Co-design and development of a multi-component anxiety management programme for people with an intellectual disability

© [Copyright © 2022, Emerald Publishing Limited]. This AAM is provided for your own personal use only. It may not be used for resale, reprinting, systematic distribution, emailing, or for any other commercial purpose without the permission of the publisher.Purpose – This paper aims to understand the lived experience of people with intellectual disability ofvtheir anxiety and of being co-design partners in developing a multi-component approach to the management of anxiety. Design/methodology/approach – The development of an anxiety manual and programme was part of a service development which allowed existing and established psychological therapies to be adapted for people with intellectual disability. A qualitative approach was used to better understand the views of people who experienced anxiety on a daily basis. The feedback generated was used to make modifications to the manuals and the anxiety management programme. Findings – The study has demonstrated the value of involving people with intellectual disability in the coproduction of an anxiety management programme. Additional findings identified the real-life challenges and experiences of the impact anxiety has on people’s lives. Originality/value – To our knowledge, this is the first study to involve people with intellectual disability in developing an anxiety management programme as co-production partners. This paper underlines the value of understanding and involving people as co-production partners in developing clinical interventions

Group cognitive stimulation therapy versus usual care for people with intellectual disabilities and dementia (CST-IDD) in the UK: protocol for a mixed-methods feasibility randomised controlled trial

INTRODUCTION: The prevalence of dementia is almost five times higher in people with intellectual disabilities compared with the general population. However, evidence-based treatments for this population are lacking, as most randomised controlled trials for dementia interventions have not included people with intellectual disabilities. Cognitive stimulation therapy (CST) has a robust evidence base in the general dementia population, consistently showing benefits to cognition, quality of life and being cost-effective. We are conducting a mixed-methods feasibility trial of group CST for people with intellectual disabilities and dementia, to determine if a future definitive randomised controlled trial is feasible. METHODS AND ANALYSIS: Fifty individuals with intellectual disabilities and dementia will be randomised to either the intervention arm (14 sessions of group CST plus treatment as usual) or the control arm (treatment as usual). Randomisation will occur after informed consent has been obtained and baseline assessments completed. Each arm will have 25 participants, with the intervention arm divided into five or more CST groups with three to five participants in each. The outcomes will be feasibility of recruitment, acceptability and adherence of the intervention, suitability of study outcome measures and feasibility of collecting resource use data. Quantitative and qualitative approaches, including semistructured interviews with group participants, carers and group facilitators, will be employed to assess these outcomes. ETHICS AND DISSEMINATION: This study has been approved by Essex REC (Ref: 21/EE/027) and the HRA ethical approval process through the Integrated Research Application System (IRAS ID: 306 756). We plan to publish the results in peer-reviewed journals and conferences as well as provide feedback to funders, sponsors and study participants. TRIAL REGISTRATION NUMBER: ISRCTN88614460

Is there a hormonal regulation of phagocytosis at unicellular and multicellular levels? A critical review

Phagocytosis is an ancient cell function, which is similar at unicellular and multicellular levels. Unicells synthesize, store, and secrete multicellular (mammalian) hormones, which influence their phagocytosis. Amino acid hormones, such as histamine, serotonin, epinephrine, and melatonin stimulate phagocytosis, whereas peptide hormones, such as adrenocorticotropic hormone (ACTH), insulin, opioids, arginine vasopressin, and atrial natriuretic peptide decreased it, independently on their chemical structure or function in multicellulars. Macrophage phagocytosis of multicellulars is also stimulated by amino acid hormones, such as histamine, epinephrine, melatonin, and thyroid hormones, however, the effect of peptide hormones is not uniform: prolactin, insulin, glucagon, somatostatin, and leptin have positive effects, whereas ACTH, human chorionic gonadotropin, opioids, and ghrelin have negative ones. Steroid hormones, such as estrogen, hydrocortisone, and dexamethasone are stimulating macrophage phagocytosis, whereas progesterone, aldosterone, and testosterone are depressing it. Considering the data and observations there is not a specific phagocytosis hormone, or a hormonal regulation of phagocytosis neither unicellular, nor multicellular level, however, hormones having specific functions in multicellulars also influence phagocytosis at both levels universally (in unicellulars) or individually (in macrophages). Nevertheless, the hormonal influence cannot be neglected, as phagocytosis (as a function) is rather sensitive to minute dose of hormones and endocrine disruptors. The hormonal influence of phagocytosis by macrophages can be deduced to the events at unicellular level

