A qualitative study exploring why adults with intellectual disabilities and obesity want to lose weight and views of their carers

Background: Obesity is more prevalent in adults with intellectual disabilities (ID) compared to the general population. Motivations for weight loss may influence engagement with weight management programmes and have only been studied in adults without ID. Aims: To determine reasons given by adults with ID and obesity for seeking weight loss and whether these reasons differ from those of their carers. Methods: Prior to a multi-component weight management intervention, participants were asked “why do you want to lose weight?” Carers were asked their views and these were compared to the answers given by the adult with ID. Responses were themed. The Fisher’s Exact analysis was used to test for any relationship between reasons for seeking weight loss and participants’ level of ID, age, gender and BMI. Results: Eighteen men and 32 women; age 41.6 SD 14.6 years; BMI 40.8 SD 7.5 kg/m2; Level ID Mild (28 %), Moderate (42 %), Severe (22 %), Profound (8 %). Eleven were unable to respond. Six themes emerged; Health; Fitness / Activity / Mobility; Appearance / Clothes; Emotional / Happiness; For Others; Miscellaneous. The most frequent reason given overall and by women was “appearance.” Carers cited “health” most frequently and “appearance” least, rarely agreeing with participants. “Health” was given as a reason more from older adults and those with milder ID. No statistically significant associations were found between reasons for seeking weight loss and BMI age, gender or level of ID but the differing views of adults with ID and their carers were clear. Conclusions: Views of adults with obesity and mild or moderate ID can be collected. The opposing views of adults and their carers may affect motivation for weight loss

N released from organic amendments is affected by soil management history

A ryegrass bioassay was conducted to investigate the effect of soil management history on nitrogen mineralisation from composted manure and pelleted poultry manure. Soils were used from 2 field experiments comparing conventional and organic/low input management systems. When composted manure was added, soils which had received high rates of composted FYM under biodynamic management released a greater amount of nitrogen for plant uptake than those with a history of mineral or fresh manure fertilisation, suggesting that biological preconditioning may result in greater efficiency of composted FYM as a nitrogen source for plants. “Native” N mineralisation was found to be related to total soil N content

A feasibility study of behavioural activation for depressive symptoms in adults with intellectual disabilities

Background: Important work has been carried out adapting cognitive behavioural therapy for people with intellectual disabilities. However, there is a lack of alternative psychological therapies available for people with intellectual disabilities and emotional difficulties. Behavioural activation for depression is less reliant on verbal communication and focuses on increasing purposeful activity and reducing avoidance. Method: This feasibility study involved the development and piloting of an adapted manual of behavioural activation for people with intellectual disabilities. The intervention consisted of 10–12 sessions and a key adaptation was that the therapist worked with the clients alongside a significant other in their life, either a paid carer or family member. Baseline, post-intervention (3 months after entering the study) and 6-month quantitative follow-up data were obtained. Primary outcome data were gathered, concerning depressive symptoms, participants' levels of activity and general well-being. Results: Twenty-three adults with intellectual disabilities with symptoms of depression were recruited from specialist health services. In terms of acceptability, the behavioural activation intervention was well received and only two individuals dropped out, with a further two lost to follow-up. The main measures of depression appeared to be sensitive to change. Pre- to post-intervention data showed a significant reduction in self-report of depressive symptoms with a strong effect size (r = 0.78), that was maintained at follow-up (r = 0.86). Positive change was also obtained for informant reports of depressive symptoms from pre- to post-intervention, with a strong effect size (r = 0.7). Once again, this positive change was maintained at follow-up (r = 0.72). Conclusions: The study suggested that behavioural activation may be a feasible and worthwhile approach to tackling depression in people with intellectual disabilities. However, a randomised controlled trial would be required to establish its effectiveness, with more sensitive measurement of change in activity

Effects of Nutritional Interventions on Cardiovascular Disease Health Outcomes in Aboriginal and Torres Strait Islander Australians: A Scoping Review.

