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Development Of A Goal Setting And Goal Management System: Intervention Mapping, Eunyoung Kang, Erin R Foster

2020-Current year OA Pubs

BACKGROUND: Although goal setting and goal management (GSGM) is a key component of chronic disease management and rehabilitation practice, there is currently no widely used evidence-based intervention system available. This paper describes the theoretical underpinnings and development of a new intervention called MyGoals. MyGoals is designed to guide occupational therapy (OT) practitioners to implement theory-based, client-engaged GSGM for adults with chronic conditions in community-based OT rehabilitation settings.

METHODS: We first developed a planning team with two adults with chronic conditions, two clinicians, and two researchers. As a collaborative team, we co-developed MyGoals by following Intervention Mapping (IM) steps 1-4 and …

Guiding Principles For Effective Collaborative Implementation Strategies For Multisite Hospital Improvement Initiatives: A Mixed-Method Realist Evaluation Of Collaborative Strategies Used In Four Multisite Initiatives At Public Hospitals In New South Wales, Australia, Janet C. Long, Mitchell N. Sarkies, Emilie Francis-Auton, Natalie Roberts, Rebecca Hardwick, Hoa Mi Nguyen, Jean Frederic Levesque, Diane E. Watson, Johanna Westbrook, Peter D. Hibbert, Frances Rapport, Jeffrey Braithwaite

Peninsula Medical School

Objective Large-scale, multisite hospital improvement initiatives can advance high-quality care for patients. Implementation support is key to adoption of change in this context. Strategies that foster collaboration within local teams, across sites and between initiative developers and users are important. However not all implementation strategies are successful in all settings, sometimes realising poor or unintended outcomes. Our objective here is to develop guiding principles for effective collaborative implementation strategies for multi-site hospital initiatives. Design Mixed-method realist evaluation. Realist studies aim to examine the underlying theories that explain differing outcomes, identifying mechanisms and contextual factors that may trigger them. Setting We …

Abnormal Thalamic Functional Connectivity Correlates With Cardiorespiratory Fitness And Physical Activity In Progressive Multiple Sclerosis, Francesco Romanò, Robert W. Motl, Paola Valsasina, Maria Pia Amato, Giampaolo Brichetto, Nicolò Bruschi, Jeremy Chataway, Nancy D. Chiaravalloti, Gary Cutter, Ulrik Dalgas, John Deluca, Rachel Farrell, Peter Feys, Jennifer Freeman, Matilde Inglese, Cecilia Meza, Amber Salter, Brian M. Sandroff, Anthony Feinstein, Maria A. Rocca, Massimo Filippi

School of Health Professions

BackgroundAltered thalamic volumes and resting state (RS) functional connectivity (FC) might be associated with physical activity (PA) and cardiorespiratory fitness (CRF) in people with progressive multiple sclerosis (PMS).ObjectivesTo assess thalamic structural and functional alterations and investigate their correlations with PA/CRF levels in people with PMS.MethodsSeven-day accelerometry and cardiopulmonary exercise testing were used to assess PA/CRF levels in 91 persons with PMS. They underwent 3.0 T structural and RS fMRI acquisition with 37 age/sex-matched healthy controls (HC). Between-group comparisons of MRI measures and their correlations with PA/CRF variables were assessed.ResultsPMS people had lower volumes compared to HC (all p < 0.001). At corrected threshold, PMS showed decreased intra- and inter-thalamic RS FC, and increased RS FC between the thalamus and the hippocampus, bilaterally. At uncorrected threshold, decreased thalamic RS FC with caudate nucleus, cerebellum and anterior cingulate cortex (ACC), as well as increased thalamic RS FC with occipital regions, were also detected. Lower CRF, measured as peak oxygen consumption (VO2peak), correlated with lower white matter volume (r = 0.31, p = 0.03). Moreover, lower levels of light PA correlated with increased thalamic RS FC with the right hippocampus (r = − 0.3, p = 0.05).DiscussionPeople with PMS showed widespread brain atrophy, as well as pronounced intra-thalamic and thalamo-hippocampal RS FC abnormalities. White matter atrophy correlated with CRF, while increased thalamo-hippocampal RS FC was associated to worse PA levels. Thalamic RS FC might be used to monitor physical impairment and efficacy of rehabilitative and disease-modifying treatments in future studies.

