5,191 research outputs found

    Undergraduate Catalog of Studies, 2023-2024

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    Congenital diaphragmatic hernia:A critical appraisal of perinatal care

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    A congenital diaphragmatic hernia (CDH) is a rare birth defect characterised byincomplete closure of the diaphragm. After birth, CDH is associated with significantneonatal morbidity and mortality due to a combination of pulmonary hypoplasia,pulmonary hypertension, and cardiac dysfunction. Despite improvements in clinicalcare, around 30% of these infants do not survive. The research projects reportedin this thesis provide a critical appraisal of important aspects of perinatal care forinfants with CDH.<br/

    It doesn't end with closure:Optimizing health care throughout life after esophageal atresia repair

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    Congenital diaphragmatic hernia:A critical appraisal of perinatal care

    Get PDF
    A congenital diaphragmatic hernia (CDH) is a rare birth defect characterised byincomplete closure of the diaphragm. After birth, CDH is associated with significantneonatal morbidity and mortality due to a combination of pulmonary hypoplasia,pulmonary hypertension, and cardiac dysfunction. Despite improvements in clinicalcare, around 30% of these infants do not survive. The research projects reportedin this thesis provide a critical appraisal of important aspects of perinatal care forinfants with CDH.<br/

    CANCER TREATMENT BY TARGETING HDAC4 TRANSLOCATION INDUCED BY MICROSECOND PULSED ELECTRIC FIELD EXPOSURE: MECHANISTIC INSIGHTS THROUGH KINASES AND PHOSPHATASES

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    Epigenetic modifications, arising from sub-cellular shifts in histone deacetylase (HDAC) activity and localization, present promising strategies for diverse cancer treatments. HDACs, enzymes responsible for post-translational histone modifications, induce these epigenetic changes by removing acetyl groups from ε-N-acetyl-lysine residues on histones, thereby suppressing gene transcription. Within the HDAC group, class IIa HDACs are notable for their responsiveness to extracellular signals, bridging the gap between external stimuli, plasma membrane, and genome through nuclear-cytoplasmic translocation. This localization offers two significant mechanisms for cancer treatment: nuclear accumulation of HDACs represses oncogenic transcription factors, such as myocyte-specific enhancer factor 2C (MEF2C), triggering various cell death pathways. Conversely, cytoplasmic HDAC accumulation acts similarly to HDAC inhibitors by silencing genes. My dissertation introduces an innovative approach for glioblastoma and breast cancer treatment by investigating the application of microsecond pulsed electric fields. It particularly focuses on HDAC4, a class IIa HDAC overexpressed in these cancers. Beyond demonstrating HDAC4 translocation, my research delves into the intricate roles of kinases and phosphatases, shedding light on the underlying factors governing HDAC4 translocation

    An exploration of the parental experience of diagnosis of foetal abnormalities during routine antenatal ultrasound screening

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    Background: Prenatal ultrasound screening is a routine aspect of antenatal care for women in the UK, typically at 12 weeks of gestation to confirm pregnancy and at 20 weeks to screen for foetal abnormalities. The diagnosis of foetal abnormality is likely to be an emotional and stressful time for a woman and her family; however, the impact on maternal mental health in the short-term has not been systematically evaluated. This systematic review aimed to assess the mental health consequences of diagnosis of foetal abnormalities by routine ultrasound screening for women in the perinatal period. Methods: A systematic review of six electronic databases (Embase, Medline, PsycInfo, CINAHL, Scopus, and Web of Science) was conducted to identify relevant studies published before April 2023. A narrative synthesis of findings was produced. Included studies were those using standardised measures to assess maternal mental health following prenatal diagnosis of foetal abnormality. Results: A total of 3221 studies were screened and 13 met inclusion criteria (eight prospective observational and five cross-sectional studies). A narrative synthesis of findings was presented according to three main mental health outcome domains identified: anxiety, depression, and traumatic stress. Women with recent diagnoses of foetal abnormality on average had anxiety reaching clinical threshold for concern, significantly higher than normal controls. Depression symptoms were, on average, higher than those with normal ultrasound findings. Approximately one third of those surveyed demonstrated traumatic stress above threshold for clinical concern. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Tool for Quasi-Experimental Studies. Conclusions: Prenatal diagnosis of foetal abnormality appears to be associated with poor mental health, and increased risk of anxiety, depression, and traumatic stress symptoms for women during pregnancy. Studies in this area are limited by the lack of assessment of mental health prior to diagnosis. It is recommended that clinicians providing ultrasound screening and prenatal diagnoses should consider the psychological needs of women during this process. Sources of support should be considered to minimise the potential impact of these risks on obstetric and child development outcomes. Background: Congenital pulmonary airway malformation (CPAM) is a term used to describe a range of foetal abnormalities of the lung typically identified during routine antenatal ultrasound screening at 20 weeks' gestation. Babies are typically born without symptoms and as such there is uncertainty about the best course of treatment: to operate, or to watch and wait. This uncertainty can have psychological consequences for the parents receiving such a diagnosis. This study aims to explore the experience of parents who have been involved in decision making about their infant’s care following diagnosis of CPAM in the context of uncertainty about treatment. Methods: This study used a qualitative approach in which four participants participated in a semi-structured interview about their experiences. Interviews were recorded and transcribed verbatim. Transcripts were then analysed using Interpretative Phenomenological Analysis (IPA) to generate group experiential themes. Results: Four group experiential themes were developed across the four interviews conducted: diagnosis changed the expected course of pregnancy; searching for information about the condition; making decisions about surgery; and life after decision making. Eleven subthemes were identified and are discussed. Conclusions: The findings of this study provide an insight into the experiences of parents who received a diagnosis of CPAM during routine antenatal screening. Participants highlighted the changes to the course of pregnancy, the importance of finding out more information about the condition, the process of making decisions about surgery, and the impact this continued to have on their lives in the present day. Recommendations are made for clinicians when providing similar diagnoses, particularly with regards to families’ informational needs. Possible future research directions are also discussed

