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Changing Patterns of Psychotropics Use Among Older Adults With Intellectual Disability Over a Decade, With a Focus on Designated Mental Health Conditions
No full textABSTRACTBackground: Psychotropics (sometimes off-label), mental health diagnoses and behaviours of concern are common in olderadults with intellectual disability. Guidelines recommend non-pharmacological interventions and regular medication review.This study examined changes in psychotropics among older adults (≥40) with intellectual disability.Methods: Longitudinal data were obtained from the Intellectual Disability Supplement to the Irish Longitudinal Study onAgeing (IDS-TILDA) at two timepoints [Wave 1(2009/10); Wave 4(2019/20)]. Post hoc analysis, Chi-squared tests and univariatebinary logistic regression were conducted.Results: Overall, psychotropics decreased (59.2% to 56.5%). Significant decreases in antipsychotics (43.1%–40.1%) and sedatives/hypnotics (13.6%–8.1%) and significant increase in antidepressants (26.2%–31.8%) were found. Nearly half of antidepressant usersreported depression at Wave 1, compared with under 30% at Wave 4. Antipsychotics and antidepressants were common (75% and60%, respectively) among those with behaviours of concern, after excluding clinical indications.Conclusion: Psychotropic prescribing remained consistent, though class-specific patterns shifted, with some decreases or increases observed
Colonisation, globalisation and a pandemic: developing understandings of inclusive education in Malaysia
No full textThis is a theoretical paper that examines how colonisation, globalisation and a crisis such as the Covid-19 pandemic have had a significant influence on the development of inclusive education policy and practice in Malaysia. Drawing on the ideas of dependency from Farid Alatas, and Carol Bacchi’s focus on the identification of the underlying problem within policies, as well as Stephen Ball’s policy cycle, we highlight how global events have repercussions at a policy level now and into the future. This paper contributes to the wider inclusive education debate through the innovative use of these three different theoretical lenses, informed by Asian historical experiences and cultural practices. This is significant as together they emphasise the impact of colonisation, globalisation and a pandemic on the process of inclusive education policy development in Malaysia as we argue for a repositioning of education to recognise learning that goes on outside of the school gates
SAFE practice guidance and brief manual revised
No full textRevised and updated practice manual for SAFE2 websit
I wasn’t prepared for that”: UK social worker experiences of training in and knowledge of acquired brain injury
No full textSummary: Acquired brain injury is a major cause of death and disability. Due to the impact of acquired brain injury on an individual\u27s and a family\u27s functioning, social workers are likely to encounter individuals and families affected by the condition. This study aimed to (1) identify the existing level of knowledge and skills of social workers in working with individuals with acquired brain injury and their families and (2) examine the training needs of social workers to improve their knowledge and skills in working with those with acquired brain injury. A series of semi-structured interviews with newly qualified social workers (six), brain injury specialist social workers (nine), team leaders (two), and commissioners (three) were conducted and analyzed using thematic analysis. Findings: The data highlighted that social workers in England and Wales have no formal training around acquired brain injury but felt there was a need for different levels of training and guidance for social workers. Participants also discussed the need for better integration with health care and a greater focus on relational working to enact positive change for individuals and families. Applications: Social work training should be embedded within prequalification training with additional postqualification training where appropriate. Work and training within social work should take an interdisciplinary approach. The authors have taken the data to develop a freely available online training program for social workers
Making the Implicit Explicit: Leadership in Primary Care Dental Practice