Crisis Care For Children And Young People With Mental Health Problems: National Mapping, Models Of Delivery, Sustainability And Experience (Camh-Crisis2). A Study Protocol., Clare Bennett, Ben Hannigan, Mair B. Elliott, Martin Elliott, Nicola Evans, Claire Fraser, Euan Hails, Aled Jones, Iain Mcmillan, Steven Pryjmachuk, Leanne Sawle, Rachael Vaughan

School of Nursing and Midwifery

Background: One in six five 16-year-olds have a probable mental health difficulty. Of these, almost half of older teenagers and a quarter of 11–16-year-olds report having self-harmed or attempted suicide. Currently, there is little research into mental health crisis services for young people, with little understanding of what services exist, who uses them, or what works best. Question: ‘How are mental health crisis responses for children and young people up to the age of 25 sustained, experienced and integrated within their local systems of services’? Objectives: 1. To describe National Health Service (NHS), local authority, education and third sector approaches …

“I Am Not A Good Woman?” Exploring The Views And Challenges Of Nurses When Discussing Hpv Testing And Associated Cervical Screening With Women In Iraq, Suhailah M. Ali, Rebecca Lawes, Ayla Khedher Ghalib

School of Nursing and Midwifery

Introduction: Cervical cancer is mostly caused by high-risk Human papillomavirus HPV, with an estimation prevalence of HPV of 99.7% worldwide. The US Food and Drug Administration (FDA) approved an HPV test for primary cervical screening in 2014. An HPV-DNA test, which provides higher protection against invasive cervical carcinomas, is replacing the long-standing Pap smear as the primary method of cervical cancer screening. Objective: To explore nurses’ experience and knowledge of HPV DNA testing and how screening impacts on women's health through increasing awareness and proposing actions for health education strategies. Method: A qualitative exploratory study was conducted on a purposeful …

Nutritional Practices And Dietetic Provision In The Endometriosis Population, With A Focus On Functional Gut Symptoms, Komal Deepak Kumar, Bridie Appleby-Gunnill, Kate Maslin

School of Nursing and Midwifery

Background: Endometriosis is a common condition causing chronic pain, fatigue and gut symptoms. Research suggests that dietary changes may improve symptoms; however, evidence is lacking. The present study aimed to investigate the nutritional practices and needs of individuals with endometriosis (IWE) and the management of endometriosis by dietitians in the UK, focusing on gut symptoms. Methods: Two online questionnaires were distributed via social media: a survey of dietitians working with IWE and functional gut symptoms and a survey of IWE. Results: All respondents to the dietitian survey (n = 21) used the low fermentable oligosaccharides disaccharides monosaccharides and polyols (FODMAP) …

Telerehabilitation For People With Physical Disabilities And Movement Impairment: Development And Evaluation Of An Online Toolkit For Practitioners And Patients, Sarah Buckingham, Krithika Anil, Sara Demain, Hilary Gunn, Ray B. Jones, Bridie Kent, Angela Logan, Jonathan Marsden, E. Diane Playford, Jenny Freeman

School of Nursing and Midwifery

PurposeTelerehabilitation has increasingly been used since the COVID-19 pandemic but with limited guidance available on undertaking physical assessments using remote methods. We aimed to provide such guidance by developing a Telerehab Toolkit, an online information and training resource for practitioners, patients, and carers on telerehabilitation for people with physical disabilities and movement impairment.Materials and methodsDevelopment and evaluation of the toolkit were informed by the Knowledge to Action framework and took place iteratively in two phases—knowledge creation and action. Information was collated from various sources including literature review, online survey, service evaluation, and focus group discussions. The toolkit has been evaluated …

Preconception Care For People With Health Conditions: What Approaches Work, For Whom, And In What Circumstances? A Realist Review, Heather Hopper, Kerryn Husk, Kate Maslin, Bridie Kent, Amanda Wanner, Jill Shawe

