Fluoridation policy and practice: a European story separating myths from reality.

Background. Controversy surrounding the addition of fluoride to water has prevailed in public discourse for the past ~ 20 years but recently an anti-fluoride stance has been gaining more traction in the Republic of Ireland undoubtedly assisted by social media with an ever increasing number of local authorities voting to ban the practice of adding fluoride to the water supply. No previous research has examined fluoridation policy and practices across the EU. The aim of this review was to examine water fluoridation policy and practices across the EU to explore how they had come about and what they are based on. Methods. The Office’s with responsibility for fluoridation policy in all 28 EU members were contacted, seeking information on fluoridation policy and practice. Responses were then grouped into common categories by country. Results. Ireland and the UK are the only EU member states currently adding fluoride to water at a whole population level. Some regions in Spain are also fluoridated. None of the other 25 member states had a specific policy on fluoridation and none add fluoride to water currently, although some had in the past. Some policy makers said fluoride was not added because of naturally high levels arising from volcanic regions, presence in other foodstuffs or alternative sources such as tablets and toothpaste were advised. No policy maker contacted could cite evidence of harm except at exceptionally high doses. The rationale for not adding/discontinuing fluoridation of water was cited by some as resistance from anti-fluoride lobby groups, concerns about mass medication, concerns about it being unethical and unecological. Discussion. it appears that countries across Europe discontinued the practice of water fluoridation for a variety of reasons but none of them were due to evidence of harmful or adverse effects. Conclusion. There is no evidence that any country ceased adding fluoride because of evidence of harm. Politicians/elected representatives should act on evidence before advocating for the removal of fluoride from community water schemes which could have potentially serious personal and economic consequences particularly for disadvantaged children

Living with Autism as a university student at Dublin City University: developing an Autism friendly university.

