Being a Parent with a Learning Disability: A Qualitative Study

This research portfolio aims to further explore the issues faced by parents with a learning disability. Firstly, a systematic review of qualitative research into the social support of parents with a learning disability is presented. This not only indicated that a range of social support is provided to parents with a learning disability and received with different perceptions, but also highlighted the need for further qualitative research in the area, to gain a better insight into the lived experiences of this group of parents. Secondly, and further to the findings of the systematic review, is the empirical research study. Adopting a qualitative design (Interpretative Phenomenological Analysis- IPA) (Smith, 1996; Smith et al., 2009), the study aimed to explore what parents with a learning disability understood about their learning disability and how they perceived it to impact on them in their parenting role. Analysis revealed five themes which reflect the perceptions and experiences of a sample of eight parents with a learning disability. Finally, to enable efficient and effective dissemination of the findings to the wider audience a journal article is presented. The journal article, as well as attempting to summarise the methodology used, focused on the most salient theme of the findings, which was how participants viewed themselves in relation to having a learning disability and being a parent

So far, yet so close: α-Catenin dimers help migrating cells get together

Epithelial cells in tissues use their actin cytoskeletons to stick together, whereas unattached cells make active plasma membrane protrusions to migrate. In this issue, Wood et al. (2017. J. Cell Biol. https://doi.org/10.1083/jcb.201612006) show that the junction component α-catenin is critical in freely moving cells to promote adhesion and migration

TorsinA folding and N-linked glycosylation are sensitive to redox homeostasis

The Endoplasmic Reticulum (ER) is responsible for the folding and post-translational modification of secretory proteins, as well as for triaging misfolded proteins. During folding, there is a complex yet only partially understood interplay between disulfide bond formation, which is an enzyme catalyzed event in the oxidizing environment of the ER, along with other post-translational modifications (PTMs) and chaperone-supported protein folding. Here, we used the glycoprotein torsinA as a model substrate to explore the impact of ER redox homeostasis on PTMs and protein biogenesis. TorsinA is a AAA+ ATPase with unusual oligomeric properties and controversial functions. The deletion of a C-terminal glutamic acid residue (∆E) is associated with the development of Early-Onset Torsion Dystonia, a severe movement disorder. TorsinA differs from other AAA+ ATPases since it is an ER resident, and as a result of its entry into the ER torsinA contains two N-linked glycans and at least one disulfide bond. The role of these PTMs on torsinA biogenesis and function and the identity of the enzymes that catalyze them are poorly defined. Using a yeast torsinA expression system, we demonstrate that a specific protein disulfide isomerase, Pdi1, affects the folding and N-linked glycosylation of torsinA and torsinA∆E in a redox-dependent manner, suggesting that the acquisition of early torsinA folding intermediates is sensitive to perturbed interactions between Cys residues and the quality control machinery. We also highlight the role of specific Cys residues during torsinA biogenesis and demonstrate that torsinA∆E is more sensitive than torsinA when these Cys residues are mutated.Fil: Honer, Jonas. University of Pittsburgh; Estados UnidosFil: Niemeyer, Katie M.. University of Pittsburgh; Estados UnidosFil: Fercher, Christian. The University of Queensland; AustraliaFil: Diez Tissera, Ana Laura. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones Bioquímicas de Buenos Aires. Fundación Instituto Leloir. Instituto de Investigaciones Bioquímicas de Buenos Aires; ArgentinaFil: Jaberolansar, Noushin. The University of Queensland; AustraliaFil: Jafrani, Yohaann M.A.. The University of Queensland; AustraliaFil: Zhou, Chun. The University of Queensland; AustraliaFil: Caramelo, Julio Javier. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones Bioquímicas de Buenos Aires. Fundación Instituto Leloir. Instituto de Investigaciones Bioquímicas de Buenos Aires; ArgentinaFil: Shewan, Annette M.. The University of Queensland; AustraliaFil: Schulz, Benjamin L.. The University of Queensland; AustraliaFil: Brodsky, Jeffrey L.. University of Pittsburgh; Estados UnidosFil: Zacchi, Lucia Florencia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones Bioquímicas de Buenos Aires. Fundación Instituto Leloir. Instituto de Investigaciones Bioquímicas de Buenos Aires; Argentina. University of Pittsburgh; Estados Unidos. The University of Queensland; Australi

