Etiological Histories of 35 Deaf and Hard-of-Hearing Residential School Students with Delinquent Behavior

This paper reviews the etiological histories of deaf and hard-of-hearing juveniles with delinquent behaviors. The etiologies of hearing loss and incidence of secondary or multiple disabilities in students with delinquent behaviors is examined through a review of existing school records for thirty- five (35) students born between the years of 1939-1986. Case studies, percentages, IQ scores, and reading grade level scores are used to provide a description of the neurological and behavioral issues of deaf and hard-of- hearing residential school youth who have experienced criminal legal problems. The purpose is to improve awareness among educators and juvenile Justice professionals of some potential effects of multiple disabilities on delinquency in signing deaf and hard of-hearing youth

Ways Ahead: developing a supported self-management programme for people living with low- and intermediate-grade gliomas - a protocol for a multi-method study

INTRODUCTION: Living with and beyond a diagnosis of a low- and intermediate-grade glioma (LIGG) can adversely impact many aspects of people's lives and their quality of life (QoL). In people with chronic conditions, self-management can improve QoL. This is especially true if people are supported to self-manage. Supported self-management programmes have been developed for several cancers, but the unique challenges experienced by LIGG survivors mean these programmes may not be readily transferable to this group. The Ways Ahead study aims to address this gap by exploring the needs of LIGG survivors to develop a prototype for a supported self-management programme tailored to this group. METHODS AND ANALYSIS: Ways Ahead will follow three sequential phases, underpinned by a systematic review of self-management interventions in cancer. In phase 1, qualitative methods will be used to explore and understand the issues faced by LIGG survivors, as well as the barriers and facilitators to self-management. Three sets of interviews will be conducted with LIGG survivors, their informal carers and professionals. Thematic analysis will be conducted with reference to the Theoretical Domains Framework and Normalisation Process Theory. Phase 2 will involve co-production workshops to generate ideas for the design of a supported self-management programme. Workshop outputs will be translated into a design specification for a prototype programme. Finally, phase 3 will involve a health economic assessment to examine the feasibility and benefits of incorporating the proposed programme into the current survivorship care pathway. This prototype will then be ready for testing in a subsequent trial. ETHICS AND DISSEMINATION: The study has been reviewed and approved by an National Health Service Research Ethics Committee (REC ref: 20/WA/0118). The findings will be disseminated through peer-reviewed journals, conference presentations, broadcast media, the study website, The Brain Tumour Charity and stakeholder engagement activities

Health‑related quality of life in adults with low‑grade gliomas: a systematic review

Purpose Low-grade glioma (LGG) patients may face health-related quality-of-life (HRQoL) impairments, due to the tumour, treatment and associated side-effects and prospects of progression. We systematically identified quantitative studies assessing HRQoL in adult LGG patients, for: aspects of HRQoL impacted; comparisons with non-cancer controls (NCC) and other groups; temporal trends; and factors associated with HRQoL. Methods MEDLINE, CINAHL, Embase, PubMed, and PsycINFO were systematically searched from inception to 14th September 2021. Following independent screening of titles and abstracts and full-texts, population and study characteristics, and HRQoL findings were abstracted from eligible papers, and quality appraised. Narrative synthesis was conducted. Results Twenty-nine papers reporting 22 studies (cross-sectional, n = 13; longitudinal, n = 9) were identified. Papers were largely good quality, though many excluded patients with cognitive and communication impairments. Comparators included high-grade gliomas (HGG) (n = 7); NCCs (n = 6) and other patient groups (n = 3). Nineteen factors, primarily treatment (n = 8), were examined for association with HRQoL. There was substantial heterogeneity in HRQoL instruments used, factors and aspects of HRQoL assessed and measurement timepoints. HRQoL, primarily cognitive functioning and fatigue, in adult LGG patients is poor, and worse than in NCCs, though better than in HGG patients. Over time, HRQoL remained low, but stable. Epilepsy/seizure burden was most consistently associated with worse HRQoL. Conclusion LGG patients experience wide-ranging HRQoL impairments. HRQoL in those with cognitive and communication impairments requires further investigation. These findings may help clinicians recognise current supportive care needs and inform types and timings of support needed, as well as inform future interventions

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Etiological Histories of 35 Deaf and Hard-of-Hearing Residential School Students with Delinquent Behavior

This paper reviews the etiological histories of deaf and hard-of-hearing juveniles with delinquent behaviors. The etiologies of hearing loss and incidence of secondary or multiple disabilities in students with delinquent behaviors is examined through a review of existing school records for thirty- five (35) students born between the years of 1939-1986. Case studies, percentages, IQ scores, and reading grade level scores are used to provide a description of the neurological and behavioral issues of deaf and hard-of- hearing residential school youth who have experienced criminal legal problems. The purpose is to improve awareness among educators and juvenile Justice professionals of some potential effects of multiple disabilities on delinquency in signing deaf and hard of-hearing youth

Project shake-it-up: using health promotion, capacity building and a disability studies framework to increase self efficacy,” Disability and Rehabilitation

