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Background: Depression and anxiety are amongst the most prevalent mental health disorders in the older population with intellectual disability (ID). There is a paucity of research that pertains to associative biopsychosocial factors for depression and anxiety in this population. The aim of this study is to determine the biopsychosocial factors associated with depression and anxiety in a population of older adults with ID in Ireland. Methods: The study was part of 'The Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing'. Depressive symptoms were assessed using the Glasgow Depression Scale for people with a Learning Disability. Anxiety symptoms were measured using the Glasgow Anxiety Scale for people with a Learning Disability. The cross‐sectional associations of depression and anxiety with biopsychosocial parameters were measured using a variety of self‐report and proxy‐completed questionnaires. Results: For the study population, 9.97% met the criteria for depression, and 15.12% met the criteria for an anxiety disorder. Participants meeting criteria for depression were more likely to be taking regular mood stabiliser medications and to exhibit aggressive challenging behaviour. Participants meeting criteria for anxiety were more likely to have sleep difficulties and report loneliness. Participants meeting criteria for either/both depression and anxiety were more likely to report loneliness. Conclusions: This study identified both treatable and modifiable, as well as unmodifiable, biopsychosocial factors associated with depression and/or anxiety in older adults with ID. A longitudinal study follow‐up will further develop our knowledge on the causality and direction of associated biopsychosocial factors with depression and anxiety in older adults with ID and better inform management strategies, prevention policies and funding of services. [ABSTRACT FROM AUTHOR]

Purpose: Contributions of cerebrospinal fluid (CSF) have not been previously taken into account in the quantification of APT CEST effects, and correction for the dilution of CEST effects by CSF may allow for more robust measurement of CEST signals. The objective of this study was to compare the robustness of a partial volume (PV) correction model against a standard (4‐pool) multi‐pool model as far as their ability to quantify CEST effects in healthy, normal, and pathological tissue. Methods: MRI data from 12 patients presenting with ischemic stroke, and 6 healthy subjects, were retrospectively analyzed. CEST signals derived from a 4‐pool model and a PV correction model were compared for repeatability and pathological tissue contrast. The effect of PV correction (PVC) was assessed within 3 ranges of tissue PV estimate (PVE): high PVE voxels, low PVE voxels, and the whole slice. Results: In voxels with a high tissue PVE, PV correction did not make a significant difference to absolute APTR*. In low PVE voxels, the PVC model exhibited a significantly decreased ischemic core signal. The PVC measures exhibited higher repeatability between healthy subjects (4 pools: 3.4%, PVC: 2.4%) while maintaining a similar ischemic core CNR (0.7) to the 4‐pool model. In whole slice analysis it was found that both models exhibited similar results. Conclusions: PV correction yielded a measure of APT effects that was more repeatable than standard 4‐pool analysis while achieving a similar CNR in pathological tissue, suggesting that PV‐corrected analysis was more robust at low values of tissue PVE. [ABSTRACT FROM AUTHOR]

Background: Exposures to life events are associated with emotional, psychological and behavioural problems in those with intellectual disability (ID). Older adults with ID may experience different life events given differences in living circumstances, cognitive decline, greater dependency on others and less autonomy. This study examines the relationship of life events and mental ill health in an older ID population in Ireland. Methods: The study was part of 'The Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing'. The frequency of life events was assessed using a 20‐item checklist, and the level of stress experienced was assessed using a three‐point Likert scale measuring the burden of the life event. The associations of life events with factors associated with mental ill health were measured using a variety of self‐report and proxy completed questionnaires. Results: For the study population, 88.1% had been exposed to at least one life event in the preceding 12 months and 64.5% to two or more life events. Frequency and burden of life events were significantly higher in individuals living in institutional settings and in individuals with any current psychiatric condition, increased depressive and anxiety symptoms, challenging behaviour and reported poorer self‐rated mental and physical health. More life events were significantly associated with new psychiatric diagnoses as well as initiation and increased dosage of mood stabilising, hypnotic and sedative medications. Conclusions: Life events are significantly associated with mental ill health in the older ID population. Service providers must focus on limiting the exposure to these events and, in situations where they cannot be avoided, should support and manage individuals compassionately and effectively, prioritising their mental and physical well‐being. [ABSTRACT FROM AUTHOR]

