Digital Commons Network^™

Starting A New Anti-Seizure Medication In Drug-Resistant Epilepsy: Add-On Or Substitute?, Mubeen Janmohamed, Nicholas Lawn, Katrina Spilsbury, Josephine Chan, John Dunne

IHR Papers and Journal Articles

Objectives: Randomized studies in drug-resistant epilepsy (DRE) typically involve addition of a new anti-seizure medication (ASM). However, in clinical practice, if the patient is already taking multiple ASMs, then substitution of one of the current ASMs commonly occurs, despite little evidence supporting this approach.

Methods: Longitudinal prospective study of seizure outcome after commencing a previously untried ASM in patients with DRE. Multivariable time-to-event and logistic regression models were used to evaluate outcomes by whether the new ASM was introduced by addition or substitution.

Results: A total of 816 ASM changes in 436 adult patients with DRE between 2010 and 2018 …

Parent Carer Quality Of Life And Night-Time Attendance In Non-Ambulant Youth With Neuromuscular Disorders, Vivienne Travlos, Shane Patman, Jenny Downs, Dana Hince, Andrew C. Wilson

Physiotherapy Papers and Journal Articles

Purpose: To describe and explore carer quality of life (QoL) and night-time attendance to their child in parents of non-ambulant youth with Neuromuscular Disorders.

Methods: A cross-sectional population-based, comprehensive survey including the Adult Carer QoL (ACQoL) questionnaire, measures of social context and youths’ physical status. Associations between carerQoL or frequency of parents’ night-time attendance with independent variables were explored using linear and logistic regression models, respectively.

Results: Parents’ perceived lower carer-QoL (mean 76.5/120, SD 18.5) when they attended to their child twice a night or more (n = 17/35) and with shorter time since their child was prescribed noninvasive ventilation …

Systematic Review Of Medical Education On Spirituality, John Wenham, Megan Best, David Kissane

IES Papers and Journal Articles

Background

Spirituality is a fundamental dimension of our human nature that impacts on medical care and yet is relatively neglected by medical education courses in Australia.

Aim

This systematic review was conducted to assess the curriculum content currently used to develop medical student understanding of, and engagement with, spirituality in the context of patient care.

Methods

Studies published in English from 2010 to the review date were included in order to focus on the most recent curricula. Studies included medical students in undergraduate or postgraduate programmes, doctors in resident training programmes and registrars. Interventions considered for inclusion were curriculum modules …

Employability As Sustainable Balance Of Stakeholder Expectations - Towards A Model For The Health Professions, Martin Cake, Melinda Bell, Liz Mossop, Caroline F. Mansfield

Health Sciences Papers and Journal Articles

The conceptual complexity of employability remains a barrier for its integration into discipline-based curricula. In the health professions, a particular challenge lies in integrating employability with the dominant paradigms of competency and professionalism. In this study, we explore these contextual challenges, and present the rationale and conceptual basis for a potential re-framing of employability within the context of this discipline group. We propose a novel definition and a conceptual model of employability better aligned to the needs of health professions. While employability has proven difficult to define broadly, it is framed around the expectations of both the employer and employee, …

Turning Participation Into Power: A Water Justice Case Study, Jaime Alison Lee

All Faculty Scholarship

No abstract provided.

Unaccompanied Youth In Our Public Schools And Our Opportunity To Lead For Emancipatory Practices (Jóvenes No Acompañados En Nuestras Escuelas Públicas Y Nuestra Oportunidad Para Liderar Prácticas Emancipatorias), Leyda W. Garcia

LMU Theses and Dissertations

Unaccompanied youth are migrant children who travel by themselves to the United States, mostly from Central America and Mexico. Since 2014, more than 200,000 unaccompanied youth have entered the United States, with approximately 28,000 residing in Los Angeles, California (U.S. Customs and Border Protection [CBP], CBP 2018, 2019, 2020, 2021a, 2021b). Hundreds of these young migrants have enrolled in public schools (Pierce, 2016). Schools seek adequate and effective ways to support these students’ complex needs and aspirations. Within the body of research about this sub-group of immigrants there is a significant absence of the voices of unaccompanied youth themselves, which …

Understanding Catholic School Attrition: Catholic Elementary School Students’ And Parents’ Perceptions And Matriculation Decisions, Thomas Gasper

LMU Theses and Dissertations

This mixed methods study shed light on the issue of attrition within Catholic education and points to opportunities for leaders to improve the effectiveness of elementary and secondary schools as well as identify barriers impacting access to poor and vulnerable populations. The purpose was to: describe factors eighth-grade Catholic school students and their parents consider in choosing a high school; determine correlations between degree of satisfaction with Catholic elementary schools and perceptions of programs in Catholic high schools; and understand the extent students’ and parents’ identified attributes corresponded to their high school selection.