Abstract Purpose. Project Shake-It-Up provided a health promotion and capacity building program for individuals with spinal cord injury, multiple sclerosis, and related neurological impairments. Major research aims were to evaluate changes in participants' self-efficacy, ability to set/achieve goals, and perceived independent-living status. Methods. Participants completed self-efficacy measures at baseline, program completion, 6-and 12-month follow-up, and set health and/or independent living goals. Progress toward goal attainment was monitored periodically and assessed qualitatively. Results. There was a statistically significant difference in the change in self-efficacy scores for intervention participants compared to non-participants. Participants gained independent-living skills and confidence in their abilities to set and achieve a variety of goals, in the areas of education, employment, housing, transportation, accessing community resources and activities, participation in sports and leisure, and health promotion. Conclusions. Researchers evaluated results using a disability studies framework of empowerment which recognizes the role of environment, gender, race/ethnicity, and social status in the experience of disability. Participants reported increased independence, community access, and participation. They took action in multiple arenas with changes observed and reported in areas of intrapersonal, interpersonal, and behavioral functioning that indicated greater personal empowerment

Project shake-it-up: using health promotion, capacity building and a disability studies framework to increase self efficacy,” Disability and Rehabilitation

Abstract Purpose. Project Shake-It-Up provided a health promotion and capacity building program for individuals with spinal cord injury, multiple sclerosis, and related neurological impairments. Major research aims were to evaluate changes in participants' self-efficacy, ability to set/achieve goals, and perceived independent-living status. Methods. Participants completed self-efficacy measures at baseline, program completion, 6-and 12-month follow-up, and set health and/or independent living goals. Progress toward goal attainment was monitored periodically and assessed qualitatively. Results. There was a statistically significant difference in the change in self-efficacy scores for intervention participants compared to non-participants. Participants gained independent-living skills and confidence in their abilities to set and achieve a variety of goals, in the areas of education, employment, housing, transportation, accessing community resources and activities, participation in sports and leisure, and health promotion. Conclusions. Researchers evaluated results using a disability studies framework of empowerment which recognizes the role of environment, gender, race/ethnicity, and social status in the experience of disability. Participants reported increased independence, community access, and participation. They took action in multiple arenas with changes observed and reported in areas of intrapersonal, interpersonal, and behavioral functioning that indicated greater personal empowerment

London Plane Tree bioaerosol exposure and allergic sensitization in Sydney, Australia

Exposure to London Plane Tree (Platanus) bioaerosols in Sydney, Australia has been anecdotally linked to respiratory irritation, rhinitis, and conjunctivitis. To determine the relationships between Platanus bioaerosol exposure, allergic sensitization, and symptoms. Sixty-four subjects with self-reported Platanus symptoms were recruited from inner-urban Sydney. Allergic sensitization was determined by skin prick test (SPT) to 13 allergens. Airborne concentrations of Platanus pollen, trichomes, and achene fibers, and other pollen and fungal spores, were measured over the spring and summer of 20062007. Subjects' allergic symptoms were monitored concurrently. The Halogen immunoassay (HIA) was used to measure subjects' immunoglobulin E (IgE) reactivity to collected bioaerosols. Platanus pollen constituted 76% of total pollen between July 2006 and April 2007. Airborne concentrations of Platanus pollen peaked from August until October. Non-Platanus pollen peaked from July to December. Elevated concentrations of trichomes and achene fibers occurred from September to December and August to October, respectively. As determined by SPT, 85.9% of subjects were sensitized, 65.6% to any pollen tested, 56.3% to Lolium perenne, and 23.4% to Platanus. Higher mean daily symptom scores were only associated with high counts of non-Platanus pollens. HIA analysis demonstrated IgE binding to Platanus pollen in all Platanus sensitized subjects. Personal nasal air sampling detected airborne trichomes that were capable of being inhaled. Platanus trichomes or achene fibers did not bind IgE from any subject. Platanus bioaerosols exist in high concentrations between August and November in inner-urban Sydney but were not associated with seasonal symptoms. Platanus trichomes are inhaled and may constitute a respiratory irritant

Experiences of work for people living with a grade 2/3 oligodendroglioma: a qualitative analysis within the Ways Ahead study

Objectives This study aimed to explore the work experiences of people living with an oligodendroglioma.Design This was a descriptive qualitative study. One-time semi-structured interviews exploring supportive care needs were conducted; work was discussed at various points throughout each interview. An inductive thematic analysis was undertaken.Setting Participants were recruited across the UK through four National Health Service hospitals and the Brain Tumour Charity research involvement networks.Participants 19 people with grade 2 or 3 oligodendroglioma (mean age 52 years; male n=11). At diagnosis, 16 participants were working, 2 studying and 1 retired. At the interview (mean time since diagnosis 9.6 years; range 1–18 years), seven participants were working, eight retired (four on medical grounds) and four unable to work due to illness.Results Seven themes were constructed: (1) physical and cognitive limitations; (2) work ability and productivity; (3) work accommodations; (4) changing roles; (5) attitudes of clients and coworkers; (6) feelings and ambitions; and (7) financial implications. Fatigue, seizures and cognitive deficits influenced work ability. A stressful work environment could exacerbate symptoms. Changes in job roles and work environment were often required. Employer and coworker support were integral to positive experiences. Work changes could result in financial stress and strain.Conclusions This study has highlighted, for the first time, influences on work experiences in this understudied population. These findings have implications for clinicians and employers, when considering the importance of work in rehabilitation for people with oligodendrogliomas, and the individually assessed adjustments required to accommodate them, should employment be desired