Health and wellbeing during transition to adulthood for young people with intellectual disabilities: a qualitative study

Background: Transition to adulthood may have negative consequences for health and wellbeing in individuals with intellectual disabilities (ID), but this aspect of transition has received little investigation. This qualitative study aimed to explore the transition experiences of individuals with ID from their own perspectives, and from that of their parents, in order to identify health or wellbeing implications of transition. Method: Semi-structured interviews were conducted with 17 young people with mild, moderate and severe ID aged 16–27 years and with 23 parents of young people with mild, moderate, severe and profound ID aged 16–26 years. Interviews were analysed using thematic analysis, deploying both emic and etic coding categories. Results: This study provides direct insights into the issues on health and wellbeing that young people with ID and their parents find important during transition. The primary health implication of transition centred on mental health and wellbeing; young people experienced heightened anxiety during transition, and themes identified as contributing to anxiety included: a lack of meaningful activity following school exit; inadequate support during transition; and difficulties associated with ‘growing up’. Problem behaviours and obesity were also implicated. Conclusion: The transition from school needs to be better supported in order to ease anxiety for young people during this difficult period

What effect does transition have on health and well-being in young people with intellectual disabilities? A systematic review

Background: Transition to adulthood might be a risk period for poor health in people with intellectual disabilities. However, we could find no synthesis of evidence on health and wellbeing outcomes during transition in this population. This review aimed to answer this question. Method: PRISMA/MOOSE guidelines were followed. Search terms were defined, electronic searches of six databases were conducted, reference lists and key journals were reviewed and grey literature was searched. Papers were selected based on clear inclusion criteria. Data was extracted from the selected papers, and their quality was systematically reviewed. The review was prospectively registered on PROSPERO: CRD42015016905. Results: 15,985 articles were extracted; of these 17 met the inclusion criteria. The results of these articles were mixed but suggested the presence of some health and wellbeing issues in this population during transition to adulthood, including obesity and sexual health issues. Conclusion: This review reveals a gap in the literature on transition and health, and points to the need for future work in this area

Telehealth for expanding the reach of early autism training to parents.

Although there is consensus that parents should be involved in interventions designed for young children with autism spectrum disorder (ASD), parent participation alone does not ensure consistent, generalized gains in children's development. Barriers such as costly intervention, time-intensive sessions, and family life may prevent parents from using the intervention at home. Telehealth integrates communication technologies to provide health-related services at a distance. A 12 one-hour per week parent intervention program was tested using telehealth delivery with nine families with ASD. The goal was to examine its feasibility and acceptance for promoting child learning throughout families' daily play and caretaking interactions at home. Parents became skilled at using teachable moments to promote children's spontaneous language and imitation skills and were pleased with the support and ease of telehealth learning. Preliminary results suggest the potential of technology for helping parents understand and use early intervention practices more often in their daily interactions with children

Systematic review of topical treatments for fungal infections of the skin and nails of the feet

OBJECTIVE: To identify and synthesise the evidence for efficacy and cost effectiveness of topical treatments for superficial fungal infections of the skin and nails of the feet. DESIGN: Systematic review. INTERVENTIONS: Topical treatments for superficial fungal infections. MAIN OUTCOME MEASURES: Cure confirmed by culture and microscopy for skin and by culture for nails in patients with clinically diagnosed fungal infections. RESULTS: Of 126 trials identified in 121 papers, 72 (57.1%) met the inclusion criteria. Placebo controlled trials yielded pooled relative risks of failure to cure skin infections: allylamines (0.30, 95% confidence interval 0.24 to 0.38); azoles (0.54, 0.42 to 0.68); undecenoic acid (0.28, 0.11 to 0.74); and tolnaftate (0.46, 0.17 to 1.22). Although meta-analysis of 11 trials comparing allylamines and azoles showed a relative risk of failure to cure of 0.88 (0.78 to 0.99) in favour of allylamines, there was evidence of language bias. Seven reports in English favoured allylamines (0.79, 0.69 to 0.91), but four reports in foreign languages showed no difference between the two drugs (1.01, 0.90 to 1.13). Neither trial of nail infections showed significant differences between alternative topical treatments. CONCLUSIONS: Allylamines, azoles, and undecenoic acid were efficacious in placebo controlled trials. There are sufficient comparative trials to judge relative efficacy only between allylamines and azoles. Allylamines cure slightly more infections than azoles but are much more expensive than azoles. The most cost effective strategy is first to treat with azoles or undecenoic acid and to use allylamines only if that fails

