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BackgroundThere is high co-occurrence between intellectual disability and Autism Spectrum Disorder (ASD). It is important to identify people who have both conditions for clinical and research reasons. This study explored if the Child and Adolescent Intellectual Disability Screening Questionnaire (CAIDS-Q) and Learning Disability Screening Questionnaire (LDSQ) could accurately identify intellectual disability in autistic children and adults respectively.MethodPre-existing CAIDS-Q data for 40 autistic children and LDSQ data for 27 autistic adults were used. The participants were classified as likely to have an intellectual disability or not based on the age-appropriate cut-off score on the relevant screening tools. This was compared with their clinical diagnosis of intellectual disability.ResultsThe sensitivity, specificity, and positive and negative predictive values, for the CAIDS-Q were 93.1 %, 88.5 %, 90 % and 92 % respectively. The corresponding figures for the LDSQ were 75 %, 95.6 %, 75 %, and 95.6 %.ConclusionsThe values for the CAIDS-Q were broadly consistent with figures found in previous research. The sensitivity and PPV figures for the LDSQ, were somewhat lower. The specificity and sensitivity values for both measures were above the threshold for levels that are generally considered to be acceptable for a developmental screening tool. The results suggest that the CAIDS-Q and LDSQ may be appropriate measures to screen for intellectual disability in autistic people.

Objectives: To determine the effects of autistic-like traits (ALT), empathy and situational cues on emotion recognition ability.\ud \ud Methods: Eighty-six participants (64 male, 22 female) completed measures of empathy, ALT and emotion recognition (with and without situational cues) online. Results were analysed using a multilevel logistic model.\ud \ud Results: The presence of situational cues and ALT were significantly related to emotion recognition.\ud \ud Conclusions: High levels of ALTs and a lack of situational cues resulted in poorer emotion recognition. Future research should seek to control possible confounds, including processing style. Potential implications of the current study are discussed.

Background\ud \ud The importance of non-technical skills (NTS) to patient outcomes is increasingly being recognised, however, there is limited research into how such skills can be taught and evaluated in student nurses in relation toward rounds.\ud \ud Objectives\ud \ud This pilot study describes an evaluation of a NTS framework that could potentially be used to measure ward round skills of student nurses.\ud \ud Design and Methods\ud \ud The study used an observational design. Potential key NTS were identified from existing literature and NTS taxonomies. The proposed framework was then used to evaluate whether the identified NTS were evident in a series of ward round simulations that final year general nursing students undertook as part of their training. Finally, the views of a small group of qualified nurse educators, qualified nurses and general nursing students were sought about whether the identified NTS were important and relevant to practice.\ud \ud Results\ud \ud The proposed NTS framework included seven categories: Communication, Decision Making, Situational Awareness, Teamwork and Task Management, Student Initiative and Responsiveness to Patient. All were rated as important and relevant to practice.\ud \ud Conclusion\ud \ud The pilot study suggests that the proposed NTS framework could be used as a means of evaluating student nurse competencies in respect of many non-technical skills required for a successful ward round. Further work is required to establish the validity of the framework in educational settings and to determine the extent to which it is of use in a non-simulated ward round setting.

This study aimed to evaluate the emotion recognition abilities of adults (n = 23) with an intellectual disability (ID) compared with a control group of children (n = 23) without ID matched for estimated cognitive ability. The study examined the impact of: task paradigm, stimulus type and preferred processing style (global/local) on accuracy. We found that, after controlling for estimated cognitive ability, the control group performed significantly better than the individuals with ID. This provides some support for the emotion specificity hypothesis. Having a more local processing style did not significantly mediate the relation between having ID and emotion recognition, but did significantly predict emotion recognition ability after controlling for group. This suggests that processing style is related to emotion recognition independently of having ID. The availability of contextual information improved emotion recognition for people with ID when compared with line drawing stimuli, and identifying a target emotion from a choice of two was relatively easier for individuals with ID, compared with the other task paradigms. The results of the study are considered in the context of current theories of emotion recognition deficits in individuals with ID.

