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Intellectual Disability is under-ascertained worldwide and is associated with greater physical and mental health difficulties. This research aimed to identify clinical features and characteristics of children with Intellectual Disability in a population of 126 6–18 year olds in mainstream school, attending paediatric developmental clinics. Intellectual Disability was defined according to the DSM-5 (deficits in intellectual and adaptive functioning, present during childhood). Measures used to assess this were WISC-IV IQ (score

This study investigated whether young adults with ASD (n = 29) had impairments in Cognitive Empathy (CE), Affective Empathy (AE) or Empathic Accuracy (EA; the ability to track changes in others’ thoughts and feelings) compared to typically-developing individuals (n = 31) using the Empathic Accuracy Task (EAT), which involves watching narrators recollecting emotionally-charged autobiographical events. Participants provided continuous ratings of the narrators’ emotional intensity (indexing EA), labelled the emotions displayed (CE) and reported whether they shared the depicted emotions (AE). The ASD group showed deficits in EA for anger but did not differ from typically-developing participants in CE or AE on the EAT. The ASD group also reported lower CE (Perspective Taking) and AE (Empathic Concern) on the Interpersonal Reactivity Index, a self-report questionnaire.

Why you should read this article: • To enhance your knowledge of the beneficial effects of dance on health and well-being • To gain awareness of the potential of dance as a form of exercise during the COVID-19 pandemic • To reflect on the use of dance as a socially prescribed intervention in mental health services Background: Restrictions during the COVID-19 pandemic have resulted in people having to find new ways to exercise. One such way is dance, an activity that can be undertaken at home and adapted to suit most people's abilities. Dance has been shown to have physical and psychological benefits, but little is known about the effect of dance on mood according to dance style. Aim: To explore the effect of dance on mood in two groups of participants – one engaging in ballet and the other in tap – compared with a control group, and to assess whether the effect of dance on mood differs depending on dance style. Methods: Eighty-two participants (78 females) recruited from three dance schools and clubs in the Midlands and the north-east of England completed the Positive and Negative Affect Schedule (PANAS) mood scale. Participants in the intervention groups completed the PANAS before and after participating in a ballet class or a tap class. Participants in the control group completed the PANAS before and after a one-hour wait in a similar environment to the two dance groups. Results: Participating in a dance class, whether ballet or tap, resulted in greater improvements in mood than being in the control group. Both age and dance class status predicted improved mood, but age was a stronger predictor than dance class status. There was no statistically significant difference in mood improvements between those attending a ballet class and those attending a tap class. Conclusion: Dance may offer a way of enhancing mood, particularly for those who are restricted to exercising at home. Mental health nurses could consider using dance as a mental health intervention in addition to more traditional therapeutic approaches, potentially as a social prescription intervention.

We wanted to find out what would help care staff to stay in their jobs. The most important thing for them was getting on well with the person they supported. The next most important thing was their pay. These results can be used to find ways to help staff stay in their jobs. This is important to make sure that people with a learning disability get good support. Abstract: Background: High staff turnover presents a challenge to the provision of good quality community-based support to people with an intellectual disability. While recent research has identified factors that are thought to be important for staff retention, their relative importance to social care staff is unknown. The aim of this study was to address this gap. Methods: 205 social care staff who worked in intellectual disability services completed an online questionnaire that asked them to: rank factors that had been previously identified as influencing staff retention in order of importance; identify the extent to which their most important factor was met by their organisation (fulfilment score); and rate their recent job-seeking intentions. Findings: The most important factor overall was the relationship of the staff member with the person they supported. This was also identified as the most important factor by the most participants, followed by pay. All of the factors, with the exception of “benefits” (such as pensions), were rated by at least one person as the most important factor. A significant negative relationship was found between fulfilment score and job-seeking score; that is, the lower the former, the more the person agreed that they had been seeking a new job. Conclusion: The results suggest that interventions to improve staff retention should take account of differences in staff views about which work-related factors are most important to them; use multi-component approaches where possible; prioritise staff pay; and help ensure that staff relationships with those they support are positive and fulfilling.

Background: Concern about the poor care of some people with an intellectual disability has highlighted the need for systemic, large scale interventions to develop a skilled workforce. \ud Method: We outline how an implementation science theoretical model informed the development of a region wide Positive Behavioural Support (PBS) Workforce Development (WFD) approach. \ud Results: We provide an example of the application of the model in practice and demonstrate how this enabled us to: understand the competencies and development needs of the workforce; engage effectively with stakeholders; and develop, deliver, and evaluate a PBS WFD model.\ud Conclusion: The application of the model helped us to identify, prioritise, and address the multiple and complex factors that were relevant to the implementation of the PBS WFD approach.

Background It is important for social care staff to understand what a learning disability is so that they can identify people with learning disabilities and provide them with the support they need.\ud \ud Aim To explore whether there have been changes in the knowledge of social care staff about the diagnostic criteria for learning disability more than 20 years after the researchers first explored the topic.\ud \ud Method A sample of 264 social care staff were asked to describe what they understood by ‘learning disability’. Their responses were compared with the three diagnostic criteria of learning disability – that is, significant impairments in intellectual functioning, significant impairments in adaptive functioning and childhood onset.\ud \ud Results Impairments in intellectual functioning was the most commonly identified criterion and childhood onset the least commonly identified criterion. Only 5% of participants (n=13) identified all three criteria, while 57% (n=150) identified none or only one of the criteria.\ud \ud Conclusion While the results are an improvement on those found more than 20 years ago, they still indicate an ongoing need for improved understanding, among social care staff, of what a learning disability is, and learning disability nurses have a role to play in this.

