Leadership in Elite Football Academy Management Teams

Purpose: In the United Kingdom (U.K.), football academies are required to have an Academy Management Team (AMT); middle management responsible for ensuring the Academy functions effectively and efficiently. This study sought to explore the training and educational requirements for AMT members and suggest practical recommendations for the development of AMT members in the future. Methodology: Recruiting 45 AMT members, a mixed-methods approach was employed using a survey and semi-structured interviews. Findings: Thematic analysis developed themes reflecting large differences in the leadership and management training of AMT members. This related to the specific concept of interpretation and translation of strategy throughout their own department and the Academy. Practical Implications: Leadership and management training for middle managers (AMT) is poorly funded with current skills primarily developed through previous experience. Those who had undertaken leadership and management training felt better equipped at interpreting and translating information to inform more effective decisions Training needs ranged from area such as performance management of staff and allocating resources to managing change and strategic planning within the academy. Research Contribution: This study explored the training and educational needs of middle managers (AMT) within elite UK football academies

Developing participant engagement within a MAT to empower senior leaders within schools and across the Trust

The thesis examines how a new multi-academy trust (MAT) facilitates the use of participatory engagement (Woods, 2004) within and across a group of schools through working with leadership teams. More specifically the study reviews how democratic leadership (Liggett, 2025) can be applied to adapt the MAT operating model to increase participation of senior leaders in decision making, to impact positively on their relationships and role (Myers, 1993). This element of the research challenges and seeks solutions to the top-down model of decision making inherent in MAT structures (Woods and Simkins, 2014:42) which are unsuitable for a multisite organisation. To this end the research study questions how the process of empowerment (Herrenkohl, 1999) can enable senior leader contribution and collaboration for improvement, to support the strategic development of each school and the Trust. The research is presented from an insider perspective of a researcher, who is also the CEO of the MAT. This study applies an ethnographic methodology framed within an interpretivist approach over the phases of the MAT’s development. A range of qualitative methods, including semi-structured interviews and focus groups were used to capture participant voices, on their leadership journey where roles and responsibilities changed, alongside the MAT’s growth and development. A Foucauldian lens was applied to the analyse of data collected, focusing on the elements connected to power, which provided a useful tool of analysis. The findings highlight how MAT operating models can be adapted to facilitate democratic leadership, while being flexible to respond to changing neoliberal agendas. The research study highlights ways senior leaders can make a significant contribution to the strategic development of a MAT and build a strong culture of interconnectedness (Kaplan and Owings, 2013). Further, there is evidence of how senior leaders use these supportive MAT structures to strategically respond to government agendas and align this to the agreed vision for the MAT. However, the findings highlight the need for clarification on future government policy direction in a diverse education system particularly at a local level. This study offers an original contribution to knowledge in the leadership field within a multi-site setting and adds to the existing understanding of leadership in multi-academy trusts (MATs), particularly the senior leaders to make a significant contribution in the leadership of an organisation

The Use and Reproducibility of Transabdominal Ultrasound to Provide Indices of Left Common Iliac Vein Diameter

