Psychiatric morbidity in older people with moderate and severe learning disability (mental retardation). Part I: development and reliability of the patient interview (the PAS-ADD)

This paper describes the development of the PAS-ADD, a semistructured clinical interview for use specifically with patients with learning disabilities, based on items drawn from the PSE. The PAS-ADD includes a number of novel features including: parallel interviewing of patient and informant; a three-tier structure to provide a flexible interview appropriate to the patient's intellectual level; use of a memorable 'anchor event' in the patient's life to improve time focus; and simplified wording, improved organisation and lay out. Inter-rater reliability was investigated using an experimental design in which two raters viewed and re-rated videotaped PAS-ADD interviews which had been conducted by an experienced clinician. Reliability results compared favourably with those obtained in a major study of PSE reliability with a sample drawn from non-learning disabled individuals. Mean kappa for all items was 0.72. Other indexes of reliability were also good. In the current phase of development, the PAS-ADD is to be expanded to include further diagnostic categories, including schizophrenia and autism. The new version will be updated for use with ICD-10 criteria

Corpus to curriculum: Developing word lists for adult learners of Welsh

The launch of a language's first comprehensive general corpus promises a sea-change in teaching and learning resources. Effective transition from corpus to classroom is not necessarily straightforward, though; expert and end-user input is essential for the potential of the corpus resource to be realised. This paper outlines the process by which fit-for-purpose vocabulary lists were derived from the new National Corpus of Contemporary Welsh (Corpws Cenedlaethol Cymraeg Cyfoes – CorCenCC). The immediate purpose in this case was to inform the revision of A1 and A2 level course materials for adult learners. A longer-term aim was to put in place a method by which vocabulary lists for more advanced level learners and learners of different ages could be extracted and developed from the corpus. The new corpus means that for the first time, the Welsh language curriculum is able to use word frequency information; teaching and assessment materials in major languages have been informed by word frequencies for several decades. Raw frequency lists, though, include troublesome content, and can exclude items with high relevance to learners. This paper demonstrates how, by working in partnership, Welsh language curriculum writers, assessors, language experts and corpus linguists can effectively manipulate corpus data into curriculum content. The methods and approaches reported here are replicable for use in other language contexts

Public Health Risks in Urban Slums : Findings of the Qualitative 'Healthy Kitchens Healthy Cities' Study in Kathmandu, Nepal

BACKGROUND: Communities in urban slums face multiple risks to their health. These are shaped by intermediary and structural determinants. Gaining a clear understanding of these determinants is a prerequisite for developing interventions to reduce the health consequences of urban poverty. With 828 million people living in slum conditions, the need to find ways to reduce risks to health has never been greater. In many low income settings, the kitchen is the epicentre of activities and behaviours which either undermine or enhance health. METHODS: We used qualitative methods of semi-structured interviews, observation and participatory workshops in two slum areas in Kathmandu, Nepal to gain women's perspectives on the health risks they faced in and around their kitchens. Twenty one women were interviewed and four participatory workshops with a total of 69 women were held. The women took photographs of their kitchens to trigger discussions. FINDINGS: The main health conditions identified by the women were respiratory disease, gastrointestinal disease and burn injuries. Women clearly understood intermediary (psychosocial, material and behavioural) determinants to these health conditions such as poor ventilation, cooking on open fires, over-crowding, lack of adequate child supervision. Women articulated the stress they experienced and clearly linked this to health conditions such as heart disease and uptake of smoking. They were also able to identify protective factors, particularly social capital. Subsequent analysis highlighted how female headed-households and those with disabilities had to contend with greater risks to health. CONCLUSIONS: Women living in slums are very aware of the intermediary determinants-material, behavioural and psycho-social, that increase their vulnerability to ill health. They are also able to identify protective factors, particularly social capital. It is only by understanding the determinants at all levels, not just the behavioural, that we will be able to identify appropriate interventions

A systematic review of optical coherence tomography findings in adults with mild traumatic brain injury

