The relationship of dementia prevalence in older adults with intellectual disability (ID) to age and severity of ID

Background: Previous research has shown that adults with intellectual disability (ID) may be more at risk of developing dementia in old age than expected. However, the effect of age and ID severity on dementia prevalence rates has never been reported. We investigated the predictions that older adults with ID should have high prevalence rates of dementia that differ between ID severity groups and that the age-associated risk should be shifted to a younger age relative to the general population. Method: A two-staged epidemiological survey of 281 adults with ID without Down syndrome (DS) aged >60 years; participants who screened positive with a memory task, informant-reported change in function or with the Dementia Questionnaire for Persons with Mental Retardation (DMR) underwent a detailed assessment. Diagnoses were made by psychiatrists according to international criteria. Prevalence rates were compared with UK prevalence and European consensus rates using standardized morbidity ratios (SMRs). Results: Dementia was more common in this population (prevalence of 18.3%, SMR 2.77 in those aged >65 years). Prevalence rates did not differ between mild, moderate and severe ID groups. Age was a strong risk factor and was not influenced by sex or ID severity. As predicted, SMRs were higher for younger age groups compared to older age groups, indicating a relative shift in age-associated risk. Conclusions: Criteria-defined dementia is 2–3 times more common in the ID population, with a shift in risk to younger age groups compared to the general population

Carer-led health interventions to monitor, promote and improve the health of adults with intellectual disabilities in the community: a systematic review

Using carers to help assess, monitor, or promote health in people with intellectual disabilities (ID) may be one way of improving health outcomes in a population that experiences significant health inequalities. This paper provides a review of carer-led health interventions in various populations and healthcare settings, in order to investigate potential roles for carers in ID health care. We used rapid review methodology, using the Scopus database, citation tracking and input from ID healthcare professionals to identify relevant research. 24 studies were included in the final review. For people with ID, the only existing interventions found were carer-completed health diaries which, while being well received, failed to improve health outcomes. Studies in non-ID populations show that carers can successfully deliver screening procedures, health promotion interventions and interventions to improve coping skills, pain management and cognitive functioning. While such examples provide a useful starting point for the development of future carer-led health interventions for people with ID, the paucity of research in this area means that the most appropriate means of engaging carers in a way that will reliably impact on health outcomes in this population remains, as yet, unknown

CeRu4_4Sn6_6: heavy fermions emerging from a Kondo-insulating state

The combination of low-temperature specific-heat and nuclear-magnetic-resonance (NMR) measurements reveals important information of the ground-state properties of CeRu$_4$Sn$_6$, which has been proposed as a rare example of a tetragonal Kondo-insulator (KI). The NMR spin-latticerelaxation rate $1/T_1$ deviates from the Korringa law below 100 K signaling the onset of an energy gap $\Delta E_g1/k_B \simeq 30$K. This gap is stable against magnetic fields up to 10 T. Below 10 K, however, unusual low-energy excitations of in-gap states are observed, which depend strongly on the field H. The specific heat C detects these excitations in the form of an enhanced Sommerfeld coefficient $\gamma = C(T)/T$ : In zero field, $\gamma$ increases steeply below 5 K, reaching a maximum at 0.1 K, and then saturates at $\gamma = 0.6$ J/molK$^2$. This maximum is shifted to higher temperatures with increasing field suggesting a residual density of states at the Fermi level developing a spin gap $\Delta E_g2$. A simple model, based on two narrow quasiparticle bands located at the Fermi level - which cross the Fermi level in zero field at 0.022 states/meV f.u. - can account qualitatively as well as quantitatively for the measured observables. In particular, it is demonstrated that fitting our data of both specific heat and NMR to the model, incorporating a Ce magnetic moment of $\mu = \Delta E_g1/\mu_{0H} \simeq 1 \mu_B$, leads to the prediction of the field dependence of the gap. Our measurements rule out the presence of a quantum critical point as the origin for the enhanced $\gamma$ in CeRu$_4$Sn$_6$ and suggest that this arises rather from correlated, residual in-gap states at the Fermi level. This work provides a fundamental route for future investigations into the phenomenon of narrow-gap formation in the strongly correlated class of systemComment: 11 pages, 13 figure

Errors in drug administration by anaesthetists in public hospitals in the Free State