Adolescents with ASN can develop identity, competence and connectedness online.Range of ability present impacts development of identity, competence and connectedness.Adolescents with ASN require individualised support to develop in the above ways.Identity, competence and connectedness may improve psychological well-being. This article documents findings, from one of the first studies in this field of research, considering young people with Additional Support Needs' use of the internet and how this might contribute to the development of identity and social connectedness. Six focus groups, including 36 young people with Additional Support Needs (aged 13-18) were completed. Transcribed group discussions were analysed using Framework Analysis. Two themes were developed: 'Identity and Connectedness' and 'Issues related to Risk'. The theme 'Identity and Connectedness' is detailed in the current article and encompassed three sub-themes (implicit belonging, explicit belonging and competence). The use of the internet by adolescents in the current study appears to allow the young people to engage in activities which support the development of identity, competence and a sense of connectedness and belonging within a social network, essential to healthy development and psychological well-being and areas that may present a challenge for this population in offline environments. Findings also indicate a need to consider how best to support this group, in relation to understanding the role of supervision, the range of cognitive ability within this population and additional social pressures, which may impact on safe and effective internet use and this populations' ability to take full advantage of what the internet has to offer.

Young people with Additional Support Needs are aware of risks online.This group demonstrate knowledge of strategies to manage online risk.Supervision and range of ability present barriers to ensuring online safety.The internet may provide important opportunities to improve psychological wellbeing. The aim of this study was to investigate the understanding of online risks by young people with Additional Support Needs and this group's ability to manage these risks. Six focus groups with 36 young people (13-18) were run in local schools. Discussions were recorded, transcribed and analysed using Framework Analysis. Two themes were identified 'Identity and Connectedness' and 'Issues relating to Risk'. The theme 'Issues relating to Risk' is presented in the current article. Results showed that young people with ASN are aware of a range of risks online and have developed some strategies to manage these. Issues including supervision and the diverse range of ability within the population are also shown to present barriers to ensuring online safety. The results were discussed in light of literature relating to online risk, safety and potential psychological impact indicating that the internet may also provide important opportunities for young people with ASN to improve psychological well-being.

Background\ud A diagnosis of autism spectrum disorder (ASD) can be beneficial in ensuring the person receives appropriate support. People with intellectual disability often have undiagnosed co-occurring ASD, due to the specific diagnostic challenges that having intellectual disability can present. Screening tools can be useful to indicate those who are likely to require full diagnostic assessment of ASD.\ud \ud Method\ud We conducted a systematic review of the literature. The databases ProQuest, PsycArticles, PubMed, and Web of Science were searched for articles published before July 2019. When duplicates were removed 3068 articles were retained. Articles were removed in stages and were retained if there was a possibility that the content was relevant. In total, 14 articles were reviewed fully.\ud \ud Results\ud The articles covered eight ASD screening instruments and were reviewed in respect of the quality of the available reliability and validity data when used with people with intellectual disability.\ud \ud Conclusion\ud A few tools have psychometric properties that indicate they have potential to screen for ASD in people with intellectual disability, but overall research with this group is limited, particularly in terms of reliability. The implications for screening and diagnosis of ASD in people with intellectual disability are discussed.

Aims To identify the main factors predicting delays in diagnosis for Autism Spectrum Disorder (ASD) at three stages in the diagnostic process: wait for first appointment; assessment duration, and total wait for diagnosis. Method Data were gathered from 150 case notes (80 child and 70 adult cases) from 16 diagnosing services across Scotland. Results Having more information pre-assessment was associated with a reduced duration of the diagnostic process for children. This relationship was partially mediated by a reduction in the number of contacts required for diagnosis. In adults, having more factors associated with ASD (increased risk) reduced the wait time from referral to first appointment, but increased the overall duration of the diagnostic process. The latter relationship was partially mediated by an increase in the number of contacts required for diagnosis. Conclusion Within children's services, increasing the amount of relevant information available pre-assessment is likely to reduce total duration of the assessment process by reducing number of contacts required. Having a high risk of ASD as an adult appears to result in being seen more quickly following referral, but also to increase the number of contacts needed and assessment duration. As a result, it increases and total duration overall.