No full textObjectives: This paper reports on research aimed at understanding leadership activities in primary care dental practice, an under-explored area within the extant literature. Methods: The research employed a qualitative, exploratory paradigm, using Video Reflexive Ethnography (VRE) and Activity Theory (AT) to capture the lived experiences of seven participating dentists. Results: The research outlines the ways in which dentists demonstrate leadership skills in their daily work, identifying three interacting activity systems that define leadership in this setting: Patient Care (PC), Running the Surgery (RS), and Running the Practice (RP). Findings emphasise that leadership is directly related to patient care and is informed by explicit and implicit ‘rules’ governing these activities, which are often learnt and developed tacitly over the course of a dentist\u27s career. Conclusions: Leadership is based on relationships and emotional intelligence and effects dentists’ general well-being in addition to the effective delivery of clinical care. Clinical Significance: Unconscious, implicit and often automatic behaviours, skills and activities related to leadership and teamwork have been uncovered and linked directly to patient care. Findings and conclusions can enhance patient outcomes and experience alongside clinician wellbeing; and underpin effective surgery and practice management. Relevant in the clinical patient care context for every clinician
Building the Ark (Long Gallery, Lanhydrock)
No full text3D digital model of the \u27Building the Ark\u27 plaster relief in the Long Gallery at Lanhydrock House (c. 1638/39-1643), based on LiDAR surveys in 2025
Investigating the potential utilisation of black soldier fly (Hermetia illucens) as an alternative protein source in tilapia and carp feed
No full textThree experimental trials were conducted to evaluate defatted black soldier fly (BSF; Hermetia illucens) larvae meal and BSF frass as alternative protein ingredients. Defatted BSF larvae meal was tested in diets for both Nile tilapia (Oreochromis niloticus) and mirror carp (Cyprinus carpio), whereas BSF frass was assessed only in Nile tilapia.In the first experiment, dietary inclusion of 20% and 40% BSF meal, replacing mainly soybean meal (SBM) and corn gluten meal (CGM), was evaluated in Nile tilapia over 5 weeks. BSF improved growth and feed utilisation in a dose-dependent manner, increased posterior intestinal fold length, muscularis thickness, and goblet cell density, while intraepithelial lymphocytes abundance and enterocyte microvilli length were elevated only at 40% BSF meal. Posterior intestinal endochitinase A, slc6a18, and cytokines (il1β, tnfα, il10) in either the intestine or head kidney were not significantly affected, but slc15a1a was upregulated at 40% BSF meal compared with the control.Similar results were obtained in juvenile mirror carp fed the same BSF meal at 20% and 40% over 8 weeks, replacing mainly SBM and soy protein concentrate (SPC). 16S rRNA gene metabarcoding profiling of the posterior intestine revealed that BSF inclusion induced beneficial microbiome changes. BSF meal significantly increased the relative abundance of Firmicutes and reduced a number of potentially pathogenic phyla. At the genus level, BSF meal enriched the relative abundances of beneficial Bacillus and Enterococcus while reducing potentially pathogenic Mycobacterium, Staphylococcus, and Enterobacter. In the third experiment, 30% BSF frass inclusion was evaluated on growth, intestinal health, immune responses, and intestinal microbiota in Nile tilapia over 6 weeks. Results revealed that BSF frass significantly increased posterior intestine enterocyte microvilli length and density without affecting overall tissue morphology. Expressions of posterior intestinal cytokines (il1β, tnfα, il10, tgfβ), tight junction proteins (cldn3, ocln), and mucosal immunity markers (IgM, pIgR, muc2) were unaffected, while β-defensin 1, pcna, and hsp70 were downregulated. While microbiota diversity remained stable across the diets, BSF frass reduced Proteobacteria and Campylobacterota, and increased Spirochaetota and Brevinema. Growth performance and carcass composition did not differ significantly between the groups. These trials demonstrate that incorporating defatted BSF larvae meal at 20% and 40% inclusion rates is a viable alternative to plant-based proteins in diets for Nile tilapia and mirror carp, and that including BSF frass at 30% is a feasible option for Nile tilapia diets. Both ingredients provide nutritional and functional benefits in these species
Angle-based formation stabilization and maneuvers in port-Hamiltonian form with bearing and velocity measurements
No full textThis paper proposes a port-Hamiltonian approach for angle-based formation stabilization and maneuvers using bearing and velocity measurements with an underlying triangulated Laman graph. The corresponding port-Hamiltonian controller is designed using virtual couplings on the errors of angle constraints in angle space. Then, the angle constraints and agent actuators are mapped by the constraint Jacobian, which can be applied to other formation constraints. In addition, to avoid unavailable distance terms in the control law, an estimator is designed based on port-Hamiltonian theory and the property that energy is coordinate-free for different sensor modalities using bearing and velocity measurements, which permits our framework to inject damping for the formation maneuvers. Furthermore, the stability analysis for several maneuvers is provided. Simulations are performed to illustrate the effectiveness of the approach
An audit of endodontic diagnostic documentation compliance among undergraduate dental students in a UK primary care–based dental school.