    Talking about personal recovery in bipolar disorder: Integrating health research, natural language processing, and corpus linguistics to analyse peer online support forum posts

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    Background: Personal recovery, ‘living a satisfying, hopeful and contributing lifeeven with the limitations caused by the illness’ (Anthony, 1993) is of particular value in bipolar disorder where symptoms often persist despite treatment. So far, personal recovery has only been studied in researcher-constructed environments (interviews, focus groups). Support forum posts can serve as a complementary naturalistic data source. Objective: The overarching aim of this thesis was to study personal recovery experiences that people living with bipolar disorder have shared in online support forums through integrating health research, NLP, and corpus linguistics in a mixed methods approach within a pragmatic research paradigm, while considering ethical issues and involving people with lived experience. Methods: This mixed-methods study analysed: 1) previous qualitative evidence on personal recovery in bipolar disorder from interviews and focus groups 2) who self-reports a bipolar disorder diagnosis on the online discussion platform Reddit 3) the relationship of mood and posting in mental health-specific Reddit forums (subreddits) 4) discussions of personal recovery in bipolar disorder subreddits. Results: A systematic review of qualitative evidence resulted in the first framework for personal recovery in bipolar disorder, POETIC (Purpose & meaning, Optimism & hope, Empowerment, Tensions, Identity, Connectedness). Mainly young or middle-aged US-based adults self-report a bipolar disorder diagnosis on Reddit. Of these, those experiencing more intense emotions appear to be more likely to post in mental health support subreddits. Their personal recovery-related discussions in bipolar disorder subreddits primarily focussed on three domains: Purpose & meaning (particularly reproductive decisions, work), Connectedness (romantic relationships, social support), Empowerment (self-management, personal responsibility). Support forum data highlighted personal recovery issues that exclusively or more frequently came up online compared to previous evidence from interviews and focus groups. Conclusion: This project is the first to analyse non-reactive data on personal recovery in bipolar disorder. Indicating the key areas that people focus on in personal recovery when posting freely and the language they use provides a helpful starting point for formal and informal carers to understand the concerns of people diagnosed with bipolar disorder and to consider how best to offer support

    AI: Limits and Prospects of Artificial Intelligence

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    The emergence of artificial intelligence has triggered enthusiasm and promise of boundless opportunities as much as uncertainty about its limits. The contributions to this volume explore the limits of AI, describe the necessary conditions for its functionality, reveal its attendant technical and social problems, and present some existing and potential solutions. At the same time, the contributors highlight the societal and attending economic hopes and fears, utopias and dystopias that are associated with the current and future development of artificial intelligence

    Medicinal cannabis as a potential treatment for chronic pain and anxiety

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    Since its legalisation in Australia in 2016, the most common indications for which medicinal cannabis is prescribed are chronic pain and anxiety. This thesis aimed to explore the real-world use of cannabis for these indications, and the potential of translating this evidence into a clinical trial setting. The effectiveness and tolerability of medicinal cannabis for chronic pain, with a subset analysis on arthritis was explored using data from the CA Clinics Observational Study (CACOS). The chronic pain patients and arthritis subset reported significantly reduced pain intensity, with dry mouth, somnolence, and fatigue the most common AEs reported. The incidence of AEs in this cohort, and the association that these may have with concomitant medicines, cannabis constituents, and dose was also reported. Each patient was taking a median of six concomitant medications. Patients taking a gabapentinoid were more likely to report dizziness, and those taking a tricyclic antidepressant were more likely to report somnolence and anxiety. Next in this thesis clinical trial protocols were developed, the first to examine the efficacy of a transdermal CBD cream on patients with osteoarthritis. The second protocol follows a review on aromatase inhibitor associated-arthralgia, and proposes an oral CBD-extract to improve joint pain and health-related quality of life (HRQoL). Finally, use of cannabis for anxiety was reviewed and the effectiveness and tolerability of cannabis for anxiety, including post-traumatic stress disorder (PTSD) was explored using CACOS data. Significantly reduced anxiety was observed in patients with unspecified anxiety and PTSD, and the most common AEs reported were dry mouth, somnolence, and fatigue. The observed improvements in various HRQoL outcomes in both the chronic pain and anxiety cohorts, and the possible safety concerns raised in this thesis supports ongoing exploration of medicinal cannabis in clinical trial settings
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