Introduction: May Thurner Syndrome (MTS) is a rare vascular condition whereby the left common iliac vein (CIV) is compressed by the overlying right common iliac artery. It can lead to serious medical problems such as deep vein thrombosis or pulmonary embolism. Currently the gold standard for diagnosis is invasive imaging techniques such as catheter venography or intravascular ultrasound. Opinions differ on the best way to use transabdominal ultrasound to determine CIV compression and the size at which a CIV measured with transabdominal ultrasound would indicate compression and necessitate the need for further imaging. Aims: This thesis aims to investigate the use and reproducibility of transabdominal ultrasound to provide indices of left CIV diameter, to aid diagnosis of MTS in patients presenting with unexplained left leg swelling. Methods: 40 patients were recruited from the vascular department at Imperial College Healthcare NHS Trust. 20 patients were symptomatic for left leg venous disease and 20 patients were asymptomatic. Three clinical vascular scientists performed a transabdominal ultrasound assessment on each patient, measuring the diameter of the left CIV three times with the patient supine and three times with the patient tilted to 45-degrees reverse trendelenburg (RT), to assess for intra- and inter-operator reliability. Results: Readings were obtained from 36 out of 40 patients, partial data obtained from 3 patients and no readings could be obtained from 1 patient. Analysis of the data from the 36 patients found an average diameter of the left CIV of 8.0mm ± 3.8mm in the symptomatic group (n=16, 6 male, 10 female) and 7.8mm ± 2.7mm in the asymptomatic group (n=20, 11 male, 9 female). There was no statistically significant difference in left CIV diameter between the symptomatic group and asymptomatic group, however, there was a statistically significant difference in left CIV diameter based on posture (p<0.05). The diameter of the left CIV measured 7.0mm ± 2.6mm when assessed supine and 9.0mm ± 3.3mm when tilted to 45-degree RT. Intra-operator reliability was excellent (ICC=0.92 with 95% confidence interval =0.90-0.93) whereas inter-operator reliability was moderate (ICC=0.67 with 95% confidence interval 0.60-0.72). Conclusion: This study determined an average left CIV diameter of 7.0mm ± 2.6mm as measured by transabdominal ultrasound. Importantly, the diameter of the left CIV significantly increases when a patient is examined in the 45-degree RT position (7.0mm ± 2.6mm vs 9.0mm ± 3.3mm, supine vs tilted; p<0.05). This suggests that symptomatic patients presenting with a left CIV measuring smaller than 7.0mm ± 2.6mm should be reassessed in the tilted position, and if still measuring smaller than this, further investigations should be considered. In this study intra-operator reliability was excellent whereas inter-operator reliability was moderate, therefore results from scans should be interpreted with caution. Further larger scale studies using MTS patients would be beneficial to confirm the average diameter measurements established in this study and to further determine a diameter range that would be highly suggestive of left CIV compression when examined using transabdominal ultrasound

Development of The COMBINED approach: Integrating a brief behaviour change intervention supported by a physiotherapist for people with rotator cuff disorders

Background: Modifiable lifestyle factors (smoking, inactivity, overweight) could contribute to the onset and persistence of rotator cuff disorders, yet physiotherapy practice rarely addresses them. Brief interventions (BIs) can support behaviour change but are not routinely embedded in musculoskeletal care. Objectives: To develop The COMBINED approach: a physiotherapist-supported intervention integrating BI's tar geting modifiable health behaviours into routine consultations for people with rotator cuff disorders; and to explore how physiotherapists can be supported to deliver it. Materials and methods: A theory-, evidence-, and pragmatic-based development process incorporated stakeholder co-design, behavioural theory, and evidence across three workstreams: (1) narrative review of BIs targeting smoking, inactivity, and weight management; (2) four co-design workshops with 26 stakeholders (physiother apists, patients, experts) to select and adapt a BI and identify key intervention features; (3) theoretical modelling using COM-B, TDF, and BCTTv1 to map barriers/facilitators, select behaviour change techniques, and develop prototype components. Findings: Fourteen BIs were identified; Moving Medicine had greatest utility. Barriers included time constraints, limited skills and confidence, and fear of offending patients, contrasting with patients’ acceptability of lifestyle conversations. Recommendations included embedding the BI into routine care, scripts, infographics, patient resources, and training. Twelve TDF domains and 20 BCTs informed prototype development comprising: (1) patient-level intervention: a BI (adapted from Moving Medicine) embedded in routine consultations with tailored resources; (2) clinician-level implementation toolkit. Conclusion: The COMBINED approach is the first formally developed intervention supporting integration of BI's within routine consultations for people with rotator cuff disorders and is now ready for feasibility testing

Bridging Accuracy and Explainability: A SHAP-Enhanced CNN for Skin Cancer Diagnosis

