Adults with intellectual disabilities: prevalence, incidence and remission of aggressive behaviour and related factors

<b>Introduction:</b> Aggressive behaviours can be disabling for adults with intellectual disabilities (ID), with negative consequences for the adult, their family and paid carers. It is surprising how little research has been conducted into the epidemiology of these needs, given the impact they can have. This study investigates point prevalence, 2-year incidence and 2-year remission rates for aggressive behaviour (physically aggressive, destructive and verbally aggressive), and it investigates which factors are independently associated with aggressive behaviour. <b>Methods:</b> All adults with ID – within a geographically defined area of Scotland, UK – were recruited to a longitudinal cohort. At baseline, assessments were undertaken of demography, lifestyle, supports, development, problem behaviours, disabilities and physical and mental health. These were repeated for a 2-year period. <b>Results:</b> At baseline, the participation rate was 1023 (65.5%). After 2 years, the cohort retention was 651 adults. The point prevalence of Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation (DC-LD) aggressive behaviour was 9.8% (95% confidence interval = 8.0–11.8%), 2-year incidence was 1.8%, and 2-year remission rate from all types of aggressive behaviour meeting DC-LD criteria was 27.7%. The factors independently associated with aggressive behaviours were lower ability, female gender, not living with a family carer, not having Down syndrome, having attention-deficit hyperactivity disorder and having urinary incontinence. Incidence of aggressive behaviour meeting DC-LD criteria in adult life is similar to that for each of psychotic, anxiety and organic disorders. <b>Conclusions:</b> Aggressive behaviour is common among adults with ID, but contrary to previous suggestions, more than a quarter remit within the short to medium term. This is important knowledge for professionals as well as the person and her/his family and paid carers. There is much yet to learn about the mechanisms underpinning aetiology and maintenance of aggressive behaviour in this population, and exploratory epidemiological investigations such as this have a role to play in progressing research towards further hypothesis testing and trials to influence clinical practice, service development and policy

Hendra Virus Infection Dynamics in Australian Fruit Bats

Hendra virus is a recently emerged zoonotic agent in Australia. Since first described in 1994, the virus has spilled from its wildlife reservoir (pteropid fruit bats, or ‘flying foxes’) on multiple occasions causing equine and human fatalities. We undertook a three-year longitudinal study to detect virus in the urine of free-living flying foxes (a putative route of excretion) to investigate Hendra virus infection dynamics. Pooled urine samples collected off plastic sheets placed beneath roosting flying foxes were screened for Hendra virus genome by quantitative RT-PCR, using a set of primers and probe derived from the matrix protein gene. A total of 1672 pooled urine samples from 67 sampling events was collected and tested between 1 July 2008 and 30 June 2011, with 25% of sampling events and 2.5% of urine samples yielding detections. The proportion of positive samples was statistically associated with year and location. The findings indicate that Hendra virus excretion occurs periodically rather than continuously, and in geographically disparate flying fox populations in the state of Queensland. The lack of any detection in the Northern Territory suggests prevalence may vary across the range of flying foxes in Australia. Finally, our findings suggest that flying foxes can excrete virus at any time of year, and that the apparent seasonal clustering of Hendra virus incidents in horses and associated humans (70% have occurred June to October) reflects factors other than the presence of virus. Identification of these factors will strengthen risk minimization strategies for horses and ultimately humans

Prevalence of challenging behaviour in adults with intellectual disabilities, correlates, and association with mental health

Purpose of Review To summarise findings about the prevalence and correlates of challenging behaviour in adults with intellectual disabilities from robust research. We also describe findings on the interplay between challenging behaviour and mental health. Recent Findings Recent studies that have utilised psychometrically evaluated tools, with clear operational definitions, show similar findings on the prevalence of challenging behaviour of about 1 in every 5–6 adults known to services. We describe common correlates identified such as communication impairments, severity of intellectual disability, and living in institutional settings or congregate care. We also describe the complex and multifaceted relationship between challenging behaviour and mental health. Summary Based on recent studies, we propose a revised framework model to help understand challenging behaviour. We propose a number of areas where more research is required, particularly the development of risk tools clinicians can utilise in practice

The prevalence and incidence of mental ill-health in adults with autism and intellectual disabilities

The prevalence, and incidence, of mental ill-health in adults with intellectual disabilities and autism were compared with the whole population with intellectual disabilities, and with controls, matched individually for age, gender, ability-level, and Down syndrome. Although the adults with autism had a higher point prevalence of problem behaviours compared with the whole adult population with intellectual disabilities, compared with individually matched controls there was no difference in prevalence, or incidence of either problem behaviours or other mental ill-health. Adults with autism who had problem behaviours were less likely to recover over a two-year period than were their matched controls. Apparent differences in rates of mental ill-health are accounted for by factors other than autism, including Down syndrome and ability level

Ой дзеўкі беда

Ой дзеўкі беда, / Куды тут дзівацца. / Па калена барада, / Лезець цалавацца

qRT-PCR summary statistics on biological samples collected from the three surveyed Australian <i>Pteropus</i> species.

<p>¹Packed haemocytes</p><p>qRT-PCR summary statistics on biological samples collected from the three surveyed Australian <i>Pteropus</i> species.</p

Details of 2840 flying-foxes captured and sampled in the eastern Australian states of Queensland (QLD) and New South Wales (NSW) between February 2012 and June 2014.

<p>¹BFF = Black flying-fox (<i>Pteropus alecto</i>); GHFF = Grey-headed flying-fox (<i>P</i>. <i>poliocephalus</i>); LRFF = Little red flying-fox (<i>P</i>. <i>scapulatus</i>).</p><p>² Roosts shared with a structured longitudinal study investigating HeV infection and transmission dynamics in flying-foxes (reported elsewhere); site selection changed after first bi-monthly sampling event from Toowoomba to Boonah.</p><p>³ Roosts shared with a cross-sectional study series investigating the association between flying-fox roost disturbance and HeV infection dynamics [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0140670#pone.0140670.ref025" target="_blank">25</a>].</p><p>Details of 2840 flying-foxes captured and sampled in the eastern Australian states of Queensland (QLD) and New South Wales (NSW) between February 2012 and June 2014.</p

qRT-PCR Ct results on biological samples, and physiological characteristics of 42 HeV-positive Black flying-foxes (<i>P</i>. <i>alecto</i>)¹.

<p>¹All 42 HeV-positive flying-foxes in the study were Black flying-foxes (<i>P</i>. <i>alecto</i>) caught at the Boonah roost.</p><p>²M = Male; F = Female: A = Adult; SA = Sub adult; J = Juvenile: G = Gestation; L = Lactation; P = Pup attached: Urogenital = vulvovaginal swab in females and preputial swab in males; PHemo = Packed haemocytes.</p><p>qRT-PCR Ct results on biological samples, and physiological characteristics of 42 HeV-positive Black flying-foxes (<i>P</i>. <i>alecto</i>)<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0140670#t003fn001" target="_blank">¹</a>.</p