Exploring the potential role of coaching skills.

Part of our role is to develop and inspire the leaders of the future; so they will go onto deliver high quality healthcare services for all of us. However, inspiring leaders of the future is not as simple as including in a curriculum. Various reports examining the failures within the UK NHS seem to emphasize this unfortunately (Francis, 2012: Keogh, 2012: Morecambe Bay, 2015). Addressing intrinsic motivation is key in embedding the concept of leadership into our graduates, as future clinical leaders within the NHS. This is also where a coaching approach in both personal tutoring and in the class setting (team coaching) can work. Using a coaching approach we may begin to tap into that area below the waterline and encourage the student to reach their own solution; one which addresses their inherent motivation. In this invited talk I will outline some of those strategies and why you should consider building some of them into your practice.N/

Personal resilience for diagnostic radiographer healthcare education: Lost in translation?

A research study was undertaken to gain a better understanding of the concept of resilience from the perspective of the undergraduate students on a BSc (Hons) Diagnostic Radiography programme; and the impact of resilience ‘training’ interventions (based on some resilience coaching principles) prior to their first clinical placement. This article sets out the findings from a qualitative research study, analysed using thematic analysis, where students were asked about their definition of personal resilience. Few students used an approximation of the ‘traditional’ definition of resilience; indeed, some seemed to view resilience as a weakness or something to be guarded against. In terms of what students thought affected their resilience, there was no clear pattern; thus seeming to confirm that resilience is personal, and therefore questioning a one-size approach in relation to resilience ‘training’. There could be some merit in encouraging discussion around resilience in the academic setting, but there are some considerable caveats. At the outset fostering an understanding of resilience as a positive trait seems important, otherwise discussion about resilience in a class or tutorial setting may not be received by the learner in the way we may hope or expect.N/

Trigeminal neuralgia: Imaging and the patient experience of Magnetic Resonance Imaging (MRI) of the brain: Findings from an on-line survey of patient experience of MRI imaging.

Background This is the first study to explore the experience of this group of patients and their experience of having an MRI brain scan. It is also unique in specifically focusing on MRI brain scan alone. This gives a new perspective on the nature of patient-centred service we should be delivering, not only to patients with this rare condition, but perhaps when scanning anyone with a pain condition – or indeed in personalizing an examination for any patient. Aims/Objectives To understand the patient’s lived experience of having an MRI brain scan, to understand what made a positive difference and what the patient would like or expect the radiographer to know about their condition. Methods Qualitative method utilized an online survey (Lime survey) with free text responses and some limited demographic data. Survey was advertised on closed social media group and on National charity website (Trigeminal Neuralgia Association UK). 96 responses were received, with 50 free text responses to the open questions. These were analysed using thematic analysis. Results Five themes emerged, with a number of subthemes within each. These are that there are some good stories, there are some not so good experiences, that care and communication makes a difference, that Trigeminal neuralgia (TN) pain is more than just a headache and finally that we need to be involving our patients in their scan. In describing the experience of having an MRI brain scan it was striking that narratives seemed to be clear cut in terms of ‘good or bad’ , but an interesting key difference seemed to be the perceived ‘kindness’ of the staff. Conclusions A recommendation is given in terms of working with a TN patient and their pain triggers, this is for everyone’s benefit as this is also more likely to result in a timely scan with minimal blur artefacts if the patient’s pain is minimized.Seed funding from College of Health and Social car

Ventilatory muscle strength, diaphragm thickness and pulmonary function in world-class powerlifters.

Resistance training activates the ventilatory muscles providing a stimulus similar to ventilatory muscle training. We examined the effects of elite powerlifting training upon ventilatory muscle strength, pulmonary function and diaphragm thickness in world-class powerlifters (POWER) and a control group (CON) with no history of endurance or resistance training, matched for age, height and body mass

Dissecting the Shared Genetic Architecture of Suicide Attempt, Psychiatric Disorders, and Known Risk Factors

Background Suicide is a leading cause of death worldwide, and nonfatal suicide attempts, which occur far more frequently, are a major source of disability and social and economic burden. Both have substantial genetic etiology, which is partially shared and partially distinct from that of related psychiatric disorders. Methods We conducted a genome-wide association study (GWAS) of 29,782 suicide attempt (SA) cases and 519,961 controls in the International Suicide Genetics Consortium (ISGC). The GWAS of SA was conditioned on psychiatric disorders using GWAS summary statistics via multitrait-based conditional and joint analysis, to remove genetic effects on SA mediated by psychiatric disorders. We investigated the shared and divergent genetic architectures of SA, psychiatric disorders, and other known risk factors. Results Two loci reached genome-wide significance for SA: the major histocompatibility complex and an intergenic locus on chromosome 7, the latter of which remained associated with SA after conditioning on psychiatric disorders and replicated in an independent cohort from the Million Veteran Program. This locus has been implicated in risk-taking behavior, smoking, and insomnia. SA showed strong genetic correlation with psychiatric disorders, particularly major depression, and also with smoking, pain, risk-taking behavior, sleep disturbances, lower educational attainment, reproductive traits, lower socioeconomic status, and poorer general health. After conditioning on psychiatric disorders, the genetic correlations between SA and psychiatric disorders decreased, whereas those with nonpsychiatric traits remained largely unchanged. Conclusions Our results identify a risk locus that contributes more strongly to SA than other phenotypes and suggest a shared underlying biology between SA and known risk factors that is not mediated by psychiatric disorders.Peer reviewe