But in the night we are all the same

The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file.Title from title screen of research.pdf file viewed on (June 28, 2006)Includes bibliographical references.Vita.Thesis (Ph. D.) University of Missouri-Columbia 2004.Dissertations, Academic -- University of Missouri--Columbia -- English.But In the Night We Are All the Same, a critical dystopian novel, explores the creation and perpetuation of power structures, gender identity, and desire. The protagonist, Lemon, is a member of the oppressed class. She lives in a nameless city where she and her peers are kept endlessly alive by "hospital machines," a technology that cures every illness and prolongs life. The ruling group (the Those That) uses mindcontrol technologies known as noodles and stroodles to compel the oppressed class to buy the items they see advertised and to make them perform various violent, sexual and degrading acts for the Those That's amusement. Although the people of the city dislike aspects of their lives, most worship and admire the Those That as much as they fear them. Lemon's partner and love interest Astrix, once a member of the Those That, has had his memory erased and must struggle to find out his identity and to come to terms with who he is once he remembers his past. Lemon and Astrix help each other to resist and to determine their identities. Like other modern dystopian novels, this one focuses on an individual's struggle to resist the society and ends with a hopeful conclusion that shows that a better society can exist in the future. Additionally, this novel uses a female protagonist to illustrate the ways in which a person can be oppressed in both gender-specific and non-gender-specific ways. It also illustrates the power structures that lie beneath social systems, and examines how people's desires can be manipulated into a form of social control

The influence of socio-economic deprivation on mobility, participation and quality of life following major lower extremity amputation in the West of Scotland

Objective: Lower extremity amputation (LEA) is more common in people from lower socio-economic groups. This study examined this further by investigating the influence of socio-economic status on mobility, participation, and quality of life (QoL) after LEA. Methods: Prospective data were gathered for all LEAs performed in one year in one Scottish Health Board, commencing March 2014. A postcode derived Scottish Index of Multiple Deprivation (SIMD) was applied by quintile (SIMD 1 = most deprived). Routine data were collected on the cohort of 171 patients; 101 participants consented and received postal questionnaires on QoL (EQ-5D-5L), participation (Reintegration to Normal Living Index [RNLI]), and mobility (Prosthetic Limb User Survey of Mobility), six (n = 67) and 12 months (n = 50) after LEA. Results: The mean ± SD age of the cohort was 66.2 ± 11.4 years; 75% were male and 53% had diabetes. In total, 67% lived in SIMD 1 and 2 and 11.1% in SIMD 5. Sixty per cent had a transtibial amputation. Mortality was 6% at 30 days 17% at six, and 29% at 12 months. Those in SIMD 1 were significantly younger (62.9 years) than those in SIMD 5 (76.3 years). Significantly more participants with a transfemoral amputation (TFA) lived in SIMD 1 (44%) compared with SIMD 5 (11%) (p = .004). Participation was low (RNLI scores: 6 months = 55.7; 12 months = 56.6) and PLUS M scores suggested mobility was poor overall at six (39.1) and 12 months (38.9). Mean QoL was 0.37 at 6 months and 0.33 at 12 months. Conclusion: Although this study observed more LEAs in those from low socio-economic areas, it is impossible to conclude whether QoL after LEA is truly influenced by socio-economic status. There was an association between the disproportionately high rate of LEAs in SIMD groups 1 and 2 and the high prevalence of smoking, 61% vs. only 21% of those in the least deprived areas (SIMD 3, 4, and 5) being current smokers