Quantitative data was generated from surveys of …

Building An Ignatian Ummah: The Experience Of Muslim International Students At An American Jesuit University, Csilla V. Samay

LMU Theses and Dissertations

In 2020, over a million international students enrolled at universities in the United States. A significant percent come from Muslim-majority countries whose governments sponsor their education abroad. As overall international enrollments decrease, recruiting this population remains attractive to U.S. institutions. International students face the challenge of entering higher education in a foreign country and culture, navigating their education during a time of political battles over immigration and issues of diversity. Muslim students face prejudice and exclusion due to Islamophobia in the U.S. Universities have a responsibility to understand and fully support students from whom they benefit financially.

This study examined …

Student Self-Harm: The Impact On An Elementary School Principal's Leadership, Jason Daniel Rose

LMU Theses and Dissertations

Research on self-harm and children tends to focus on adolescent children (12 years of age and above). There is limited available information about self-harm in children ages 11 years and younger. This study utilized autoethnography as the methodology to provide a rich description of the professional experiences and practices of an elementary school principal who worked with self-harming primary-aged students. Based on an autoethnographical analysis, this study proposes future research and makes recommendations for school leaders implementing trauma-informed practices, educators working with self-harming students, and districts committed to proactive support.

Testimonios Of Latin@ Leaders In Large Urban School Systems: Educación, Lenguaje Y Cultura, Hilda L. Maldonado

LMU Theses and Dissertations

Across the nation, Latina/o educational leaders who serve large urban school systems face the challenges of educating historically marginalized Latinx student populations, many of whom represent a diverse group of English Learners (ELs) in school systems designed for monolingual English speakers. This study is an exploratory, qualitative, multiple case study, using testimonio methodology to document the experiences of seven Latina/o leaders across the nation to arrive at new understandings of their practices. The review of the literature focused on the sociopolitical history of Latina/o education, linguistic hegemony in schooling, and theories of leaders of color. These concepts were used were …

Muchos Somos Más Fuertes: Testimonios Of Latina Parent Leaders In The Local Control And Accountability Plan Process, Sylvia J. Hodge

LMU Theses and Dissertations

English Learners represent 18.6% of the entire California public school population or 1.1 million students; 81.4% speak Spanish (California Department of Education [CDE], 2021b). Historically, English Learners have experienced inequitable educational opportunities when compared to their English-only counterparts in California (Gándara & Contreras, 2010; Gándara et al., 2003; Perez Huber et al., 2015; Rumberger & Gándara, 2004), which has led to low educational achievement CDE, 2019a; Gándara & Mordechay, 2017; Olsen, 2010). To address underserved students’ inequitable educational opportunities throughout California, then-Governor Edmund G. Brown signed into law the Local Control Funding Formula (LCFF) in 2013. The LCFF provides equitable …

A Decade Of Gomri Dispersant Science: Lessons Learned And Recommendations For The Future, Antonietta Quigg, John W. Farrington, Sherryl Gilbert, Steven A. Murawski, Vijay T. John

Marine Science Faculty Publications

Dispersants are among a number of options available to oil spill responders. The goals of this technique are to remove oil from surface waters in order to reduce exposure of surface-dwelling organisms, to keep oil slicks from impacting sensitive shorelines, and to protect responders from volatile organic compounds. During the Deepwater Horizon response, unprecedented volumes of dispersants (Corexit 9500 and 9527) were both sprayed on surface slicks from airplanes and applied directly at the wellhead (~1,500 m water depth). A decade of research followed, leading to a deeper understanding of dispersant effectiveness, fate, and effects. These studies resulted in new …

