Glasgow Psychosis Screening tool for use in adults with Intellectual Disabilities (GPS-ID): development and psychometric properties

Background: Prevalence of psychosis is known to be higher in adults with intellectual disabilities (ID) than in the general adult population. However, there have been no attempts to develop a psychosis screening tool specifically for the adult ID population. The present study describes the development and preliminary evaluation of a new measure, the Glasgow Psychosis Screening tool for use in Adults with Intellectual Disabilities (GPS-ID). Method: An item pool was generated following: 1) focus groups with adults with ID and psychosis, and their carers and/or workers; 2) expert input from clinicians. A draft scale was compiled and refined following expert feedback. The new scale, along with the Psychotic Symptom Rating Scales was administered to 20 adults with ID (10 with and 10 without psychosis) and their relative or carers. Results: The GPS-ID total score, self-report subscale and informant rating-subscale differentiated psychosis and non-psychosis groups. The tool had good internal consistency (Cronbach’s α=0.91), and a cut-off score ≥4 yielded high sensitivity (90%) and specificity (100%). The method of tool development supports face and content validity. Criterion validity was not supported. Conclusions: Preliminary investigation of the tool’s psychometric properties is positive, although further investigation is required. The tool is accessible to adults with mild to moderate ID and can be completed in 15-30 minutes. The GPS-ID is not a diagnostic tool, therefore any adult exceeding the cut-off score of ≥4 should receive further assessment

Prospective study of the mental ill-health of adults with intellectual disabilities: outcomes and predictive determinants

Background: The prevalence of mental ill-health and problem behaviour within the intellectually disabled population is reported to range from 30 to 50%. However, the longer term outcomes of mental ill-health and problem behaviour, such as persistence, new onset, remission and resilience, are unknown. Accordingly, the factors predictive of such outcomes are also unknown. Aims: To determine the long term outcomes of mental ill-health and problem behaviour, and the factors predictive of and associated with such outcomes, over a 10 year time-period in a cohort of adults with mild to profound intellectual disabilities. Method: A population-based cohort of adults with intellectual disabilities (n=100) was investigated at three time points over a 10 year period. Data were collected using a range of measures. Descriptive statistics were derived and regression analyses performed to determine factors predictive of outcomes. Results: The rate of psychopathology was found to have increased in the cohort over the 10 year period. Factors predictive of this increase were experiencing an angry interaction and trusting to share a secret with only one person, or anyone. The majority of the cohort experienced episodic mental ill-health, with relapse being predicted by being female and experiencing life events. New onset of mental ill-health was predicted by experiencing life events, and resilience was predicted by not experiencing life events and having urinary continence. Problem behaviours were persistent in 50%, with 50% remitting. New onset of problem behaviours was predicted by not experiencing life events, and resilience was predicted by having mild intellectual disabilities, not experiencing an angry interaction and having more than one close friend. Small but significant negative correlations were found between psychopathology and participation in social, leisure, and peer activities. Findings should be interpreted with caution due to the small sample size. Conclusions: The present study is the only existing longitudinal investigation following an adult cohort with mild to profound intellectual disabilities, at several time points over a 10 year period. Therefore, future research is needed to confirm findings. Given the increase in psychopathology, more effective monitoring, treatment and intervention is needed

Money Stories: Financial resilience among Aboriginal and Torres Strait Islander Australians

This report builds on previous work on financial resilience in Australia and represents the beginning of an exploration of the financial resilience of Aboriginal and Torres Strait Islander peoples. Overall, we found significant economic disparity between Indigenous and non-Indigenous Australians. This is not surprising, given the histories of land dispossession, stolen wages and the late entry of Indigenous Australians into free participation in the economy (it is only 50 years since the referendum to include Aboriginal and Torres Strait Islander peoples as members of the Australian population)

Generation and <i>ex vivo</i> culture of murine and human pancreatic ductal adenocarcinoma tissue slice explants

Traditional 2D/3D co-culture models typically do not reflect the cellular heterogeneity of pancreatic ductal adenocarcinoma (PDAC) tumors, while in vivo models can be slow and ill-suited to mechanistic investigations. Here, we present a protocol for culturing murine PDAC explants and a corresponding human PDAC model using tissue slice explants. We describe steps for sponge production, preparation of media and materials, tissue collection, and sectioning. We then detail procedures for explant plating, daily culture, and collection of samples

Developing a pressure ulcer risk factor minimum data set and risk assessment framework

AIM: To agree a draft pressure ulcer risk factor Minimum Data Set to underpin the development of a new evidenced-based Risk Assessment Framework.BACKGROUND: A recent systematic review identified the need for a pressure ulcer risk factor Minimum Data Set and development and validation of an evidenced-based pressure ulcer Risk Assessment Framework. This was undertaken through the Pressure UlceR Programme Of reSEarch (RP-PG-0407-10056), funded by the National Institute for Health Research and incorporates five phases. This article reports phase two, a consensus study.DESIGN: Consensus study.METHOD: A modified nominal group technique based on the Research and Development/University of California at Los Angeles appropriateness method. This incorporated an expert group, review of the evidence and the views of a Patient and Public Involvement service user group. Data were collected December 2010-December 2011.FINDINGS: The risk factors and assessment items of the Minimum Data Set (including immobility, pressure ulcer and skin status, perfusion, diabetes, skin moisture, sensory perception and nutrition) were agreed. In addition, a draft Risk Assessment Framework incorporating all Minimum Data Set items was developed, comprising a two stage assessment process (screening and detailed full assessment) and decision pathways.CONCLUSION: The draft Risk Assessment Framework will undergo further design and pre-testing with clinical nurses to assess and improve its usability. It will then be evaluated in clinical practice to assess its validity and reliability. The Minimum Data Set could be used in future for large scale risk factor studies informing refinement of the Risk Assessment Framework

Fine-mapping identifies multiple prostate cancer risk loci at 5p15, one of which associates with TERT expression

Associations between single nucleotide polymorphisms (SNPs) at 5p15 and multiple cancer types have been reported. We have previously shown evidence for a strong association between prostate cancer (PrCa) risk and rs2242652 at 5p15, intronic in the telomerase reverse transcriptase (TERT) gene that encodes TERT. To comprehensively evaluate the association between genetic variation across this region and PrCa, we performed a fine-mapping analysis by genotyping 134 SNPs using a custom Illumina iSelect array or Sequenom MassArray iPlex, followed by imputation of 1094 SNPs in 22 301 PrCa cases and 22 320 controls in The PRACTICAL consortium. Multiple stepwise logistic regression analysis identified four signals in the promoter or intronic regions of TERT that independently associated with PrCa risk. Gene expression analysis of normal prostate tissue showed evidence that SNPs within one of these regions also associated with TERT expression, providing a potential mechanism for predisposition to disease

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Evaluating passive physiological data collection during Spravato treatment

Spravato and other drugs with consciousness-altering effects show significant promise for treating various mental health disorders. However, the effects of these treatments necessitate a substantial degree of patient monitoring which can be burdensome to healthcare providers and may make these treatments less accessible for prospective patients. Continuous passive monitoring via digital devices may be useful in reducing this burden. This proof-of-concept study tested the MindMed Session Monitoring System™ (MSMS™), a continuous passive monitoring system intended for use during treatment sessions involving pharmaceutical products with consciousness-altering effects. Participants completed 129 Spravato sessions with MSMS at an outpatient psychiatry clinic specializing in Spravato treatment. Results indicated high rates of data quality and self-reported usability among participants and health care providers (HCPs). These findings demonstrate the potential for systems such as MSMS to be used in consciousness-altering treatment sessions to assist with patient monitoring