Purpose: Students are a vulnerable segment of the population in relation to mental health problems and understanding the risk factors for mental health issues in this group is important for informing prevention and intervention efforts. Most previous studies have, however, relied on non-population representative samples and analyses of risk factors in representative samples are needed to ensure accurate estimates of the predictors of student mental health outcomes. This study examines how socio-economic characteristics are linked to the variation in mental health among students to help provide information on who is most at risk in a large UK population-representative sample.Methods: A series of linear regressions adjusted for the complex sampling design were used to study predictors of students’ mental health. The 12-item General Health Questionnaire (GHQ-12) and the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) were regressed on predictors that included age, sex, employment, health, ethnicity and highest education qualification in the student sub-sample of the first wave of . the UK Longitudinal Household Survey (UKHLS) from Understanding Society.Results: Results suggested that student mental health is linked to variation in age, health, employment, minority ethnic backgrounds and sex. Female students showed lower levels of wellbeing than male students. Unemployment and poorer health were also linked to poorer student well-being. Conclusions: Variation in students' mental health is related to socio-economic characteristics. Female students, those of minority ethnic backgrounds and non-UK born appear to be most vulnerable and hence should be the highest priority in monitoring and prevention efforts.

Background: The use of therapeutic untruths raises a number of ethical issues, which have begun to be explored to some extent, particularly in dementia care services, where their use has been found to be high. Little is known, however, about their use by health professionals working in learning disability services. Research question: The study aimed to explore the frequency of use of therapeutic untruths by student learning disability nurses, and by their colleagues; how effective the students perceived them to be as a means of responding to behaviours that challenge; and their level of comfort with using them. Research design: A correlational design was used to gather data from an online version of the Best Interest Scale, adapted for a learning disability context. Participants were 30 learning disability student nurses (female = 28, ages 18–48 years, M = 26.8, standard deviation = 7.3) studying at a university in the North-East of England. Ethical considerations: The study was reviewed and received ethical approval from the first author’s university ethics committee. Findings: Overall, 96% of participants reported using therapeutic untruths. ‘Omission’ was the most frequently used type of therapeutic untruths, the most effective and the type that the students felt most comfortable using. Frequency of use of therapeutic untruths correlated significantly and positively with perceived effectiveness and the level of comfort that the students felt when using them, for all types of therapeutic untruths. Conclusion: The use of therapeutic untruths by the student nurses was consistent with that found in research in dementia care services in the United Kingdom and abroad. Further research to explore the generalisability of the results to the wider context of learning disability services is needed. The study highlights that there may be a need for more formal guidance and educational input to student nurses in the use of therapeutic untruths with people with a learning disability.

The attitudes of mental health workers toward individuals with mental health conditions can impact the quality of care they provide. Negative attitudes among mental health workers seem particularly common in response to people diagnosed with borderline personality disorder (BPD). The current review aimed to identify and review the literature regarding mental health workers' attitudes toward individuals diagnosed with BPD, specifically focusing on studies comparing workers' attitudes toward BPD with attitudes toward other mental health diagnoses. The findings suggest that mental health workers have more negative attitudes toward individuals labeled as having BPD than toward individuals with other diagnoses, such as depression. This is likely due to factors associated with the label itself, in addition to workers' perceptions of BPD symptoms and previous experiences of delivering treatment. The implications of these findings are considered, with a particular focus on how mental health services can effectively address negative attitudes toward BPD.

This chapter describes the attributes of topical and spatial arthropod repellents (SRs) and the use of semi-field environments to evaluate their efficacy parameters. Topical arthropod repellents are chemical compounds placed directly on the exposed skin and require either contact by the biting arthropods or very close proximity to stop them from biting at the very last stages of their feeding processes. In contrast, SRs are volatile compounds that become airborne and prevent/discourage blood-seeking arthropods from making physical contact or even entering a defined space occupied by a potential host, thus protecting it from bites. The SRs can reduce biting arthropod density and ultimately human-vector contact over a larger area as long as the active ingredient concentration in air is high enough to repel or kill the arthropod vectors. The focus of this chapter is on the use of semi-field environments to conduct efficacy testing of commercially available arthropod repellent products and the development of novel ones. Semi-field studies serve as a bridge between laboratory and field studies, and not a replacement for either. Not only are semi-field environments useful for understanding the biology and behavior of biting arthropods, but also for developing methods of control and disease mitigation. The structure and types of experiments that have been conducted in semi-field environments found worldwide are briefly summarized. While the dimensions of these screened enclosures varied, they were sufficiently large to reflect an area that SRs are intended to protect under local ambient environmental conditions. SR studies conducted at the USDA Center for Medical, Agricultural and Veterinary Entomology, Gainesville, Florida, United States, past, current, and future are presented in more detail.

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.

Background: Research suggests that providing staff with input in relation to Positive Behavioural Support (PBS) can have beneficial outcomes. Much of this research, however, fails to take account of systemic issues and does not include a control group. Method: We used a non-randomised, controlled group design to evaluate accredited PBS programmes, delivered as part of a systemic, regional, workforce development approach. We compared outcomes of those attending the programmes (n = 240) with a control group (n = 54), pre and post intervention and at 3 months follow up. Results: The programme and its wider impact were rated positively. Significant intervention effects were found for staff practice and retention, but not for staff knowledge and attributions, or behaviours that challenge and quality of life of those being supported.Conclusions: The results are discussed in the context of the study limitations and restrictions resulting from the Covid-19 pandemic.