School of Nursing and Midwifery

Preconception care for people with chronic health conditions is recommended in view of the implications for them and their offspring during pregnancy and beyond. This realist review of published and grey literature explored factors that explain why people seek or receive appropriate preconception counseling and why they engage in recommended health behavior change prior to pregnancy. Fifty-two studies contributed to phase one synthesis, and 38 studies provided explanations in phase two. Ten program theories were developed, explored, and refined through iterative discussion and coding. Causal explanations of the ways in which components of preconception care contribute to effective access to …

Incorporating Usability Evaluation Into Iterative Development Of An Online Platform To Support Research Participation In Parkinson’S Disease: A Mixed Methods Protocol, Rebecca Chapman, Marie Louise Zeissler, Edward Meinert, Stephen Mullin, S Whipps, J Whipps, K Hockey, P Hockey, Camille B. Carroll

School of Nursing and Midwifery

Abstract Introduction Many people with Parkinson’s (PwP) are not given the opportunity or do not have adequate access to participate in clinical research. To address this, we have codeveloped with users an online platform that connects PwP to clinical studies in their local area. It enables site staff to communicate with potential participants and aims to increase the participation of the Parkinson’s community in research. This protocol outlines the mixed methods study protocol for the usability testing of the platform. Methods and analysis We will seek user input to finalise the platform’s design, which will then be deployed in a …

Ethnic Differences In The Indirect Effects Of The Covid-19 Pandemic On Clinical Monitoring And Hospitalisations For Non-Covid Conditions In England: A Population-Based, Observational Cohort Study Using The Opensafely Platform, Ruth E. Costello, John Tazare, D Piehlmaier, Emily Herrett, Edward P.K. Parker, Bang Zheng, Kathryn E. Mansfield, Alasdair D. Henderson, Helena Carreira, Patrick Bidulka, Angel Y.S. Wong, Charlotte Warren-Gash, Joseph F. Hayes, Jennifer K. Quint, Brian Mackenna, Amir Mehrkar, Rosalind M. Eggo, Srinivasa Vittal Katikireddi, Laurie Tomlinson, Sinéad M. Langan, R Mathur, Nishi Chaturvedi, Chloe Park, Alisia Carnemolla, Dylan Williams, Anika Knueppel, Andy Boyd, Emma L. Turner, Katharine M. Evans, Richard Thomas

School of Engineering, Computing and Mathematics

Background The COVID-19 pandemic disrupted healthcare and may have impacted ethnic inequalities in healthcare. We aimed to describe the impact of pandemic-related disruption on ethnic differences in clinical monitoring and hospital admissions for non-COVID conditions in England. Methods In this population-based, observational cohort study we used primary care electronic health record data with linkage to hospital episode statistics data and mortality data within OpenSAFELY, a data analytics platform created, with approval of NHS England, to address urgent COVID-19 research questions. We included adults aged 18 years and over registered with a TPP practice between March 1, 2018, and April 30, …

Lead In Painted Surfaces And Dusts From Rented Urban Properties (Plymouth, Uk), Sarah Tooms, Alison Stokes, Andrew Turner

School of Geography, Earth and Environmental Sciences

X-ray fluorescence (XRF) spectrometry has been used to measure lead (Pb) in painted surfaces and indoor dusts from 14 rented properties in the city of Plymouth, UK. Lead was detected in 78 out of 164 surfaces measured (and in 69 out of 150 interior surfaces) with an overall median concentration of 7100 mg kg−1 (range from 157 to 139,000 mg kg−1), and was detected in all but two properties that included one building constructed within the last 25 years. Selected measurements on an area basis (n = 48) returned Pb concentrations ranging from below 0.01 to 16.1 mg cm−2 that …

Resuspension Of Microplastics And Microrubbers In A Semi-Arid Urban Environment (Shiraz, Iran), Nafiseh Khodabakhshloo, Sajjad Abbasi, Andrew Turner