Nutrition interventions can support Aboriginal and Torres Strait Islander peoples to reduce their risk of cardiovascular disease (CVD). This review examines nutritional interventions aiming to improve CVD outcomes and appraises peer-reviewed interventions using an Aboriginal and Torres Strait Islander Quality Appraisal Tool. Five electronic databases and grey literature were searched, applying no time limit. Two reviewers completed the screening, data extraction and quality assessment independently. The study quality was assessed using the South Australian Health and Medical Research Institute and the Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange Aboriginal and Torres Strait Islander Quality Appraisal Tool (QAT). Twenty-one nutrition programs were included in this review. Twelve reported on anthropometric measurements, ten on biochemical and/or hematological measurements and sixteen on other outcome domains. Most programs reported improvements in measurable CVD risk factors, including reduced body mass index (BMI), waist circumference (WC), weight, blood pressure and improved lipid profiles. Most programs performed well at community engagement and capacity strengthening, but many lacked the inclusion of Indigenous research paradigms, governance and strengths-based approaches. This review highlights the need for contemporary nutrition programs aimed at improving cardiovascular health outcomes to include additional key cultural components

Engineering Comes Home: Co-designing nexus infrastructure from the bottom-up

The ‘nexus’ between water, food and energy systems is well established. It is conventionally analysed as a supply-side problem of infrastructure interdependencies, overlooking demand-side interactions and opportunities. The home is one of the most significant sites of nexus interactions and opportunities for redesigning technologies and infrastructure. New developments in ‘smart city’ technologies have the potential to support a bottom-up approach to designing and managing nexus infrastructure. The Engineering Comes Home was a research project that turned infrastructure design on its head. The objectives of the project were to: Demonstrate a new paradigm for engineering design starting from the viewpoint of the home, looking out towards systems of provision to meet household demands. Integrate thinking about water, energy, food, waste and data at the domestic scale to support userled innovation and co-design of technologies and infrastructure. Test new design methods that connect homes to communities, technologies and infrastructure, enhancing positive interactions between data, water, energy, food and waste systems. Develop a robust Lifecycle Assessment (LCA) Calculator tool to support environmental decisionmaking in co-design. Working with residents of the Meakin Estate in South London, the project followed a co-design method to identify requirements, analyse options and develop and test a detailed design for a preferred option. The outputs were: 1) Ethnographic study of how residents use water, energy and food resources in their homes and key opportunities for engineering design to improve wellbeing and reduce resource consumption. 2) Co-design of decentralised infrastructural systems in three workshops in 2016-2017. The first workshop identified key priorities for development from the community using a novel token-based system design method, to enable participants to build up alternative designs for local provision of water, energy, food and waste services. The second workshop provided participants with factsheets and photographs of the candidate technologies, which were then analysed using a LCA Calculator tool. 47 Rainwater harvesting was selected as the technology for further co-design in the third workshop, which focussed on scaling up a pilot installation. 3) Pilot-scale smart rainwater system was installed in partnership with the Over The Air Analytics (OTA). OTA’s system enables remote control of the rainwater storage tanks to optimise their performance as stormwater attenuation as well as non-potable water supply. 4) Lifecycle Assessment (LCA) Calculator to enable quick estimation of the impacts of new systems and technology to deliver water, energy and food, and manage waste at the household and neighbourhood scale. 5) Stakeholders, including utilities, design consultancies and community based organisations, were engaged in three workshops to inform the wider relevance and development of the co-design methods and tools. 6) Toolbox and method statements to standardise and disseminate the methods used in the project for wider application and development

Attractiveness and injury of Phaseolus vulgaris L. genotypes by Anticarsia gemmatalis Hübner (Lepidoptera: Erebidae).

The aim of this study we evaluated the attractiveness and the leaf injury caused by A. gemmatalis larvae in bean genotypes

Stakeholder views on the barriers and facilitators of psychosocial interventions to address reduction in aggressive challenging behaviour in adults with intellectual disabilities.

BACKGROUND: Success of psychosocial interventions in reducing aggressive challenging behaviour is likely to be related not only to mechanistic aspects, but also to therapeutic and system factors. The study aims to examine the facilitators and barriers that influence whether psychosocial interventions for aggressive challenging behaviour in adults with intellectual disabilities lead to positive change. METHODS: We conducted 42 semi-structured interviews with adults with intellectual disabilities and aggressive challenging behaviour, family/paid carers, and professionals engaged in or delivering a psychosocial intervention across the UK. Data were analysed thematically using a framework approach. RESULTS: Stakeholders considered therapeutic and supportive relationships and personalised care as facilitating factors of psychosocial interventions to address aggressive challenging behaviour. The operational structure of community intellectual disability services and conflicting expectations of professionals and carers were the main contextual barriers that impeded the implementation of psychosocial interventions addressing aggressive challenging behaviour in adults with intellectual disabilities. CONCLUSIONS: Findings highlight the valued components that maximise positive change in adults with intellectual disabilities who display aggressive challenging behaviour. Several operational adjustments including referral criteria, roles of professionals and workforce issues need to be addressed in services to maximise the implementation of psychosocial interventions to reduce aggressive challenging behaviour in adults with intellectual disabilities