Accessible summary The way that people with an intellectual disability are supported is very important.The COVID‐19 virus has changed the way that staff help people with an intellectual disability.We wanted to know about those changes and whether learning about positive behavioural support (PBS) helped staff to cope with them.The main changes were that people with an intellectual disability could not go out or see family and friends as often.Staff came up with new things to do for the people they supported, and PBS learning seemed to help staff to cope. Abstract Background It has been suggested that COVID‐19 and the associated restrictions are likely to have a negative impact on the provision of positive behavioural support (PBS) to people with an intellectual disability. Methods Fifty‐eight staff, who had recently completed an accredited positive behavioural support (PBS) programme, responded to an online questionnaire, which asked them to rate the impact of COVID‐19 on factors related to PBS. Results Participants reported a neutral or somewhat positive impact on all the areas measured, with the exception of the activities and quality of life of those they supported, which were somewhat negatively affected. The participants rated the learning from their PBS programme as helping them cope with COVID‐19 to some extent. Examples of positive and negative effects and ways in which PBS helped staff to cope are presented. Conclusions Many staff developed creative solutions that allowed them to provide PBS despite the COVID‐19 restrictions. PBS learning appeared to help staff cope with the negative impact of the restrictions.

Research aims: People with an intellectual disability generally have poorer emotion recognition than their typically developing peers, but there is limited research on how processing style might influence this. Our study aimed to explore this. \ud Methods: Children with (n = 45) and without (n = 57) an intellectual disability completed an emotion recognition naming task and a processing style task. A path mediation model was used to evaluate whether having an intellectual disability predicted poorer emotion recognition and whether this was mediated by a more local processing style. \ud Results: We found that, while children with an intellectual disability were significantly less accurate at emotion recognition, having a local processing preference was not a significant factor in this. \ud Conclusion: The results of the present study may be helpful for nurses who are involved in developing, delivering and evaluating interventions to improve the emotion recognition of people with an intellectual disability.

This case study is designed to provide detailed information about the water crisis in Flint, Michigan brought on by a series of decisions that could have been researched better prior to enactment. The results were catastrophic to the citizens that public officials were sworn to protect. This case study will provide university classes with information to use while analyzing the causes and decisions that lead to the Flint Water Crisis. This study is not designed to provide all information, but to supplement class research in order to determine what happened and what should have happened. Available research offers numerous issues and plenty of blame, but no definitive answers.

Background: Good practice guidelines aim to promote equity in service provision and quality in order to improve the outcomes, experiences and quality of life of service users.Specific Aims: to evaluate the extent to which the practices of NHS services for people with an intellectual disability and dementia in Scotland were consistent with a range of quality indicators that covered screening, assessment, and intervention. Method: Participants were staff from 10 intellectual disability services in Scotland who completed an online survey. They rated the extent to which their service met quality indicators adapted from the British Psychological Society, Division of Clinical Psychology & Royal College of Psychiatrists (2015) Good Practice Standards Self-Assessment Checklist. Findings: The areas that were most commonly ‘fully met’ related to assessment and diagnosis, those that were most commonly ‘not/only partially met’ related to areas such as flexible funding, service development and monitoring and location of out of area placements. Discussion: The results suggest there is some disparity in the extent to which the participating services have practices which are consistent with all of the quality indicators. The limitations and implications for nurses are discussed.

Objectives\ud There has been an increasing interest in the use of mindfulness-based practices by people with an intellectual disability (ID); however, research about the perspectives of people with ID is limited. The aim of the study was to explore the experiences of people with ID of mindfulness practice.\ud \ud Methods\ud This qualitative study involved semi-structured interviews with 6 participants with ID (4 males and 2 females, aged 18–53, M = 36.17) who had taken part in a mindfulness programme. Interpretative phenomenological analysis was used to analyse the data.\ud \ud Results\ud Two themes were revealed: “The impact of mindfulness” and “The mechanisms of the group”. The results indicated that the participants perceived a number of psychological benefits of attending the programme including improved self-esteem, confidence, self-control, and compassion for oneself and others. A full understanding of what mindfulness is or its purpose was not required in order to lead to therapeutic gains.\ud \ud Conclusions\ud The results suggest that mindfulness may represent an effective psychoeducational approach for some people with ID.

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.

Studies of non‐autistic individuals and people with an intellectual disability show that contextual information impacts positively on emotion recognition ability, however, this area is not well researched with autistic adults. We investigated this using a static emotion recognition task. Participants completed an emotion recognition task in person or online. In total, 46 autistic participants and 379 non‐autistic participants completed the task. A linear mixed model showed that autistic adults had significantly lower accuracy when identifying emotions across all contexts, compared to control participants, even when contextual information was present. No significant effect of context was found in either group, nor was gender shown to be an influential variable. A supplementary analysis showed that higher scores on the Autism‐Spectrum Quotient led to lower scores on the emotion recognition task; no effect of context was found here either. This research adds to the limited work investigating the influence of contextual factors in emotion recognition in autistic adults. Overall, it shows that context may not aid emotion recognition in this group in the same way as it does for non‐autistic individuals.