Background: Autism is a developmental disability that affects how one relates to, and communicates with other people. A number of definitions for autism exist but there is general agreement that the following characteristics are common amongst those on this spectrum - difficulties with communication, socialising, repetitive behaviours and a heightened sensory perception. Last year, Dublin City University (DCU) announced it’s intention to make the University more autism friendly https://www4.dcu.ie/news/2016/jan/s0116j.shtml The project reported on here marks the end of an 18-month programme to create an environment within DCU that allows students with Autism to take part more fully in college life and also to enhance their opportunity to gain employment after their studies are completed. Researchers at the School of Nursing and Human Sciences at DCU, in collaboration with AsIAm https://asiam.ie/ undertook a multi-arm study that explored the experiences of those living with Autism as a DCU student. Aims and Methods: The study aimed to identify and explore current services for DCU students with Autism, to explore their adequacy and to identify any gaps that could be addressed to improve life on campus. A whole campus approach to the study was taken, involving students, academics and support staff from across the multi-site university. By reviewing what is currently known about the challenges faced by students with Autism in higher education and by identifying the specific concerns/difficulties of DCU students with Autism, the research team set out to make a series of recommendations to the University to further meet the needs of students while on campus. In making these recommendations, it is hoped that they will, in turn, lead to an improved college experience for DCU students with Autism. As an integral part of this project, a literature review of peer reviewed studies was undertaken to explore what other Higher Education Institutes (HEIs) have been doing in this space. A comprehensive search and review of HEI websites across Europe and the United States of America was also undertaken. Both of these reviews then informed the methods and materials for four separate, but linked, studies described below. Study 1. An online anonymous survey was administered, via the Qualtrics software platform, to DCU students with Autism who have attended DCU for at least one semester. This survey was advertised to students through the DCU Disability & Learning Support Service (DLSS) but was also advertised via a call for participants issued by the Principal Investigator to the general student mailing list as we wanted it to be accessible to all students with Autism, including those who have not disclosed their diagnosis to the DLSS. The purpose of the survey was to explore the experiences of students with Autism attending DCU, to examine what services and parts of the university experience were and were not working well for them and to explore how these might be improved. Forty-five students with Autism began the online anonymous survey, but just 17 completed all aspects of it. Study 2. An online anonymous survey of the entire student body in DCU was administered, via Qualtrics, to explore the attitudes of the general student body to their peers with Autism and also to examine their levels of knowledge about Autism. This survey took the format of a short vignette and a range of questions about the vignette character (who has Autism). Participants in the study were asked to read a short vignette and to respond to a series of eight statements about the central character, using a 5-point Likert scale, where responses ranged from Strongly Disagree to Strongly Agree. In total, 227 students completed the general student body survey. Study 3. Focus groups and semi-structured interviews were conducted with academic and support staff of the University to explore the services and supports currently available on campus for students with Autism, to examine the issues arising for staff in engaging with students with Autism and to explore how they could be supported to engage more effectively with this student group. One focus group was conducted with academic staff (n=9) representing Chemical Sciences, Mathematical Sciences, Physical Sciences, the Institute of Education, Nursing and Human Sciences, Biotechnology, Engineering, Computing and Special Education. Another focus group was conducted with staff (n=4) from the DLSS, Student Services, Accommodation Services and INTRA Services. To augment these focus groups, five one-to-one interviews were conducted with staff from the DLSS, the Centre for Talented Youth in Ireland (CTYI), the Library and the Catering services. A further one-to-one interview was also conducted with a member of the Student’s Union team. Study 4. A sensory audit of both the DCU Glasnevin and DCU St. Patrick’s Campus was conducted by four students with Autism accompanied by two members of the research team to explore the issues that might arise for students in navigating the physical environment. An audit tool was developed and used and photographic records were taken. The goal of this audit was to look at the physical environment primarily from the perspective of noise, smells, lighting and signage. Key Findings: Literature review/HEI websites scoping exercise: The literature review revealed that there are pockets of activity in relation to creating an Autism friendly environment within many HEIs in the USA and the UK. Within the Irish context, there is evidence that HEIs are now placing a greater emphasis on ensuring that students with Autism are catered for in terms of general and specific student support services. Importantly, there is an increased recognition that students with Autism might need and benefit from supports that extend beyond and complement the support services that are typically provided to all students. Study 1: Survey of Students with Autism The majority of students with Autism felt that they had the academic skills to attend DCU, but only around half of the sample felt that they had the social skills needed to succeed at University. Many reported that they feel stigmatised by their diagnosis of Autism and are reluctant to disclose it, even to the DLSS. In total, 54% of students had not disclosed their diagnosis to the DLSS and even fewer (27%) had disclosed their diagnosis to academic staff. Because of this reluctance to disclose, many had not linked in with the DLSS, which could have provided valuable resources and supports. The reported reasons for non-disclosure included stigma, fear of discrimination, embarrassment, shame and adverse experiences in the past when having disclosed to somebody. Half of those surveyed reported that they felt lonely in DCU and that they do not cope effectively with