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While evidence exists for the negative and positive effects of the COVID-19 pandemic and associated lockdown on the mental health and well-being of adolescents and parents separately, the potential impact of lockdown, and the effective coping strategies that have been used have so far, by both children and their parents still needs to be explored. A dyadic approach was used to explore the perceived impact of COVID-19 restrictions among early adolescents and their parents in Northwest England. Nine parents (8 female and 1 male) and their 10 children (6 boys and 4 girls) aged 11-13, were recruited from 4 secondary schools to be interviewed. Remote interviews took place between October and December 2020 for the adolescents and between March and May 2021 for their parents. Inductive thematic analysis was used. Five inter-related themes were identified: (1) overcoming barriers for learning at home; (2) juggling a work-life balance; (3) loss of experiences; (4) caring for other family members; and (5) adopting new self-care and coping strategies during the pandemic. Themes identified will help to inform policy and practice for supporting adolescents and parents in the future, including the promotion of positive coping strategies and the provision of resources for adolescents, schools and families.

Background: The provision of education, health, and social care for children with special educational needs and disabilities (SEND) in England has long been criticised for its inequities and chronic underfunding. These systemic issues were further exacerbated by the onset of the COVID-19 pandemic and the accompanying restrictions, which disrupted essential services and resulted in widespread unmet needs and infringements on the rights of many children with SEND. This study aimed to use a three-phase consensus-building approach with 1353 participants across five stakeholder groups to collaboratively develop evidence-informed priorities for policy and practice. The priorities sought to help address the longstanding disparities and respond to the intensified challenges brought about by the pandemic. Methods: A total of 55 children with SEND (aged 5–16), 893 parents/carers, and 307 professionals working in SEND-related services participated in the first phase through online surveys. This was followed by semi-structured interviews with four children and young people, ten parents/carers, and 15 professionals, allowing for deeper exploration of lived experiences and priorities. The data were analysed, synthesised, and structured into five overarching areas of priority. These were subsequently discussed and refined in a series of activity-based group workshops involving 20 children with SEND, 11 parents/carers, and 38 professionals. Results and Conclusions: The consensus-building process led to the identification of key priorities for both pandemic response and longer-term recovery, highlighting the responsibilities of central Government and statutory services to consider and meet the needs of children with SEND. These priorities are framed within a children’s rights context and considered against the rights and duties set out in the United Nations Convention on the Rights of the Child (1989). Priorities include protecting and promoting children with SEND’s rights to (1) play, socialise, and be part of a community, (2) receive support for their social and emotional wellbeing and mental health, (3) feel safe, belong, and learn in school, (4) “access health and social care services and therapies”, and (5) receive support for their parents/carers and families. Together, they highlight the urgent need for structural reform to ensure that children with SEND receive the support they are entitled to—not only in times of crisis but as a matter of routine practice and policy.

This PhD thesis explores the phenomenon of resilience in people with spinal cord injury (SCI). The purpose of this research is to understand how resilience is experienced and given meaning in people with SCI, as well how resilience is fostered, how it impacts upon health and well-being, and how it can be managed to achieve maximum benefits with regard to health and well-being. It is the first in depth narrative investigation of resilience in people with SCI. Using both life story interviews and the process of timelining, participants stories were collected. Following this they were then analysed using dialogical narrative analysis (Frank, 2010, 2012). This enabled participants stories to be examined with regard to their effects on resilience and health and well-being. The analysis shows that firstly, due to the intangible nature of resilience, participants had trouble in articulating exactly what resilience meant to them. Instead, resilience was shown through participants stories which could be grouped into four different narrative types: loss, adaptation, posttraumatic growth (PTG), and life-as-normal. Together, these narrative types constructed resilience, and as such, resilience in people with SCI has four facets or faces , like a four-sided dice. The process of resilience in people with SCI worked by participants drawing upon the different narrative types at different times depending upon the demands being placed upon them. The loss narrative was drawn upon immediately following injury, and was concerned with the narration of the physical, psychological and social losses participants incurred following SCI. The loss narrative fostered resilience by enabling participants to talk about their losses, enabling participants to survive the hardest time of their lives. The second narrative type was the adaptation narrative. This narrative type focussed upon rehabilitation in both the spinal unit and in the community. This narrative type built resilience via progression through rehabilitation towards a quality of life comparable to pre-injury levels. The PTG narrative was concerned with the ways in which participants had developed following SCI and built resilience by shifting the focus onto the positives to come out of participants experiences of SCI. The life-as-normal narrative was used by two participants across their entire life story and enabled participants to continue with their lives with minimal disruption. It built resilience by placing disability in the background and therefore making it unimportant. This thesis then concludes with the empirical, theoretical, methodological and practical implications arising from this research. The potential for resilience to help improve the health and well-being of people with SCI is discussed, as well as the ways in which resilience can have a maximum benefit on health and well-being of people with SCI.