There is an increasing emphasis on the importance of research having an impact on policy and practice. This can be more difficult to evidence in intellectual disability services because of the wide range of stakeholders involved. We evaluated whether an impact questionnaire covering: knowledge production, capacity building, informing policy and practice, social and economic benefits could successfully be used to evaluate the impact of research into and use of two screening questionnaires: the Learning Disability Screening Questionnaire (LDSQ) and Child and Adolescent Intellectual Disability Screening Questionnaire (CAIDS-Q). We conducted an online search for published peer reviewed and grey literature, and Internet resources that referenced LDSQ and/or CAIDS-Q. The resultant literature and resources were assessed for relevance and organized according to the categories outlined in the impact questionnaire. Evidence was found for all the areas of impact, with the largest body of evidence being in relation to informing policy and practice and social benefits and the least for economic benefits. The impact questionnaire provided the basis for a comprehensive and useful evaluative framework to assess impact, although there was some overlap between the different categories. The process of using it highlighted some wider issues to consider when attempting to evaluate impact. The results indicated that the research underpinning the LDSQ and CAIDS-Q had resulted in significant, generally positive, and wide-reaching impact on policy and practice in intellectual disability and other services, resulting in a number of positive outcomes.

Previous research has provided evidence for developmental cascades between externalizing and internalizing problems via mechanisms such as peer and academic problems; however, there remains a need to illuminate other key mediating processes that could serve as intervention targets. This study, thus, evaluated whether developmental associations between aggression and internalizing are mediated by teacher—as well as peer—relationships. Using data from z-proso, a longitudinal study of Swiss youth (n = 1523; 785 males), an autoregressive latent trajectory model with structured residuals (ALT-SR) was fit over ages 11, 13, and 15 to examine within-person developmental links between aggression, internalizing problems, and the mediating role of peer and teacher relationships, while disaggregating between- and within-person effects. Teacher and peer relationships did not play a role in the progression of externalizing to internalizing problems or vice versa, however, teacher and peer relationships showed a protective effect against developing internalizing problems at ages 13. The results suggest that good quality relationships with teachers in early adolescence can help prevent internalizing problems from developing.

Background We used a qualitative approach to explore the experiences of social care staff regarding the provision of positive behavioural support (PBS) to people with an intellectual disability at the height of the Covid‐19 restrictions. Method We conducted semi‐structured interviews with 19 staff who had recently completed a PBS workforce development programme. Data were analysed using thematic analysis. Results Three themes were identified in the context of the restrictions: The challenges to maintaining quality of life and PBS of the people being supported and staff attempts to overcome these; the ways in which PBS and behaviour support plans were implemented and the impact on behaviours that challenge; the ways in which PBS principles were applied at organisational levels to help to understand and address staff stress and distress. Conclusions Overall, the staff identified many unexpected benefits of the restrictions. The results are discussed in the context of the study limitations.

Background: Therapeutic untruths (TU) are used in dementia services to de-escalate distressing situations. We explored the use of TU by care staff supporting people with an intellectual disability who displayed behaviours that challenged.\ud \ud Method: Data was collected from 126 staff (female = 72.2%; mean age = 41.9 years, SD = 10.7) via an online survey in relation to three areas: responses to three scenarios, reported use of different forms of TU, and ratings of perceived effectiveness of, and level of comfort using, each type. \ud \ud Results: 96% of participants reported using TU themselves and observing their colleagues doing likewise. Models which included perceived effectiveness of, and level of staff comfort with using, different TU were significant, although only perceived effectiveness significantly independently contributed to the model.\ud \ud Conclusion: The use of TU was common, with levels consistent with those found in dementia services. The limitations and implications of the findings are discussed.

This study used a within-participant design to evaluate the concurrent validity and test–retest reliability of the Violent Ideations Scale in a general population, English-speaking opportunistic sample. Data from 116 adult participants (M age = 33.7, SD = 11.9, male = 30 [25.9%]) were used to compare scores on the Violent Ideations Scale and Aggression Questionnaire and responses to the Schedule of Imagined Violence. A subgroup of 27 participants (M age = 37.2, SD = 13.6, male = 8 [29.6%]) completed the Violent Ideations Scale on a second occasion, 2 weeks later. The Violent Ideations Scale was found to correlate significantly with the Aggression Questionnaire subscale and total scores, with the strongest correlations being with physical aggression and total scores. Participants were more likely to be categorized as having experienced a violent ideation based on responses to the Violent Ideation Scale, compared with the Schedule of Imagined Violence, most likely due to the Schedule of Imagined Violence underestimating the prevalence of violent ideation. A significant, strong correlation was found between total Violent Ideations Scale scores at Time 1 and Time 2. Overall, the Violent Ideations Scale was found to have concurrent validity when compared with the Aggression Questionnaire and good test–retest reliability, suggesting that it would be suitable for use with a nonclinical, English-speaking sample. © 2018, The Author(s) 2018.

Background Many people with a learning disability are unable to benefit from health improvement measures because their learning disability is unrecognised. Screening tools such as the Child and Adolescent Intellectual Disability Screening Questionnaire (CAIDS-Q) can assist with the identification of learning disability.\ud \ud Aim To explore whether the use of a new online version of the CAIDS-Q to identify whether or not an individual was likely to have a learning disability was consistent with reported learning disability as identified previously by a healthcare or education professional.\ud \ud Methods Anonymous data from people who used the online CAIDS-Q in the first weeks of the launch were collated and analysed.\ud \ud Results Of the 159 people who used the online CAIDS-Q, 126 (79%) were family members and/or carers of the person being screened and 31 (19%) were professionals (predominantly healthcare and education professionals). Of the 52 people who had been identified previously as having a learning disability, 47 (90%) were correctly identified as such by the CAIDS-Q score.\ud \ud Conclusion The CAIDS-Q online screening tool for learning disability can be used by professionals and parents. It correctly identified 90% of people who had previously been identified as having a learning disability. The accuracy of the online version of the CAIDS-Q is similar to hard copy versions, which suggests that it may be an accurate tool that can assist with the identification of people with a learning disability.