School of Geography, Earth and Environmental Sciences

Although airborne urban particles are a concern for air quality and human health, little information exists on the levels and characteristics of microplastics (MPs) and microrubbers (MRs) in this setting. In the present study, MPs and MRs are quantified and characterised in road dusts and accumulations captured passively (and up to elevations of 177 cm above road level) in the steps of utility poles at 18 locations throughout the city of Shiraz, southwest Iran. Dust accumulation rates were greatest at road level (median = 45 g m−2 month−1) and declined with elevation (median = 2.0 g m−2 month−1 at 177 …

Accumulation Of Polystyrene Nanoplastics And Triclosan By A Model Tooth-Carp Fish, Aphaniops Hormuzensis (Teleostei: Aphaniidae), Maryam Saemi-Komsari, Reza Pashaei, Sajjad Abbasi, Hamid Reza Esmaeili, Reda Dzingelevičienė, Hadavand B Shirkavand, Kalako M Pasalari, Malgorzata Szultka-Mlynska, Renata Gadzała-Kopciuch, Boguslaw Buszewski, Andrew Turner

School of Geography, Earth and Environmental Sciences

The presence and effects of nanoplastics (NPs; <1 μm) in the aquatic environment are a growing concern. In this study, a model tooth-carp fish, Aphaniops hormuzensis, has been exposed to different concentrations of fluorescent polystyrene nanoplastics (PS-NP) in its diet (up to 5 mg kg−1) over periods of 28 d and the particle accumulation in different tissues determined. Accumulation was observed in both digestive and non-digestive organs, with concentrations greater in the gut, liver and gill (up to 400 μg kg−1 dw) than in the skin and muscle (<180 μg kg−1 dw), but no dependency on exposure time or dose was evident. The presence of the organic contaminant, triclosan (TCS), in the diet and at concentrations up to 0.5 μg kg−1 did not affect PS-NP uptake by A. hormuzensis, while TCS accumulation in the whole body increased with time (up to 10 μg kg−1) and, likewise, appeared to be unaffected by the presence of PS-NPs. These observations suggest that the two contaminants do not interact with each other or that any interactions have no impact on accumulation. The results of this study add to the growing body of evidence that NPs can be translocated by aquatic organisms after ingestion, and reveal that, for the species and conditions employed, nanoplastics are accumulated more readily than a widely used organic chemical.

Monitoring Of Drying Kinetics Evolution And Hygrothermal Properties Of New Earth-Based Materials Using Climatic Chamber Simulation, Athmane Azil, Karim Touati, Nassim Sebaibi, Malo Le Guern, Francois Streiff, S Goodhew, Moussa Gomina, M Boutouil

School of Art, Design and Architecture

This study focuses on the drying kinetics of cob and light-earth layers comprising a hybrid walling system. Volumetric water content sensors are immersed and placed at different positions on the walls of a building to measure the drying kinetics. In addition, an experimental analysis of the effect of temperature, relative humidity (RH), and wind velocity variations on thermal conductivity in a climatic chamber under winter and summer conditions was conducted. The analysis of samples in laboratory aims to investigate the hygrothermal properties of cob and light-earth materials, and their dependency on the aforementioned parameters. The in situ drying kinetics of …

Climate Action And Sdg Synergies: Strengthening The Evidence Base For Synergistic Action, Souran Chatterjee

School of Geography, Earth and Environmental Sciences

No abstract provided.

Three-Layer Model With Absorption For Conservative Estimation Of The Maximum Acoustic Transmission Coefficient Through The Human Skull For Transcranial Ultrasound Stimulation, David Attali, Thomas Tiennot, Mark Schafer, Elsa Fouragnan, Jérôme Sallet, Charles F. Caskey, Robert Chen, Ghazaleh Darmani, Ellen J. Bubrick, Christopher Butler, Charlotte J. Stagg, Miriam Klein-Flügge, Lennart Verhagen, Seung Schik Yoo, Kim Butts Pauly, Jean Francois Aubry

