Comprehensive health assessments during de-institutionalisation: An observational study

Background: People with intellectual disability leaving institutions pass through a transition stage that makes them vulnerable to inadequate health care. They pass into community care under General Practitioners that are often untrained and inexperienced in their needs. Specifically designed health reviews may be of assistance to both them and their new GPs as they go through that phase. Method: This research aimed to investigate the effectiveness of a specially designed health review, the CHAP health review, in a group of adults as they transitioned out of the care of the last institution for people with intellectual disability in Tasmania. There were 25 residents reviewed by their GPs. Results: The CHAP reviews picked up a number of health conditions that possibly would not have been noted without it. Some of the findings were: a high number of abnormal BMIs (19 / 23), immunisations given (13 / 23), vision impairment reported (2 / 23), mental health issues recorded (4 / 23), and skin abnormalities described (17 / 23). There were 22 referrals made to other health professionals (Australian Hearing Service 4, dentists 3, optometrists 3, psychiatrists 2, neurologists 2, ophthalmologist 1, urologist 1, ultrasound 1, mammogram 1, family planning 1, physiotherapist 1, continence nurse 1 and respiratory physician 1). These were in additional to various requests for pathology. Conclusions: The CHAP health review was effective in detecting a number of health issues in the population of people with intellectual disability as they transitioned out of Institutional care into the general community

A model for the detection of breast cancer using machine learning and thermal images in a mobile environment

Breast cancer is the most common cancer amongst women and one of the deadliest. Various modalities exist which image the breasts, all with a focus on early detection; thermography is one such method. It is a non-invasive test, which is safe and can be used for a wide variety of breast densities. It functions by analysing thermal patterns captured via an infrared camera of the surface of the breast. Advances in infrared and mobile technology enable this modality to be mobile based; allowing a high degree of portability at a lower cost. Furthermore, as technology has improved, machine learning has played a larger role in medical practices by offering unbiased, consistent, and timely second opinions. Machine learning algorithms are able to classify medical images automatically if offered in the correct format. This study aims to provide a model, which integrates breast cancer detection, thermal imaging, machine learning, and mobile technology. The conceptual model is theorised from three literature studies regarding: identifiable aspects of breast cancer through thermal imaging, the mobile ecosystem, and classification using machine learning algorithms. The model is implemented and evaluated using an experiment designed to classify automatically thermal breast images of the same quality that mobile attachable thermal cameras are able to capture. The experiment contrasts various combinations of segmentation methods, extracted features, and classification algorithms. Promising results were shown in the experiment with a high degree of accuracy obtained. The successful results obtained from the experimentation process validates the feasibility of the model

A model for the detection of breast cancer using machine learning and thermal images in a mobile environment

Breast cancer is the most common cancer amongst women and one of the deadliest. Various modalities exist which image the breasts, all with a focus on early detection; thermography is one such method. It is a non-invasive test, which is safe and can be used for a wide variety of breast densities. It functions by analysing thermal patterns captured via an infrared camera of the surface of the breast. Advances in infrared and mobile technology enable this modality to be mobile based; allowing a high degree of portability at a lower cost. Furthermore, as technology has improved, machine learning has played a larger role in medical practices by offering unbiased, consistent, and timely second opinions. Machine learning algorithms are able to classify medical images automatically if offered in the correct format. This study aims to provide a model, which integrates breast cancer detection, thermal imaging, machine learning, and mobile technology. The conceptual model is theorised from three literature studies regarding: identifiable aspects of breast cancer through thermal imaging, the mobile ecosystem, and classification using machine learning algorithms. The model is implemented and evaluated using an experiment designed to classify automatically thermal breast images of the same quality that mobile attachable thermal cameras are able to capture. The experiment contrasts various combinations of segmentation methods, extracted features, and classification algorithms. Promising results were shown in the experiment with a high degree of accuracy obtained. The successful results obtained from the experimentation process validates the feasibility of the model

Diabetes and Intellectual Disability: Perceptions from People with Disability and Their Supporters

