4 results
Pilot study of a ketogenic diet in bipolar disorder
- Nicole Needham, Iain H. Campbell, Helen Grossi, Ivana Kamenska, Benjamin P. Rigby, Sharon A. Simpson, Emma McIntosh, Pankaj Bahuguna, Ben Meadowcroft, Frances Creasy, Maja Mitchell-Grigorjeva, John Norrie, Gerard Thompson, Melissa C. Gibbs, Ailsa McLellan, Cheryl Fisher, Tessa Moses, Karl Burgess, Rachel Brown, Michael J. Thrippleton, Harry Campbell, Daniel J. Smith
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- Journal:
- BJPsych Open / Volume 9 / Issue 6 / November 2023
- Published online by Cambridge University Press:
- 10 October 2023, e176
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Background
Recent evidence from case reports suggests that a ketogenic diet may be effective for bipolar disorder. However, no clinical trials have been conducted to date.
AimsTo assess the recruitment and feasibility of a ketogenic diet intervention in bipolar disorder.
MethodEuthymic individuals with bipolar disorder were recruited to a 6–8 week trial of a modified ketogenic diet, and a range of clinical, economic and functional outcome measures were assessed. Study registration number: ISRCTN61613198.
ResultsOf 27 recruited participants, 26 commenced and 20 completed the modified ketogenic diet for 6–8 weeks. The outcomes data-set was 95% complete for daily ketone measures, 95% complete for daily glucose measures and 95% complete for daily ecological momentary assessment of symptoms during the intervention period. Mean daily blood ketone readings were 1.3 mmol/L (s.d. = 0.77, median = 1.1) during the intervention period, and 91% of all readings indicated ketosis, suggesting a high degree of adherence to the diet. Over 91% of daily blood glucose readings were within normal range, with 9% indicating mild hypoglycaemia. Eleven minor adverse events were recorded, including fatigue, constipation, drowsiness and hunger. One serious adverse event was reported (euglycemic ketoacidosis in a participant taking SGLT2-inhibitor medication).
ConclusionsThe recruitment and retention of euthymic individuals with bipolar disorder to a 6–8 week ketogenic diet intervention was feasible, with high completion rates for outcome measures. The majority of participants reached and maintained ketosis, and adverse events were generally mild and modifiable. A future randomised controlled trial is now warranted.
5 - Innovative Ways of Engaging Young People Whose Voices Are Less Heard
- Edited by Louca-Mai Brady
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- Book:
- Embedding Young People's Participation in Health Services
- Published by:
- Bristol University Press
- Published online:
- 25 February 2021
- Print publication:
- 07 October 2020, pp 131-154
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Summary
Introduction
The Association for Young People's Health (AYPH) is the UK's leading independent voice for youth health. We work to improve the health and wellbeing of 10–24-year-olds by improving understanding of young people's health needs and promoting youth-friendly health services. We do this through influencing policy and practice, producing evidence-based reports and briefings (such as our biennial Key Data on Young People publications), and running projects to test new models of health care delivery for this age group. Involving young people in all our activities is essential for us, and much of our work focuses on ensuring their voices are heard. AYPH has a particular mission to ensure that opportunities to engage in the development of health services are extended to young people who may be more marginalised from the mainstream, and who may find it harder to get their voices heard.
In this chapter we draw on three projects we have undertaken recently, each presenting rather different challenges to participation. The first was a project to get young people's views on acute care, the second related to young people who had been affected by sexual exploitation and the third was on obesity. Each presented different challenges relating to the particular topic of the study and the method of engagement, but there were also common lessons to be learned about how to engage more marginalised young people and how to draw on creative approaches to amplify their voices in ways that do not threaten their need for confidentiality. Two case studies from young people involved in participation projects illustrate some of these issues and their solutions.
Background
Every young person has a right to be heard. For those up to 18 this is enshrined in the UN Convention on the Rights of the Child (United Nations General Assembly, 1989). For those who are young adults the right may not be so clearly articulated in international protocols, but they have as much right as anyone else. This sounds obvious but is not always well articulated. In the UK, young people's participation in political and social dialogue is low (Electoral Commission, 2002; British Youth Council, 2015).
Variants of the scimitar syndrome
- Ilaria Bo, Julene S. Carvalho, Emma Cheasty, Michael Rubens, Michael L. Rigby
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- Journal:
- Cardiology in the Young / Volume 26 / Issue 5 / June 2016
- Published online by Cambridge University Press:
- 16 September 2015, pp. 941-947
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Introduction
The scimitar syndrome comprises hypoplastic right pulmonary artery and lung, anomalous right pulmonary venous drainage to the inferior caval vein, aortopulmonary collateral(s) to the right lung, and bronchial anomalies.