School of Psychology

Transcranial ultrasound stimulation (TUS) has been shown to be a safe and effective technique for non-invasive superficial and deep brain stimulation. Safe and efficient translation to humans requires estimating the acoustic attenuation of the human skull. Nevertheless, there are no international guidelines for estimating the impact of the skull bone. A tissue independent, arbitrary derating was developed by the U.S. Food and Drug Administration to take into account tissue absorption (0.3 dB/cm-MHz) for diagnostic ultrasound. However, for the case of transcranial ultrasound imaging, the FDA model does not take into account the insertion loss induced by the skull bone, nor …

Investigating The Role Of Action-Contingent Expectancy Biases In Dysphoria-Linked Activity Engagement Behavioural Choice, Julie L. Ji, Colin Macleod

School of Psychology

Reduced tendency to engage in potentially rewarding activities is a hallmark of depression. The present study investigated the role of future expectancy biases in depression-linked behavioural choice, in participants varying in self-reported depression symptoms (dysphoria). A novel laboratory paradigm was developed to test the hypotheses that the degree to which higher dysphoria is associated with reduced tendency to engage in a potentially rewarding activity is dependent on the presence of negative biases in the expected outcomes of activity engagement. Specifically, two types of expectancy biases were distinguished: a) the expected likelihood of a negative rather than positive outcome, and b) …

Bottle With A Message: The Role Of Story Writing As An Engagement Tool To Explore Children's Perceptions Of Marine Plastic Litter, Estelle Praet, Jostein Baeza-Álvarez, Veer D De, Geraldine Holtmann-Ahumada, Jen S. Jones, Sarah Langford, Jessica Michel Dearte, John Schofield, Martin Thiel, Kayleigh J. Wyles

School of Psychology

As human behaviors play a crucial role in addressing the global threat of plastic pollution, it is vital to understand perceptions about marine plastic litter (MPL) and to develop interventions encouraging pro-environmental behaviors (PEBs). This study evaluates story writing as a window to explore perceptions and as an engagement activity to boost PEBs. During the COVID-19 lockdowns, schoolchildren from the East Pacific coast participated in this activity, each creating a story and answering a pre-post survey. Qualitative and quantitative analysis of 81 stories and 79 surveys show awareness of sources and impacts. Participants identified land and local pollution as significant …

Does Variability In Recognition Memory Scale With Mean Memory Strength Or Encoding Variability In The Uvsd Model?, Rory W. Spanton, Christopher J. Berry

School of Psychology

The unequal variance signal detection (UVSD) model of recognition memory assumes that the variance of old item memory strength (σo) is typically greater than that of new items. It has been suggested that this old item variance effect can be explained by the encoding variability hypothesis. However, Spanton and Berry (2020) failed to find evidence for this account, suggesting that σo may simply scale with mean memory strength ( d) in the UVSD model. Experiments 1 and 2 examined the effects of encoding variability and strength scaling on old item variance by creating conditions in which mean memory strength and …

Fast-Track Extubation After Orthotopic Liver Transplant Associates With Reduced Incidence Of Acute Kidney Injury And Renal Replacement Therapy: A Propensity-Matched Analysis, J Fabes, G Wells, Z Abdi, R Bhatia, P Muehlschlegel, M Fortune-Ely, D Krzanicki, S Rahman, M Spiro

Peninsula Medical School

Introduction Liver transplantation is the only available definitive treatment for end-stage liver disease and subtypes of hepatocellular carcinoma. Patient outcomes have significantly improved alongside developments in surgical technique, peri-operative patient optimisation and post-transplantation management [1]. However, it remains a high risk procedure with significant morbidity and mortality attributable in the short term largely to surgical complications and rejection, and in the longer term to organ dysfunction and malignancy, often related to immunosuppressive medication [2,3]. Due to the challenges inherent to the surgical procedure, traditional post-operative management has been to maintain a period of clinical observation while the patient remains mechanically …

An Organotypic Oral Mucosal Infection Model To Study Host-Pathogen Interactions, Samantha J. Gould, Andrew D. Foey, Vehid M. Salih