Amide proton transfer (APT) imaging is a pH mapping method based on the chemical exchange saturation transfer phenomenon that has potential for penumbra identification following stroke. The majority of the literature thus far has focused on generating pH-weighted contrast using magnetization transfer ratio asymmetry analysis instead of quantitative pH mapping. In this study, the widely used asymmetry analysis and a model-based analysis were both assessed on APT data collected from healthy subjects ( n = 2) and hyperacute stroke patients ( n = 6, median imaging time after onset = 2 hours 59 minutes). It was found that the model-based approach was able to quantify the APT effect with the lowest variation in grey and white matter (≤ 13.8 %) and the smallest average contrast between these two tissue types (3.48 %) in the healthy volunteers. The model-based approach also performed quantitatively better than the other measures in the hyperacute stroke patient APT data, where the quantified APT effect in the infarct core was consistently lower than in the contralateral normal appearing tissue for all the patients recruited, with the group average of the quantified APT effect being 1.5 ± 0.3 % (infarct core) and 1.9 ± 0.4 % (contralateral). Based on the fitted parameters from the model-based analysis and a previously published pH and amide proton exchange rate relationship, quantitative pH maps for hyperacute stroke patients were generated, for the first time, using APT imaging. © 2014 The Authors. NMR in Biomedicine published by John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Aim To provide a synthesis of literature on international policy concerning professional regulation in nursing and midwifery, with reference to routes of entry into training and pathways to licensure. Background Internationally, there is evidence of multiple points of entry into initial training, multiple divisions of the professional register and multiple pathways to licensure. Evaluation Policy documents and commentary articles concerned with models of initial training and pathways to licensure were reviewed. Item selection, quality appraisal and data extraction were undertaken and documentary analysis was performed on all retrieved texts. Key issues Case studies of five Western countries indicate no single uniform system of routes of entry into initial training and no overall consensus regarding the optimal model of initial training. Conclusions Multiple regulatory systems, with multiple routes of entry into initial training and multiple pathways to licensure pose challenges, in terms of achieving commonly-agreed understandings of practice competence. Implications for nursing management The variety of models of initial training present nursing managers with challenges in the recruitment and deployment of personnel trained in many different jurisdictions. Nursing managers need to consider the potential for considerable variation in competency repertoires among nurses trained in generic and specialist initial training models. [ABSTRACT FROM AUTHOR]

Aim This paper aims to develop understanding of the nature, costs and strategies to reduce or prevent a range of adverse events experienced by people within the healthcare system. Background Care interventions are not always based on safe practice and adverse events can and do occur that cause or place at risk patients lives and well-being. The nature of adverse events is diverse and can be attributed to a multitude of individual and system contributory factors and causes. Evaluation A review of the literature was undertaken in 2006 and 2007 using the following databases: Pubmed, CINAHL, Biomed Ovid, Synergy and the British Nursing Index. This paper evaluates the literature that pertains to adverse events and seeks understanding of this complex issue. Key issues Published statistics confirm that globally, professional errors in clinical practice and care delivery occur at an unacceptably high level and result in considerable human and financial consequences. Conclusion Reaching understanding of the multiple factors that contribute to unsafe clinical practice situations requires a cultural shift in organizations. Implication for Nursing Management Reasons for adverse events are complex and require healthcare managers to evaluate the system issues which impact on the delivery and organization of care. [ABSTRACT FROM AUTHOR]

Parenting by learning disabled persons is a highly emotive issue, eliciting arguments from both extremes. Many of the arguments against such parenting have their basis in eugenic theory, whereas those in favour, often cite human rights declarations, and philosophies such as 'normalization'. This review of the literature describes the chronological development of theory on the subject, spanning 1900 to the present day. It has become clear that, whereas parents with learning difficulties may be more predisposed to having problems, they can indeed perform as adequate parents, given appropriate training and support. This paper traces the development of current theory, through an in-depth discussion of the available literature. [ABSTRACT FROM AUTHOR]