Background: Positive behavioural support (PBS) has been identified as a means of improving the quality of life and support of people with an intellectual disability. This qualitative study explored the views of service providers about a regional PBS programme, that was underpinned by a workforce development approach. Method: Semi-structured interviews were conducted with senior staff (n = 42), from organizations which provided services to people with an intellectual disability, about their views about, and perceived impact of, the PBS programme, Data were analysed using thematic analysis. Results: Two themes were identified: “It's what PBS is about, isn't it?” emphasized the importance of the programme being systemic- and evidence-based; “Macro to micro” highlighted the different points in the systems of care at which the programme was seen to impact. Conclusions: We discuss the results in the context of the study limitations.

Physical exercise can enhance various aspects of character and education, but children may not engage due to a variety of barriers. Circus Skills Training (CST) is a novel approach to encourage participation in exercise and develop physical literacy. It delivers circus skills in a positive, non-competitive and supportive social atmosphere, making it particularly appealing to those who avoid traditional competitive team sports. In a between-subjects design we compared 2 groups of children (aged 9–12) on various measures of physical and psychological wellbeing at baseline, and again after one group had received 6 months of CST training as part of their school’s physical education classes. Significant differences between CST and none-CST children were found for teacher ratings of emotional problems, with the CST-group showing fewer such problems. CST could offer an innovative means of encouraging children to engage with exercise and provide wider benefits in terms of psychological wellbeing.

Aims and objectives: To identify the factors that are associated with considering a career in mental health.Background: The mental health specialty is facing a recruitment crisis in the United Kingdom but there is limited evidence about which factors encourage and discourage people to consider a career in mental health.Design: Quantitative, observational, online survey using a multiple ordinal logistic regression model to identify if there were any significant predictors of the extent to which participants would consider a career in mental health. The design and write up of the study were guided by the STROBE checklist.Method: We gathered the views of 231 participants (female = 188, 81.7%) aged between 16 and 65 (mean = 22.7, SD = 8.9), using an online survey, the majority of whom were studying on, or graduates of, psychology/social studies degrees. Information was gathered about the extent to which a range of factors influenced consideration of a career in mental health. Results: The majority (71.2%) of participants reported that they would definitely or probably consider undertaking a career in mental health, and over half (51.4%) would consider a career as a mental health nurse. The ability to help others and receiving appropriate training required for the role were important career choice factors. Being female, having a mental health condition, and greater knowledge of mental health, were associated with a significantly greater likelihood of considering a career in mental health, while having had experience of working with people with mental health difficulties was significantly negatively associated.Conclusions: Students and graduates of psychology and social studies degrees appear to be a large, untapped recruitment pool for mental health services.Relevance to clinical practice: The results can inform more targeted recruitment strategies and development of suitable career pathways for those interested in a career in mental health.

Background Children with a learning disability can experience stigma in several ways, for example through abuse or barriers such as social rejection that limit their opportunities. The level of awareness of stigma can vary from person to person; however, those who perceive themselves to have a stigmatised identity have been found to have reduced aspirations and self-esteem. Research suggests that children with a learning disability have lower self-esteem than their typically developing peers.\ud \ud Aim To explore whether having more than one potentially stigmatising characteristic or attribute (‘double discrimination’) influences the self-esteem of children with a learning disability; and to understand whether therapeutic interventions could improve self-esteem.\ud \ud Method Data collected by teachers, including self-esteem scores for 20 children with a learning disability, were analysed to explore whether double discrimination was related to lower self-esteem, and whether receiving a therapeutic intervention in the form of input from a clinical psychologist, and/or participating in a gardening group, influenced self-esteem.\ud \ud Results The pilot study found that those children who experienced double discrimination had significantly lower self-esteem than those who did not. Those in the therapeutic intervention group had increased self-esteem scores compared with baseline, while the scores of those in the control group and who received normal schooling fell slightly, although the difference was not significant.\ud \ud Conclusion The results may assist nurses to develop interventions that improve the self-esteem of children with a learning disability.

ADHD symptoms show considerable individual variation in the contexts in which they are expressed. It has previously been proposed that subtyping individuals according to the contexts in which symptoms are expressed may be clinically useful. We examined context-based patterns of ADHD symptoms in a longitudinal cohort study of n = 1388 children, as well as context-specific and context-general predictors of symptoms. Participants were community-ascertained and provided ADHD symptom data at ages 7, 9, and 11. Using growth mixture modelling we identified five inattention and five hyperactivity/impulsivity categories that differed in the developmental patterns of symptoms reported by parent and teacher informants. We found some evidence that context-specific predictors were related to context-specific expressions. Specifically, after controlling for other risk factors for ADHD symptoms, relationships with teachers predicted school-specific (teacher-reported) but not home-specific (parent-reported) symptom levels. However, no subtypes defined by exclusively home-based symptoms emerged, suggesting that while symptoms may sometimes be specific to the school context, they are only rarely confined to the home context. Subtyping by context could be informative; however, further work will required to uncover the nature of any etiological, functional, or outcome differences between those who show symptom expression in different contexts. Electronic supplementary material The online version of this article (10.1007/s10578-018-0842-4) contains supplementary material, which is available to authorized users.