AimThe aim of this study was to describe the morphological and clinical spectrum of variants from the classical scimitar syndrome in a single institution over 22 years.
ResultsIn total, 10 patients were recognised. The most consistent feature was an aortopulmonary collateral to the affected lung (90%), but there was considerable variation in the site and course of pulmonary venous drainage. This was normal in 3 (one with meandering course), anomalous right to superior caval vein in 1, to the superior caval vein and inferior caval vein in 2, and to the superior caval vein and the left atrium in 1; one patient had a right pulmonary (scimitar) vein occluded at the insertion into the inferior caval vein but connected to the right upper pulmonary vein via a fistula. There were two left-sided variants, one with anomalous left drainage to the coronary sinus and a second to the innominate vein.
Among all, three patients had an antenatal diagnosis and seven presented between 11 and 312 months of age; 90% of the patients were symptomatic at first assessment.
All the patients underwent cardiac catheterisation; collateral embolisation was performed in 50% of the patients. Surgical repair of the anomalous vein was carried out in two patients, one patient had a right pneumonectomy, and one patient was lost to follow-up. There was no mortality reported in the remainder of patients during the study period.
ConclusionThe heterogeneity of this small series confirms the consistent occurrence of an anomalous arterial supply to the affected lung but considerable variation in pulmonary venous drainage.
Radio Continuum Surveys with Square Kilometre Array Pathfinders
- Part of
- Ray P. Norris, J. Afonso, D. Bacon, Rainer Beck, Martin Bell, R. J. Beswick, Philip Best, Sanjay Bhatnagar, Annalisa Bonafede, Gianfranco Brunetti, Tamás Budavári, Rossella Cassano, J. J. Condon, Catherine Cress, Arwa Dabbech, I. Feain, Rob Fender, Chiara Ferrari, B. M. Gaensler, G. Giovannini, Marijke Haverkorn, George Heald, Kurt Van der Heyden, A. M. Hopkins, M. Jarvis, Melanie Johnston-Hollitt, Roland Kothes, Huib Van Langevelde, Joseph Lazio, Minnie Y. Mao, Alejo Martínez-Sansigre, David Mary, Kim Mcalpine, E. Middelberg, Eric Murphy, P. Padovani, Zsolt Paragi, I. Prandoni, A. Raccanelli, Emma Rigby, I. G. Roseboom, H. Röttgering, Jose Sabater, Mara Salvato, Anna M. M. Scaife, Richard Schilizzi, N. Seymour, Dan J. B. Smith, Grazia Umana, G.-B. Zhao, Peter-Christian Zinn
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- Journal:
- Publications of the Astronomical Society of Australia / Volume 30 / 2013
- Published online by Cambridge University Press:
- 27 March 2013, e020
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In the lead-up to the Square Kilometre Array (SKA) project, several next-generation radio telescopes and upgrades are already being built around the world. These include APERTIF (The Netherlands), ASKAP (Australia), e-MERLIN (UK), VLA (USA), e-EVN (based in Europe), LOFAR (The Netherlands), MeerKAT (South Africa), and the Murchison Widefield Array. Each of these new instruments has different strengths, and coordination of surveys between them can help maximise the science from each of them. A radio continuum survey is being planned on each of them with the primary science objective of understanding the formation and evolution of galaxies over cosmic time, and the cosmological parameters and large-scale structures which drive it. In pursuit of this objective, the different teams are developing a variety of new techniques, and refining existing ones. To achieve these exciting scientific goals, many technical challenges must be addressed by the survey instruments. Given the limited resources of the global radio-astronomical community, it is essential that we pool our skills and knowledge. We do not have sufficient resources to enjoy the luxury of re-inventing wheels. We face significant challenges in calibration, imaging, source extraction and measurement, classification and cross-identification, redshift determination, stacking, and data-intensive research. As these instruments extend the observational parameters, we will face further unexpected challenges in calibration, imaging, and interpretation. If we are to realise the full scientific potential of these expensive instruments, it is essential that we devote enough resources and careful study to understanding the instrumental effects and how they will affect the data. We have established an SKA Radio Continuum Survey working group, whose prime role is to maximise science from these instruments by ensuring we share resources and expertise across the projects. Here we describe these projects, their science goals, and the technical challenges which are being addressed to maximise the science return.