Ice-Breaking Fleets Of The United States And Canada : Assessing The Current State Of Affairs And Future Plans, Megan Drewniak, Dimitrios Dalaklis, Anastasia Christodoulou, Rebecca Sheehan

Articles

In recent years, a continuous decline of ice-coverage in the Arctic has been recorded, but these high latitudes are still dominated by earth’s polar ice cap. Therefore, safe and sustainable shipping operations in this still frozen region have as a precondition the availability of ice-breaking support. The analysis in hand provides an assessment of the United States’ and Canada’s polar ice-breaking program with the purpose of examining to what extent these countries’ relevant resources are able to meet the facilitated growth of industrial interests in the High North. This assessment will specifically focus on the maritime transportation sector along the …

Perspectives On Cyber Security For Offshore Oil And Gas Assets, Iosif Progoulakis, Nikitas Nikitakos, Paul Rohmeyer, Barry Bunin, Dimitrios Dalaklis, Stavros Karamperidis

Articles

In an ever-evolving technological industry, the oil and gas sector is already moving forward through the adaptation of Industry 4.0 and the adaptation of advanced cyber technologies through Oil and Gas 4.0. As IT/OT (information technology/operational technology) systems are evolving technologically, so are the cyber security threats faced by the offshore oil and gas assets. This paper aims to raise the awareness of cyber security threats and the organizational and technical measures that need to be adopted by the oil and gas industry for remote and complex assets in the upstream sector. A comprehensive literature review covering the areas of …

Perspectives On Cyber Security For Offshore Oil And Gas Assets, Iosif Progoulakis, Nikitas Nikitakos, Paul Rohmeyer, Barry Bunin, Dimitrios Dalaklis, Stavros Karamperidis

Articles

In an ever-evolving technological industry, the oil and gas sector is already moving forward through the adaptation of Industry 4.0 and the adaptation of advanced cyber technologies through Oil and Gas 4.0. As IT/OT (information technology/operational technology) systems are evolving technologically, so are the cyber security threats faced by the offshore oil and gas assets. This paper aims to raise the awareness of cyber security threats and the organizational and technical measures that need to be adopted by the oil and gas industry for remote and complex assets in the upstream sector. A comprehensive literature review covering the areas of …

The Northwest Passage In The Arctic : A Brief Assessment Of The Relevant Marine Transportation System And Current Availability Of Search And Rescue Services, Rebecca Sheehan, Dimitrios Dalaklis, Anastasia Christodoulou, Megan Drewniak, Peter Raneri, Angelos Dalaklis

Articles

No abstract provided.

Liquefied Natural Gas As Ship Fuel : A Maltese Regulatory Gap Analysis, Mark Philip Cassar, Dimitrios Dalaklis, Fabio Ballini, Seyedvahid Vakili

Articles

With water covering almost three-quarters of the Earth’s surface and by factoring in that the maritime transport industry is holding a comparative advantage in relation to all other means, activities associated with the seas and oceans of our planet are extremely vital for a normal functioning of global trade. Furthermore, evaluating the opportunities of the so-called “Blue Economy” and possibilities for further growth should be at the epicentre of future development plans. Indicative examples - apart from various endeavours of maritime transport - include other sectors, like shipbuilding and repairs, fishing activities and related processes, as well as oil and …

Insoles To Ease Plantar Pressure In People With Diabetes And Peripheral Neuropathy: A Feasibility Randomised Controlled Study With Embedded Qualitative Component, Richard Collings

Other Faculty of Health Theses

Collings, R. Insoles to ease plantar pressure in people with diabetes and peripheral neuropathy: a feasibility randomised controlled study with embedded qualitative component. Background: Diabetic foot ulceration is a devastating complication of diabetic foot disease. Therapeutic footwear and insoles are one preventative strategy to reduce elevated plantar pressures associated with foot ulcer risk. However, their effectiveness is variable, difficult to predict and evaluated by the high-risk strategy of observing foot health and tissue integrity over time. Aim: To develop and test, in a feasibility randomised controlled trial (fRCT), an insole prescription and fabrication intervention appropriate for chairside delivery to reduce …

