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2023

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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 Jan 2023

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 …

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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 Jan 2023

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. …

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Oral Microbes And The Formation Of Cerebral Abscesses: A Single-Centre Retrospective Study, Raul Bescos, Holly Roy, Ewen Mccoll, Umar Rehman, Elizabeth Cray, Louise A. Belfield, King David Nweze, Kevin Tsang, William Singleton, Peter Whitfield, Zoe Brookes Jan 2023

Oral Microbes And The Formation Of Cerebral Abscesses: A Single-Centre Retrospective Study, Raul Bescos, Holly Roy, Ewen Mccoll, Umar Rehman, Elizabeth Cray, Louise A. Belfield, King David Nweze, Kevin Tsang, William Singleton, Peter Whitfield, Zoe Brookes

Peninsula Medical School

Objective: Intracranial abscesses are relatively uncommon, but can result in significant mortality and morbidity. Whilst many potential causes of brain abscesses are recognised, in many cases the origin of infection remains clinically unidentified. Our objective was to investigate the role of bacteria found in the oral cavity in the development of brain abscesses. Methods: A retrospective analysis was performed using data from 87 patients admitted to a single UK neurosurgical unit with brain abscesses over a 16-year period. Using microbiological data obtained from abscess sampling and peripheral cultures, species of bacteria were categorised in patients where no primary source of …

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Covid-19 Vaccine Effectiveness Against Hospitalisation And Death Of People In Clinical Risk Groups During The Delta Variant Period: English Primary Care Network Cohort Study, Heather J. Whitaker, Ruby S.M. Tsang, Rachel Byford, Carole Aspden, Elizabeth Button, Praveen Sebastian Pillai, Gavin Jamie, Debasish Kar, John Williams, Mary Sinnathamby, Gemma Marsden, William H. Elson, Meredith Leston, Sneha Anand, Cecilia Okusi, Xuejuan Fan, Ezra Linley, Cathy Rowe, Silvia Darcangelo, Ashley D. Otter, Joanna Ellis, F.D. Richard Hobbs, Victoria Tzortziou-Brown, Maria Zambon, Mary Ramsay, Kevin E. Brown, Gayatri Amirthalingam, Nick J. Andrews, Simon De Lusignan, Jamie Lopez Bernal Jan 2023

Covid-19 Vaccine Effectiveness Against Hospitalisation And Death Of People In Clinical Risk Groups During The Delta Variant Period: English Primary Care Network Cohort Study, Heather J. Whitaker, Ruby S.M. Tsang, Rachel Byford, Carole Aspden, Elizabeth Button, Praveen Sebastian Pillai, Gavin Jamie, Debasish Kar, John Williams, Mary Sinnathamby, Gemma Marsden, William H. Elson, Meredith Leston, Sneha Anand, Cecilia Okusi, Xuejuan Fan, Ezra Linley, Cathy Rowe, Silvia Darcangelo, Ashley D. Otter, Joanna Ellis, F.D. Richard Hobbs, Victoria Tzortziou-Brown, Maria Zambon, Mary Ramsay, Kevin E. Brown, Gayatri Amirthalingam, Nick J. Andrews, Simon De Lusignan, Jamie Lopez Bernal

Peninsula Medical School

No abstract provided.

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An Intersubjective Approach To The Role Of Anger In Differentiation And The Development Of A Cohesive Self: A Case Study, Hannah Schriber Jan 2023

An Intersubjective Approach To The Role Of Anger In Differentiation And The Development Of A Cohesive Self: A Case Study, Hannah Schriber

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

The anger-turned-inward theory of depression has been extensively explored in psychodynamic literature. Still, little has been written about how modern relational approaches work with anger to aid patients in developing a healthy self-concept. This paper will first focus on a literature review of anger in Self Psychology and Intersubjective Systems Theory. These theories view anger as the manifestation of asserting one’s self after narcissistic injury. This paper will explore the relationship between anger and depression with an intersubjective lens utilizing the case study of Martha. Here I conceptualize depression as an introjective defense against misattuned early relational experiences. I explore …

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Heterotopic Sports Coaching: Facilitating Epistemic Revolution, Sebastian D. L. Harvey Jan 2023

Heterotopic Sports Coaching: Facilitating Epistemic Revolution, Sebastian D. L. Harvey

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Sports culture, including its traditional coaching practices and norms aligned with orthodox masculinity, has profound negative implications for the mental health and well-being of athletes. To improve athlete mental health and well-being sports coaching must challenge harmful cultural norms. Sports coaching has repeatedly been problematized through a poststructuralist Foucauldian lens; however, predominantly absent from the literature is Foucault’s concept of heterotopia that enables rule-breaking practices to exist. Therefore, the purpose of this paper is two-fold: (a) to explore Foucault’s heterotopia within the context of sports coaching and (b) to demonstrate its use in altering the culture of sports. I begin …

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A Qualitative Analysis Of Treatment Providers’ Understanding And Assessment Of Trauma And Autism, Leah Hanson Jan 2023

