The experiences of family carers supporting adults diagnosed with Non-Epileptic Attack Disorder (NEAD)

Non-epileptic Attack Disorder (NEAD) is the most commonly diagnosed functional neurological disorder worldwide. It is characterised by episodes which outwardly resemble epileptic seizures but have no discernible organic origin. Psychological therapy is the recommended treatment for NEAD. Those with the diagnosis, however, can be reluctant to engage with psychological therapy, believing seizures have an organic cause. Family carers have been found to be more accepting of the role of psychological factors in NEAD but have received little research attention to date. Paper one is a literature review. It aimed to provide an updated synthesis and critical appraisal of research evaluating the impact of psychological interventions on seizure frequency and/ or Quality of Life (QoL) in adults diagnosed with NEAD. Eleven studies were identified for inclusion; all measured seizure frequency and seven also measured QoL. All studies, except those which evaluated psychoeducational interventions, found improvements in QoL and reductions in seizure frequency post- intervention. Although results are promising in suggesting a range of psychological approaches may be of benefit to those diagnosed with NEAD, firm conclusions cannot be drawn because of the considerable variability in study quality and design. Paper two is an empirical paper which sought to explore the experiences of people caring for an adult family member diagnosed with NEAD. Eight family carers (four mothers and four spouses) participated in semi-structured Skype interviews. Three superordinate themes and ten subordinate themes were developed from interview data using Interpretative Phenomenological Analysis. Subordinate themes related to the personal impact of caring, navigating the reactions of others, and the importance of having an explanatory framework for seizures. Collaborative relationships with professionals, and the provision of information which led to carer understanding of seizures was described to facilitate change in caring approach and carer wellbeing. Paper three is an executive summary of paper two, produced as an accessible document to share the rationale, aim, method, findings and implications of the empirical paper with those who participated. This document was developed in consultation with a family carer for somebody with NEAD

Use of autologous adipose-derived mesenchymal stem cells for creation of laryngeal cartilage

OBJECTIVES/HYPOTHESIS: Adipose-derived mesenchymal stem cells (ASCs) are an exciting potential cell source for tissue engineering because cells can be derived from the simple excision of autologous fat. This study introduces a novel approach for tissue-engineering cartilage from ASCs and a customized collagen oligomer solution, and demonstrates that the resultant cartilage can be used for laryngeal cartilage reconstruction in an animal model. STUDY DESIGN: Basic science experimental design. METHODS: ASCs were isolated from F344 rats, seeded in a customized collagen matrix, and cultured in chondrogenic differentiation medium for 1, 2, and 4 weeks until demonstrating cartilage-like characteristics in vitro. Large laryngeal cartilage defects were created in the F344 rat model, with the engineered cartilage used to replace the cartilage defects, and the rats followed for 1 to 3 months. Staining examined cellular morphology and cartilage-specific features. RESULTS: In vitro histological staining revealed rounded chondrocyte-appearing cells evenly residing throughout the customized collagen scaffold, with positive staining for cartilage-specific markers. The cartilage was used to successfully repair large cartilaginous defects in the rat model, with excellent functional results. CONCLUSIONS: This study is the first study to demonstrate, in an animal model, that ASCs cultured in a unique form of collagen oligomer can create functional cartilage-like grafts that can be successfully used for partial laryngeal cartilage replacement

Incorporating the voice of multiple customers into product design

Listening to the voice of the customer is made complicated when the roles of the customer are carried out by more than one individual or stakeholder (a stakeholder performs one or more of the decision-making roles normally enacted by a single customer). The issues surrounding multiple stakeholder requirements are examined with particular reference to small to medium enterprises (SMEs) and the rehabilitation industry; this industry is concerned with products that enable the elderly and disabled to live more independently. A series of case studies has been conducted to identify the current practices of rehabilitation companies and the suitability of accepted design methods for incorporating the voice of the customer into the design process. The results of the study indicate that smaller companies within the rehabilitation industry do not use formal methods of design or market research; this is partly attributable to their limited resources and experience. An outline is given of a method developed by the CACTUS Project to enable resource-limited companies in the rehabilitation industry to incorporate the voice of the customer into their design. The method is currently being tested. It is hoped that the CACTUS approach will be applicable to other industries with similar characteristics and multiple stakeholders

School Outcomes in Youth Involved in the Juvenile Justice System: A Justification for School-Based Transitional Support

63 pages. A thesis presented to the Department of Family and Human Services and the Clark Honors College of the University of Oregon in partial fulfillment of the requirements for degree of Bachelor of Arts, Spring 2017This thesis aims to provide a justification for the necessity of transitional support in schools for youth involved in the juvenile justice system. Through a literature review, it shows a disparity in the school outcomes and achievements of juvenile justice-involved youth and their peers, as well as possible reasons for this disparity. It also outlines the importance of school experiences and completion for these youth. Lastly, it aims to ground these findings in a local context, comparing the criminal referrals and graduation rates for the cities of Eugene and Springfield to a county, state, and national context, as well as assessing the criminal referrals at the seven comprehensive public high schools in Eugene and Springfield as compared to their respective graduation rates