The Role Of Hippo Signalling In Merlin Null Tumours Of The Nervous System, Liyam Laraba

Other Faculty of Health Theses

Meningiomas and schwannomas are mostly benign tumours of the nervous system that currently have no clinically approved treatments apart from surgical resection. The tumour suppressor Moesin-Ezrin-Radixin-Like Protein (Merlin) is deleted in 50-60% and 70% of meningiomas and schwannomas respectively. The Hippo pathway is an evolutionarily conserved pathway that has been shown to control tissue size by contactmediated growth inhibition. Previous studies have shown that there is aberrant nuclear activity of yes-associated protein (YAP) and transcriptional coactivator with PDZbinding motif (TAZ), the co-transcriptional activators of the Hippo pathway in Merlinnull meningioma and schwannoma. Nuclear YAP and TAZ activate transcription, primarily by …

Ionic Dysregulation In White Matter Damage, Christopher Bulman

Other Faculty of Health Theses

White matter damage can occur in a variety of neurological diseases where it contributes significantly to impairment of brain function. Dysregulation of ion gradients across membranes is a common phenomenon across many diseases and can be damaging due to increased metabolic demand, oedema and activation of destructive enzyme cascades. Breakdown of ionic gradients can occur under many circumstances. For example, loss of energy supply to ion pumps causes disruption early in stroke progression. Activation of ion channels through voltage or ligand gating contributes greatly to complications such as intracellular calcium overload in many diseases. This thesis investigated the contribution of …

Helping People With Dementia To Eat Well At Home: An Investigation To Understand And Enhance Nutritional Care, Louise Mole

Other Faculty of Health Theses

In this thesis I developed a complex intervention to help people living at home with dementia to eat well, and improve nutritional care. This was achieved through four studies conducted using multiple methods. A scoping review found 61 studies reported in 63 articles after searching six databases from inception to July 2016. Content analysis was used, and the overarching categories were: ‘timely identification of nutritional risk and subsequent regular monitoring of nutritional status’, ‘multi-component tailored interventions’, and the ‘influence of the caregiving dyad on nutritional status’. Most studies were cross-sectional (n=24), cohort (n=15) or qualitative (n=9). Only three were randomised …

‘The Agony & The Ecstasy: Managing A Chronic Pain Condition Whilst Being A Mother’, Movita Chapman-Moyle

Other Faculty of Health Theses

Persistent pain is a debilitating condition affecting more women than men, and for women in their child-rearing years this means struggling to bring up children whilst contending with an unforgiving pain condition. Existing research in this area has found increased levels of pain complaints in children of mothers with persistent pain, raising the risk of them developing some form of pain in later years. A primary aim of this research was to investigate ways attachment influences pain development in children of maternal persistent pain sufferers. Additionally, the aim was to investigate how transmission of pain behaviour, including the experience of …

From Cancer Stem Cells To Brain Tumour Formation: The Role Of Heatr1 And Ribosome Biogenesis, Laura Rodríguez Díaz

Other Faculty of Health Theses

Brain tumours are initiated by neoplastic transformation of brain cells followed by uncontrolled proliferation, and are driven by genetic mutations. Despite years of study towards increasing our understanding of their origin and development, the high recurrence rate and poor prognosis of brain tumours in general, and specially of glioblastoma multiforme (GBM), the most aggressive type, highlight the need for more efficient therapeutic approaches. According to the Cancer Stem Cell (CSC) hypothesis, tumour initiation and relapse might be caused by a subpopulation of cells with stem cell characteristics. Loss of the Drosophila melanogaster tumour suppressor Brat or its human orthologue, TRIM3, …

Engaging, Enabling And Embedding Professionalism Through Scrutiny Of Practice In Healthcare, Margaret Fisher

Other Faculty of Health Theses

Introduction: This portfolio presents a critical synthesis of the nature and significance of a programme of research, spanning a decade of the candidate’s academic career as a dual-registered nurse and midwife. Collaborative studies exploring pre-registration assessment of practice and post-registration revalidation in healthcare and social work have made a distinct contribution to the body of knowledge, through national and international dissemination. Findings from the set of nine published works continue to influence academic and clinical contexts, while also contributing to the evidence-base informing professional policy. Aim: A conceptual framework is proposed, which seeks to advance the purpose of practice assessment …