Two-photon microscopy is widely used to investigate brain function across multiple spatial scales. However, measurements of neural activity are compromised by brain movement in behaving animals. Brain motion-induced artifacts are typically corrected using post hoc processing of two-dimensional images, but this approach is slow and does not correct for axial movements. Moreover, the deleterious effects of brain movement on high-speed imaging of small regions of interest and photostimulation cannot be corrected post hoc. To address this problem, we combined random-access three-dimensional (3D) laser scanning using an acousto-optic lens and rapid closed-loop field programmable gate array processing to track 3D brain movement and correct motion artifacts in real time at up to 1 kHz. Our recordings from synapses, dendrites and large neuronal populations in behaving mice and zebrafish demonstrate real-time movement-corrected 3D two-photon imaging with submicrometer precision. Real-time 3D movement correction by tracking a fluorescent bead in the field of view enables functional imaging with 3D two-photon random-access microscopy in behaving mice and zebrafish.

The Association for Respiratory Technology & Physiology (ARTP) last produced a statement on the performance of lung function testing in 1994. At that time the focus was on a practical statement for people working in lung function laboratories. Since that time there have been many technological advances and alterations to best practice in the measurement and interpretation of lung function assessments. In light of these advances an update was warranted. ARTP, therefore, have provided within this document, where available, the most up-to-date and evidence-based recommendations for the most common lung function assessments performed in laboratories across the UK. These recommendations set out the requirements and considerations that need to be made in terms of environmental and patient factors that may influence both the performance and interpretation of lung function tests. They also incorporate procedures to ensure quality assured diagnostic investigations that include those associated with equipment, the healthcare professional conducting the assessments and the results achieved by the subject. Each section aims to outline the common parameters provided for each investigation, a brief principle behind the measurements (where applicable), and suggested acceptability and reproducibility criteria.

Acute lung injury (ALI) is a common but poorly defined and understood complication of balloon pulmonary angioplasty (BPA) for chronic thromboembolic pulmonary hypertension (CTEPH). Little data are available on the medium term clinical outcomes of BPA complicated by ALI. We analyzed per‐procedure data from 282 procedures in 109 patients and per‐patient data from 85 patients. Serial right heart catheterization at baseline, after each BPA and at 3‐month follow‐up measured pulmonary vascular resistance (PVR), mean pulmonary artery pressure (mPAP), and cardiac output (CO). ALI (ALI+) was identified by chest radiography alone (ALIr+) or in association with hypoxia clinically (ALIcr+). Procedural predictors of ALI and patient outcomes at 3‐months were compared no ALI (ALI−). ALI+ occurred in 17/282 (6.0%) procedures (ALIcr+: 2.5%, ALIr+: 3.5%). Prevailing haemodynamics (PVR: p < 0.01; mPAP: p < 0.05) at a procedural and patient level, as well as number of BPA sessions (p < 0.01), total number of vessels (p < 0.05), and occlusions (p < 0.05) treated at a patient level predicted ALI+. Those with ALI had greater percentage improvement in ΔCAMPHOR symptoms score (ALI+: −63.5 ± 35.7% (p < 0.05); ALIcr+: −84.4 ± 14.5% (p < 0.01); ALI−: −27.2 ± 74.2%) and ΔNT‐proBNP (ALIcr+: −78.4 ± 11.9% (p < 0.01); ALI−: −42.9 ± 36.0%) at follow‐up. There was no net significant difference in haemodynamic changes in ALI+ versus ALI− at follow‐up. ALI is predicted by haemodynamic severity, number of vessels treated, number of BPA sessions, and treating occlusive disease. ALI in this cohort was associated with a clinical advantage at follow‐up.

Pulmonary endarterectomy (PEA) may not achieve full clearance of vascular obstructions in patients with more distal chronic thromboembolic pulmonary hypertension (CTEPH). Balloon pulmonary angioplasty (BPA) may be indicated to treat these residual vascular lesions. We compared whether patients post‐PEA (PP) treated by BPA derived similar benefit to those who had inoperable CTEPH (IC), and assessed predictors of BPA response after surgery. We treated 109 patients with BPA—89 with IC and 20 PP. Serial right heart catheterization performed at baseline (immediately before BPA) and 3 months after completing BPA, compared pulmonary vascular resistance (PVR), mean pulmonary artery pressure (mPAP) as well as change in WHO functional class and 6‐minute walk distance. We also assessed the impact of total thrombus tail length (TTTL) from photographed PEA surgical specimens and PP computed tomography pulmonary angiography (CTPA)‐quantified residual disease burden on BPA response. PP and IC groups did not differ significantly in terms of demographics, baseline hemodynamics or procedural characteristics. However, IC derived greater hemodynamic benefit from BPA: ΔPVR (−27.9 ± 20.2% vs. −13.9 ± 23.9%, p  < 0.05) and ΔmPAP (−17.1 ± 14.4% vs. −8.5 ± 18.0%, p  < 0.05). There was a negative correlation between pre‐BPA PVR and TTTL ( r  = −0.47, p  < 0.05) which persisted post‐BPA. PVR, mPAP, WHO FC and 6MWD were not improved significantly post‐BPA in PP patients. BPA response was not related to TTTL terciles or CTPA‐quantified residual disease burden. Patients PP experienced inferior response to BPA, despite similar baseline and procedural characteristics to IC. BPA does not abolish the relationship between TTTL and postsurgical PVR in PP patients, suggesting that BPA is less effective in treating residual PH after surgery in an experienced surgical center.