Objective. To investigate errors in administering drugs by anaesthetists working in public hospitals in the Free State province. Methods. Anonymous questionnaires were distributed to doctors performing anaesthesia in public hospitals in the Free State, i.e. 188 doctors at 22 public sector hospitals. Outcomes included demographic information on respondents, information regarding the administration of anaesthetics, reporting of errors, and the occurrence of errors during anaesthesia. Results. The response rate was 46.3%; 48.8% were medical officers, and 39.3% of participants were involved in at least one event of erroneous drug administration. Registrars and specialists reported the most errors. Most events were of no clinical significance, caused no permanent harm to patients, and most commonly involved fentanyl and suxamethonium. Of the respondents, 23.8% indicated that they were aware of a South African standard for colour-coding syringe labels, and 92.9% indicated that they would report anaesthetic errors if a single reporting agency for such events existed. Conclusions. More than a third of participating anaesthetists were involved in a drug error at some stage in their practice. Preventive systems and precautionary measures should be put in place to reduce drug administration errors

Relationship between pre-slaughter stress responsiveness and beef quality in three cattle breeds

The relationship between stress responsiveness and beef quality of 40 Nguni, 30 Bonsmara and 30 Angus steers was determined. The L* values, pHu, cooking loss (CL) and Warner-Bratzler shear force (WBSF) were determined. Catecholamine levels were determined from urine samples collected at slaughter. Bonsmara steers had the highest (P \u3c 0.05) levels of catecholamines with respective epinephrine, norepinephrine and dopamine concentrations of 10.8, 9.7 and 14.8 nmol/mmol. Nguni steers had the lowest (P \u3c 0.05) levels of catecholamines, with respective catecholamine concentrations of 5.1, 4.3 and 4.0 nmol/mmol. In the Nguni steers, there were significant (P \u3c 0.05) correlations between catecholamines and L* and between dopamine and tenderness in meat aged for two days (WBSF2). In the Bonsmara, dopamine was correlated (P \u3c 0.05) pHu, WBSF2 and CL. No significant correlations were found in the Angus. Therefore the relationship between stress responsiveness and certain beef quality traits may not be similar in different breeds

Relationship between pre-slaughter stress responsiveness and beef quality in three cattle breeds

The relationship between stress responsiveness and beef quality of 40 Nguni, 30 Bonsmara and 30 Angus steers was determined. The L* values, pHu, cooking loss (CL) and Warner-Bratzler shear force (WBSF) were determined. Catecholamine levels were determined from urine samples collected at slaughter. Bonsmara steers had the highest (P \u3c 0.05) levels of catecholamines with respective epinephrine, norepinephrine and dopamine concentrations of 10.8, 9.7 and 14.8 nmol/mmol. Nguni steers had the lowest (P \u3c 0.05) levels of catecholamines, with respective catecholamine concentrations of 5.1, 4.3 and 4.0 nmol/mmol. In the Nguni steers, there were significant (P \u3c 0.05) correlations between catecholamines and L* and between dopamine and tenderness in meat aged for two days (WBSF2). In the Bonsmara, dopamine was correlated (P \u3c 0.05) pHu, WBSF2 and CL. No significant correlations were found in the Angus. Therefore the relationship between stress responsiveness and certain beef quality traits may not be similar in different breeds

Incidence of dementia in older adults with intellectual disabilities

Dementia may be more common in older adults with intellectual disability (ID) than in the general population. The increased risk for Alzheimer's disease in people with Down syndrome (DS) is well established, but much less is known about dementia in adults with ID who do not have DS. We estimated incidence rates from a longitudinal study of dementia in older adults with ID without DS and compared them to general population rates. 222 participants with ID without DS aged 60 years and older were followed up an average of 2.9 years later to identify those who had declined in functional or cognitive abilities. Those who screened positive had a comprehensive assessment for dementia, diagnosed using ICD 10 and DSM IV criteria. 134 participants who did not have dementia at initial assessment were alive and interviewed at follow up; 21 (15.7%) were diagnosed with dementia. Overall incidence rate for those aged ≥ 60 was 54.6/1000 person years (95% CI 34.1-82.3). The highest incidence rate (97.8/1000 person years) was in the age group 70-74. Standardised incidence ratio for those aged ≥ 65 was 4.98 (95% CI 1.62-11.67). Incidence of dementia in older people with intellectual disabilities are up to five times higher than older adults in the general population. Screening may be useful in this population given the high incident rates, particularly as more effective treatments become available. Studies to explore the underlying aetiological factors for dementia associated with intellectual disability could help to identify novel protective and risk factors

