A systematic literature review on people with intellectual disability and health promotion

People with intellectual disability (ID) are vulnerable to poorer health outcomes than the general population, yet little is known about the optimal models for health promotion interventions for this population. This literature review was undertaken to identify the evidence base relating to health promotion for people with ID, the challenges experienced by this population and optimal approaches for intervention. Keywords, synonyms and subject headings relating to health promotion and ID were applied to eight electronic databases. Thirty-two studies met the inclusion criteria out of 7,390 research papers, and a narrative synthesis was undertaken to elicit key findings. Evidence to date suggests that the lack of theory-based interventions and an over-reliance on strategies that target cognitive beliefs are substantial challenges for developing effective interventions for the ID research. Whilst there is limited empirical evidence, the included studies suggest that tailored and theory-based interventions may be more successful in creating behavioural changes of the people with ID. The literature base is currently limited by a lack of comparable studies; making generalisations challenging. Greater theoretical and methodological justification to explain the personal, social, economic and behavioural drivers and consequences of health promotion interventions designed for people with ID are required

Radiofrequency ablation compared with argon plasma coagulation after endoscopic resection of high-grade dysplasia or stage T1 adenocarcinoma in Barrett's esophagus: a randomized pilot study (BRIDE).

BACKGROUND AND AIMS: Endoscopic resection (ER) is safe and effective for Barrett's esophagus (BE) containing high-grade dysplasia (HGD) or mucosal adenocarcinoma (T1A). The risk of metachronous neoplasia is reduced by ablation of residual BE by using radiofrequency ablation (RFA) or argon plasma coagulation (APC). These have not been compared directly. We aimed to recruit up to 100 patients with BE and HGD or T1A confirmed by ER over 1 year in 6 centers in a randomized pilot study. METHODS: Randomization was 1:1 to RFA or APC (4 treatments allowed at 2-month intervals). Recruitment, retention, dysplasia clearance, clearance of benign BE, adverse events, healthcare costs, and quality of life by using EQ-5D, EORTC QLQ-C30, or OES18 were assessed up to the end of the trial at 12 months. RESULTS: Of 171 patients screened, 76 were randomized to RFA (n = 36) or APC (n = 40). The mean age was 69.7 years, and 82% were male. BE was 10 cm (n = 4). Sixty-five patients completed the trial. At 12 months, dysplasia clearance was RFA 79.4% and APC 83.8% (odds ratio [OR] 0.7; 95% confidence interval [CI], 0.2-2.6); BE clearance was RFA 55.8%, and APC 48.3% (OR 1.4; 95% CI, 0.5-3.6). A total of 6.1% (RFA) and 13.3% (APC) had buried BE glands. Adverse events (including stricture rate after starting RFA 3/36 [8.3%] and APC 3/37 [8.1%]) and quality of life scores were similar, but RFA cost $27491 more per case than APC. CONCLUSION: This pilot study suggests similar efficacy and safety but a cost difference favoring APC. A fully powered non-inferiority trial is appropriate to confirm these findings. (Clinical trial registration number: NCT01733719.)

A Crowded desert: Early results from survey and excavation of nomadic sites in north-west Qatar (poster)

This paper presents the results and preliminary conclusions of the 2016 season of the Crowded Desert Project, which aimed to find out about nomadic occupation and its relations with settled peoples in the region. Activities included extensive and intensive surveys and excavations in the area delimited by the areas of Umm al-Mā' and Mulayha in the north-west desert of the Qatar peninsula. Conclusions so far complement and expand the ideas developed during the pilot season of the project in 2015, and also provide finer chronological detail and a wider coverage of the area of research than before. The distribution of glass, metal, and pottery recovered showed important chronological differences in the patterns of occupation of the landscape. The paper also presents observed differences in the spatial distribution of features, showing how cairns (presumably pre-Islamic tombs), Islamic burials and cemeteries, and mosques and places of prayer (sing, musallā, pl. musallayāt) are distributed with respect to the tents and spaces habitation found. Finally, this paper introduces the first stratigraphic and geoarchaeological assessments undertaken in the area. Stratigraphic sequences are hard to find, and often nothing remains of them around any preserved structures. In cases where some have been found, their interpretation is restricted by their poor state of preservation and the constraints imposed by small trenches. A geoarchaeological programme is being developed in the hope of overcoming these problems and providing environmental information that might be useful for the understanding of the history of the region