency) to monitor the prevalence of doping use by elite athletes. For this model we derived a maximum likelihood estimator that allows for binary logistic regression analysis. Three studies were conducted on online platforms with a total of over 6, 000 respondents; two on controlled substance use and one on compliance with COVID-19 regulations in the UK during the first lockdown. The results of these studies are promising. The goodness-of-fit tests showed little to no evidence for response biases, and the ECWM yielded higher prevalence estimates than direct questions for sensitive questions, and similar ones for non-sensitive questions. Furthermore, the randomizer with the shortest number sequences yielded the smallest response error rates on a control question with known prevalence.
Previous research suggests that children and adolescents with visual impairment may face several challenges in their academic learning and socio-emotional development due to restricted mobility, feelings of loneliness, and dependency on others. Habilitation services attempt to provide support with respect to many of these challenges that may positively impact on well-being and mental health, such as enabling independence in daily tasks, participation in social activities, and developing self-confidence. The literature also shows that individuals who have received educational and vocational rehabilitation support report higher quality of life and more positive self-esteem. Therefore, the primary focus of this study was on the rehabilitation, recreational opportunities, and educational resources provided by vision habilitation services for children and adolescents with visual impairments. The role that these services may play in school and daily life, as well as in the socio-emotional development of children and adolescents with visual impairments was also examined. This research covers the perspectives of professional staff, parents, children, and adolescents and considers both the immediate and potential long-term benefits of these services. The findings of the study highlighted the positive impact that this support has on children and adolescents’ independence, personal-safety, and self-confidence. The findings also indicated the positive impact of this support on the mental health of their families and benefits of providing continued support and expanding these habilitation and recreation services.
Rugby Union place kicking is influential to match outcome. Previous research has analysed kicker motion prior to ball contact in detail, but ball orientation and the impact phase are typically ignored. This study aims to firstly identify the ball orientations used by international place kickers, and secondly to experimentally analyse the foot-ball interaction in trained kickers using different ball orientations. Overall, 25.5% of the international kickers used an upright ball orientation, 27.5% used a diagonal orientation and 47.1% used a horizontal orientation. However, ball orientation preference was not significant in predicting kick outcome in a binomial logistic regression model. To address the second aim, ball orientation was experimentally manipulated and lower limb and ball kinematics were captured using high-speed (4000 Hz) video. Whilst the impact location on the ball differed significantly between most ball orientation conditions, the impact location relative to the global vertical was largely consistent across all conditions. This was likely due to kickers adopting very consistent lower limb kinematics, although the shank and ankle angles at impact were affected by ball orientation conditions for some kickers. Impact durations also differed between some conditions, although this did not appear to affect the impact efficiency.
Protecting clean sport, and the rights of athletes to a clean sport environment, is at the centre of anti-doping policies. To better support and enable clean athletes and sport, an understanding of the clean athlete lifeworld is required. The current study explored the ways that clean athletes are personally affected by others’ actual or suspected instances of doping and anti-doping rule violations, and by aspects of the anti-doping system. Qualitative Secondary Analysis (QSA) was used to re-analyse and interpret 13 focus group transcripts generated from the ‘Research-Embedded Strategic Plan for Anti-Doping Education Clean Sport Alliance Initiative for Tackling Doping’ (RESPECT) project (see Petróczi et al., 2021b). The sample in the parent study included 82 self-declared clean elite athletes, from Germany, Ireland, Netherlands, Slovenia, and the UK. Reflexive thematic analysis generated three overarching themes: The harm done by clean athletes having to coexist with dopers, how clean athletes are undermined by a disingenuous interest in clean sport, and the anxiety experienced by clean athletes over mistakes that could lead to anti-doping rule violations. The impacts of doping on clean athletes – direct or indirect – are experienced by all clean athletes in some way. The results indicate that current approaches to anti-doping rule compliance frequently undermine clean athletes and the perceived legitimacy of the anti-doping system.