2010).A complicated grief intervention model

ABSTRACT Complicated grief refers to a prolonged state of grief and indicates the inability of the client to incorporate the death into his or her life. Few social workers in South Africa assess the possibility of complicated grief as a contributing factor to impaired social functioning. This can be as a result of limited knowledge, ignorance and/or insufficient skills on the part of the social worker to assess and identify complicated grief. In this article, the researchers tabulate some of the models and approaches to bereavement and discusses its applicability to complicated grief. Specific attention is given to the Dual Process Model (Stroebe & Schut 1999) and the Task-Centred approach (a social work approach to therapy) in an attempt to develop a model for complicated grief intervention. This article furthermore proposes the Complicated Grief Intervention Model through the integration of the Dual Process Model and the Task-Centred approach while drawing on intervention techniques from other therapeutic approaches. OPSOMMING Gekompliseerde rou verwys na 'n verlengde staat van rou en impliseer 'n onvermoë by die klient om die dood van 'n geliefde in sy/haar lewe te integreer. Gekompliseerde rou word deur min maatskaplike werkers as bydraende faktor tot verlaagde maatskaplike funksionering geassesseer. Dit kan toegeskryf word aan beperkte kennis, ignorering van/of ontoereikende vaardighede by die maatskaplike werker in die identifisering en assessering van gekompliseerde rou. Die outeurs tabuleer sommige van die rouberadingsmodelle en -benaderings in hierdie artikel en bespreek die toepaslikheid daarvan op gekompliseerde rou. Spesifieke aandag word aan die Tweeledige Prosesmodel (Dual Process Model) (Stroebe & Schut 1999) verleen, asook aan die taakgesentreerde benadering ('n maatskaplike werkbenadering) in 'n poging om 'n model te ontwikkel vir gekompliseerde rou intervensie. Die artikel beveel aan dat die Gekompliseerde Rou Intervensie Model (GRIM) deur middel van die integrasie van die Tweeledige Prosesmodel en die taakgesentreerde maatskaplike werkbenadering aangebied word, terwyl intervensietegnieke van verskeie terapeutiese benaderings benut word

Errors in drug administration by anaesthetists in public hospitals in the Free State

Objective. To investigate errors in administering drugs by anaesthetists working in public hospitals in the Free State province. Methods. Anonymous questionnaires were distributed to doctors performing anaesthesia in public hospitals in the Free State Province, i.e. 188 doctors at 22 public sector hospitals. Outcomes included demographic information on respondents, information regarding the administration of anaesthetics, reporting of errors, and the occurrence of errors during anaesthesia. Results. The response rate was 46.3%; 48.8% were medical officers, and 39.3% of participants were involved in at least one event of erroneous drug administration. Registrars and specialists reported the most errors. Most events were of no clinical significance, caused no permanent harm to patients, and most commonly involved fentanyl and suxamethonium. Of the respondents, 23.8% indicated that they were aware of a South African standard for colour coding syringe labels, and 92.9% indicated that they would report anaesthetic errors if a single reporting agency for such events existed. Conclusions. More than a third of participating anaesthetists were involved in a drug error at some stage in their practise. Preventative systems and precautionary measures should be put in place to reduce drug administration errors

Improved high-temperature expansion and critical equation of state of three-dimensional Ising-like systems

High-temperature series are computed for a generalized $3d$ Ising model with arbitrary potential. Two specific ``improved'' potentials (suppressing leading scaling corrections) are selected by Monte Carlo computation. Critical exponents are extracted from high-temperature series specialized to improved potentials, achieving high accuracy; our best estimates are: $\gamma=1.2371(4)$, $\nu=0.63002(23)$, $\alpha=0.1099(7)$, $\eta=0.0364(4)$, $\beta=0.32648(18)$. By the same technique, the coefficients of the small-field expansion for the effective potential (Helmholtz free energy) are computed. These results are applied to the construction of parametric representations of the critical equation of state. A systematic approximation scheme, based on a global stationarity condition, is introduced (the lowest-order approximation reproduces the linear parametric model). This scheme is used for an accurate determination of universal ratios of amplitudes. A comparison with other theoretical and experimental determinations of universal quantities is presented.Comment: 65 pages, 1 figure, revtex. New Monte Carlo data by Hasenbusch enabled us to improve the determination of the critical exponents and of the equation of state. The discussion of several topics was improved and the bibliography was update