The Assessment of Behavioural Decline in Adults with Down's Syndrome

The present study examines two methods of using the Vineland Adaptive Behaviour Scales as a measure of behavioural change in people with Down syndrome who are at risk of developing Alzheimer’s disease. The first method uses the Vineland scales as the basis of a semi-structured interview and notes all areas of behavioural change identified by staff; the second method scores the Vineland scales using the basal rule outlined in the manual. The comparison of these two methods illustrated that using the second method highlighted a significant decline in scores for the group meeting the criteria for ‘probable Alzheimer’s disease’ on a number of domains between baseline and 12–24 months. However, this scoring method also appeared to miss more subtle changes in behaviour, which may be important early indicators of Alzheimer’s disease, which were picked up by the first method. The implications of the study are discussed

Owner perceptions of radiotherapy treatment for veterinary patients with cancer

Veterinary clients may have trepidation about treating their pet with radiotherapy due to concerns about radiation side effects or repeated anaesthetics. The purpose of this study is to assess whether owners’ attitudes towards veterinary radiotherapy, including concerns over side effects, change during the course of treatment, and whether radiotherapy was perceived to affect pets’ quality of life. A prospective cohort study of clients from 2012-2015 was performed. Pets received palliative or definitive radiotherapy for various tumours. Clients completed questionnaires before, during and after radiotherapy. Questions assessed owner preconceptions before treatment, including side effect expectations, actual side effects experienced, and overall satisfaction with the process. In addition, at each time point the owners assessed their pet’s quality of life using a simple numerical scale. 49 patients were included. After completing treatment, owners were significantly less concerned about potential side effects of radiotherapy (P<0.001), side effects associated with repeat anaesthetics (P<0.001), and about radiotherapy in general (P<0.001). Quality of life did not show a significant change at any point during or after treatment. Following treatment, 94% reported the experience was better than expected and 100% supported the use of radiotherapy in pets. This is the first prospective study evaluating client attitudes and satisfaction before and after radiotherapy treatment in pets. The results indicate that radiotherapy is well tolerated, and the anxiety associated with radiotherapy is significantly alleviated after experiencing the process. These results will help veterinarians allay client concerns, and will hopefully lead to an increase in clients pursuing radiotherapy in pets

An Examination of the Severe Impairment Battery as a Measure of Cognitive Decline in Clients with Down's Syndrome

The present study examined the validity of the Severe Impairment Battery (SIB) as a tool for measuring cognitive decline in clients with Down syndrome. Two groups participated: 10 clients who showed behavioural decline over at least a 2 year period as measured by the Vineland Adaptive Behaviour Scales, and 14 clients who showed no decline on this measure over the same period. No differences were found between the two groups in relation to health or life factors which may have impacted on functional and cognitive decline. The deteriorating group were found to be significantly older than the non-deteriorating group. The comparison of the SIB scores indicated that the deteriorating group showed a significant decline between baseline and 12 months and baseline and 24 months on the orientation factor. By contrast, for the non-deteriorating group, significant increases were found for praxis, orientating to name and total scores

Health and social care staff responses to working with people with a learning disability who display sexual offending type behaviours

This study found that 59% of social care staff were currently supporting a client with a learning disability who had offended or displayed an offending type behaviour. The range of behaviours was similar to that displayed by clients in a secure health facility and included rape, sexual assault and exposure. Only 22.9% of social care staff had received training in this area, while none of the health stuff had. Both groups expressed low levels of confidence in supporting this client group. The areas of difficulty were common to both groups and included personal attitudes and attitudes of others to the behaviour, and concern over risk, responsibility and safety. In respect of attitudes, social care staff were found to be significantly more likely to hold negative attitudes towards the person's behaviour, while health staff were significantly more likely to feel negatively towards the person. Health staff were significantly more likely to identify training as a means of further support, while social care staff identified professional input. Both groups identified the need for theoretical training about working with this client group. Despite this no significant differences were found between those who had and had not received training and confidence, attitudes and the need for further support

Cohort Profile:Scottish Diabetes Research Network Type 1 Bioresource Study (SDRNT1BIO)

No abstract available

An open label pilot trial of low‐dose lithium for young people at ultra‐high risk for psychosis

Aim: Lithium, even at low doses, appears to offer neuroprotection against a wide variety of insults. In this controlled pilot, we examined the safety (i.e., side‐effect profile) of lithium in a sample of young people identified at ultra‐high risk (UHR) for psychosis. The secondary aim was to explore whether lithium provided a signal of clinical efficacy in reducing transition to psychosis compared with treatment as usual (TAU). Methods: Young people attending the PACE clinic at Orygen, Melbourne, were prescribed a fixed dose (450 mg) of lithium (n = 25) or received TAU (n = 78). The primary outcome examined side‐effects, with transition to psychosis, functioning and measures of psychopathology assessed as secondary outcomes. Results: Participants in both groups were functionally compromised (lithium group GAF = 56.6; monitoring group GAF = 56.9). Side‐effect assessment indicated that lithium was well‐tolerated. 64% (n = 16) of participants in the lithium group were lithium‐adherent to week 12. Few cases transitioned to psychosis across the study period; lithium group 4% (n = 1); monitoring group 7.7% (n = 6). There was no difference in time to transition to psychosis between the groups. No group differences were observed in other functioning and symptom domains, although all outcomes improved over time. Conclusions: With a side‐effect profile either comparable to, or better than UHR antipsychotic trials, lithium might be explored for further research with UHR young people. A definitive larger trial is needed to determine the efficacy of lithium in this cohort