Early detection of melanoma, the most lethal form of skin cancer, can greatly enhance patient survival rates. Although AI models have demonstrated strong diagnostic capabilities, their integration into clinical practice remains limited due to concerns over explainability and trust. This work proposes a SHAP-enhanced Convolutional Neural Network (SCNN) for binary classification of skin lesions into melanoma and non-melanoma categories, directly integrating Shapley Additive Explanations (SHAP) as an additional input channel to enhance performance and explainability. We evaluated SCNN on the ISIC 2017 and ISIC 2018 datasets, achieving ROC-AUC scores of 0.80 and 0.91, respectively. These results indicate substantial improvements in classification accuracy and robustness compared to baseline models. An analysis of model explainability on the ISIC 2017 dataset reveals that SCNN more accurately highlights lesion areas identified by experts, achieving a mean Intersection-over-Union score of 0.34, which marginally improved the baseline score of 0.32. 53% of the correct melanoma predictions made by the SCNN model were based on clinically relevant regions, compared to only 40% for the baseline model. Qualitative evaluations via Grad-CAM visualisations further confirmed that SCNN prioritised medically meaningful features, such as lesion asymmetry and border irregularities. These results demonstrate that integrating explainability into model training can enhance transparency without compromising performance, thereby gaining more trust from clinicians

CsdA-LaeB Regulatory Hub Contributes to Aspergillus fumigatus Virulence via Fumiquinazoline C Biosynthesis

Fungal secondary metabolism plays a critical role in pathogen–host interactions, yet the regulatory networks linking metabolic reprogramming to virulence remain poorly understood. This study identifies a conserved regulatory hub in the human pathogen Aspergillus fumigatus, where the RNA-binding protein (RBP) CsdA interacts with the global regulator LaeB in the nucleus to regulate biosynthesis of the secondary metabolite fumiquinazoline C (FqC). Disruption of the CsdA-LaeB interaction hyperactivates FqC production, enhancing fungal colonization and lethality in murine invasive aspergillosis models. Integrative metabolomic and transcriptomic analyses reveal that CsdA and LaeB function as co-regulators of a broader secondary metabolic gene cluster network, with FqC emerging as an effector that mediates virulence in vivo. Genetic validation confirms that FqC is strictly required for the increased virulence phenotype of CsdA- or LaeB-deficient strains, while analyses of clinical isolates demonstrate a striking inverse correlation: reduced CsdA and LaeB expression coincides with elevated FqC production, showing consistency with the infection outcomes of the deletion mutants. This work identifies the RBP-based interaction that regulates fungal metabolic virulence, shedding new light on the post-transcriptional regulatory logic linking secondary metabolism to pathogenicity and offering alternative strategies for diagnostic development and therapeutic intervention in invasive fungal diseases

User-centric Privacy-preserving Framework for Vehicle Data Sharing and Monetization

Modern connected vehicles continuously generate large volumes of data, enabling new data-sharing and monetization services while simultaneously raising serious concerns about privacy, access control, and scalability. Recent blockchain-based approaches improve transparency and user control, but often rely on coarse-grained access policies, costly symmetric key management, and limited scalability, making them unsuitable for realistic, high-volume vehicle data markets. Moreover, purely owner-centric access control may conflict with legitimate requirements from authorized third parties, such as manufacturers or regulatory authorities. In this paper, we propose a scalable, privacy-preserving framework for vehicle data sharing and monetization that combines blockchain-based smart contracts with attribute-based and identity-based encryption. The framework enables fine-grained, policy-driven access control while preserving data confidentiality and supporting authorized exceptional access when required. We evaluate the proposed design through security analysis and experimental measurements1 , demonstrating that it achieves strong privacy guarantees with modest overhead and scales to realistic workloads

A Mixed Methods Examination of Intimate Partner Homicide-Suicide by Age Using Domestic Homicide Reviews From England and Wales