Objective: Significant anxiety often occurs in the presence of ADHD symptoms; however, the reasons are not well understood. We aimed to establish whether the relations between ADHD symptons and anxiety are bidirectional or unidirectional. Method: Weexamined the developmental relations between ADHD and anxiety symptoms across adolescence (ages 13, 15, and 17) in a community-ascertained, normative longitudinal sample of 1,483 youth (52% male). We used an autoregressive latent trajectory model with structured residuals (ALT-SR) to examine within-person developmental relations between ADHD and anxiety symptoms to determine whether it is ADHD symptoms that lead to anxiety symptoms and/or the reverse. Results: Results suggested that there are reciprocal within-person developmental relations between ADHD and anxiety symptoms. Conclusions: Our findings support the recommendation that targeting ADHD symptoms can be fruitful for addressing anxiety symptoms; however, they suggest that targeting anxiety symptoms may also benefit ADHD symptoms. Results also underline the importance of careful assessment for underlying ADHD symptoms among adolescents presenting with anxiety.

This research aimed to identify current national provision by health services in Scotland in relation to proactive screening and reactive assessment for people with an intellectual disability in Scotland who have, or are at risk of developing, dementia. Staff from 12 intellectual disability services, representing the 11 health board areas in Scotland, completed an online questionnaire which asked about proactive screening and reactive assessment for people with intellectual disability who had, or were at risk of developing, dementia as well as suggested areas for improvement. All of the areas provided services for people with intellectual disability who have, or are at risk of developing, dementia, but differed as to whether this was reactive, proactive or both. Nine services offered intervention following diagnosis. The most common elements used across both proactive screening and reactive assessment were conducting a health check, using a general dementia questionnaire designed for people with an intellectual disability and direct assessment with the person. Clinical psychology and community learning disability nurses were the professions most likely to be involved routinely in both proactive screening and reactive assessments. The psychometric properties of the most commonly used assessments of cognitive and behavioural functioning were mixed. The areas of improvement suggested by practitioners mainly related to ways of improving existing pathways. This research represents the first step in providing an overview of service provision in Scotland. There was some inconsistency in relation to the general and specific components which were involved in proactive screening and reactive assessment. Implications for service provision are discussed.

This study examined waiting times for diagnostic assessment of Autism Spectrum Disorder in 11 adult services, prior to and following the implementation of a 12 month change program. Methods to support change are reported and a multi-level modelling approach determined the effect of the change program on overall wait times. Results were statistically significant (b = - 0.25, t(136) = - 2.88, p = 0.005). The average time individuals waited for diagnosis across all services reduced from 149.4 days prior to the change program and 119.5 days after it, with an average reduction of 29.9 days overall. This innovative intervention provides a promising framework for service improvement to reduce the wait for diagnostic assessment of ASD in adults across the range of spectrum presentations.

Background The increasing number of individuals with an intellectual disability who are at risk of developing dementia highlights the need to use measures with strong psychometric properties as part of the screening, assessment and diagnostic process. Method Searches were made of clinical and good practice guidelines and English language journal articles sourced from Proquest, Web of Science and Scopus databases (up to July 2017) for tools which were designed or adapted for the purpose of helping to diagnose dementia in people with intellectual disability. Results Based on a detailed review of 81 articles and guidelines, the present authors identified 22 relevant tools (12 cognitive, 10 behaviour). These were reviewed in terms of their psychometric properties. Conclusions A number of tools were found to be available for use with people with intellectual disability; however, few were specifically standardized for this purpose which also had comprehensive information about reliability and validity.

Bed bugs, Cimex lectularius L. (Hemiptera: Cimicidae), have become a major health nuisance in the past 20 ysin cities and elsewhere throughout many areas of the world. Few studies have reported on repellent compounds that could reduce their transport in luggage. We evaluated the repellency of six naturally occurring or related compounds used in flavor/fragrance applications or structurally related compounds, para-menthane-3,8-diol, and N,N-diethyl-meta-toluamide (DEET) to bed bugs in a 183 × 183-cm arena . Repellency was assessed using soft-sided polyester lunch bags serving as surrogates of luggage and barrier cloth towels upon which rested untreated lunch bags. We report for the first time repellency of delta dodecalactone, 2-(3, 7-dimethyl-2, 6-nonadien-1-yl)-cyclopentanone (a.k.a. 'methyl apritone'), gamma dodecalactone, and para-menthane-3,8-diol to bed bugs. Propyl dihydrojasmonate, 3-methyl-5-hexyl-2-cyclohexenone, gamma methyl tridecalactone, and DEET are also documented to be repellent to bed bugs. These compounds provided relatively long-term protection. Propyl dihydrojasmonate prevented bed bugs from seeking refuge in treated lunch bags 27 d after treatment, and when applied to cloth towels repelled harborage-seeking bed bugs for 146 d. Methyl apritone blended with 3-methyl-5-hexyl-2-cyclohexenone and delta dodecalactone as an individual compound applied to cloth towels repelled bed bugs for 190 and 276 d, respectively. The above-mentioned compounds, either individually or as blends, may reduce risk of bed bugs seeking harborage in treated suitcases or towels upon which untreated luggage is placed.

