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Working collaboratively with people with lived experience to map and co-create guidance on improving health services for people with attention deficit hyperactivity disorder (ADHD)
Background: Attention deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in children and adolescents, with an average worldwide prevalence of 5%. Young people with ADHD experience poorer outcomes than their peers across multiple domains, with treatment shown to reduce these risks. Evidence shows that young people with ADHD can experience multiple challenges when seeking access to healthcare. Debates over how to tackle a ‘failure of healthcare’ for ADHD often include reorganisation of services, including better provision of adult ADHD services, and an expanded role for primary care. However, adult services remain patchy and primary care practitioners feel unsure about how to support young people at this vulnerable stage in their lives, reporting needs for more evidence-based guidance. There is also a lack of national level understanding of the different models, and pathways of care for young people with ADHD aged 16 to 25, hindering efforts to improve access to care and optimise outcomes for this underserved group. Research into this area needs to be guided by people with lived experience of ADHD and informed by perspectives from a range of stakeholders.Aim: To use collaborative research methods to provide an evidence-base by mapping current services. Then co-produce guidance to improve and better co-ordinate healthcare for young people aged 16-25 with ADHD.Methods: A national survey about mental health service provision for adults with ADHD (informed by people with lived experience) was developed and distributed. Evidence from this survey stimulated research into primary care service provision, consisting of three interlinked studies guided by research advisory groups of people with lived experience and healthcare professionalsDisclosure of InterestNone Declared
Journal Article
Osteoarthritis
Osteoarthritis is a major source of pain, disability, and socioeconomic cost worldwide. The epidemiology of the disorder is complex and multifactorial, with genetic, biological, and biomechanical components. Aetiological factors are also joint specific. Joint replacement is an effective treatment for symptomatic end-stage disease, although functional outcomes can be poor and the lifespan of prostheses is limited. Consequently, the focus is shifting to disease prevention and the treatment of early osteoarthritis. This task is challenging since conventional imaging techniques can detect only quite advanced disease and the relation between pain and structural degeneration is not close. Nevertheless, advances in both imaging and biochemical markers offer potential for diagnosis and as outcome measures for new treatments. Joint-preserving interventions under development include lifestyle modification and pharmaceutical and surgical modalities. Some show potential, but at present few have proven ability to arrest or delay disease progression.
Journal Article
Recommendations for daytime, evening, and nighttime indoor light exposure to best support physiology, sleep, and wakefulness in healthy adults
Ocular light exposure has important influences on human health and well-being through modulation of circadian rhythms and sleep, as well as neuroendocrine and cognitive functions. Prevailing patterns of light exposure do not optimally engage these actions for many individuals, but advances in our understanding of the underpinning mechanisms and emerging lighting technologies now present opportunities to adjust lighting to promote optimal physical and mental health and performance. A newly developed, international standard provides a SI-compliant way of quantifying the influence of light on the intrinsically photosensitive, melanopsin-expressing, retinal neurons that mediate these effects. The present report provides recommendations for lighting, based on an expert scientific consensus and expressed in an easily measured quantity (melanopic equivalent daylight illuminance (melaponic EDI)) defined within this standard. The recommendations are supported by detailed analysis of the sensitivity of human circadian, neuroendocrine, and alerting responses to ocular light and provide a straightforward framework to inform lighting design and practice.