Minding the gaps – an investigation into language policy and practice in four Eastern Cape districts

South Africa's new Language in Education Policy (LiEP) has been described as one of the most progressive in the world but few schools have implemented it. This article describes research that investigates the gap between the policy goals and what is actually happening in schools in four districts in the Eastern Cape. The research attempts to make explicit community and school language practices and the factors that support or frustrate the formation and enactment of a school language policy in these four linguistically diverse sites. It appears that school governing bodies are not well equipped to make decisions about school language policy which meet the requirements of the national LiEP and economic imperatives to acquire English override considerations of multilingualism and additive bilingualism as expressed in the policy

Identification of the Visceral Pain Pathway Activated by Noxious Colorectal Distension in Mice

In patients with irritable bowel syndrome, visceral pain is evoked more readily following distension of the colorectum. However, the identity of extrinsic afferent nerve pathway that detects and transmits visceral pain from the colorectum to the spinal cord is unclear. In this study, we identified which extrinsic nerve pathway(s) underlies nociception from the colorectum to the spinal cord of rodents. Electromyogram recordings were made from the transverse oblique abdominal muscles in anesthetized wild type (C57BL/6) mice and acute noxious intraluminal distension stimuli (100–120 mmHg) were applied to the terminal 15 mm of colorectum to activate visceromotor responses (VMRs). Lesioning the lumbar colonic nerves in vivo had no detectable effect on the VMRs evoked by colorectal distension. Also, lesions applied to the right or left hypogastric nerves failed to reduce VMRs. However, lesions applied to both left and right branches of the rectal nerves abolished VMRs, regardless of whether the lumbar colonic or hypogastric nerves were severed. Electrical stimulation applied to either the lumbar colonic or hypogastric nerves in vivo, failed to elicit a VMR. In contrast, electrical stimulation (2–5 Hz, 0.4 ms, 60 V) applied to the rectum reliably elicited VMRs, which were abolished by selective lesioning of the rectal nerves. DiI retrograde labeling from the colorectum (injection sites 9–15 mm from the anus, measured in unstretched preparations) labeled sensory neurons primarily in dorsal root ganglia (DRG) of the lumbosacral region of the spinal cord (L6-S1). In contrast, injection of DiI into the mid to proximal colon (injection sites 30–75 mm from the anus, measured in unstretched preparations) labeled sensory neurons in DRG primarily of the lower thoracic level (T6-L2) of the spinal cord. The visceral pain pathway activated by acute noxious distension of the terminal 15 mm of mouse colorectum is transmitted predominantly, if not solely, through rectal/pelvic afferent nerve fibers to the spinal cord. The sensory neurons of this spinal afferent pathway lie primarily in the lumbosacral region of the spinal cord, between L6 and S1

Conscious voiding during bladder obstruction in guinea pigs correlates with contractile activity of isolated bladders

© 2015. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/. Following 12 month embargo from date of publication (10 August 2015) in accordance with publisher copyright policy

System size effects on calculation of the viscosity of extended molecules

We consider finite size effects on calculation of the viscosity of bulk molecular fluids using molecular dynamics simulations. The results are obtained using equilibrium simulations, direct calculations from nonequilibrium molecular dynamics simulations and calculations of the transient time correlation function expression, based on the dissipation theorem for nonlinear response. As with atomic fluids, strain induced by the periodic boundary conditions on the molecular systems can become significant for small systems at high densities and low temperatures. It addition to this effect, the dissipation function has a finite size contribution below a critical size, and this becomes more important as the system size is reduced and the length of the molecule increases. In this paper we show how calculations can be carried out to obtain convergence to bulk values with limited system size simulations

Understanding the Public Perception and Satisfaction of a UK Police Constabulary

This study explores the public perception of a community in Britain, towards a police constabulary in the UK. The study sought to explore how the levels of satisfaction between Black and Minority Ethnicities (BME) and non BME communities towards this police force in the UK. Using a mixed-methods approach, data was obtained by the use of self-completion questionnaires of 112 participants in an area in the UK and the use of a total of 31 semistructured interviews. The findings show that participants questioned police competence, the duty of police officers, policing conduct in relation to investigations, experiences of prejudice and expectations communities have of the police. The results for this study showed that there is some support for the idea that the perception of the police during the first contact with a member of the public is likely to be the most powerful predictor of future opinions on the police. This comes from the idea that the public are concerned not only with what the police do in the community, but how they do their work. Finally, as the current study is concerned with policing the local communities, it is important to remember that members of the community will respond positively to being included in police procedure deliberations and audits. The findings suggest that there is still much work to be done by the police service in order to improve the relationship with the communities that they serve. We argue much more emphasis should be placed on community work and increased engagement with younger people in schools and the wider general public