A Qualitative Analysis Of Treatment Providers’ Understanding And Assessment Of Trauma And Autism, Leah Hanson

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Patients with autism spectrum disorder (ASD) are particularly vulnerable to traumatic experiences and further development of posttraumatic stress disorder (PTSD). Underlying traumatic stress is commonly missed and remained untreated in the autism population. In a previous pilot study, Hanson and Richards (2021) gathered providers’ understandings on trauma and autism The current study is a further, systemic content analysis on archival data from Hanson and Richard’s pilot study. Results from the current content analysis of the responses to Question 1 (How do you assess for trauma in your patients?) revealed that providers assess patients’ trauma primarily by interviewing caregiver and patients, …

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Post-Covid Syndrome And Adults With Intellectual Disability: Another Vulnerable Population Forgotten?, R Shankar, B Perera, A Roy, Et Al Jan 2023

Post-Covid Syndrome And Adults With Intellectual Disability: Another Vulnerable Population Forgotten?, R Shankar, B Perera, A Roy, Et Al

Peninsula Medical School

An area of interest presently is the lingering symptoms after COVID-19, i.e. post-COVID-19 syndrome (PCS). Specifics of diagnosis and management of PCS are emerging. However, vulnerable populations such as those with intellectual disabilities, who were disproportionately affected by the pandemic, risk being ‘left behind’ from these considerations.

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Awareness Of Social Care Needs In People With Epilepsy And Intellectual Disability, A. Gabrielsson, S. Tromans, H. Newman, P. Triantafyllopoulou, A. Hassiotis, P. Bassett, L. Watkins, I. Sawhney, M. Cooper, L. Griffiths, A. Pullen, A. Roy, H. Angus-Leppan, Rh Thomas, M. Kinney, P. Tittensor, R. Shankar Jan 2023

Awareness Of Social Care Needs In People With Epilepsy And Intellectual Disability, A. Gabrielsson, S. Tromans, H. Newman, P. Triantafyllopoulou, A. Hassiotis, P. Bassett, L. Watkins, I. Sawhney, M. Cooper, L. Griffiths, A. Pullen, A. Roy, H. Angus-Leppan, Rh Thomas, M. Kinney, P. Tittensor, R. Shankar

Peninsula Medical School

Background: Nearly a quarter of people with intellectual disability (ID) have epilepsy with large numbers experiencing drug-resistant epilepsy, and premature mortality. To mitigate epilepsy risks the environment and social care needs, particularly in professional care settings, need to be met. Purpose: To compare professional care groups as regards their subjective confidence and perceived responsibility when managing the need of people with ID and epilepsy. Method: A multi-agency expert panel developed a questionnaire with embedded case vignettes with quantitative and qualitative elements to understand training and confidence in the health and social determinants of people with ID and epilepsy. The cross-sectional …

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An Evidence-Based Approach To Provide Essential And Desirable Components To Develop Surveys On Sudden Unexpected Death In Epilepsy (Sudep) For Doctors: A Focused Review, L. V. Watkins, S. Ashby, J. Hanna, W. Henley, R. Laugharne, R. Shankar Jan 2023

An Evidence-Based Approach To Provide Essential And Desirable Components To Develop Surveys On Sudden Unexpected Death In Epilepsy (Sudep) For Doctors: A Focused Review, L. V. Watkins, S. Ashby, J. Hanna, W. Henley, R. Laugharne, R. Shankar

Peninsula Medical School

Sudden Unexpected Death in Epilepsy (SUDEP) is a major concern for people with epilepsy, their families, their care givers, and medical professionals. There is inconsistency in the SUDEP counselling doctors provide, compared to what is recommended in clinical guidelines. Numerous national and international surveys have highlighted how epilepsy professionals, usually doctors, deliver SUDEP risk counselling, particularly, when they deliver it and to whom. These surveys help understand the unmet need, develop suitable strategies, and raise awareness among clinicians with the eventual goal to reduce SUDEPs. However, there is no standardised survey or essential set of questions identified that can be …

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Cardiovascular Risk Factors In Secondary Progressive Multiple Sclerosis: A Cross‐Sectional Analysis From The Ms‐Stat2 Randomized Controlled Trial, Thomas Williams, Nevin John, Alberto Calvi, Alessia Bianchi, Floriana De Angelis, Anisha Doshi, Sarah Wright, Madiha Shatila, Marios C. Yiannakas, Fatima Chowdhury, Jon Stutters, Antonio Ricciardi, Ferran Prados, David Macmanus, Marie Braisher, James Blackstone, Olga Ciccarelli, Cam Gandini Wheeler‐Kingshott, Frederik Barkhof, Jeremy Chataway, Jeremy Hobart Jan 2023