Background: Agents, race-organisers, and sponsors have a key influence in shaping the world of elite professional distance running. Yet to date this important but hard-to reach stakeholder group has been omitted from the global research landscape of doping and anti-doping. The purpose of this study is to address this gap in the literature and explore the systematic contributors to doping in elite long-distance running, along with potential solutions to this issue, from this influential perspective. Methods: 13 in-depth interviews were conducted with agents (n = 8) of world-class long-distance runners, major race organisers (n = 3), and sports marketing managers (n = 2) for global brands. The interviews were conducted via the phone, audio recorded, and transcribed verbatim. Results: Reflexive thematic analysis generated three themes which focused on: 1) The framework of professional distance running and the contextual aspects which may contribute to doping risk; 2) the impact of various recruitment strategies on doping and anti-doping; and 3) the lessons that can be learnt from the participants’ first-hand experiences with doping cases and/or managing anti-doping requirements. Reflecting on the sector rather than the sample, the results highlighted that not all commercial stakeholders feel responsible for anti-doping. Conclusion: Collective responsibility from all stakeholders, which is currently borne by some and not others, is necessary to minimise doping in distance running. The challenge is how to convince all stakeholders of their share of responsibility. Structural and policy-level changes are needed to protect athletes and the sport.
Extensive consumption of cobalt in the chemical field such as for battery materials, alloy, pigments, and dyes has aggravated the pollution of cobalt both in food and the environment, and assays for its on-site monitoring are urgently demanded. Herein, we utilized enzyme dependence on metal cofactors to develop terminal transferase (TdT) as a recognition element, achieving a one-pot sensitive and specific assay for detecting cobalt pollution. We engineered a 3'-OH terminus primer to improve the discrimination capacity of TdT for Co2+ from other bivalent cations. The TdT extension reaction amplified the recognition of Co2+ and yielded a limit of detection of 0.99 μM for Co2+ detection. Then, the TdT-based assay was designed to precisely detect cobalt in food and agricultural soil samples. By end-measurement of fluorescence using a microplate reader, the multiplexing assay enabled the rapid screening of the peptide remover for cobalt pollution. The TdT-based assay can be a promising tool for cobalt pollution monitoring and control.
Introduction: Obesity affects nearly 1 in 4 European adults increasing their risk for mortality and physical and psychological morbidity. Obesity is a chronic relapsing disease characterized by abnormal or excessive adiposity with risks to health. Medical nutrition therapy based on the latest scientific evidence should be offered to all Europeans living with obesity as part of obesity treatment interventions. Methods: A systematic review was conducted to identify the latest evidence published in the November 2018-March 2021 period and to synthesize them in the European guidelines for medical nutrition therapy in adult obesity. Results: Medical nutrition therapy should be administered by trained dietitians as part of a multidisciplinary team and should aim to achieve positive health outcomes, not solely weight changes. A diverse range of nutrition interventions are shown to be effective in the treatment of obesity and its comorbidities, and dietitians should consider all options and deliver personalized interventions. Although caloric restriction-based interventions are effective in promoting weight reduction, long-term adherence to behavioural changes may be better supported via alternative interventions based on eating patterns, food quality, and mindfulness. The Mediterranean diet, vegetarian diets, the Dietary Approaches to Stop Hypertension, portfolio diet, Nordic, and low-carbohydrate diets have all been associated with improvement in metabolic health with or without changes in body weight. In the November 2018-March 2021 period, the latest evidence published focused around intermittent fasting and meal replacements as obesity treatment options. Although the role of meal replacements is further strengthened by the new evidence, for intermittent fasting no evidence of significant advantage over and above continuous energy restriction was found. Pulses, fruit and vegetables, nuts, whole grains, and dairy foods are also important elements in the medical nutrition therapy of adult obesity. Discussion: Any nutrition intervention should be based on a detailed nutritional assessment including an assessment of personal values, preferences, and social determinants of eating habits. Dietitians are expected to design interventions that are flexible and person centred. Approaches that avoid caloric restriction or detailed eating plans (non-dieting approaches) are also recommended for improvement of quality of life and body image perceptions.
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Peter S. Hooda
  • School of Engineering and the Environment
Mehmet Sahinkaya
  • School of Mechanical and Automotive Engineering
Payam Khazaeinejad
  • Department of Mechanical Engineering
Andrey Karlyshev
  • School of Life Sciences
London, United Kingdom