The Leeds Evaluation of Efficacy of Detoxification Study (LEEDS) prisons project: a randomised controlled trial comparing dihydrocodeine and buprenorphine for opiate detoxification

<p>Abstract</p> <p>Background</p> <p>Many opiate users entering British prisons require prescribed medication to help them achieve abstinence. This commonly takes the form of a detoxification regime. Previously, a range of detoxification agents have been prescribed without a clear evidence base to recommend a drug of choice. There are few trials and very few in the prison setting. This study compares dihydrocodeine with buprenorphine.</p> <p>Methods</p> <p>Open label, pragmatic, randomised controlled trial in a large remand prison in the North of England. Ninety adult male prisoners requesting an opiate detoxification were randomised to receive either daily sublingual buprenorphine or daily oral dihydrocodeine, given in the context of routine care. All participants gave written, informed consent. Reducing regimens were within a standard regimen of not more than 20 days and were at the discretion of the prescribing doctor. Primary outcome was abstinence from illicit opiates as indicated by a urine test at five days post detoxification. Secondary outcomes were collected during the detoxification period and then at one, three and six months post detoxification. Analysis was undertaken using relative risk tests for categorical data and unpaired t-tests for continuous data.</p> <p>Results</p> <p>64% of those approached took part in the study. 63 men (70%) gave a urine sample at five days post detoxification. At the completion of detoxification, by intention to treat analysis, a higher proportion of people allocated to buprenorphine provided a urine sample negative for opiates (abstinent) compared with those who received dihydrocodeine (57% vs 35%, RR 1.61 CI 1.02–2.56). At the 1, 3 and 6 month follow-up points, there were no significant differences for urine samples negative for opiates between the two groups. Follow up rates were low for those participants who had subsequently been released into the community.</p> <p>Conclusion</p> <p>These findings would suggest that dihydrocodeine should not be routinely used for detoxification from opiates in the prison setting. The high relapse rate amongst those achieving abstinence would suggest the need for an increased emphasis upon opiate maintenance programmes in the prison setting.</p> <p>Trial registration</p> <p>Current Controlled Trials ISRCTN07752728</p

Adjunctive rifampicin for Staphylococcus aureus bacteraemia (ARREST): a multicentre, randomised, double-blind, placebo-controlled trial.

