Overview
I began working at the University of Exeter in March 2013 where I joined the medical imaging team as a senior lecturer delivering the image interpretation module to undergraduate students. I have since led on developing, gaining accreditation for and running a Radiographer Reporting masters. This has involved the delivery of teaching, designing of assessments as well administrative duties such as communicating with applicants and their clinical mentors and managing teaching schedules.
This has evolved into an MSc Advanced Clinical Practice which I now the deputy lead for. These latest developments have allowed us to offer broaden our scope in order to offer a range of modules, including new and clinically relevant modules in order to support the development of advanced clinical skills in the healthcare community. In addition, in september 2021 we welcomed our first cohort of Advanced Clinical Practice Degree apprentices.
Prior to joining the university I was employed as a diagnostic radiographer in a large regional hospital undertaking a range of radiographic duties for several years. I gained my MSc in Clinical Reporting and practiced as an advanced practitioner reporting radiographer with a focus on musculoskeletal plain image reporting. I still undertake some reporting sessions with my local trust as a member of the bank staff.
Qualifications
- BSc Hons Diagnostic Radiography, University of Hertfordshire 1996
- MSc Clinical Reporting, Canterbury Christchurch University College, 2005
- Postgraduate Certificate in Academic Practice, University of Exeter, 2017
- Fellowship of the Higher Education Academy, 2017
- Aspire Fellowship 2017
- Currently studying towards a PhD
Research
Research interests
I am currently undertaking a PhD looking at the impact of haemochromatosis (an inherited iron overload disorder) on the musculoskeletal system using imaging studies obtained from UK Biobank.
Publications
Journal articles
Banfield LR, Knapp KM, Pilling LC, Melzer D, Atkins JL (2023). Hemochromatosis Genetic Variants and Musculoskeletal Outcomes: 11.5‐Year Follow‐Up in the <scp>UK</scp> Biobank Cohort Study.
JBMR PlusAbstract:
Hemochromatosis Genetic Variants and Musculoskeletal Outcomes: 11.5‐Year Follow‐Up in the UK Biobank Cohort Study
ABSTRACTThe iron overload disorder hemochromatosis is primarily caused by the homozygous HFE p.C282Y variant, but the scale of excess related musculoskeletal morbidity is uncertain. We estimated hemochromatosis‐genotype associations with clinically diagnosed musculoskeletal outcomes and joint replacement surgeries in the UK Biobank community cohort. A total of 451,143 European ancestry participants (40 to 70 years at baseline) were followed in hospital records (mean 11.5‐years). Cox proportional hazards models estimated HFE p.C282Y and p.H63D associations with incident outcomes. Male p.C282Y homozygotes (n = 1294) had increased incidence of osteoarthritis (n = 52, hazard ratio [HR]: 2.12 [95% confidence interval, CI: 1.61 to 2.80]; p = 8.8 × 10−8), hip replacement (n = 88, HR: 1.84 [95% CI: 1.49 to 2.27]; p = 1.6 × 10−8), knee replacement (n = 61, HR: 1.54 [95% CI: 1.20 to 1.98]; p = 8.4 × 10−4), and ankle and shoulder replacement, compared to males with no HFE mutations. Cumulative incidence analysis, using Kaplan–Meier lifetable probabilities demonstrated 10.4% of male homozygotes were projected to develop osteoarthritis and 15.5% to have hip replacements by age 75, versus 5.0% and 8.7% respectively without mutations. Male p.C282Y homozygotes also had increased incidence of femoral fractures (n = 15, HR: 1.72 [95% CI: 1.03 to 2.87]; p = 0.04) and osteoporosis (n = 21, HR: 1.71 [95% CI: 1.11 to 2.64]; p = 0.02), although the latter association was limited to those with liver fibrosis/cirrhosis diagnoses. Female p.C282Y homozygotes had increased incidence of osteoarthritis only (n = 57, HR: 1.46, [95% CI: 1.12 to 1.89]; p = 0.01). Male p.C282Y/p.H63D compound heterozygotes experienced a modest increased risk of hip replacements (n = 234, HR: 1.17 [95% CI: 1.02 to 1.33], p = 0.02), but this did not pass multiple testing corrections. In this large community cohort, the p.C282Y homozygote genotype was associated with substantial excess musculoskeletal morbidity in males. Wider HFE genotype testing may be justified, including in orthopedic clinics serving higher HFE variant prevalence populations. © 2023 the Authors. JBMR Plus published by Wiley Periodicals LLC. on behalf of American Society for Bone and Mineral Research.
Abstract.
Rachuba S, Knapp K, Ashton L, Pitt M (2018). Streamlining pathways for minor injuries in emergency departments through radiographer-led discharge.
Operations Research for Health Care,
19, 44-56.
Abstract:
Streamlining pathways for minor injuries in emergency departments through radiographer-led discharge
Diagnostic imaging services are essential to the diagnosis pathway for many patients arriving at hospital emergency departments with a suspected fracture. Commonly, these patients need to be seen again by a doctor or emergency nurse practitioner after an X-ray image has been taken in order to finalise the diagnosis and determine the next stage in the patients’ pathway. Here, significant waiting times can accrue for these follow-up consultations after radiographic imaging although the vast majority of patients are discharged. Research evidence from pilot studies suggests that patients with minor appendicular injuries could be safely discharged by a suitably qualified radiographer directly after imaging thereby avoiding queues for repeated consultation. In this study, we model patient pathways through an emergency department (ED) at a hospital in the South West of England using process mapping, interviews with ED staff and discrete event simulation (DES). The DES model allowed us to compare the current practice at the hospital with scenarios using radiographer-led discharge of patients directly after imaging and assess the reduction in patients’ length of stay in ED. We also quantified trade-offs between the provision of radiographer-led discharge and its effects, i.e. reduction in waiting times and ED workload. Finally, we discuss how this decision support tool can be used to support understanding for patients and members of staff.
Abstract.
Knapp K, Meertens R, Ashton LR, Hopkins S (2015). Dual energy x-ray absorptiometry beyond bone mineral density measurement: vertebral fracture assessment. Imaging and Oncology for Imaging and Therapy Professionals, 48-53.
Conferences
Banfield L, Aboelmagd S, Seymour R, Atkins J, Melzer D, Knapp K (2022). Demonstration of degenerative disease as identified on iDXA images: an inter-observer reliability study. European Congress of Radiology (ECR) Overture. 2nd - 6th Mar 2022.
Abstract:
Demonstration of degenerative disease as identified on iDXA images: an inter-observer reliability study
Abstract.
Ashton L, Fulford J, McAnulla S, Knapp KM, Heales C, Silver D, Williams CA (2017). The incidence of bone marrow oedema in asymptomatic adolescent footballers - an observational study.
Abstract:
The incidence of bone marrow oedema in asymptomatic adolescent footballers - an observational study
Abstract.
Lucy_Ashton Details from cache as at 2023-09-30 05:00:42
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Teaching
My teaching interests mainly focus on the interpretation of musculosketal plain x-ray images, including normal variants, appearances resulting from trauma and pathological processes.
I am module lead for HPDM128 Principles of Advanced Clinical Practice within MSc Advanced Clinical Practice. I also teach on PAM3019 Pathology and Image Interpretation 2 which is a BSc Medical Imaging module and RAD3001DA Applied Radiographic Knowledge (ARK) 3, one of the medical imaging degree apprenticeship modules.
Modules
2023/24