Putting children forward for epilepsy surgery:a qualitative study of UK parents' and health professionals' decision-making experiences

Background Against a backdrop of recommendations for increasing access to and uptake of early surgical intervention for children with medically intractable epilepsy, it is important to understand how parents and professionals decide to put children forward for epilepsy surgery and what their decisional support needs are. Aim The aim of this study was to explore how parents and health professionals make decisions regarding putting children forward for pediatric epilepsy surgery. Methods Individual interviews were conducted with nine parents of children who had undergone pediatric epilepsy surgery at a specialist children's hospital and ten healthcare professionals who made up the children's epilepsy surgery service multidisciplinary healthcare team (MDT). Three MDT meetings were also observed. Data were analyzed thematically. Findings Four themes were generated from analysis of interviews with parents: presentation of surgery as a treatment option, decision-making, looking back, and interventions. Three themes were generated from analysis of interviews/observations with health professionals: triangulating information, team working, and patient and family perspectives. Discussion Parents wanted more information and support in deciding to put their child forward for epilepsy surgery. They attempted to balance the potential benefits of surgery against any risks of harm. For health professionals, a multidisciplinary approach was seen as crucial to the decision-making process. Advocating for the family was perceived to be the responsibility of nonmedical professionals. Conclusion Decision-making can be supported by incorporating families into discussions regarding epilepsy surgery as a potential treatment option earlier in the process and by providing families with additional information and access to other parents with similar experiences.

Treatment for Complicated Grief : State of the Science and Ways Forward

Peer reviewed

Performance improvement of broadband distributed Raman amplifier using bidirectional pumping with first and dual order forward pumps

In this paper, a new bidirectional pumping scheme with dual order forward pumps is proposed. Performance is compared numerically with conventional bidirectional and backward only pumping schemes for a 70 nm bandwidth, 61.5 km distributed Raman amplifier. We demonstrate that it is possible to design a flat gain spectrum with improved noise figure and OSNR, as well as a low gain ripple (<1 dB).

Youth Sports: Implementing Findings and Moving Forward with Research

This paper reviews the literature, outlines practical implications, and discusses future studies in youth sport researc h. The literature is discussed in light of three potential benefits of youth sport participation 1) physic al health, 2) psycho- social development, and 3) motor skills acquisition. The ultimate objective of youth sport programs is to consider all the benefits of youth sport participation rather than focusing on one or two at the cost of the other(s). It is suggested that researchers, s port administrators, coaches, and parents work together to promote sporting activities and programs that are more likely to enhance children’s physical health, psychosocia l development and lifelong recreational or elite sport participation.

Repositories for open education, a reflection and look forward for EPrints

Update on the work undertaken by EPrints team at University of Southampton (EPrints Services) to migrate the OER repository solution 'EdShare' to the latest EPrints 3.3 core and setting out areas for the solution to continue to develop and embrace ethos of open education to reach a global community of educators, students and self-learners. Presentation given at 11th International Open Repositories conference in Dublin (OR2016).

Thinning of the Goban Spur continental margin and formation of early oceanic crust: Constraints from forward modelling and inversion of marine magnetic anomalies

The deep seismic reflection profile Western Approaches Margin (WAM) cuts across the Goban Spur continental margin, located southwest of Ireland. This non-volcanic margin is characterized by a few tilted blocks parallel to the margin. A volcanic sill has been emplaced on the westernmost tilted block. The shape of the eastern part of this sill is known from seismic data, but neither seismic nor gravity data allow a precise determination of the extent and shape of the volcanic body at depth. Forward modelling and inversion of magnetic data constrain the shape of this volcanic sill and the location of the ocean-continent transition. The volcanic body thickens towards the ocean, and seems to be in direct contact with the oceanic crust. In the contact zone, the volcanic body and the oceanic magnetic layer display approximately the same thickness. The oceanic magnetic layer is anomalously thick immediately west of the volcanic body, and gradually thins to reach more typical values 40 km further to the west. The volcanic sill would therefore represent the very first formation of oceanic crust, just before or at the continental break-up. The ocean-continent transition is limited to a zone 15 km wide. The continental magnetic layer seems to thin gradually oceanwards, as does the continental crust, but no simple relation is observed between their respective thinnings.