Summary Background Although the germicidal properties of ultraviolet (UV) light have long been known, it is only comparatively recently that the antimicrobial properties of visible violet–blue 405nm light have been discovered and used for environmental disinfection and infection control applications. Aim To review the antimicrobial properties of 405nm light and to describe its application as an environmental decontamination technology with particular reference to disinfection of the hospital environment. Methods Extensive literature searches for relevant scientific papers and reports. Findings A large body of scientific evidence is now available that provides underpinning knowledge of the 405nm light-induced photodynamic inactivation process involved in the destruction of a wide range of prokaryotic and eukaryotic microbial species, including resistant forms such as bacterial and fungal spores. For practical application, a high-intensity narrow-spectrum light environmental disinfection system (HINS-light EDS) has been developed and tested in hospital isolation rooms. The trial results have demonstrated that this 405nm light system can provide continuous disinfection of air and exposed surfaces in occupied areas of the hospital, thereby substantially enhancing standard cleaning and infection control procedures. Conclusion Violet–blue light, particularly 405 nm light, has significant antimicrobial properties against a wide range of bacterial and fungal pathogens and, although germicidal efficacy is lower than UV light, this limitation is offset by its facility for safe, continuous use in occupied environments. Promising results on disinfection efficacy have been obtained in hospital trials but the full impact of this technology on reduction of healthcare-associated infection has yet to be determined.

Screening tools can provide an indication of whether a child may have an intellectual disability (ID). Item response theory (IRT) analyses can be used to assess whether the statistical properties of the tools are such that their utility extends beyond their use as a screen for ID. We used non-parametric IRT scaling analyses to investigate whether the Child and Adolescent Intellectual Disability Screening Questionnaire (CAIDS-Q) possessed the statistical properties that would suggest its use could be extended to estimate levels of functional ability and to estimate which (if any) features associated with intellectual impairment are consistently indicative of lower or higher levels of functional ability. The validity of the two proposed applications was assessed by evaluating whether the CAIDS-Q conformed to the properties of the Monotone Homogeneity Model (MHM), characterised by uni-dimensionality, local independence and latent monotonicity and the Double Monotone Model (DMM), characterised by the assumptions of the MHM and, in addition, of non-intersecting item response functions. We analysed these models using CAIDS-Q data from 319 people referred to child clinical services. Of these, 148 had a diagnosis of ID. The CAIDS-Q was found to conform to the properties of the MHM but not the DMM. In practice, this means that the CAIDS-Q total scores can be used to quickly estimate the level of a person's functional ability. However, items of the CAIDS-Q did not show invariant item ordering, precluding the use of individual items in isolation as accurate indices of a person's level of functional ability.

BackgroundThe present study aimed to investigate whether there is an association between type of living environment (urban versus rural) and anxiety, depression and psychosis in the Scottish population.MethodsData were obtained from the Scottish Neighbourhood Statistics database on Scottish Index of Multiple Deprivation and urban–rural classifications for 6505 data zones across Scotland. Multiple regression was used to test the association between prescriptions for psychotropic medication for anxiety, depression and psychosis, and type of living environment according to urban–rural classification, controlling for a range of socio-economic factors.ResultsUrban–rural classification significantly predicted poorer mental health both before (β=−.29) and after (β=−.20) controlling for a large number of socio-economic variables, with more urban areas having higher rates of prescription for psychotropic medication for anxiety, depression and psychosis.LimitationsThe current study focussed on macro-level variables and did not include individual level data. As such, the study did not include data on individual diagnoses, but instead used drug prescriptions for anxiety, depression and psychosis as a proxy for level of affective disorders within data zones.ConclusionMore urban living environments in Scotland are associated with higher rates of prescription for psychotropic medication for anxiety, depression and psychosis.