stress or anxiety. A majority of students reported that they feel isolated or generally depressed and reported that they eat alone in the cafeteria or preferred to spend spare time alone in quiet places on campus. The majority indicated that they have considered dropping out. Most commonly cited difficulties related to socialising were - difficulties in talking to people, not knowing what to expect, difficulties in meeting people with similar interests and difficulties in being part of a group. As reported, heightened sensory awareness of noise, bustling environment, smells and lighting often exacerbates the isolation, with the restaurants, student bars, events etc being reported as too noisy. While some students felt that there was little else that DCU could do to support them in their social experience, other students had clear ideas about what they would need to improve their opportunities for socialising on campus. Among the suggestions made was the education of class representatives regarding the problems faced by students with Autism socially, reduction in the academic workload, and the setting up of a society specifically for students with Autism. Another suggestion was the hosting of smaller events and workshops by the Student’s Union. The majority of the students reported that they did not find group work easy and just over half the sample felt they did not have a good routine established around their study and assignments. Just over half of the students indicated that it was not easy to ask questions and seek guidance from lecturers, and just over one third reported that it was not easy to get support and information from the DCU support services. The majority of the students reported that they found attending lectures stressful and almost one in three reported that it is not easy to keep up with lectures. Over half the sample indicated that they did not manage their time effectively. Around half the sample did not find academic or support staff knowledgeable about Autism and many felt that academic staff are often unaware of students with Autism in their lecture theatre or are unsure of how to engage with them. The majority (65%) of students indicated that the range of supports available at DCU were adequate to meet their needs while 35% said they were not adequate. When asked what else would support them, some felt that the university did enough already but others made concrete suggestions about what they considered would be beneficial. Among the suggestons for improvements made were the creation of a society for students with Autism, to help them make friends and socialise and have a more involved role in DCU extra-curricular life, greater involvement with the disability office, more information, conversations and awareness of the needs of persons with Autism on campus, tackling the sensory issues on campus that impact negatively on students with autism, more overt offers of support (without having to go looking for them), support with exams, assignments, planning and organisation, quiet spaces to sit and eat at break times - as the canteens can be daunting and noisy and lead to social isolation at break times - as well as more information on the supports available. Other suggestions included - the provision of guidelines to staff around students with Autism, greater range of teaching and learning methods, greater variety of assessments, better spread of workload across the semester and greater flexibility with re-sit opportunities. Additional suggestions for improvements related to addressing over-crowding and noise in lectures and laboratories, reducing time pressure in labs, increased the number of posts on Loop (DCU's Virtual Learning Environment (VLE)), and better explanations of assignments. The role of the Student’s Union, student ambassadors, class representatives and Clubs and Societies was highlighted as a means to increasing awareness, promoting inclusion and improving life on campus for students with Autism Just over a third of final year students felt that they get enough support in preparing their Curriculum Vitae in preparation for employment and around one fifth of students felt they were adequately supported from the careers service to transition to employment. When asked what they liked about DCU, students identified the campus and its location, the fact that the DCU community was friendly and accepting, the friendliness of the DLSS office, the number of Clubs and Societies, very good lectures, the library, the Student’s Union, fellow students and the campus accommodation. Greatest needs identified • A Society for students with Autism, which can be attended with friends and allies. • Sensory issues on campus should be addressed. • Quite spaces to be provided. • Quite times at busy events such as Orientation, signing up for Clubs and Societies etc. • More visible information should be available on the DCU website for students with difficulties. • Reduce stigma - make DCU a campus where students feel they can reveal their diagnosis without fear or any adverse effects. • Specific autism training for staff across all sectors of campus, appropriate to their level of engagement with students. • Better communication across the different offices. • Improve signage, ensuring that it is clear, un-ambiguous and at the correct level (eye level). • Library - support in filtering information. • Catering - pre-orientation visit/tour and introduction of a prepay card system in order to avoid queuing. Study 2: Student-body Survey Whilst it is recognised that the survey may not have captured fully respondents’ views, attitudes and beliefs, student responses to the series of questions related to the short vignette about an individual with Autism generally reflected positive rather than negative attitudes and beliefs about their peers with Autism. Study 3: Focus groups and semi-structured interviews with academic and support staff There was a clear openness among participants in all focus groups and interviews to the concept of DCU becoming an Autism Friendly Campus. Participants were keen to support students with Autism and they offered a range of suggestions about how this could be approached in a way that would utilise existing forums and structures to embed the necessary principles and practices into a busy, growing university. Lack of knowledge about Autism and the tools and techniques to provide appropriate support to students with Autism were an issue for staff. While participants’ professional and personal knowledge and experience varied widely, there was a clear willingness to engage with others to address this knowledge gap. The student’s right to non-disclosure was acknowledged but focus groep and interview participants identified that students who do not disclose may miss out on benefits