4,757 results match your criteria: "University of Exeter Medical School[Affiliation]"

Rapid genome sequencing for infantile-onset epilepsy within a national health-care setting.

Lancet Neurol

February 2024

Exeter Genomics Laboratory (NHS South West Genomic Laboratory Hub), Royal Devon University Healthcare NHS Foundation Trust, Exeter EX2 5DW, UK; Peninsula Clinical Genetics Service, Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK; RILD Wellcome Wolfson Centre, University of Exeter Medical School, Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK. Electronic address:

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Objective: With high prevalence of obesity and overlapping features between diabetes subtypes, accurately classifying youth-onset diabetes can be challenging. We aimed to develop prediction models that, using characteristics available at diabetes diagnosis, can identify youth who will retain endogenous insulin secretion at levels consistent with type 2 diabetes (T2D).

Research Design And Methods: We studied 2,966 youth with diabetes in the prospective SEARCH for Diabetes in Youth study (diagnosis age ≤19 years) to develop prediction models to identify participants with fasting C-peptide ≥250 pmol/L (≥0.

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Opioids, microglia, and temporal lobe epilepsy.

Front Neurol

January 2024

Hatherly Laboratories, Department of Clinical and Biomedical Sciences, University of Exeter Medical School, University of Exeter, Exeter, United Kingdom.

A lack of treatment options for temporal lobe epilepsy (TLE) demands an urgent quest for new therapies to recover neuronal damage and reduce seizures, potentially interrupting the neurotoxic cascades that fuel hyper-excitability. Endogenous opioids, along with their respective receptors, particularly dynorphin and kappa-opioid-receptor, present as attractive candidates for controlling neuronal excitability and therapeutics in epilepsy. We perform a critical review of the literature to evaluate the role of opioids in modulating microglial function and morphology in epilepsy.

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Disentangling the impact of the weather on transmission of infectious diseases is crucial for health protection, preparedness and prevention. Because weather factors are co-incidental and partly correlated, we have used geography to separate out the impact of individual weather parameters on other seasonal variables using campylobacteriosis as a case study. Campylobacter infections are found worldwide and are the most common bacterial food-borne disease in developed countries, where they exhibit consistent but country specific seasonality.

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Participatory design research for the development of real-time simulation models in healthcare.

Health Syst (Basingstoke)

February 2023

Centre for Simulation, Analytics and Modelling (CSAM), University of Exeter Business School, Exeter, United Kingdom.

The implementation challenges for modelling and simulation in health and social care are well-known and understood. Yet increasing availability of data and a better understanding of the value of Operational Research (OR) applications are strengthening opportunities to support healthcare delivery. Participative approaches in healthcare modelling have shown value through stakeholder engagement and commitment towards co-creation of models and knowledge but are limited in focus on model design and development.

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Correction: Marine Protected Area Expansion and Country-Level Age-Standardized Adult Mortality.

Ecohealth

March 2024

Department of Medicine, Division of Occupational, Environmental and Climate Medicine, University of California, San Francisco, 490 Illinois Street, San Francisco, CA, 94143, USA.

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Insulitis in human type 1 diabetes: lessons from an enigmatic lesion.

Eur J Endocrinol

January 2024

Islet Biology Exeter (IBEx), Exeter Centre of Excellence in Diabetes (EXCEED), Department of Clinical and Biomedical Science, University of Exeter Medical School, Exeter EX2 5DW, UK.

Type 1 diabetes is caused by a deficiency of insulin secretion which has been considered traditionally as the outcome of a precipitous decline in the viability of β-cells in the islets of Langerhans, brought about by autoimmune-mediated attack. Consistent with this, various classes of lymphocyte, as well as cells of the innate immune system have been found in association with islets during disease progression. However, analysis of human pancreas from subjects with type 1 diabetes has revealed that insulitis is often less intense than in equivalent animal models of the disease and can affect many fewer islets than expected, at disease onset.

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Although the mechanisms underpinning short-term muscle disuse atrophy and associated insulin resistance remain to be elucidated, perturbed lipid metabolism might be involved. Our aim was to determine the impact of acipimox administration [i.e.

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Article Synopsis
  • A new scoring system for the UK's Clinical Impact Awards was created to better assess clinical excellence among senior doctors and dentists, based on expert consensus from a three-round online Delphi process.
  • The Delphi panel, consisting of 45 experts, agreed on principles for the new scoring system, which uses a 0-10 scale to evaluate performance.
  • A shadow scoring exercise indicated that the new system might be more reliable than the existing one, providing better differentiation at higher performance levels, highlighting the need for evidence-based spending in clinical awards.
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The aim of this study was to explore unpaid carers' experiences of supporting people with dementia to use social media. Unpaid carers ( = 234) responded to an online survey about their attitudes towards people with dementia using social media and any experiences supporting this usage. Responses to closed questions were analysed using frequency analysis; qualitative data were analysed thematically.

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Background: The objective of this systematic review is to identify prognostic factors among women and their offspring affected by gestational diabetes mellitus (GDM), focusing on endpoints of cardiovascular disease (CVD) and type 2 diabetes (T2D) for women, and cardiometabolic profile for offspring.

Methods: This review included studies published in English language from January 1st, 1990, through September 30th, 2021, that focused on the above outcomes of interest with respect to sociodemographic factors, lifestyle and behavioral characteristics, traditional clinical traits, and 'omics biomarkers in the mothers and offspring during the perinatal/postpartum periods and across the lifecourse. Studies that did not report associations of prognostic factors with outcomes of interest among GDM-exposed women or children were excluded.