Robot-assisted measurement for hydrologic understanding in data sparse regions

This article describes the field application of small, low-cost robots for remote surface data collection and an automated workflow to support water balance computations and hydrologic understanding where water availability data is sparse. Current elevation measurement approaches, such as manual surveying and LiDAR, are costly and infrequent, leading to potential inefficiencies for quantifying the dynamic hydrologic storage capacity of the land surface over large areas. Experiments to evaluate a team of two different robots, including an unmanned aerial vehicle (UAV) and an unmanned surface vehicle (USV), to collect hydrologic surface data utilizing sonar and visual sensors were conducted at three different field sites within the Arkavathy Basin river network located near Bangalore in Karnataka, South India. Visual sensors were used on the UAV to capture high resolution imagery for topographic characterization, and sonar sensors were deployed on the USV to capture bathymetric readings; the data streams were fused in an automated workflow to determine the storage capacity of agricultural reservoirs (also known as “tanks”) at the three field sites. This study suggests: (i) this robot-assisted methodology is low-cost and suitable for novice users, and (ii) storage capacity data collected at previously unmapped locations revealed strong power-type relationships between surface area, stage, and storage volume, which can be incorporated into modeling of landscape-scale hydrology. This methodology is of importance to water researchers and practitioners because it produces local, high-resolution representations of bathymetry and topography and enables water balance computations at small-watershed scales, which offer insight into the present-day dynamics of a strongly human impacted watershed

Human Apolipoprotein B Transgenic Mice Generated with 207- and 145-Kilobase Pair Bacterial Artificial Chromosomes. Evidence that a distant 5'-element confers appropriate transgene expression in the intestine

We reported previously that ~80-kilobase pair (kb) P1 bacteriophage clones spanning either the human or mouse apoB gene (clones p158 and p649, respectively) confer apoB expression in the liver of transgenic mice, but not in the intestine. We hypothesized that the absence of intestinal expression was due to the fact that these clones lacked a distant DNA element controlling intestinal expression. To test this possibility, transgenic mice were generated with 145- and 207-kb bacterial artificial chromosomes (BACs) that contained the human apoB gene and more extensive 5'- and 3'-flanking sequences. RNase protection, in situ hybridization, immunohistochemical, and genetic complementation studies revealed that the BAC transgenic mice manifested appropriate apoB gene expression in both the intestine and the liver, indicating that both BACs contained the distant intestinal element. To determine whether the regulatory element was located 5' or 3' to the apoB gene, transgenic mice were generated by co-microinjecting embryos with p158 and either the 5'- or 3'-sequences from the 145-kb BAC. Analysis of these mice indicated that the apoB gene's intestinal element is located 5' to the structural gene. Cumulatively, the transgenic mouse studies suggest that the intestinal element is located between -33 and -70 kb 5' to the apoB gene

Informal Care and Caregiver's Health

This study aims to measure the causal effect of informal caregiving on the health and health care use of women who are caregivers, using instrumental variables. We use data from South Korea, where daughters and daughters‐in‐law are the prevalent source of caregivers for frail elderly parents and parents‐in‐law. A key insight of our instrumental variable approach is that having a parent‐in‐law with functional limitations increases the probability of providing informal care to that parent‐in‐law, but a parent‐in‐law's functional limitation does not directly affect the daughter‐in‐law's health. We compare results for the daughter‐in‐law and daughter samples to check the assumption of the excludability of the instruments for the daughter sample. Our results show that providing informal care has significant adverse effects along multiple dimensions of health for daughter‐in‐law and daughter caregivers in South Korea. Copyright © 2013 John Wiley & Sons, Ltd.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/110580/1/hec3012.pd

Flat Tire... Alone... No Need for Panic

Glittt - Bang - Plop, Plop, Plop, and now there\u27s you, your car, and a flat tire. Can you fix it yourself