that those who disclose receive. It was acknowledged that stigma is still an issue. Resources are also an issue within classes and labs. Improved or shared communications between the various university offices, with appropriate staff, along with a clear referral pathway to the DLSS was identified as a potential means to provide solutions to many of the difficulties currently experienced. Greater awareness across all services and offices in the University, in addition to sharing of expertise from the CTYI (eg. Prepay and Buddy systems) were identified as potentially useful. Staff training was highlighted as a gap - guidance, information and Autism specific training on how to better support students with Autism was identified as needed. This could, for example, take the format of videos or presentations at staff meetings. An increased role for the DCU Office of Student Life, which includes the Student’s Union, Clubs and Societies, student ambassadors and class representatives was identified as a potential route to explore. An expanded role of and increased visibility of DLSS was also identified as potentiallly important as was timing of information to all students. Among the suggestions made was provision of information at orientation by the President, which may improve reach but also work to reduce the stigma associated with Autism. Provision of quiet times at typically busy events and provision of quite spaces were also identified as very important. Furthermore, it was suggested that parental involvement should be considered where a student agrees or requests this. The notion of a designated autism service in the University was also put forward as this would demonstrate that the University is serious about the term “Autism Friendly Campus”. Study 4: Sensory Audit From the sensory audit, it was apparent that some aspects of the physical environment on campus was working well for the students who took part in the audit while other aspects could be a source of potential difficulty, particularly for those with heightened sensory awareness to smells (e.g. cooking smells and cigarette smoke), bright colours (e.g. red on walls), fluorescent lighting and noise (e.g. a bustling noisy space, such as the restaurants at peak times). Queuing systems in on campus eateries created significant difficulties for some of the participants of the audit. Other less obvious things such as hard seating surfaces, dimly lit spaces, noise from photocopiers in the library and unused or stacked cluttered furniture in classrooms were all identified as making life more difficult for these students. Other aspects of the campus environment that could potentially cause difficulties included missing, busy or ambiguous signage or signage not at eye level. A low humming noise from a projector left on in one of the lecture theatres was also highlighted as a potential sensory irritant as it could be detected by some as a high-pitched sound. Conclusion This whole campus project provides important information about the experiences of third level students with Autism. Whilst DCU is already providing a wide variety of supports to students with Autism, we have, through this project, identified that additional supports (policy, practice and practical) would help enhance the experiences of students with Autism and would help empower these students to flourish socially and academically. This will, we believe, be particularly important as more students with Autism transition from secondary education to third level in the future. In conclusion, based on the findings from the separate but linked aspects of this project, it is apparent that there are many things that DCU is currently doing well in terms of meeting the needs of students with Autism. There are, however, many students with Autism who are struggling with the everyday navigation of academic and social life and there is much we could do to support them further. In this research, we have, in line with internation literature, identified that the needs of students with Autism are not fully being met with the traditional services offered by Disability and Learning Support units and that additional Autism-specific supports should be put in place to complement the standard services offered. Additional support services to benefit students with Autism should include complementary academic and social supports as well as supports in the realm of communication, information processing, life skills, navigation of the physical campus and securing internships and employment. These student-centered supports should be augmented by increated Autism-specific training and awareness elements amongst academic and support staff across the whole campus. Arising out of this project, we outline a series of principles that are grounded in the findings of this research and we have now begun the process of translating these principals into DCU-specific actions that will be implemented within a three-year timeframe. To achieve this, we have begun the process of identifying the DCU offices and services that are best placed, in terms of their expertise, to support the implementation of these actions. This will constitute Phase Two of this larger project. The President of DCU, Prof. Brian McCraith, has committed to adopting the eight Principles of an Autism Friendly University outlined below and to delivering on the proposed DCU-specific proposed actions to embed the principles of the Autism Friendly University over the next three years. Given this commitment, AsIAm and Specialisterene Ireland now recognise DCU as an Autism Friendly University and will award DCU Provisional Accreditation as an Accessible, Welcoming and Empowering (AWE) University. Ultimately, it is hoped that the principles identified here could be adopted by other HEIs that, like DCU, wishes to be recognised as an Autism Friendly University. Principles of an Autism Friendly University 1. Encourage and enable students with Autism to transition into and participate in university programmes. 2. Support and build capacity to equip students with Autism to meet the academic challenges of everyday university life. 3. Support and build capacity to equip students with Autism to meet the social challenges of everyday university life. 4. Seek to establish an Autism friendly operational environment. 5. Seek to combat the stigma around Autism and recognise the diverse experiences of those with the condition. 6. Develop understanding and relevant knowledge and skills within the University community. 7. Establish channels so that students with Autism can have a voice in various aspects of university life. 8. Increase employability of graduates with Autism, through a range of initiatives that will help develop their soft skills to support their transition beyond University