Co-production is commonly conceptualised as a more equal sharing of power and decision-making between a dichotomy of service user and service provider, each bringing valuable and different assets to the process. ‘Experts by experience’ lie in the overlap between this conceptually created duality, providing the services they now do by virtue of having once used services themselves. Previous related studies suggest that their involvement in co-production could impact positively on their social capital, self-esteem, self-efficacy and life skills. However, no studies have been explicitly psychological or phenomenological in nature, and the theoretical basis for such outcomes remains under-developed. This phenomenological study explored the psychological impact of co-production for young people who were paid ‘experts by experience’ for a young person's mental health charity in a large and diverse urban area in the UK, looking at the ‘what’ of psychological impact, as well as the theoretical ‘why?’ and ‘how?’. Semi-structured interviews were conducted with a convenience sample of five males, with a mean age of 25 years. Interpretative phenomenological analysis yielded three master themes: ‘the co-production approach’, ‘I'm a professional’ and ‘identities in transition’. Participants valued a collegiate organisational approach that prioritised empowerment, agency and equality between ‘experts by experience’ and ‘experts by qualification’, leading to a positive impact on their self-efficacy and self-esteem. Co-production impacted fundamentally on their identity structure, enabling them to explore a new identity as a ‘professional’. The results are framed within identity process theory and point to the potential benefits of this model to co-production.

School-based psychosocial interventions are a widely used approach to preventing or reducing externalising behaviour. However, evaluating the effects of such interventions is complicated by the fact that the interventions may not only change the target behaviour, but also the way that informants report on that behaviour. For example, teachers may become more aware of bullying behaviour after delivering lessons on the topic, resulting in increased teacher reports of the behaviour. In this study, we used multi-group confirmatory factor analysis to evaluate whether teachers exposed to the Promoting Alternative Thinking Strategies (PATHS) intervention changed the way they reported on child externalising behaviour. Using data from the z-proso study (802 participants; 51% male; 69 teachers), teacher reports of aggressive behaviour, attention deficit hyperactivity disorder, and non-aggressive conduct disorder symptoms were compared pre- and post- intervention and across the intervention and control conditions. There was no evidence that teacher reporting was affected by exposure to the intervention. This helps bolster the interpretation of intervention effects as reflecting changes in child behaviour, rather than in the manner of informant reporting.

Although a wide range of measures of bullying have been developed, there remains a need for brief psychometrically supported measures for use in contexts in which there are constraints on the number of items that can be administered. We thus evaluated the reliability and validity of scores from a 10-item self-report measure of bullying victimization and perpetration in adolescents: the Zurich Brief Bullying Scales. The measure covers social exclusion, property destruction, verbal and physical aggression, and sexual bullying in both traditional and cyber forms. We evaluated factorial validity, internal consistency, developmental invariance, gender invariance, and convergent and divergent validity of the measure. Our sample was the normative longitudinal Zurich Project on Social Development from Childhood to Adulthood (z-proso) sample ( N = 1,304). The study involved the administration of Zurich Brief Bullying Scales to participants aged 11, 13, 15, and 17 years. Strengths and weaknesses of the measure and recommendations for utilizing and improving the measure were identified. Overall, results suggest that the items provide a reasonable general but brief measure of bullying victimization and perpetration that can be used across early to late adolescence and in both males and females.

People with an intellectual disability (ID) face significant health inequalities and barriers to accessing appropriate support, which are made worse if the person is also homeless. An important barrier is that services may not recognise that the person has ID. This qualitative study explored the views of staff members and service users about the identification and support needs of homeless people with ID and the role of an ID screening questionnaire as a way to help improve service provision. Semi-structured interviews were conducted with 16 staff members and 8 service users from homeless services in the South East of Scotland between March 2017 and 2018. Thematic analysis identified four themes: 'not diagnosed or declared', which explored the barriers to support due to the person's ID not being identified by others or disclosed by the person; 'It will crumble men', which reported on the additional challenges faced by homeless people with ID; 'disabling environment' which identified the ways in which organisations can make support difficult for people with ID to access; and 'It's not against them, it's to help them' which explored the benefits and issues associated with screening for ID in homeless services. The results identified the complex support needs likely to be experienced by many homeless people with ID and suggested a number of implications for practice. First, the screening tool was seen as having a number of benefits, if used where there is a process to provide the person with further specialist assessment and support. Second, staff members identified a need for training in relation to identifying and supporting this group of people. Third, the screening tool was seen as a way to help provide information about the prevalence and needs of people with ID, in order to inform and shape policy, service development, and delivery.