This study assessed the effects of high-intensity violet light on selected yeast and mould fungi. Cell suspensions of Saccharomyces cerevisiae, Candida albicans, and dormant and germinating spores (conidia) of the mould Aspergillus niger were exposed to high-intensity narrow band violet light with peak output at 405 nm generated from a light-emitting diode (LED) array. All three fungal species were inactivated by the 405-nm light without a requirement for addition of exogenous photosensitiser chemicals. Of the fungal species tested, S. cerevisiae was most sensitive and dormant conidia of A. niger were most resistant to 405-nm light exposure. Five-log10 colony forming units per millilitre (CFU ml(-1)) reductions of the tested species required exposure doses of 288 J cm(-2) for S. cerevisiae, 576 J cm(-2) for C. albicans, and a much higher value of 2.3 kJ cm(-2) for dormant conidia of A. niger. During germination, A. niger conidia became more sensitive to 405-nm light exposure and sensitivity increased as germination progressed over an 8 h test period. Light exposure under aerobic and anaerobic conditions, together with results obtained using ascorbic acid as a scavenger of reactive oxygen species, revealed that 405-nm light inactivation in fungi involved an oxygen-dependent mechanism, as previously described in bacteria. The inactivation results achieved with yeast cells and fungal spores together with operational advantages associated with the use of a visible (nonultraviolet (UV)) light source highlight the potential of 405-nm light for fungal decontamination applications.

The study assessed the validity of an intellectual disability screening tool, the Learning Disability Screening Questionnaire (LDSQ), in three forensic settings: a community intellectual disability forensic service; a forensic in-patient secure unit and a prison, using data for 94 individuals. A significant positive relationship was found between full scale IQ and LDSQ score, indicating convergent validity. Discriminative validity was indicated by, firstly, a significant difference in the LDSQ scores between those with and without an intellectual disability, with those with a diagnosis of intellectual disability, scoring significantly lower. Secondly, a ROC analysis indicated that the sensitivity and specificity of the LDSQ were both above 80%. The screening tool was found to have lower sensitivity in the forensic populations than was obtained in the original community standardisation sample, but had slightly higher specificity. Limitations and implications of the study are discussed.

This study investigated whether methylphenidate is effective in improving response inhibition in children with Attention Deficit Hyperactivity Disorder (ADHD). Children with ADHD were compared with normally developing children on measures of response inhibition. Participants with ADHD were compared across two conditions--medicated and unmedicated. There was no significant difference between the inhibitory control of children with and without ADHD. Children with ADHD showed significant improvements in inhibitory control following methylphenidate. The findings of the present study contrast with previous studies which document reduced inhibitory control in ADHD, compared with normally developing children. Reports of methylphenidate improving functioning in children with ADHD are supported. Limitation and implications of the study are discussed.

We examined the performance of the Child and Adolescent Intellectual Disability Screening Questionnaire with 103 young children aged 6–7 years, 11 months referred to mental health services. Sensitivity and specificity were both over 80% and convergent validity with IQ scores was found, suggesting it could be useful for screening with this age group.

We present the hypothesis that the laws of thermodynamics can be usefully applied to psychotherapy. In this model psychotherapy is presented as a means of entropy management, whereby the patient trades entropy (in this case the expressed symptoms of mental disorder) with the therapist. The therapist serves to increase the capacity of the patient, both through developing a shared understanding of the challenges the patient faces and through generating shared solutions. This process can be understood in terms of entropy trade where energy is successfully redirected into adaptive behaviour. The hypothesis and proposed model of psychotherapy are evaluated in the context of current thinking about the components of successful psychotherapeutic outcomes; including evidence based practice, therapist competence and adherence and the therapeutic alliance.