No full textBackground: Erroneous pulpal and periapical diagnoses can lead to inappropriate treatment planning, unnecessary procedures, and compromised patient outcomes. While undergraduate endodontic education emphasises history taking, clinical testing and radiographic assessment, less is known about how consistently students document diagnostic conclusions in clinical records.Aim: To evaluate the completeness and compliance of endodontic diagnostic documentation among undergraduate dental students, benchmarked against British Endodontic Society (BES) and European Society of Endodontology (ESE) standards, and to explore trends across different stages of training.Methods: Records of 196 root canal treatments completed by Year 3–5 Bachelor of Dental Surgery students (2022–2024) were reviewed. Audit standards were based on the British Endodontic Society Guide to Good Endodontic Practice (2022) and United Kingdom record-keeping guidance. Parameters included history-taking, sensibility testing, radiographic justification and reporting, and documentation of provisional and definitive diagnoses. Compliance was analysed descriptively, with limited inferential comparison where appropriate.Results: Compliance with core record keeping elements was high across all cohorts. Documentation of diagnostic conclusions and signs and symptoms varied across student groups and academic years. Provisional diagnoses were recorded in 12.37% of cases overall, whereas definitive diagnoses were documented in 66.31%, with the highest compliance observed in Year 5. Documentation of signs and symptoms was 65.83% in 2022–2023, increasing to 67.76% in 2023–2024.Conclusions: Undergraduate dental students consistently document clinical findings relevant to endodontic diagnosis; however, explicit recording of diagnostic conclusions, particularly provisional diagnoses, and documentation of signs and symptoms remain inconsistent. Strengthening educational emphasis on documenting diagnostic reasoning may support preparedness for independent practice
Single‐Use Versus Multiple‐Use Endotracheal Suction Catheters in Mechanically Ventilated Patients: A Feasibility Randomised Controlled Trial
No full textBackgroundIn resource-limited settings, single-use open endotracheal suction catheters are commonly used multiple times. The current evidence of this practice on ventilator-associated pneumonia (VAP) among mechanically ventilated patients remains unclear.AimThe aim of this study was to test the feasibility of single-use and multiple-use endotracheal suction catheters flushed with chlorhexidine versus standard care (multiple-use endotracheal suction catheters flushed with normal saline) to reduce VAP in resource-limited intensive care units (ICUs) and evaluate study methods for designing a future definitive randomised controlled trial (RCT).Study DesignA three-armed feasibility RCT was conducted in three ICUs at a university hospital in Egypt.ResultsSixty mechanically ventilated patients were randomized into three groups: Intervention I group, single-use catheters, Intervention II group, multiple-use catheters flushed with chlorhexidine, and Control group (standard care) multiple-use catheters flushed with normal saline. Data on feasibility parameters, intervention adherence, and patient outcomes were collected. Recruitment and retention rates were high across all groups, with 96.7% (n = 58) of participants completing the 3-day follow-up and 93.3% (n = 56) completing the 6-day follow-up. Adherence to intervention protocols was excellent, with 100% of participants receiving the designed interventions. No adverse events were reported. Chlorhexidine flushing and single-use catheters were practical and successfully implemented. Challenges of budget constraints, supply shortages and the need for staff training were observed. The incidence of VAP was 31.6% in the Intervention I group, 26.3% in the Intervention II group, and 40% in the standard care group. The relative risk of developing VAP compared with the control group was 0.79 (95% CI: 0.51–1.23) for Intervention I and 0.66 (95% CI: 0.42–1.03) for Intervention II.ConclusionsA full-scale RCT comparing single-use and multiple-use catheters with chlorhexidine flushing is feasible in resource-limited ICUs. Further investigation into the effectiveness of interventions on VAP prevention is needed in future definitive RCTs.Relevance to Clinical PracticeThis study highlights the practical implementation of endotracheal suctioning strategies, such as chlorhexidine flushing and single-use suction catheters, to potentially reduce VAP in resource-limited ICUs. These findings can inform clinical decision-making and infection control.Trial Registration: ClinicalTrials.gov, identifier NCT0620751