The Science Performance of JWST as Characterized in Commissioning

This paper characterizes the actual science performance of the James Webb Space Telescope (JWST), as determined from the six month commissioning period. We summarize the performance of the spacecraft, telescope, science instruments, and ground system, with an emphasis on differences from pre-launch expectations. Commissioning has made clear that JWST is fully capable of achieving the discoveries for which it was built. Moreover, almost across the board, the science performance of JWST is better than expected; in most cases, JWST will go deeper faster than expected. The telescope and instrument suite have demonstrated the sensitivity, stability, image quality, and spectral range that are necessary to transform our understanding of the cosmos through observations spanning from near-earth asteroids to the most distant galaxies.Comment: 5th version as accepted to PASP; 31 pages, 18 figures; https://iopscience.iop.org/article/10.1088/1538-3873/acb29

The James Webb Space Telescope Mission

Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least $4m$. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the $6.5m$ James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 years, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit.Comment: Accepted by PASP for the special issue on The James Webb Space Telescope Overview, 29 pages, 4 figure

Care givers experiences of caring for people with intellectual disability and dementia: a qualitative evidence synthesis

© [insert the copyright line of the published article]. This AAM is provided for your own personal use only. It may not be used for resale, reprinting, systematic distribution, emailing, or for any other commercial purpose without the permission of the publisherPurpose A systematic review of the literature was completed to examine the needs of those who provide care to people with intellectual disability and dementia. The purpose was to develop an understanding of the complexities, challenges, and support available to meet the needs of an ageing population. Design/methodology/approach A qualitative evidence synthesis was used to appraise 12 studies. An evidence synthesis approach was used to better understand the challenges care givers experience in caring for a person with intellectual disability and dementia. Aggregating and integrating findings from multiple studies allowed to identify inconsistencies, quality, relationships, and trends to enhance the awareness of gaps in care provision. Findings There were six main domains identified from the available literature which included; 1) caring for older adults with intellectual disability Gaps in knowledge and skills 2) limitation in knowledge of ageing and dementia Early identification of dementia and associated difficulties 3) coping strategies Managing behaviour, 4) identifying dementia coping, 5) burden of care managing changes in behaviour, 6) Impact on confidence burden of care. Originality. This is the first paper to use qualitative evidence synthesis to understand the challenges of caring for a person with intellectual disability and dementia

Dementia education and training for caregivers supporting older people with intellectual disability: a scoping review of the literature

‘© [insert the copyright line of the published article]. This AAM is provided for your own personal use only. It may not be used for resale, reprinting, systematic distribution, emailing, or for any other commercial purpose without the permission of the publisher’Education and training is vital in improving age related care provisions . However, a lack of awareness and understanding of dementia could be a factor in meeting the age related needs of people. This article examines the impact dementia education has on caregivers’ confidence to provide person centred care for people with intellectual disability and identifies additional training needs. A systematic scoping review was completed using PRISMA-ScR to guide the process of mapping existing evidence of dementia education and training programmes available to caregivers of people with intellectual disability. A search of five electronic databases, identified 11 articles that reported on the role of dementia education in improving the knowledge of caregivers in effectively delivering the age related care. Findings suggest that improved training provision is needed to support early diagnosis and increase caregivers confidence in meeting the physical and psychological needs of older adults with intellectual disability. This review contributes to the literature by identifying the value of and need for continued development in dementia education and training to improve person centred dementia care

Additional file 2: of Synthetic versus autologous reconstruction (Syn-VAR) of the medial patellofemoral ligament: a study protocol for a randomised controlled trial

MPFL reconstruction postoperative rehabilitation protocol. (DOCX 22 kb