Forward - Green Virtual Enterprises and Their Breeding Environments: Sustainable Manufacturing, Logistics and Consumption

Part 9: Innovation Networks

Effects of a resistance and stretching training program on forward head and protracted shoulder posture in physical education classes in students aged 15-17 years old

Purpose: This study aimed to characterize the postural alignment of the head and shoulder in the sagittal plane of Portuguese adolescents, 15-17 years old, and to evaluate the effects of a 32-week resistance and stretching training program applied in Physical Education classes on forward head posture and protracted shoulder posture of Portuguese adolescents. After 32-training weeks the detraining effects after a 16-week period were measured. Methods: This randomized and controlled study was conducted in two secondary schools in Portugal for 48 weeks. Prior the study 275 students aged 15-17 years old were evaluated. Sagittal head, cervical and shoulder angle were measured with photogrammetry and Postural Analysis Software. After this assessment 130 adolescents were considered to have forward head and protracted shoulder posture and were randomly assigned to a control group, an experimental group one or experimental group two. The control group (n=46) only did the Physical Education classes whereas the intervention group one (n=42) and two (n=42) performed a 16-week and 32-week stretching and strengthening program in addition to Physical Education classes, respectively. The postural angles were measured before and after the 16-week and 32-week time intervention period for the three groups and after a 16-week detraining period following the 32-week in intervention group two. Results: 68% of the adolescents studied revealed anteriorization of the head whereas 58% of them had protraction of the shoulder. Significant increases were observed in the cervical and shoulder angle in the experimental group (n=84) following the 16-week and in experimental group two (n=42)after the 32 week-intervention period. After the 16-week detraining period no significant differences were observed in the three postural angles in the intervention group two. Conclusions: Forward head and protracted shoulder are common postural disorders in Portuguese adolescents. The exercise intervention was successful ate decreasing forward head and protracted shoulder in adolescents. Detraining period of 16-week didn´t reduce the overall training effects.

Bringing forward semantic relations: Issues and proposals

Semantic relations are an important element in the construction of ontologies and models of problem domains. Nevertheless, they remain fuzzy or under-specified. This is a pervasive problem in software engineering and artificial intelligence. Thus, we find semantic links that can have multiple interpretations in wide-coverage ontologies, semantic data models with abstractions that are not enough to capture the relation richness of problem domains, and improperly structured taxonomies. However, if relations are provided with precise semantics, some of these problems can be avoided, and meaningful operations can be performed on them. In this paper we present some insightful issues about the modeling, representation and usage of relations including the available taxonomy structuring methodologies as well as the initiatives aiming to provide relations with precise semantics. Moreover, we explain and propose the control of relations as a key issue for the coherent construction of ontologies.

Physical activity and osseointegration: "step forward" to improve the quality of life of a trans-femoral amputee person

Lower limb amputation is an event that inevitably changes the lifestyle of the person with a significant impact on quality of life. The socket-type prosthesis entails that the residual limb is in direct contact with the socket which often implies numerous disadvantages. Osseointegrated prosthesis is a solution that avoids skin problems because not include the presence of the socket. In this type of prosthesis, a stem is surgically inserted inside the medullary canal and connected with the external prosthetic limb. Therefore, this thesis aims to highlight and explore the main strengths and problems of osseointegrated prostheses and to examine the role of physical activity, with attention to functional capacity and bone quality. The objectives of the thesis will be developed through 5 studies: (I) A gait analysis of a 44 years-old male patient who underwent surgery for the implantation of an osseointegrated prosthesis; (II) A systematic review to investigate the state of stump bone quality in patients with limb amputations; (III) A systematic review of the technologies involved in such devices has been carried out to identify the most fruitful ones in improving bone quality; (IV) A systematic review investigating the topic of physical activity and bone turnover biomarkers; (V) A systematic review to investigate the effects of physical activity interventions combined with drug treatments on bone biomarkers in people with osteopenia and osteoporosis. The integrated prosthesis is a good solution for people with lower limb amputation who cannot use their traditional socket-type prosthesis. Although many objectives have already been achieved, there are still many aspects that we can improve. These include the creation of a multidisciplinary path that support patients along their path, with particular attention to the pre-surgery and the post-rehabilitation phase that is still lacking even if of fundamental impact in determining the quality of life.