Cardiovascular Risk Factors In Secondary Progressive Multiple Sclerosis: A Cross‐Sectional Analysis From The Ms‐Stat2 Randomized Controlled Trial, Thomas Williams, Nevin John, Alberto Calvi, Alessia Bianchi, Floriana De Angelis, Anisha Doshi, Sarah Wright, Madiha Shatila, Marios C. Yiannakas, Fatima Chowdhury, Jon Stutters, Antonio Ricciardi, Ferran Prados, David Macmanus, Marie Braisher, James Blackstone, Olga Ciccarelli, Cam Gandini Wheeler‐Kingshott, Frederik Barkhof, Jeremy Chataway, Jeremy Hobart

Peninsula Medical School

Background and purpose.There is increasing evidence that cardiovascular risk (CVR) contributes to disability progression in multiple sclerosis (MS). CVR is particularly prevalent in secondary progressive MS (SPMS) and can be quantified through validated composite CVR scores. The aim was to examine the cross‐sectional relationships between excess modifiable CVR, whole and regional brain atrophy on magnetic resonance imaging, and disability in patients with SPMS. Methods. Participants had SPMS, and data were collected at enrolment into the MS‐STAT2 trial. Composite CVR scores were calculated using the QRISK3 software. Prematurely achieved CVR due to modifiable risk factors was expressed as QRISK3 premature CVR, …

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Poo Matters! A Scoping Review Of Impact Of Constipation On Epilepsy, Alexandra Gabrielsson, Samuel Tromans, Lance Watkins, Lisa Burrows, Richard Laugharne, Rohit Shankar Jan 2023

Poo Matters! A Scoping Review Of Impact Of Constipation On Epilepsy, Alexandra Gabrielsson, Samuel Tromans, Lance Watkins, Lisa Burrows, Richard Laugharne, Rohit Shankar

Peninsula Medical School

BACKGROUND: Epilepsy is a common neurological disorder which frequently presents with co-morbid physical health conditions, including constipation. However, the nature of the relationship between the two conditions has not been well defined. AIM: To quantify constipation's relationship with epilepsy and anti-seizure medication (ASM). METHOD: A scoping review registered on PROSPERO (CRD42022320079) with suitable search terms was conducted and reported in accordance with PRISMA guidance. CINAHL, Embase, PsycInfo and MEDLINE electronic databases were searched by an information specialist. The Joanna Briggs Institute (JBI) critical appraisal tools alongside the Oxford Centre for Evidence Based Medicine (OCEBM) levels of evidence were used to …

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Goal-Directed Haemodynamic Therapy Improves Patient Outcomes In Kidney Transplantation, J Fabes, Midani A Al, As Sarna, Dh Hadi, Sa Naji, Nr Banga, Gl Jones, Pd Berry, Md Wittenberg Jan 2023

Goal-Directed Haemodynamic Therapy Improves Patient Outcomes In Kidney Transplantation, J Fabes, Midani A Al, As Sarna, Dh Hadi, Sa Naji, Nr Banga, Gl Jones, Pd Berry, Md Wittenberg

Peninsula Medical School

Introduction: Kidney transplant graft function depends on optimised haemodynamics. However, high fluid volumes risk hypervolaemic complications. The Edwards Lifesciences ClearSight™ device permits fluid titration through markers of preload and beat-to-beat blood pressure monitoring. We evaluated the implementation of a novel goal-directed haemodynamic therapy protocol to determine whether patient outcomes had improved. Design: A retrospective evaluation of standard care versus goal-directed haemodynamic therapy in adults undergoing kidney transplantation was performed in a single centre between April 2016 and October 2019. Twenty-eight standard-of-care patients received intraoperative fixed-rate infusion and 28 patients received goal-directed haemodynamic therapy. The primary outcome was volume of fluid …

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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 Jan 2023

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 …

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Patients With Low Socio-Economic Status (Ses): What Are Their Perceptions And Experiences Of Mental Health Provision Within Primary Care?, Katy Stevenson Jan 2023

Patients With Low Socio-Economic Status (Ses): What Are Their Perceptions And Experiences Of Mental Health Provision Within Primary Care?, Katy Stevenson

Peninsula Medical School

No abstract provided.

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Novel Compact Magnetless Isolator Based On A Magneto-Optical Garnet Material, Gianni Portela, Miguel Levy, Hugo E. Hernandez-Figueroa Jan 2023

Novel Compact Magnetless Isolator Based On A Magneto-Optical Garnet Material, Gianni Portela, Miguel Levy, Hugo E. Hernandez-Figueroa

Michigan Tech Publications, Part 1

A compact magnetless isolator for optical communication systems based on a ring resonator with an outer layer made of silicon and an inner layer made of a magneto-optical material that does not require an external magnet to keep its magnetization saturated is suggested. Three-dimensional computational simulations of the device performed with the full-wave electromagnetic solver COMSOL Multiphysics show that the insertion loss and isolation levels are about −1.9 dB and −23 dB, respectively, thus confirming the feasibility of the isolator. An analytical model of the device based on the temporal coupled-mode theory method has been formulated and there is a …

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