The Control Of Safeguarding Children Social Work: A Mixed Methods Study Of The Interaction Between Managerial And Professional Control In A Social Policy Context, Julie Brown

Other Faculty of Health Theses

While central government guidance has standardised children’s social work processes, social work practice remains fundamentally the application of professional knowledge in complex and unpredictable situations. Existing empirical studies have prioritised the perspective of social workers and their frustration with the changes imposed on them by central government and local management and have neglected the view of management. This mixed methods study includes content analysis of official guidance and an analysis of interviews with local authority managers and social workers. This evidence reveals both the roles and attitudes towards control, of policy makers, managers and practitioners in their exercise of control …

Improving Visual Field Tests For Populations With Advanced Glaucoma And Visual Field Loss In The Periphery, Catherine Bain

Other Faculty of Health Theses

The visual field can extend up to 100° in the temporal visual region; however, in patients with glaucoma and other diseases that affect peripheral vision, only the central 30° of the visual field is monitored regularly in clinical practice using static perimetry. These static tests are rapid and robust against human errors due to their testing strategies. However, approximately 80% of the rest of the visual field is less regularly examined due to the length of time it takes to measure, using both static and kinetic stimuli. Currently, there is not an established automated kinetic test to measure the visual …

Can The Value And Acceptability Of A Patient Feedback Tool For Revalidating Psychiatrists Be Improved For Both Patients And Psychiatrists Through Its Co-Production? An Action Research Approach., Rebecca Baines

Other Faculty of Health Theses

Background: Co-production is often suggested as an alternative approach to patient feedback design. However, critical exploration of how co-production may affect the perceived value and acceptability of a patient feedback tool is severely limited, particularly in the context of revalidation for practising psychiatrists. Aim: This research sought to address four research questions: i) how are patients and the public involved in the design, delivery and evaluation of patient feedback tools for practising psychiatrists, if at all; ii) what are patient and psychiatrist perceptions, experiences and aspirations for patient feedback tools in revalidation; iii) how do these compare and iv) can …

The Role Of Daxx In The Selective Autophagy Receptor Sqstm1/P62 Phase Condensation, Yi Yang

Other Faculty of Health Theses

Macroautophagy (‘autophagy’ hereafter) is a lysosome-dependent degradation system for intracellular protein quality control. Autophagy can selectively remove cargo materials, which is dependent on cargo receptors. SQSTM1/p62 (‘p62’ hereafter) is one of the best characterised receptors mediating the autophagic degradation of misfolded proteins, and its body formation is essential for its cargo recognition and clearance. Mounting evidence has revealed that membraneless compartments, participating in various biological processes, are assembled via liquid-liquid phase separation (LLPS). These phase-separated condensates ensure that cellular activities occur in a spatiotemporally controlled manner and provide a method for concentrating and segregating cellular components. Liquid-like non-membrane condensates present …

An Assessment Of Universal Tumour Associated Antigens In Primary Liver Neoplasms, Oliver Rupar

Other Faculty of Health Theses

Rates of primary liver cancer are increasing in the Western world, a fact yet to be reflected in research with most currently undertaken in Asia. Whilst here in the UK, during a diagnostic and therapeutic workup within the NHS, surgically resected tumours are routinely kept in storage for up to thirty years. Meaning there is a huge, currently unused, resource that could potentially be included in clinical research. The regional specialist centre in the Southwest of England has been performing liver resections since 2005, no basic-science research has been performed using these archived specimens. In this research I have assessed …

Exploring The Influence Of Social Relationships On Multisource Feedback Assessments For Uk General Practitioners: A Social Network Analysis, Sebastian Andrew George Stevens

Other Faculty of Health Theses

One of the most common approaches to assess the performance of qualified doctors is that of multisource feedback (MSF). Previous research often cites MSF to be a valid, reliable and feasible method of assessing performance. However, potential biases in the self-selection of raters has been highlighted as a concern for the utility of MSF, particularly when used in high-stakes assessments such as medical Revalidation. This research uses general practice as the study setting to explore the extent to which social relationships influence the rater selection choices made by doctors. A case study approach was adopted recruiting three GP practices varying …