IntroductionMaking a diagnosis of asthma can be challenging for clinicians and patients. A clinical decision support system (CDSS) for use in primary care including a patient-facing mode, could change how information is shared between patients and healthcare professionals, and improve the diagnostic process. MethodsParticipants diagnosed with asthma within the last five years were recruited from general practices across four UK regions. In-depth interviews were used to explore patient experiences relating to their asthma diagnosis, and to understand how a CDSS could be used to improve the diagnostic process for patients. Interviews were audio recorded, transcribed verbatim and analysed using a thematic approach. Results17 participants (12 female) undertook interviews, including 14 individuals and 3 parents of children with asthma. Being diagnosed with asthma was generally considered an uncertain process.Participants felt a lack of consultation time and poor communication affected their understanding of asthma and what to expect. Had the nature of asthma and steps required to make a diagnosis been explained more clearly, patients felt their understanding and engagement in asthma self-management could have been improved. Participants considered that a CDSS could provide resources to support the diagnostic process, prompt dialogue, aid understanding and support shared decision making. ConclusionUndergoing an asthma diagnosis was uncertain for patients if their ideas and concerns were not addressed by clinicians and was influenced by a lack of consultation time and limitations in communication. An asthma diagnosis CDSS could provide structure and an interface to prompt dialogue, provide visuals about asthma to aid understanding, and encourage patient involvement. Patient and public contributionPre-specified semi-structured interview topic guides (young person and adult versions) were developed by the research team and piloted with members of the Asthma UK Centre for Applied Research Patient and Public Involvement (PPI) group. Findings were regularly discussed within the research group and with PPI colleagues to aid interpretation of data.

Most adults are able to take some control over where they live and are able to reflect on their migration histories, those places where they have lived and worked, and those places where they might aspire to live in the future. These life‐altering decisions have been negotiated either autonomously or in conjunction with significant others in their lives. For some adults, most notably those with learning disabilities, these life decisions are partially, if not wholly, made for them by others. It is therefore the aim of this paper to uncover more about the decision‐making opportunities afforded to people with learning disabilities regarding their home‐spaces as they navigate “moving landscapes” that they have perhaps not envisaged for themselves. The paper identifies the need for a co‐production of knowledge that recognises alternative methods of communication and participation in research, which seeks to de‐mystify the authentic, and perhaps mundane, realities of living with a learning disability. Indeed, some geographers have questioned the integrity of research that fails to allow those with learning disabilities to control at least some part of the process. And so, by embracing lives that are “differently normal,” the paper seeks to challenge the role of the expert by engaging with methods that allow the distinction between researched and researcher to become blurred, allowing the voice of the learning‐disabled individual clearly to be heard. Finally, the paper will discuss the disconnect between intended methodological approaches and those undertaken “in the field.”

Moisture-associated skin damage, especially incontinence-associated dermatitis, continues to present significant health challenges and requires multidisciplinary input to provide effective prevention and treatment. In the absence of mandatory reporting such damage is under- or wrongfully reported, resulting in a lack of accurate data on prevalence and costs of associated care. In March this year, a multidisciplinary team of experts met in the UK to seek to determine measures to improve patient skin care. They aimed to identify activities to increase awareness and education, collect data, and improve prevention and treatment regimes. This article describes that discussion and the conclusions made by the group, such as the key actions required to effect policy changes.