Associations Between Self-Reported Sleep, Wellbeing and Physical Activity in Irish Adolescents

Growing evidence suggests sleep plays an important role in the development of healthy adolescents, with increased interest in the associations between sleep and mental health. Higher duration and quality of sleep has been suggested as a mechanism for increased wellbeing in adolescents. Cross sectional data was collected from 5,661 Irish adolescents. 55% of Irish adolescents reported meeting the guidelines for adolescents of 8-10 hours per night. This was found to decrease with age. Higher duration and quality of sleep was positively associated with wellbeing and negatively associated with symptoms of anxiety and depression. A higher frequency of physical activity was associated with longer duration and higher quality of sleep. 9-10 hours of sleep was associated with the highest levels of wellbeing and lowest symptoms of anxiety and depression. The relationship between physical activity and increased wellbeing may be impacted by physical activity leading to higher durations and quality of sleep. Higher frequencies of physical activity may increase sleep quality and quantity thereby improving markers of mental health in adolescents.&nbsp

Implementing social health insurance in Ireland: Report of a meeting and workshop held in Dublin, on December 6th 2010

We considered two basic questions, 'Is it possible to implement Social Health Insurance in Ireland?', and 'How can this be done?'. Can Social Health Insurance be implemented in Ireland? Our answer is a very definite yes. Furthermore, there would be many opportunities, while working towards this end, to improve the performance of our health care system. How can it be implemented? This process will need to be actively managed. There are many difficulties in the Irish health services, but also many opportunities. The greatest strengths are the talented, well-trained and very committed staff. Getting and keeping the support of these staff, for the necessary changes in service delivery, will be critical. Ireland has the capacity to make these changes, but without high quality management, a detailed focussed plan for change, and political support, little will happen. Each step in the change needs to be planned to maintain services, improve service delivery, improve service accountability, and improve service governance. Each sector of the service will need someone to lead the change, and mind that service during the change. Primary care remains under-developed. The HSE plan to develop primary care teams (PCT) has not succeeded. There are several established PCTs which work well. In other areas there are informal arrangements for collaboration, which work well. Overall, there are many useful lessons to learn from the experience so far. Future developments will need to place general practice at the centre of primary care. The mechanisms for doing this will vary from place to place, but need to be developed urgently. Acute hospitals face a crisis of governance. Maurice Hayes' (1) recent report on Tallaght hospital gives an idea of the scale of the changes needed. Tallaght is, we believe, not atypical, and is reputed to be by no means the worst governed hospital in the system. This, alone, should provide a pressing motive for change. Redesigning Irish hospitals to a new mission of supporting primary care, of supporting care in the community where possible can, and must, be done. Long-term care for older people is also a challenge. We advise moving to an integrated needs based system with smooth transitions between different degrees of support at home, and different degrees of support in specialized housing facilities including nursing homes. A similar model should apply to other forms of long-term care, for example for people with a substantial disability. Information systems and management processes both need a major overhaul. The health service remains strikingly under-managed, and fixing this will need a substantial culture change within the services. Wide use of standardized formal project management processes will be vital. There is a separate plan being developed to improve health service IT systems, and implementing this needs to be a high priority. We have not considered other key sectors, for example mental health, disability services, and social services. This does not mean that these are unimportant, merely that we had limited time, and a great deal to cover

An exploration of the levels of clinical autonomy of advanced nurse practitioners: a narrative literature review

Aims and Objectives The aims of the review are to synthesise current evidence about advanced nurse practitioner clinical autonomy and consider how this may inform clinical practice and research. Background Clinical autonomy is one of the cornerstones of advanced nursing practice globally, yet there is limited synthesis of clinical autonomy in the literature. Design This is a narrative literature review. Data sources The databases Cumulative Index to Nursing and Allied Health Literature, EBSCO host, Cochrane Library, CINAHL and MEDLINE were searched for publications between 2005 and 2020 inclusive. Review methods A systematic approach was used to analyse the literature reviewed. Two reviewers undertook quality appraisal. Results Nineteen articles were selected. Four major themes emerged: (1) ‘ANP Stepping Up’—moving into and accepting advanced nursing practice roles and clinical responsibilities; (2) ‘ANP Living It’—ANPs' ability to act independently including an understanding of task mastery and self-determination; (3) ‘ANP Bounce-back ability’—depicted in challenges that threaten their ability to practice clinically autonomously; (4) ‘ANP Setting in Motion’—indirect care activities and service-level improvements. Conclusion A clearer understanding of advanced nurse practitioner clinical autonomy could help develop more in-depth knowledge. Research of advanced nurse practitioners' clinical autonomy would improve full utilisation in clinical practice