To evaluate the psychometric properties of the Child and Adolescent Intellectual Disability Screening Questionnaire (CAIDS-Q) in paediatric neurodevelopment clinics.Participants were 181 children (aged 6-18y) attending paediatric services in Scotland, divided into three age groups according to previous CAIDS-Q standardization cut-off scores. Fifty-four children (37 males, 17 females; mean age 117mo [SD 29.9mo]) met the criteria for intellectual disability and 127 did not (88 males, 39 females; mean age 120.1mo [SD 32.7mo]). A number of psychometric properties of the CAIDS-Q were evaluated, including test-retest and interrater reliability, convergent validity, sensitivity, specificity, and positive and negative predictive values based on existing cut-off scores.Significant positive relationships were found for all three age groups between CAIDS-Q scores and measures of intellectual and adaptive functioning. Test-retest reliability ranged from 'moderate' to 'almost perfect', whereas interrater reliability ranged from 'fair' to 'almost perfect'. Sensitivity and positive predictive value were 100% for all groups and specificity was between 83% and 94%, depending on age. Negative predictive values ranged from 75% to 91%.The CAIDS-Q appears to show psychometric properties that support its use as a screen for intellectual disability in paediatric neurodevelopmental settings.The Child and Adolescent Intellectual Disability Screening Questionnaire showed good psychometric properties. It identified all participating children who met the criteria for intellectual disability. Between 83% and 94% of children without intellectual disability were also correctly identified.CUESTIONARIO DE PESQUISA DE DISCAPACIDAD INTELECTUAL EN NIÑOS Y ADOLESCENTES PARA IDENTIFICAR DISCAPACIDAD INTELECTUAL: OBJETIVO: Evaluar las propiedades psicométricas del Cuestionario de Detección de Discapacidad Intelectual en Niños y Adolescentes (CAIDS-Q, siglas en inglés) en clínicas pediátricas de neurodesarrollo. MÉTODO: Participaron 181 niños (de 6 a 18 años) que asistían a servicios pediátricos en escocia, divididos en tres grupos de edad de acuerdo con los puntajes de corte de estandarización para la CAIDS-Q. Cincuenta y cuatro niños (37 varones, 17 mujeres, edad media 117 meses (DS 29.9 meses) cumplían con los criterios de discapacidad intelectual y 127 no cumplían con los criterios estipulados (88 varones, 39 mujeres, con una edad media de 120,1 meses (DS 32,7 meses). Se evaluaron varias propiedades psicométricas del CAIDS-Q, incluidas la repetibilidad y la confiabilidad entre evaluadores, la validez convergente, la sensibilidad, la especificidad y los valores predictivos positivos y negativos basados en los puntajes de corte preexistentes. RESULTADOS: Se encontraron correlaciones positivas significativas para los tres grupos de edad entre los puntajes CAIDS-Q y las mediciones de funcionamiento intelectual y adaptativo. La confiabilidad test-retest (repetibilidad) fue de ‘moderada’ a ‘casi perfecta’, mientras que la confiabilidad entre evaluadores fue de ‘buena’ a ‘casi perfecta’. La sensibilidad y el valor predictivo positivo fueron del 100% para todos los grupos y la especificidad fue del 83% al 94%, según la edad. Los valores predictivos negativos fueron del 75% al ​​91%. INTERPRETACIÓN: El CAIDS-Q parece mostrar propiedades psicométricas que respaldan su uso como instrumento de pesquisa para la discapacidad intelectual en contextos de neurodesarrollo pediátrico.QUESTIONÁRIO DE RASTREIO DE DEFICIÊNCIA INTELECTUAL DA CRIANÇA E DO ADOLESCENTE PARA IDENTIFICAR CRIANÇAS COM DEFICIÊNCIA INTELECTUAL: OBJETIVO: Avaliar as propriedades psicométricas do Questionário de Rastreio da Deficiência Intelectual da Criança e do Adolescente (CAIDS-Q) em clínicas de neurodesenvolvimento pediátrico. MÉTODO: Os participantes foram 181 crianças (idades 6-18 anos) que frequentam serviços pediátricos na Escócia, divididos em três grupos etários de acordo com pontos de corte da padronização do CAIDS-Q. Cinquenta e quatro crianças (37 do sexo masculino, 17 do sexo feminino; média de idade 117m [DP 29,9m]) atenderam aos critérios para deficiência intelectual e 127 não atenderam (88 do sexo masculino, 39 do sexo feminino; média de idade 120,1m [DP 32,7m]). Um número de propriedades psicométricas do CAIDS-Q foram avaliadas, incluindo confiabilidade teste-reteste e entre examinadores, validade convergente, sensibilidade, especificidade, e valores preditivos positivos e negativos, com base em pontos de corte existentes. RESULTADOS: Relações positivas significativas foram encontradas para todos os três grupos etários entre os escores CAIDS-Q e medidas de funcionamento intelectual e adaptativo. A confiabilidade teste-reteste variou de “moderada” a “quase-perfeita”, enquanto a confiabilidade entre examinadores variou de “leve” a “quase perfeita”. Os valores de sensibilidade e valores preditivo positivos foram 100% para todos os grupos, e a especificidade variou de 83% a 94%, dependendo da idade. Valores preditivos negativos variaram de 75% a 91%. INTERPRETAÇÃO: O CAIDS-Q parece mostrar propriedades psicométricas que sustentam seu uso para rastrear deficiência intelectual em ambientes de neurodesenvolvimento pediátrico.

Aim To evaluate the effect of a 12-week mindfulness-based stress reduction (MBSR) course adapted for people with an intellectual disability (ID).\ud \ud Methods Ten participants with ID completed measures of well-being and understanding of the concepts of mindfulness before and after the course, provided information about additional practise and gave feedback on the perceived benefits of the course.\ud \ud Findings No significant difference was found between mean well-being or understanding scores before and after the course. A significant relationship was found between additional practise and post-course well-being scores. Perceived benefits of mindfulness included reduced stress, increased self-control and confidence.\ud \ud Conclusion MBSR may be effective for people with ID but the benefits may not always be reflected in changes in questionnaire scores. The amount of practise of mindfulness exercises may be an important component of increasing well-being.