Journal Article
القيادة
ثمة العديد من الأمثلة عن قادة عظماء حققوا إنجازات عظيمة رغم الصعوبات التي واجهتهم، وهذا الكتاب مزود بأفكار هؤلاء القادة في الحياة الواقعية، كالاستراتيجيات والخيارات والتجارب التي قدمت حلول رائعة للتحديات التي واجهتهم والتي لربما ستصادفك شخصيا. لذا إن كنت من الأشخاص الذين بدأوا عملهم للتو، ويرغبون في رفع سقف تطلعاتهم، أو كنت من المتمرسين المحترفين الذين يهدفون للأفضل، ويسعون للقيام بما قام به أفضل القادة، فإن هذا الكتاب سيلهمك الكثير عن إنجازات هؤلاء العظماء وما يمكن أن تمتلكه من إمكانيات في سبيل ذلك. \"... قمنا بدراسة العديد من القادة المؤثرين في هذا المجال أولا، وذلك عندما بدأنا رحلة العمل في ميدان القيادة، آملين أن نمتلك قدرة التمييز بين كل منهم، ومعرفة السبب الحاسم وراء نجاحاتهم، لنتخذه معيارا للنجاح ! ولكننا سرعان ما اكتشفنا أن النجاح لا يستند مطلقا إلى عنصر أو عامل واحد فقط يصنع الفرق، بل إلى مجموعة من الأجزاء المفردة التي تجتمع معا لتشكل وحدة متكاملة. لذلك سألنا أنفسنا : ما هو المكون السحري لهذه العناصر والذي يؤدي إلى القيادة الناجح ؟\".
BOOK
Small molecule binding to surface-supported single-site transition-metal reaction centres
Despite dominating industrial processes, heterogeneous catalysts remain challenging to characterize and control. This is largely attributable to the diversity of potentially active sites at the catalyst-reactant interface and the complex behaviour that can arise from interactions between active sites. Surface-supported, single-site molecular catalysts aim to bring together benefits of both heterogeneous and homogeneous catalysts, offering easy separability while exploiting molecular design of reactivity, though the presence of a surface is likely to influence reaction mechanisms. Here, we use metal-organic coordination to build reactive Fe-terpyridine sites on the Ag(111) surface and study their activity towards CO and C
2
H
4
gaseous reactants using low-temperature ultrahigh-vacuum scanning tunnelling microscopy, scanning tunnelling spectroscopy, and atomic force microscopy supported by density-functional theory models. Using a site-by-site approach at low temperature to visualize the reaction pathway, we find that reactants bond to the Fe-tpy active sites via surface-bound intermediates, and investigate the role of the substrate in understanding and designing single-site catalysts on metallic supports.
Surface-supported metalorganics promise the best of homogenous and heterogeneous catalysts. Here the authors show that small molecules bind to an iron-terpyridine site on silver via surface bound intermediates by following molecules one at a time.
Journal Article
Low Dietary Protein Intakes and Associated Dietary Patterns and Functional Limitations in an Aging Population: A NHANES Analysis
To investigate protein intakes across demographic characteristics in relation to dietary patterns and functional outcomes in older adults.
Observational and cross-sectional study.
Non-institutionalized participants from the 2005–2014 National Health and Nutrition Examination Survey.
Data from 11,680 adults were categorized into 51–60 years (n= 4,016), 61–70 years (n=3,854), and 71 years and older (n=3,810) for analysis.
Adults were stratified by meeting or not meeting the protein recommendation (0.8 g/kg/d) to compare demographics, diet quality with Healthy Eating Index– 2015, functional limitations, and other dietary intakes. Dietary recalls were collected using the multiple pass method. Data analyses were weighted to create a nationally–representative sample.
Dietary protein intakes were significantly lower in older age groups, with up to 46% of the oldest adults not meeting the protein intake recommendation. Participants consuming protein below the recommended intake level had significantly poorer diet quality across all age groups (P<0.01), however, overall diet quality was better in older adults. Those not meeting the protein recommendation were more likely to have intakes of other nutrients below recommended levels. Those below the protein recommendation had significantly more functional limitations across all age groups, while grip strength was significantly lower in those over 70 years old.
Lower protein intakes, and lower diet quality and physical functioning are related in an aging population. Meeting the protein recommendation was linked to better overall diet quality and may be protective of lean mass; therefore, evaluation of individual characteristics which may affect protein intakes is crucial in supporting older adults to meet their protein needs.
Journal Article