Folic acid fortification and public health: Report on threshold doses above which unmetabolised folic acid appear in serum

BACKGROUND: All flour in the USA is fortified with folic acid at a level of 140 μg/100 g which is estimated to supply an extra 100 μg daily to the average diet. Some researchers have advocated that this be increased to double and even four times this amount. Based on previous research these higher levels are likely to lead to the appearance of unmetabolised vitamin in the circulation, which may have safety implications for sub-groups of the population. The UK and the Republic of Ireland will likely introduce mandatory fortification also in the next year or so. The aim of this study was to capture the short-term effect of folic acid fortification on unmetabolised folic acid in serum after chronic consumption of folic acid. METHODS: After pre-saturation with 400 μg folic acid supplements daily for 14-weeks, healthy folate replete adults (n = 20) consumed folic acid fortified bread, at three different levels (400 μg, 200 μg, 100 μg) over a period of one week each. The dose was administered in two-equal sized slices consumed at 09.00 hrs and 13.00 hrs. Serum samples for total folate and folic acid were collected at baseline, after 14-weeks of supplementation, and pre and post (at 1, 2, 3 and 4 hours) each dose tested. RESULTS: Unmetabolised folic acid was detected after the 14-week supplementation period. Folic acid was not detected in either the 200 μg or 100 μg (current US regime) doses tested but was present at the highest level (400 μg) tested. CONCLUSION: Our findings suggest that persons exposed to the current US fortification programme supplying an average of 100 μg per day or less are unlikely to have unmetabolised folic acid in serum. It also seems that daily consumption of the higher level of 200 μg or less is unlikely to be problematic. Increasing the level however to 400 μg on the other hand is likely to lead to unmetabolised folic acid appearance

Alumnae Association Bulletin of the School of Nursing, 1972

Alumnae Calendar The President\u27s Message Officers and Chairmen of Committees Financial Report Address by President Herbut School of Nursing Report School of Practical Nursing Report Report by Dr. Mary Louise Soentgen, M.D., F.A.A.P. Report of Patient Services Department Report of Staff Nurses\u27 Association Progress Report of Hospital Activities Scholarship Committee Report - Clerk-Typist Annual Luncheon - Head Table Social Events for 1971-1972 Missing Alumnae Members Jefferson Today Ways and Means Committee Report Constitution and By-Laws Report Sick and Welfare Committee Women\u27s Board Report Baccalaureate Degree Program Luncheon Pictures Resume of Minutes of Alumnae Association Meeting Class News Poem by Rosa Diseroad - 1923 Marriages Births - Hello World In Memoriam Notice

An exploration of knowledge, attitudes and advice given by health professionals to parents in Ireland about the introduction of solid foods. A pilot study