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Neurological disorders include a variety of conditions, including Alzheimer's disease, motor neuron disease and Parkinson's disease, affecting longevity and quality of life, and their pathogenesis is associated with oxidative stress. Several of the chronic neurodegenerative pathologies of the CNS share some common features, such as oxidative stress, inflammation, synapse dysfunctions, protein misfolding and defective autophagia. Neuroinflammation can involve the activation of mast cells, contributing to oxidative stress, in addition to other sources of reactive oxygen species.

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The study aims to examine the effect of the world's largest school-feeding programme, the Mid-Day Meal (MDM) programme, on the changes in the underweight prevalence among school-children in India. Data from the Indian Human Development Survey (IHDS) Rounds 1 (2004-05) and 2 (2011-12) were utilized. The sample included individual-level information of children aged 6 to 9 years in IHDS-1 who then turned 13 to 16 years in IHDS-2.

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Exploring the rise and diversity of health and societal issues that use a public health approach: A scoping review and narrative synthesis.

PLOS Glob Public Health

January 2024

Faculty of Health and Life Sciences, Department of Health and Community Sciences, Relational Health Group, University of Exeter Medical School, Exeter, United Kingdom.

There is an increase in calls across diverse issues for a "public health approach" however, it is not clear whether there is any shared understanding in approach in its conceptualisation or implementation. Our aims were to (1) identify and categorise the issues which discuss a public health approach within published literature since 2010, (2) chart the descriptions and applications of public health approaches across and within four purposively sampled categories of issues, and (3) capture any evaluations conducted. A scoping review of published literature was undertaken; Seven leading databases were searched: AMED, APA PsycInfo, ASSIA, CINAHL complete, Cochrane Library (Review), Embase, and MEDLINE for articles published between 2010 and 2022 which have applied, described or called for a "public health approach" to address any issue.

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Article Synopsis
  • Depression is a significant issue for adolescents, and this study aims to compare the effectiveness of different cognitive behavioural therapy (CBT) delivery methods in reducing depressive symptoms and assess how well participants stick with these treatments.
  • Researchers conducted a thorough literature search for randomized controlled trials focused on CBT for youths aged 10-19, analyzing various intervention formats like group, individual, remote, and self-help options.
  • Data was collected and analyzed to compare the impact of these delivery modes on depressive symptoms and intervention acceptability, applying statistical measures to rate their effectiveness and potential for participant retention.
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Background: Evidence and Gap Maps (EGMs) should be regularly updated. Running update searches to find new studies for EGMs can be a time-consuming process. Search Summary Tables (SSTs) can help streamline searches by identifying which resources were most lucrative for identifying relevant articles, and which were redundant.

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Purpose: To inform updated recommendations by the Canadian Task Force on Preventive Health Care on screening in a primary care setting for hypertension in adults aged 18 years and older. This protocol outlines the scope and methods for a series of systematic reviews and one overview of reviews.

Methods: To evaluate the benefits and harms of screening for hypertension, the Task Force will rely on the relevant key questions from the 2021 United States Preventive Services Task Force systematic review.

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Predatory publishing in medical education: a rapid scoping review.

BMC Med Educ

January 2024

Department of Clinical and Biomedical Science, Faculty of Health and Life Science, University of Exeter Medical School, University of Exeter, Exeter, UK.

Background: Academic publishing is a cornerstone of scholarly communications, yet is unfortunately open to abuse, having given rise to 'predatory publishers'- groups that employ aggressive marketing tactics, are deficient in methods and ethics, and bypass peer review. Preventing these predatory publishers from infiltrating scholarly activity is of high importance, and students must be trained in this area to increase awareness and reduce use. The scope of this issue in the context of medical students remains unknown, and therefore this sought to examine the breadth of the current literature base.

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Background: Most people with dementia have multiple health conditions. This study explores (1) number and type of health condition(s) in people with dementia overall and in relation to age, sex, dementia type, and cognition; (2) change in number of health conditions over two years; and (3) whether over time the number of health conditions at baseline is related to social isolation, loneliness, quality of life, and/or well-being.

Methods: Longitudinal data from the IDEAL (Improving the experience of Dementia and Enhancing Active Life) cohort were used.

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Article Synopsis
  • * Findings show that individuals with dementia from minority ethnic backgrounds report a lower quality of life and higher loneliness, while their carers experience greater stress and poorer relationship quality compared to their white counterparts.
  • * The research highlights the need for further studies with larger sample sizes to better understand the unique challenges faced by specific minority ethnic groups in the context of dementia care.
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Background: The revision knee complexity classification (RKCC) stratifies knee revision operations depending on their level of complexity from simple revisions (R1) to highly complex cases (R3). Current financial codes used for calculation of reimbursement for knee revision services provided at the Trust, rely on patients' comorbidities. However, previous research has demonstrated that this approach may not yield an accurate financial account of knee revision arthroplasty cost.

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Article Synopsis
  • Therapeutic exercises are crucial for treating low back pain, and this study investigates how these exercises lead to better patient outcomes through specific behavioral mechanisms.
  • A realist review approach was used, involving a combination of expert input, stakeholder feedback, and an extensive literature search to modify initial theories about the exercises' effectiveness.
  • The study concluded that factors like trust in the patient-clinician relationship, personalized exercise plans, and ongoing support significantly enhance patient motivation and adherence, ultimately improving outcomes for low back pain.
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Children and young people's mental health services have been under increasing pressure following COVID-19. Understanding, for which channels help is sought from, will highlight services needing support. This study aims to explore the professional services that parents of children, and young people get help from when they have a concern for the child's/their mental health.

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