Great Yarmouth College

IntroductionAntipsychotic use for adolescents (defined here as under 25 year olds) must be done with caution, giving due thought to advantages and potential side effects. Antipsychotics are extremely useful and effective drugs, but have side effects and many of these are problematic.It has been noted that Risperidone is often used for this age group, despite the UK guidance being cautious about its use.ObjectivesTo assess the extent of Risperidone prescribing in Norfolk/Suffolk for this patient group and to consider the monitoring of this.Given that bone mass density is set down in teens – mid 20’s, this is a particularly concerning issue when given to this age group. Additionally, distressing side effects and issues with fertility shoudl be considered. If risperidone is used, Maudsley is very clear that this must be monitored: baseline/annual prolactin levels done, and action should be taken if these are elevated and/or the patient symptomatic.Methods1)Evaluate numbers of adolescents, under 2ndry care Mental health service who have been prescribed Risperidone2)Consider who prescibed it and the indication3)to consider if routine monitoring had been completed (specifically, baseline prolactin and then annual prolactin levels)4)to consider if these patients had developed side effectsResultsAlmost 20% of 18-25 years olds, due to be seen in Youth Community Service had been prescribed Risperidone. Of these, only 44% had had prolactin levels done, despite the guidance. This equates to the over half not having prolactin checked. 60% of patients reveiwed had symptoms of hyperprolactinemia. Indications for use included emotional dysregulation/EUPD, psychosis, ADHD, OCD/ASD and depressionConclusions Risperidone should be used with extreme caution in this patient group. Medication can be very useful for some young people experiencing distressing symptoms but, as Hippocrates advises, “do no harm” and seek not to cause iatrogenic harm. Given that many of the young people seen by mental health services are experiencing emotional dysregulation (not necessarily an abnormal state in adolescent, when much is in flux), it is tempting to consider medication as one means of trying to alleviate distress. There is no clear treatment for dysregulated feelings, and most would accept that psychological support is more appropriate.Disclosure of InterestNone Declared

Background/Aims Physiotherapists generally have a positive view of research, but have identified a number of barriers to taking part, and have expressed challenges when attempting to integrate research findings into their practice. The aim of this study was to describe the self-reported impact of collecting data for a multicentre research study on physiotherapists' clinical practice. Methods Convenience sampling was used to select three of 11 NHS trusts involved in the original data collection. A questionnaire was emailed to the 28 of 34 physiotherapists working within these three Trusts who collected data and for whom contact details were available. Results A total of 21 (75%) physiotherapists completed the questionnaire. Out of the 21 physiotherapists, 15 stated they were aware of the study results; all of whom reported subsequent changes in their beliefs about prognostic factors for shoulder pain (subject of the original study) and some alteration in clinical practice. However, barriers to integrating further changes into practice were reported, including lack of time and a perception that patients would not engage with a more (bio)psychosocial approach. Overall, 85% of responders stated data collection had changed their understanding of the research process. Conclusions Clinicians' participation in the research process positively influenced practice. However, 29% were unaware of the results and only 33% of physiotherapists accessed the published article. There were perceived barriers to integrating results into practice.

Malignant mesothelioma typically presents with slowly progressive dyspnea and chest pain. Extra-thoracic symptoms and paraneoplastic presentations are very rare. The association of this malignancy with glomerular disorders has been only rarely reported in the literature. The present report describes the case of a 65-year-old man with a remote occupational exposure to asbestos more than 26 years prior who presented with a month's history of slowly progressive visual loss, minimal weight loss, and pedal edema. Assessments by several ophthalmologists concluded that he had developed non-arteritic ischemic optic neuropathy. Further nephrological work-up demonstrated that he had developed nephrotic syndrome due to minimal change disease, which was confirmed with a renal biopsy. His clinical symptoms rapidly improved with steroid treatment. The nephrotic syndrome went into clinical remission, his progressive visual loss improved, and there was no further weight loss. The initial chest X-ray performed when he first presented was reported as showing only chronic changes. He reported the symptoms of shortness of breath and chest pain 8 months later and was found to have a large right pleural effusion. Further investigation revealed pleural mesothelioma.

Sharing personal experience in narrative is challenging for individuals with intellectual disabilities. The aim was to investigate the potential of Storysharing® (Storysharing is an innovative communication method based on personal narrative, which has been developed to support conversations with people who have severe difficulties in communication) intervention. The study involved eleven pupil-educational supporter dyads at a special school. Storysharing® was implemented over a 15-week period. Personal narratives were captured on video pre- and post-intervention. The data were analysed for discourse and narrative. Significant differences revealed a decline in 'query-answer' sequences and an increase in supporter use of 'prompts'. After intervention, there were fewer story episodes. Narrative structure showed gains in action sequences leading to climax, and in closing elements, indicating a more complete narrative. The Storysharing® intervention appears to be associated with changes to the dyadic, personal narratives illustrating its potential.

Deafness Research UK is a national charity working to overcome the challenges of preventing, diagnosing and treating deafness and other hearing impairments. It is funded by voluntary donations and has invested more than £10 million in research. The charity was established by the Labour peer Jack Ashley and his late wife Pauline. Lord Ashley lost his hearing in 1968, continuing to serve as an MP until 1992.

Abstract A range of factors was established, such as knowledge and ethics, which underlay the practice of six groups of health professionals: pharmacists, dentists, doctors, nurses, optometrists and radiographers. These factors have been identified as “concepts”. The method used was content analysis of official documents of the professions, such as codes of ethics and guidance documents. Postal questionnaires were also used to collect data. Nine principal concepts were identified. A “collective professional consciousness” was evident, in which knowledge, patient welfare and ethics were important concepts for the highest quality of practice. The perceived importance of these and other concepts was broadly similar across the professions.

Reach for the stars is a child friendly book enabling the reader to have a basic understanding of what it is like to receive growth hormone treatment from the perspective of both the child and parents. The book includes five short stories written by children who are currently undergoing growth hormone therapy. There is discussion in relation to the anxieties children may experience prior to treatment and how these anxieties become reduced during time. The parent’s perspective within each short story is also given.

The Sleep Well, Live Well website is a useful resource that brings together information related to the benefits of a good night's sleep and the pitfalls of a bad night.

06:30 I am woken by the alarm. Put on the kettle and have a shower