Background: People with intellectual disability who have diabetes have few resources for themselves or their carers. There are multiple health issues present. The objective of the project was to describe the perceptions and experiences of living with diabetes as told by people with intellectual disability, their families and support staff. Methods: The project was a qualitative semi-structured interview study, conducted in southeast Queensland, Australia. There were 67 people involved - adults with intellectual disability (9), family of adults with intellectual disability (8), paid support staff of adults with intellectual disability (31), service co-ordinators (12), health professionals (6) and a worker in the sector (1). Focus group discussions were held with the participants. Their perceptions and experiences of living with and managing intellectual disability and diabetes were recorded and the themes of the discussions studied. Results: The findings revealed a number of shortcomings in relation to diabetes care in a population of people with intellectual disability and their families and support staff. There are higher than average support needs when diabetes is present. There is resentment at intrusion in their lives by diabetes from people with disability. There are feelings of fear and insecurity about diabetes in families and support staff. Families and support staff feel that generally they lack knowledge and also lack support from their organisations to manage both the intellectual disability and the diabetes. Conclusion: The general lack of confidence and knowledge about diabetes makes it difficult for people with intellectual disability and their families and support staff to function in an effective and satisfying way. There is a need for guidelines

Diabetes and People with Intellectual Disability

Intellectual disability is present in 2.7% of the population (19). For a person to have intellectual disability, three conditions must be satisfied. The person must: - have an IQ below 70 - have deficits in at least two areas of adaptive functioning - have the onset of disability before the age of 18 years (1). 'Developmental disability' is another term used. It is 'differences in neurologically-based functions associated with significant long-term difficulties (1)'. In 1998 half a million Australians were found to have developmental disability (3). The two definitions, intellectual disability and developmental disability, are very similar. Diabetes mellitus is present in this population, as in any other group of people. We do not know the exact prevalence of diabetes mellitus (DM) in people with intellectual disability (PWID) but it is likely to be higher than in the general population. Type 1 DM is up to 35 times as common in people with ID (2). Type 2 DM is also common, but there is no reliable estimate of its prevalence

Parental Concerns about the Health of Adolescents with Intellectual Disability: A Brief Report

Background. Parents of adolescents with intellectual disability are concerned about the future health and well-being needs of their children. Method. Qualitative data was collected as part of a cross-sectional descriptive study and semi-structured interviews were conducted with 32 parents. The results were themed. Results. Most parents discussed areas of their children's health which made them anxious about the future. These concerns were collated into five themes. Conclusion. The health and well-being themes were dependency, general health, challenging behaviours, and increasing support needs

Simulation-based training for increasing health service board members' effectiveness : protocol for a cluster-randomised controlled trial

Introduction Research indicates that health service boards can influence quality of care. However, government reviews have indicated that board members may not be as effective as possible in attaining this goal. Simulation-based training may help to increase board members' ability to effectively communicate and hold hospital staff to account during board meetings. Methods and analysis To test effectiveness and feasibility, a prospective, cluster-randomised controlled trial will be used to compare simulation-based training with no training. Primary outcome variables will include board members' perceived skill and confidence in communicating effectively during board meetings, and board members' perceptions of board meeting processes. These measures will be collected both immediately before training, and 3 months post-training, with boards randomly assigned to intervention or control arms. Primary analyses will comprise generalised estimating equations examining training effects on each of the primary outcomes. Secondary analyses will examine participants' feedback on the training. Ethics and dissemination Research ethics approval has been granted by Monash University (reference number: 2018-12076). We aim to disseminate results through peer-reviewed journal publication, conference presentation and social media. Trial registration number Open Science Framework: http://osf.io/jaxt6/; Pre-results. © 2019 Author(s). **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Jane Boag” is provided in this record*

To the point - diabetes information for people with intellectual disability and their carers

Objective: To describe the perceptions and experiences of living with diabetes as told by people with intellectual disability and their carers and support staff. Design: Qualitative semi-structured interview study. Setting: Southeast Queensland, Australia. Subjects: 67 people - adults with intellectual disability (9), paid carers and support staff of adults with intellectual disability (31), family carers and support staff of adults with intellectual disability (8), service co-ordinators (12), health professionals (6) and other workers in the sector. Methods: Focus group discussions were held with the participants. Their perceptions and experiences of living with and managing intellectual disability and diabetes were recorded and the themes of the discussions studied. Results: The findings revealed a number of shortcomings in relation to diabetes care in a population of people with intellectual disability and their carers and support staff. There are higher than average support needs when diabetes is present. There is resentment at intrusion in their lives by diabetes from people with disability. There are feelings of fear and insecurity about diabetes in carers and support staff. Carers and support staff feel that generally they lack knowledge and also lack support from their organizations to manage both the intellectual disability and the diabetes. Conclusion: The general lack of confidence and knowledge about diabetes makes it difficult for people with intellectual disability and their carers and support staff to function in a effective and satisfying way. There is a need for guidelines