School of Biomedical Sciences

Early in vitro oral mucosal infection models (OMMs) failed to consider the suitability of the model environment to represent the host immune response. Denture stomatitis (DS) is mediated by Candida albicans, but the role of Staphylococcus aureus remains uncertain. A collagen hydrogel-based OMM containing HaCaT and HGF cell types was developed, characterised and employed to study of tissue invasion and pro-inflammatory cytokine production in response to pathogens. Models formed a robust epithelium. Despite their inflammatory baseline, 24-h infection with C. albicans, and/or S. aureus led to tissue invasion, and significantly upregulated IL-6 and IL-8 production by OMMs when compared to …

Imaging Synaptic Density In Depression, Sophie E Holmes, Chadi Abdallah, Irina Esterlis

Faculty, Staff and Students Publications

Major depressive disorder is a prevalent and heterogeneous disorder with treatment resistance in at least 50% of individuals. Most of the initial studies focused on the monoamine system; however, recently other mechanisms have come under investigation. Specific to the current issue, studies show synaptic involvement in depression. Other articles in this issue report on reductions in synaptic density, dendritic spines, boutons and glia associated with stress and depression. Importantly, it appears that some drugs (e.g., ketamine) may lead to rapid synaptic restoration or synaptogenesis. Direct evidence for this comes from preclinical work. However, neuroimaging studies, such as magnetic resonance imaging …

Restorative Practices And Exclusionary School Discipline: An Integrative Review, Ceema Samimi, Tyler M. Han, Amy Navvab, Jennifer A. Sedivy, Yolanda Anyon

Faculty Research, Scholarly, and Creative Activity

This study used integrative review methodology to synthesize research on the relationship between school-based restorative practices and exclusionary discipline outcomes in the United States. Exclusionary discipline outcomes were defined as out-of-school suspensions, expulsions, and referrals to law enforcement. A literature search produced 5,764 publications, and 11 studies were included in the final sample. Peacemaking circles were the most common restorative practice implemented, and secondary analysis of school records was the most common method utilized. Findings indicated that restorative practices are associated with reduced suspension rates, which suggest that school-based restorative practices are a promising approach to reducing exclusionary discipline outcomes.

The Effect Of Multi-Material Architecture On The Ex Vivo Osteochondral Integration Of Bioprinted Constructs, Matthew L Bedell, Ziwen Wang, Katie J Hogan, Angelica L Torres, Hannah A Pearce, Letitia K Chim, K Jane Grande-Allen, Antonios G Mikos

Faculty, Staff and Students Publications

Extrusion bioprinted constructs for osteochondral tissue engineering were fabricated to study the effect of multi-material architecture on encapsulated human mesenchymal stem cells’ tissue-specific matrix deposition and integration into an ex vivo porcine osteochondral explant model. Two extrusion fiber architecture groups with differing transition regions and degrees of bone- and cartilage-like bioink mixing were employed. The gradient fiber (G-Fib) architecture group showed an increase in chondral integration over time, 18.5 ± 0.7 kPa on Day 21 compared to 9.6 ± 1.6 kPa on Day 1 for the required peak push-out force, and the segmented fiber (S-Fib) architecture group did not, which …

The Impact Of Myosteatosis On Outcomes Following Surgery For Gastrointestinal Malignancy: A Meta-Analysis, A Maccormick, A Streeter, M Puckett, Somaiah Aroori

Peninsula Medical School

INTRODUCTION: The aim of this review was to evaluate the impact of preoperative myosteatosis on long-term outcomes following surgery for gastrointestinal malignancy.

METHODS: We conducted a systematic search of the electronic information sources, including PubMed MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL and AMED. Studies were included if they reported the impact of preoperatively defined myosteatosis, or a similar term, on long-term survival outcomes following surgery for gastrointestinal malignancy. A subgroup analysis was performed for those studies reporting outcomes for colorectal cancer patients only.