Mild traumatic brain injury (mTBI) is common with many patients suffering disabling long-term sequelae, with visual symptoms frequently reported. There are no objective biomarkers of mTBI that are routinely used in clinical practice. Optical coherence tomography (OCT) has been used in mTBI research, as it enables visualisation of the neuroretina, allowing measurement of the retinal nerve fibre layer and ganglion cell layer. This systematic review aims to appraise the available literature and assess whether there are significant changes within the retinal nerve fibre layer and ganglion cell layer in subjects after mTBI. A systematic review was carried out in accordance with PRISMA guidelines and registered with PROSPERO (Number: CRD42022360498). Four databases were searched for relevant literature published from inception until 1 September 2022. Abstracts and full texts were screened by three independent reviewers. Initial screening of databases yielded 341 publications, of these, three fulfilled all the criteria for inclusion. All three studies showed thinning of the retinal nerve fibre layer, whereas there were no significant changes in the ganglion cell layer. This systematic review demonstrated that thinning of the retinal nerve fibre layer (but not of the ganglion cell layer) is associated with mTBI. It provides preliminary evidence for the use of the retinal nerve fibre layer as a potential biomarker of damage to the visual system in mTBI. Further prospective longitudinal studies ensuring uniform diagnosis and accurate phenotyping of mTBI are needed to understand the effects on the visual system and potential of OCT as a prognostic biomarker

Video streaming in the Wild West

Northern Lakes College in north-central Alberta is the first post-secondaryinstitution in Canada to use the Media on Demand digital video system tostream large video files between dispersed locations (Karlsen). Staff andstudents at distant locations of Northern Lakes College are now viewingmore than 350 videos using video streaming technology. This has beenmade possible by SuperNet, a high capacity broadband network thatconnects schools, hospitals, libraries and government offices throughoutthe province of Alberta (Alberta SuperNet). This article describes thetechnical process of implementing video streaming at Northern LakesCollege from March 2005 until March 2006

Video streaming in the Wild West

Northern Lakes College in north-central Alberta is the first post-secondary institution in Canada to use the Media on Demand digital video system to stream large video files between dispersed locations (Karlsen). Staff and students at distant locations of Northern Lakes College are now viewing more than 350 videos using video streaming technology. This has been made possible by SuperNet, a high capacity broadband network that connects schools, hospitals, libraries and government offices throughout the province of Alberta (Alberta SuperNet). This article describes the technical process of implementing video streaming at Northern Lakes College from March 2005 until March 2006

Cross-border and domestic surrogacy in the UK context: An exploration of practical and legal decision-making

The present study aimed to explore UK intending parent’s reasons for cross-border and domestic surrogacy, their preparations for the birth and the practical and legal challenges faced after the birth. An online survey was completed by 203 participants, of which 132 had a child had born through surrogacy, 33 were in the process of surrogacy and 38 were planning a surrogacy arrangement. The most common reason for pursuing surrogacy in the UK was wanting a relationship with the surrogate (43%, 17) and for the USA it was having a better legal framework (97%, 60). Parents returning to the UK from countries other than USA experienced greater delay and difficulties in obtaining the necessary documents for their return. This study highlights the disparities in parents’ experiences of undergoing surrogacy in different countries, the frustrations some face in obtaining legal parenthood and the feelings of stress and anxiety this may cause. Whilst this is the first study comparing the experiences of people from the UK having surrogacy in different countries, the representativeness of the sample is unknown. The findings are important in identifying future directions for research, including assessing the impact of these early decisions and experiences for later parental wellbeing and children’s welfare

Parents' relationship with their surrogate in cross-border and domestic surrogacy arrangements: comparisons by sexual orientation and location.

OBJECTIVE: To study heterosexual and gay couples' relationship with their surrogate and their disclosure decisions when the surrogacy arrangement was completed domestically compared with internationally. DESIGN: Cross-sectional study. SETTING: Not applicable. PATIENT(S): Participants were 40 gay couples and 76 heterosexual couples who had domestic surrogacy in the United Kingdom (UK) (n = 38) or international surrogacy in the United States (n = 58) or Asia (20). Most (75%) of the children were aged <4 years. INTERVENTION(S): Online surveys containing open-ended and multiple-choice questions. MAIN OUTCOME MEASURE(S): Experiences of finding a surrogate, relationship with the surrogate, and disclosure to the child were examined among UK parents who had undergone surrogacy in the UK, United States, or India/Thailand. RESULT(S): Parents who had surrogacy in the UK and United States felt very involved in the pregnancy compared with those who had surrogacy in Asia. Couples whose surrogacy was completed in Asia were less likely to want contact with their surrogate after the birth and were also less likely to have any current contact with the surrogate. Parents who had surrogacy in the UK and United States described positive relationships with their surrogate. Gay couples intended to tell their child about surrogacy more than heterosexual couples. CONCLUSION(S): The specific country where couples conducted their surrogacy arrangement (i.e. United States, UK, or Thailand/India) was associated with how involved they were in the pregnancy and their contact with the surrogate over time. Limitations of the study include use of survey methodology and that the representativeness of the sample is not known.Wellcome Trus