COVID-19 in patients undergoing chronic kidney replacement therapy and kidney transplant recipients in Scotland: findings and experience from the Scottish Renal Registry

BackgroundInfection with the severe acute respiratory coronavirus 2 (SARS-CoV-2) has led to a worldwide pandemic with coronavirus disease 2019 (COVID-19), the disease caused by SARS-CoV-2, overwhelming healthcare systems globally. Preliminary reports suggest a high incidence of infection and mortality with SARS-CoV-2 in patients receiving kidney replacement therapy (KRT). The aims of this study are to report characteristics, rates and outcomes of all patients affected by infection with SARS-CoV-2 undergoing KRT in Scotland.MethodsStudy design was an observational cohort study. Data were linked between the Scottish Renal Registry, Health Protection Scotland and the Scottish Intensive Care Society Audit Group national data sets using a unique patient identifier (Community Health Index (CHI)) for each individual by the Public Health and Intelligence unit of Public Health, Scotland. Descriptive statistics and survival analyses were performed.Results During the period 1st March 2020 to 31st May 2020, 110 patients receiving KRT tested positive for SARS-CoV-2 amounting to 2% of the prevalent KRT population. Of those affected, 86 were receiving haemodialysis or peritoneal dialysis and 24 had a renal transplant. Patients who tested positive were older and more likely to reside in more deprived postcodes. Mortality was high at 26.7% in the dialysis patients and 29.2% in the transplant patients. ConclusionThe rate of detected SARS-CoV-2 in people receiving KRT in Scotland was relatively low but with a high mortality for those demonstrating infection. Although impossible to confirm, it appears that the measures taken within dialysis units coupled with the national shielding policy, have been effective in protecting this population from infection. <br/

The impact of vaccination on incidence and outcomes of SARS-CoV-2 infection in patients with kidney failure in Scotland

Background: Patients with kidney failure requiring kidney replacement therapy (KRT) are at high risk of complications and death following SARS-CoV-2 infection with variable antibody responses to vaccination reported. We investigated the effects of COVID-19 vaccination on incidence of infection, hospitalization and death of COVID-19 infection. Methods: Study design was an observational data linkage cohort study. Multiple healthcare datasets were linked to ascertain all SARS-CoV-2 testing, vaccination, hospitalization, and mortality data for all patients treated with KRT in Scotland, from the start of the pandemic over a period of 20 months. Descriptive statistics, survival analyses, and vaccine effectiveness were calculated. Results: As of 19th September 2021, 93% (n=5281) of the established KRT population in Scotland had received two doses of an approved SARS-CoV-2 vaccine. Over the study period, there were 814 cases of SARS-CoV-2 infection (15.1% of the KRT population). Vaccine effectiveness against infection and hospitalization was 33% (95% CI 0-52) and 38% (95% CI 0-57) respectively. 9.2% of fully vaccinated individuals died within 28 days of a SARS-CoV-2 positive PCR test (7% dialysis patients and 10% kidney transplant recipients). This compares to &lt;0.1% of the vaccinated Scottish population being admitted to hospital or dying death due to COVID19 during that period. Conclusions: These data demonstrate a primary vaccine course of two doses has limited impact on COVID-19 infection and its complications in patients treated with KRT. Adjunctive strategies to reduce risk of both COVID-19 infection and its complications in this population are urgently required

Flaring efficiencies and NOx emission ratios measured for offshore oil and gas facilities in the North Sea

Gas flaring is a substantial global source of carbon emissions to atmosphere and is targeted as a route to mitigating the oil and gas sector carbon footprint due to the waste of resources involved. However, quantifying carbon emissions from flaring is resource-intensive, and no studies have yet assessed flaring emissions for offshore regions. In this work, we present carbon dioxide (CO2), methane (CH4), ethane (C2H6), and NOx (nitrogen oxide) data from 58 emission plumes identified as gas flaring, measured during aircraft campaigns over the North Sea (UK and Norway) in 2018 and 2019. Median combustion efficiency, the efficiency with which carbon in the flared gas is converted to CO2 in the emission plume, was 98.4% when accounting for C2H6 or 98.7% when only accounting for CH4. Higher combustion efficiencies were measured in the Norwegian sector of the North Sea compared with the UK sector. Destruction removal efficiencies (DREs), the efficiency with which an individual species is combusted, were 98.5% for CH4 and 97.9% for C2H6. Median NOx emission ratios were measured to be 0.003ppmppm-1CO2 and 0.26ppmppm-1CH4, and the median C2H6:CH4 ratio was measured to be 0.11ppmppm-1. The highest NOx emission ratios were observed from floating production storage and offloading (FPSO) vessels, although this could potentially be due to the presence of alternative NOx sources on board, such as diesel generators. The measurements in this work were used to estimate total emissions from the North Sea from gas flaring of 1.4Tgyr-1 CO2, 6.3Ggyr-1 CH4, 1.7Ggyr-1 C2H6 and 3.9Ggyr-1 NOx