BACKGROUND: Staphylococcus aureus bacteraemia is a common cause of severe community-acquired and hospital-acquired infection worldwide. We tested the hypothesis that adjunctive rifampicin would reduce bacteriologically confirmed treatment failure or disease recurrence, or death, by enhancing early S aureus killing, sterilising infected foci and blood faster, and reducing risks of dissemination and metastatic infection. METHODS: In this multicentre, randomised, double-blind, placebo-controlled trial, adults (≥18 years) with S aureus bacteraemia who had received ≤96 h of active antibiotic therapy were recruited from 29 UK hospitals. Patients were randomly assigned (1:1) via a computer-generated sequential randomisation list to receive 2 weeks of adjunctive rifampicin (600 mg or 900 mg per day according to weight, oral or intravenous) versus identical placebo, together with standard antibiotic therapy. Randomisation was stratified by centre. Patients, investigators, and those caring for the patients were masked to group allocation. The primary outcome was time to bacteriologically confirmed treatment failure or disease recurrence, or death (all-cause), from randomisation to 12 weeks, adjudicated by an independent review committee masked to the treatment. Analysis was intention to treat. This trial was registered, number ISRCTN37666216, and is closed to new participants. FINDINGS: Between Dec 10, 2012, and Oct 25, 2016, 758 eligible participants were randomly assigned: 370 to rifampicin and 388 to placebo. 485 (64%) participants had community-acquired S aureus infections, and 132 (17%) had nosocomial S aureus infections. 47 (6%) had meticillin-resistant infections. 301 (40%) participants had an initial deep infection focus. Standard antibiotics were given for 29 (IQR 18-45) days; 619 (82%) participants received flucloxacillin. By week 12, 62 (17%) of participants who received rifampicin versus 71 (18%) who received placebo experienced treatment failure or disease recurrence, or died (absolute risk difference -1·4%, 95% CI -7·0 to 4·3; hazard ratio 0·96, 0·68-1·35, p=0·81). From randomisation to 12 weeks, no evidence of differences in serious (p=0·17) or grade 3-4 (p=0·36) adverse events were observed; however, 63 (17%) participants in the rifampicin group versus 39 (10%) in the placebo group had antibiotic or trial drug-modifying adverse events (p=0·004), and 24 (6%) versus six (2%) had drug interactions (p=0·0005). INTERPRETATION: Adjunctive rifampicin provided no overall benefit over standard antibiotic therapy in adults with S aureus bacteraemia. FUNDING: UK National Institute for Health Research Health Technology Assessment

The rights of individuals with disability to parenthood

The issue of parenting for people with an intellectual disability (IDD) is complex. On the one hand there is recognition that people with IDD have the same rights as others to parent. On the other, it is apparent that the term ‘intellectual disability’ is applied to a heterogeneous group of people, some of whom will not have the capacity or ability to parent effectively, even with additional support. There has been a growing body of research, which has explored the needs of this group of parents. The present chapter will provide an historical context for the attitudes and behaviours towards parents with IDD. This will be followed by an exploration of current research on how parents with ID are viewed and supported, before outlining what parents with IDD themselves say about their parenting role and support needs

Being a parent with a learning disability : a qualitative study

This research portfolio aims to further explore the issues faced by parents with a learning disability. Firstly, a systematic review of qualitative research into the social support of parents with a learning disability is presented. This not only indicated that a range of social support is provided to parents with a learning disability and received with different perceptions, but also highlighted the need for further qualitative research in the area, to gain a better insight into the lived experiences of this group of parents. Secondly, and further to the findings of the systematic review, is the empirical research study. Adopting a qualitative design (Interpretative Phenomenological Analysis- IPA) (Smith, 1996; Smith et al., 2009), the study aimed to explore what parents with a learning disability understood about their learning disability and how they perceived it to impact on them in their parenting role. Analysis revealed five themes which reflect the perceptions and experiences of a sample of eight parents with a learning disability. Finally, to enable efficient and effective dissemination of the findings to the wider audience a journal article is presented. The journal article, as well as attempting to summarise the methodology used, focused on the most salient theme of the findings, which was how participants viewed themselves in relation to having a learning disability and being a parent.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

VEGF Signaling through Neuropilin 1 Guides Commissural Axon Crossing at the Optic Chiasm

During development, the axons of retinal ganglion cell (RGC) neurons must decide whether to cross or avoid the midline at the optic chiasm to project to targets on both sides of the brain. By combining genetic analyses with in vitro assays, we show that neuropilin 1 (NRP1) promotes contralateral RGC projection in mammals. Unexpectedly, the NRP1 ligand involved is not an axon guidance cue of the class 3 semaphorin family, but VEGF164, the neuropilin-binding isoform of the classical vascular growth factor VEGF-A. VEGF164 is expressed at the chiasm midline and is required for normal contralateral growth in vivo. In outgrowth and growth cone turning assays, VEGF164 acts directly on NRP1-expressing contralateral RGCs to provide growth-promoting and chemoattractive signals. These findings have identified a permissive midline signal for axons at the chiasm midline and provide in vivo evidence that VEGF-A is an essential axon guidance cue