Analysis of shared heritability in common disorders of the brain

ience, this issue p. eaap8757 Structured Abstract INTRODUCTION Brain disorders may exhibit shared symptoms and substantial epidemiological comorbidity, inciting debate about their etiologic overlap. However, detailed study of phenotypes with different ages of onset, severity, and presentation poses a considerable challenge. Recently developed heritability methods allow us to accurately measure correlation of genome-wide common variant risk between two phenotypes from pools of different individuals and assess how connected they, or at least their genetic risks, are on the genomic level. We used genome-wide association data for 265,218 patients and 784,643 control participants, as well as 17 phenotypes from a total of 1,191,588 individuals, to quantify the degree of overlap for genetic risk factors of 25 common brain disorders. RATIONALE Over the past century, the classification of brain disorders has evolved to reflect the medical and scientific communities' assessments of the presumed root causes of clinical phenomena such as behavioral change, loss of motor function, or alterations of consciousness. Directly observable phenomena (such as the presence of emboli, protein tangles, or unusual electrical activity patterns) generally define and separate neurological disorders from psychiatric disorders. Understanding the genetic underpinnings and categorical distinctions for brain disorders and related phenotypes may inform the search for their biological mechanisms. RESULTS Common variant risk for psychiatric disorders was shown to correlate significantly, especially among attention deficit hyperactivity disorder (ADHD), bipolar disorder, major depressive disorder (MDD), and schizophrenia. By contrast, neurological disorders appear more distinct from one another and from the psychiatric disorders, except for migraine, which was significantly correlated to ADHD, MDD, and Tourette syndrome. We demonstrate that, in the general population, the personality trait neuroticism is significantly correlated with almost every psychiatric disorder and migraine. We also identify significant genetic sharing between disorders and early life cognitive measures (e.g., years of education and college attainment) in the general population, demonstrating positive correlation with several psychiatric disorders (e.g., anorexia nervosa and bipolar disorder) and negative correlation with several neurological phenotypes (e.g., Alzheimer's disease and ischemic stroke), even though the latter are considered to result from specific processes that occur later in life. Extensive simulations were also performed to inform how statistical power, diagnostic misclassification, and phenotypic heterogeneity influence genetic correlations. CONCLUSION The high degree of genetic correlation among many of the psychiatric disorders adds further evidence that their current clinical boundaries do not reflect distinct underlying pathogenic processes, at least on the genetic level. This suggests a deeply interconnected nature for psychiatric disorders, in contrast to neurological disorders, and underscores the need to refine psychiatric diagnostics. Genetically informed analyses may provide important "scaffolding" to support such restructuring of psychiatric nosology, which likely requires incorporating many levels of information. By contrast, we find limited evidence for widespread common genetic risk sharing among neurological disorders or across neurological and psychiatric disorders. We show that both psychiatric and neurological disorders have robust correlations with cognitive and personality measures. Further study is needed to evaluate whether overlapping genetic contributions to psychiatric pathology may influence treatment choices. Ultimately, such developments may pave the way toward reduced heterogeneity and improved diagnosis and treatment of psychiatric disorders

Shared genetic risk between eating disorder- and substance-use-related phenotypes:Evidence from genome-wide association studies

First published: 16 February 202

Genomic Relationships, Novel Loci, and Pleiotropic Mechanisms across Eight Psychiatric Disorders

Genetic influences on psychiatric disorders transcend diagnostic boundaries, suggesting substantial pleiotropy of contributing loci. However, the nature and mechanisms of these pleiotropic effects remain unclear. We performed analyses of 232,964 cases and 494,162 controls from genome-wide studies of anorexia nervosa, attention-deficit/hyper-activity disorder, autism spectrum disorder, bipolar disorder, major depression, obsessive-compulsive disorder, schizophrenia, and Tourette syndrome. Genetic correlation analyses revealed a meaningful structure within the eight disorders, identifying three groups of inter-related disorders. Meta-analysis across these eight disorders detected 109 loci associated with at least two psychiatric disorders, including 23 loci with pleiotropic effects on four or more disorders and 11 loci with antagonistic effects on multiple disorders. The pleiotropic loci are located within genes that show heightened expression in the brain throughout the lifespan, beginning prenatally in the second trimester, and play prominent roles in neurodevelopmental processes. These findings have important implications for psychiatric nosology, drug development, and risk prediction.Peer reviewe

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead