104 research outputs found
Vulnerability to bullying in children with a history of specific speech and language difficulties
This is an electronic version of an article published in Lindsay, Geoff and Dockrell, Julie and Mackie, Clare (2008) Vulnerability to bullying in children with a history of specific speech and language difficulties. European Journal of Special Needs Education, 23 (1). pp. 1-16. European Journal of Special Needs Education is available online at: http://www.informaworld.com/10.1080/0885625070179120
"Waiting for the best day of your life". A qualitative interview study of patients' and clinicians' experiences of Per thes' disease
Aims
Perthesâ disease is an idiopathic avascular necrosis of the developing femoral head, often causing deformity that impairs physical function. Current treatments aim to optimize the joint reaction force across the hip by enhancing congruency between the acetabulum and femoral head. Despite a century of research, there is no consensus regarding the optimal treatment. The aim of this study was to describe the experiences of children, their families, and clinicians when considering the treatment of Perthesâ disease.
Methods
A qualitative study gathered information from children and their families affected by Perthesâ disease, along with treating clinicians. Interviews followed a coding framework, with the interview schedule informed by behavioural theory and patient and public involvement. Transcripts were analyzed using the framework method.
Results
A total of 24 interviews took place, with 12 child/family dyads and 12 clinicians from UK NHS centres. Interviews identified widespread variation of routine care. Children/their families recounted positive experiences when included in the decision-making process for treatment. There is a strong desire from clinicians and children/families for consistent guidance from everyone involved in care, which should be based on clinical consensus.
Conclusion
This is the first study to describe how children/families and clinicians experienced receiving or providing treatment in Perthesâ disease. The results indicate the need for robust evidence to support treatment decisions. Children and families valued feeling involved in the clinical decision-making process. Clinicians acknowledged the central importance of providing patient-centred care, particularly in the absence of robust evidence to guide the optimal treatment decisions. This study will inform a future Delphi project to develop clinical consensus guidelines for the treatment of Perthesâ disease
Clinical consensus recommendations for the non-surgical treatment of children with Perthesâ disease in the UK
Aims
The aim of this study was to produce clinical consensus recommendations about the non-surgical treatment of children with Perthesâ disease. The recommendations are intended to support clinical practice in a condition for which there is no robust evidence to guide optimal care.
Methods
A two-round, modified Delphi study was conducted online. An advisory group of childrenâs orthopaedic specialists consisting of physiotherapists, surgeons, and clinical nurse specialists designed a survey. In the first round, participants also had the opportunity to suggest new statements. The survey included statements related to âExercisesâ, âPhysical activityâ, âEducation/information sharingâ, âInput from other servicesâ, and âMonitoring assessmentsâ. The survey was shared with clinicians who regularly treat children with Perthesâ disease in the UK using clinically relevant specialist groups and social media. A predetermined threshold of â„ 75% for consensus was used for recommendation, with a threshold of between 70% and 75% being considered as âpoints to considerâ.
Results
A total of 40 participants took part in the first round, of whom 31 completed the second round. A total of 87 statements were generated by the advisory group and included in the first round, at the end of which 31 achieved consensus and were removed from the survey, and an additional four statements were generated. A total of 60 statements were included in the second round and 45 achieved the threshold for consensus from both rounds, with three achieving the threshold for âpoints to considerâ. The recommendations predominantly included self-management, particularly relating to advice about exercise and education for children with Perthesâ disease and their families.
Conclusion
Childrenâs orthopaedic specialists have reached consensus on recommendations for non-surgical treatment in Perthesâ disease. These statements will support decisions made in clinical practice and act as a foundation to support clinicians in the absence of robust evidence. The dissemination of these findings and the best way of delivering this care needs careful consideration, which we will continue to explore
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Robust diffraction-limited near-infrared-to-near-ultraviolet wide-field imaging from stratospheric balloon-borne platforms â super-pressure balloon-borne imaging telescope performance
At a fraction of the total cost of an equivalent orbital mission, scientific balloon-borne platforms, operating above 99.7% of the Earthâs atmosphere, offer attractive, competitive, and effective observational capabilitiesânamely, space-like seeing, transmission, and backgroundsâwhich are well suited for modern astronomy and cosmology. The Super-pressure Balloon-borne Imaging Telescope (SUPERBIT) is a diffraction-limited, wide-field, 0.5 m telescope capable of exploiting these observing conditions in order to provide exquisite imaging throughout the near-infrared to near-ultraviolet. It utilizes a robust active stabilization system that has consistently demonstrated a 48 mas 1Ï sky-fixed pointing stability over multiple 1 h observations at float. This is achieved by actively tracking compound pendulations via a three-axis gimballed platform, which provides sky-fixed telescope stability at < 500 mas and corrects for field rotation, while employing high-bandwidth tip/tilt optics to remove residual disturbances across the science imaging focal plane. SUPERBITâs performance during the 2019 commissioning flight benefited from a customized high-fidelity science-capable telescope designed with an exceptional thermo- and opto-mechanical stability as well as a tightly constrained static and dynamic coupling between high-rate sensors and telescope optics. At the currently demonstrated level of flight performance, SUPERBIT capabilities now surpass the science requirements for a wide variety of experiments in cosmology, astrophysics, and stellar dynamics
Genome-wide analyses identify a role for SLC17A4 and AADAT in thyroid hormone regulation.
Thyroid dysfunction is an important public health problem, which affects 10% of the general population and increases the risk of cardiovascular morbidity and mortality. Many aspects of thyroid hormone regulation have only partly been elucidated, including its transport, metabolism, and genetic determinants. Here we report a large meta-analysis of genome-wide association studies for thyroid function and dysfunction, testing 8 million genetic variants in up to 72,167 individuals. One-hundred-and-nine independent genetic variants are associated with these traits. A genetic risk score, calculated to assess their combined effects on clinical end points, shows significant associations with increased risk of both overt (Graves' disease) and subclinical thyroid disease, as well as clinical complications. By functional follow-up on selected signals, we identify a novel thyroid hormone transporter (SLC17A4) and a metabolizing enzyme (AADAT). Together, these results provide new knowledge about thyroid hormone physiology and disease, opening new possibilities for therapeutic targets
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