FINDINGS: Thirty-nine full-text articles were reviewed for inclusion, with 19 being retained after …

Impact Of Digital Technologies On Self-Efficacy In People With Parkinson’S: A Scoping Review Protocol, Andrew Michael Hall, Sree Aroori, Camille B. Carroll, Edward Meinert, Victoria Allgar

Peninsula Medical School

Introduction Parkinson’s disease (PD) is the second most common neurological disease globally, for which currently no one definitive cause or cure exists. Estimates suggest that 145 000 people with Parkinson’s (PwP) live in the UK. PD presents with motor and non-motor symptoms fluctuating significantly in and between individuals continually throughout the day. PD adversely affects activities of daily living, quality of life and well-being. Self-efficacy is an important belief to improve for PwP as it enables the individual to develop confidence in their ability to exert control over their own motivation, behaviour and social environment. This scoping review aims to …

Recommendations From Diabetes Uk's 2022 Diabetes And Physical Activity Workshop, Anna Morris, Chris Bright, Matthew Cocks, Neil Gibson, Louise Goff, Colin Greaves, Simon Griffin, Ben Jane, Florence Kinnafick, Paul Robb, Michelle Roberts, David Salman, John Saxton, Adrian Taylor, Daniel West, Thomas Yates, Rob C. Andrews, Jason M.R. Gill

Peninsula Medical School

Abstract Aims To describe the process and outputs of a workshop convened to identify key priorities for future research in the area of diabetes and physical activity and provide recommendations to researchers and research funders on how best to address them. Methods A 1‐day research workshop was conducted, bringing together researchers, people living with diabetes, healthcare professionals, and members of staff from Diabetes UK to identify and prioritise recommendations for future research into physical activity and diabetes. Results Workshop attendees prioritised four key themes for further research: (i) better understanding of the physiology of exercise in all groups of people: …

Topical Review: Optometry In Nepal—Clinical Practice, Research Advances, And Challenges, Safal Khanal, Nabin Paudel, Rabindra Adhikary, Mahesh Raj Joshi

School of Health Professions

SIGNIFICANCE This article reviews educational standard, clinical practice, research advances, and challenges associated with optometry in Nepal and provides critical considerations for contemporary and new optometry programs in countries with similar socioeconomic status and health care systems. Optometry education started in Nepal in 1998 with the primary objective of addressing the unmet needs of eye health and vision care in the country. Over the last two decades, this program has made significant contributions to facilitating and improving the delivery of quality eye care and establishing the nation's eye health system as an exemplary model in South Asia. Despite the positive …

Survey Of Parents Of Children With Intellectual Disabilities And/Or Autism Who Experience Chronic Constipation, James Rooney, Rebecca Hodge, Jade Smith, Kelly Vanstone, Richard Laugharne, Rohit Shankar

Peninsula Medical School

Background: Constipation is common in children with intellectual disabilities and/or autism, but poorly researched. This study looks to understand parental knowledge, attitudes and management practices towards constipation in children with intellectual disabilities and/or autism. Methods: A cross-sectional online survey developed with patient facing organisations was circulated to parents of children with intellectual disabilities and/or autism using an exponential and non-discriminatory snowballing method for recruitment. A smaller sample were purposively sampled for their in-depth experiences. Results: Of 68 responses, people were open to discussing constipation and knowledgeable about risk factors. In the qualitative interviews, of 15 parents, they wanted to be …

Review And Update Of The Health Of The Nation Outcome Scales For People With Learning Disabilities (Honos-Ld), Jon Painter, Nicola Adams, Barry Ingham, Michael James, Madiha Majid, Ashok Roy, Rohit Shankar, Mark Smith

Peninsula Medical School

Background: The Health of the Nation Outcomes Scales for people with Learning Disabilities (HoNOS-LD) is an 18-item measure which provides a structured and standardized approach to rating various clinical and psychosocial outcomes and has been in use nationally since 2002. Aims: To revise and improve the HoNOS-LD’s utility in contemporary intellectual disability (ID) services whilst retaining its original objectives and five-point severity ratings. Method: ID clinicians were invited to complete an online survey, rating each item on the existing measure for being fit for purpose, identifying issues and suggesting improvements based on their experience of using the HoNOS-LD in practice. …