Swim for Fun: The Importance of Open Swim for Children with Special Needs

Swimming can be a valuable activity for children with special needs, but parents may not feel comfortable taking their child to public pool facilities. The researcher investigated how parents feel about taking their child with special needs to open swim. Members of aquatic organizations were asked how to create a safe swim program that allows children to have their own time to swim. Findings from the interviews and research literature revealed that children with special needs would benefit both physically and socially from having an open swim program tailored to them. An open swim program was developed that provided children with special needs a safe and fun environment, and gave parents a sense of security and comfort when their child participated

Family preferences for home or hospital care at diagnosis for children with diabetes in the DECIDE study

Aims: A diagnosis of Type 1 diabetes in childhood can be a difficult life event for children and families. For children who are not severely ill, initial home rather than hospital-based care at diagnosis is an option although there is little research on which is preferable. Practice varies widely, with long hospital stays in some countries and predominantly home-based care in others. This article reports on the comparative acceptability and experience of children with Type 1 diabetes and their parents taking part in the DECIDE study evaluating outcomes of home or hospital-based treatment from diagnosis in the UK. Methods: Semi-structured interviews with 11 (pairs of) parents and seven children were conducted between 15 and 20 months post diagnosis. Interviewees were asked about adaptation to, management and impact of the diabetes diagnosis, and their experience of initial post-diagnosis treatment. Results: There were no differences between trial arms in adaptation to, management of or impact of diabetes. Most interviewees wanted to be randomized to the ‘home’ arm initially but expressed a retrospective preference for whichever trial arm they had been in, and cited benefits relating to learning about diabetes management. Conclusions: The setting for early treatment did not appear to have a differential impact on families in the long term. However, the data presented here describe different experiences of early treatment settings from the perspective of children and their families, and factors that influenced how families felt initially about treatment setting. Further research could investigate the short-term benefits of both settings

Camilla: A Centaur reconnaissance and impact mission concept

Centaurs, minor planets with a semi-major axis between the orbits of Jupiter and Neptune (5–30 AU), are thought to be among the most diverse small bodies in the solar system. These important targets for future missions may have recently been Kuiper Belt Objects (KBOs), which are thought to be chemically and physically primitive remnants of the early solar system. While the Kuiper Belt spans distances of 30–50 AU, making direct observations difficult, Centaurs' proximity to the Earth and Sun make them more accessible targets for robotic missions. Thus, we outline a mission concept designed to reconnoiter 10199 Chariklo, the largest Centaur and smallest ringed body yet discovered. Named for a legendary Centaur tamer, the conceptual Camilla mission is designed to fit under the cost cap of the National Aeronautics and Space Administration (NASA) New Frontiers program, leveraging a conservative payload to support a foundational scientific investigation to these primitive bodies. Specifically, the single flyby encounter utilizes a combined high-resolution camera/VIS-IR mapping spectrometer, a sub-mm point spectrometer, and a UV mapping spectrometer. In addition, the mission concept utilizes a kinetic impactor, which would provide the first opportunity to sample the composition of potentially primitive subsurface material beyond Saturn, thus providing key insights into solar system origins. Such a flyby of the Chariklo system would provide a linchpin in the understanding of small body composition, evolution, and transport of materials in the solar system

An immune dysfunction score for stratification of patients with acute infection based on whole-blood gene expression

Dysregulated host responses to infection can lead to organ dysfunction and sepsis, causing millions of global deaths each year. To alleviate this burden, improved prognostication and biomarkers of response are urgently needed. We investigated the use of whole-blood transcriptomics for stratification of patients with severe infection by integrating data from 3149 samples from patients with sepsis due to community-acquired pneumonia or fecal peritonitis admitted to intensive care and healthy individuals into a gene expression reference map. We used this map to derive a quantitative sepsis response signature (SRSq) score reflective of immune dysfunction and predictive of clinical outcomes, which can be estimated using a 7- or 12-gene signature. Last, we built a machine learning framework, SepstratifieR, to deploy SRSq in adult and pediatric bacterial and viral sepsis, H1N1 influenza, and COVID-19, demonstrating clinically relevant stratification across diseases and revealing some of the physiological alterations linking immune dysregulation to mortality. Our method enables early identification of individuals with dysfunctional immune profiles, bringing us closer to precision medicine in infection.peer-reviewe

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

Proteases and surface proteins of Streptococcus mutans

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

A multidisciplinary approach to teaching basic life support

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