<p>Abstract</p> <p>Background</p> <p>For the purposes of this paper "weaning is defined as the introduction of the first solid foods to infants". Global recommendations by the World Health Organisation (WHO) recommend that all infants be exclusively breast-fed for the first six months of life. No global recommendations have been made for formula fed infants. In Europe it is recommended that weaning foods should be introduced between 18 weeks and 26 weeks regardless of whether infants are breast or formula fed. In the United Kingdom it is recommended that solids be introduced at around six-months for both breast and formula fed infants. In Ireland official guidelines recommend that breast fed infants should be introduced solids at 6 months of age while for formula fed infants the recommendation is for 4 months. The disparity between these global, European, UK and local recommendations may be a source of confusion for parents and health care professional based in Ireland. Emerging evidence suggests that babies in Ireland are given solid foods before the recommended age but there has been little investigation of the weaning advice provided by health professionals. Since community health professionals have routine parent interactions in the pre-weaning and early-weaning period and hence are in a unique position to positively influence parental weaning decisions, this study aimed to explore their knowledge, attitudes and advice practices about weaning.</p> <p>Methods</p> <p>A mixed-methods approach was used for the research, commencing with a multi-disciplinary focus group to guide and develop a questionnaire. Questionnaires were then distributed in a postal survey to General Practitioners (GPs) (<it>n </it>179), Practice Nurses (PNs) (<it>n </it>121), Public Health Nurses (PHNs) (<it>n </it>107) and Community Dieticians (CDs) (<it>n </it>8).</p> <p>Results</p> <p>The results indicate varying levels of knowledge of official weaning recommendations and a variety of advice practices. CDs and PHNs acknowledged a clear role in providing weaning advice while demonstrating high confidence levels in providing this advice. However, 19% of PNs and 7% of GP respondents did not acknowledge that they have a role in providing weaning advice to parents; even though Health Service Executive (HSE) written literature given to parents states that they should seek information from PNs and GPs.</p> <p>Conclusion</p> <p>Small pockets of misinformation about the introduction of solid foods persist amongst health professionals which may lead to inconsistent advice for parents. Further research is needed.</p

Autistic Adult Services Availability, Preferences, and User Experiences : Results From the Autism Spectrum Disorder in the European Union Survey

There is very little knowledge regarding autistic adult services, practices, and delivery. The study objective was to improve understanding of current services and practices for autistic adults and opportunities for improvement as part of the Autism Spectrum Disorder in the European Union (ASDEU) project. Separate survey versions were created for autistic adults, carers of autistic adults, and professionals in adult services. 2,009 persons responded to the survey and 1,085 (54%) of them completed at least one of the services sections: 469 autistic adults (65% female; 55% 50% responded "don't know"). Five of seven residential services features recommended for autistic adults were experienced byPeer reviewe

Association of Accelerometry-Measured Physical Activity and Cardiovascular Events in Mobility-Limited Older Adults: The LIFE (Lifestyle Interventions and Independence for Elders) Study.

BACKGROUND:Data are sparse regarding the value of physical activity (PA) surveillance among older adults-particularly among those with mobility limitations. The objective of this study was to examine longitudinal associations between objectively measured daily PA and the incidence of cardiovascular events among older adults in the LIFE (Lifestyle Interventions and Independence for Elders) study. METHODS AND RESULTS:Cardiovascular events were adjudicated based on medical records review, and cardiovascular risk factors were controlled for in the analysis. Home-based activity data were collected by hip-worn accelerometers at baseline and at 6, 12, and 24&nbsp;months postrandomization to either a physical activity or health education intervention. LIFE study participants (n=1590; age 78.9±5.2 [SD] years; 67.2% women) at baseline had an 11% lower incidence of experiencing a subsequent cardiovascular event per 500&nbsp;steps taken per day based on activity data (hazard ratio, 0.89; 95% confidence interval, 0.84-0.96; P=0.001). At baseline, every 30&nbsp;minutes spent performing activities ≥500&nbsp;counts per minute (hazard ratio, 0.75; confidence interval, 0.65-0.89 [P=0.001]) were also associated with a lower incidence of cardiovascular events. Throughout follow-up (6, 12, and 24&nbsp;months), both the number of steps per day (per 500&nbsp;steps; hazard ratio, 0.90, confidence interval, 0.85-0.96 [P=0.001]) and duration of activity ≥500&nbsp;counts per minute (per 30&nbsp;minutes; hazard ratio, 0.76; confidence interval, 0.63-0.90 [P=0.002]) were significantly associated with lower cardiovascular event rates. CONCLUSIONS:Objective measurements of physical activity via accelerometry were associated with cardiovascular events among older adults with limited mobility (summary score &gt;10 on the Short Physical Performance Battery) both using baseline and longitudinal data. CLINICAL TRIAL REGISTRATION:URL: http://www.clinicaltrials.gov. Unique identifier: NCT01072500