This study examines the phenomenon of intimate partner homicide-suicide (IPHS), specifically, how it differs (or not) from intimate partner homicide without suicide (IPH), and how the ages of victims and perpetrators shape the risks, vulnerabilities and contextual features of cases. A mixed methods document analysis of 232 domestic homicide reviews (DHRs) was undertaken, using bivariate analysis to compare 37 IPHS to 195 IPH-without suicide, and a gendered, thematic analysis to gain deeper, contextualized insights into IPHS structured by victim and perpetrator age. IPHS victims and perpetrators were older, and in the case of perpetrators, more likely to be white. Risks and vulnerabilities also differed, with less substance use, criminality, and violence, but greater physical and mental health difficulties. Themes of “Separation and loss,” “Dependency,” and “Mental health and suicidality” ran through the 37 IPHS, but with IPHS involving older adults appearing as phenomenologically distinct, shaped by gendered contexts of care and a loss of autonomy due to chronic, degenerative illness. Our findings highlight the key role for physical and mental health services—particularly General (Medical) Practitioners—alongside the need for comprehensive support systems and coordinated care to manage the complex interdependencies in elderly couples

Health-Seeking Behaviour in Adults with Musculoskeletal Conditions: A Scoping Review

Background Musculoskeletal conditions, such as osteoarthritis and low back pain, are among the leading causes of disability worldwide. Individuals often delay or avoid seeking healthcare due to personal, social, and systemic factors. Existing research on health-seeking behaviour is fragmented and lacks synthesis across diverse contexts and populations. Objective This scoping review systematically maps the literature on health-seeking behaviour in adults with musculoskeletal conditions, highlighting knowledge gaps and generating insights for future research, clinical practice, and policy. Methods A scoping review was conducted following the Joanna Briggs Institute methodology. Six electronic databases and relevant grey literature sources were systematically searched. Eligible studies focusing on adults with musculoskeletal conditions were screened and analysed using narrative synthesis. Findings were organised into thematic tables and illustrated through a conceptual framework. Results Twenty-three studies published between 2004 and 2025 were included, representing a diverse range of geographic and socioeconomic contexts. Five key themes were identified: Clinical and Functional Need; Socioeconomic and Environmental Context; Cultural and Social Context; Healthcare System and Provider Experiences; and Use of Alternative and Digital Care Options. Conclusion This review identifies five key themes connecting clinical, socioeconomic, cultural, and systemic factors in adults with musculoskeletal conditions. Highlighting patient agency, it informs research, policy, and practice aimed at delivering more equitable and responsive musculoskeletal care

Development of a computational recommendation system for parenteral nutrition prescription: An algorithm study

There is a drive in some countries to increase the use of mul/-chamber bags as an alterna/ve to compounded parenteral support for pa/ents with chronic intes/nal failure in order to preserve asep/c pharmacy capacity. If a required regimen is that of an mul/- chamber bag plus one intravenous intravenous fluid product, then the poten/al combina/ons of available products can exceed 3000. Method A computer-based selec/on algorithm known as ‘PNMatch’ was developed, which u/lises a ‘kNearest Neighbour’ strategy for matching. Following comple/on of the computa/onal design for the algorithm, a staged tes/ng and development process was undertaken, evalua/ng the algorithm against clinician prescribing. A matching assessment was then undertaken against exis/ng prescrip/ons. Results Algorithm func/onality was assessed through 20 parenteral nutri/on formula/on requests, all of which were successfully processed. Prescrip/on selec/on demonstrated a 90% exact match rate, with one unmatched case and one non-improved match. The mean /me for prescrip/on selec/on using PNMatch was 116 seconds. Mul/-chamber mul/-chamber bags s requests were then evaluated. Most prescrip/ons matched closely with the exis/ng formula/ons, achieving a Cohen’s kappa value of 0.8. Further analysis of 44 formula/on requests showed successful product selec/on for 43 requests. The mean difference in volume was -75.3 ml, and for potassium, it was -4.9 mmol. Conclusion This is the first demonstra/on of the successful development and tes/ng of a computerbased selec/on algorithm for the prescrip/on of mul/-chamber bags-based regime for pa/ents with chronic intes/nal failure. This has the poten/al to improve efficiency and reduced variability in parenteral support prescribing