ABBREVIATION NICPR Northern Ireland Cerebral Palsy RegisterAIM To report the prevalence, clinical associations, and trends over time of oromotor dysfunction and communication impairments in children with cerebral palsy (CP).METHOD Multiple sources of ascertainment were used and children followed up with a standardized assessment including motor speech problems, swallowing ⁄ chewing difficulties, excessive drooling, and communication impairments at age 5 years.RESULTS A total of 1357 children born between 1980 and 2001 were studied (781 males, 576females; median age 5y 11mo, interquartile range 3-9y; unilateral spastic CP, n=447; bilateral spastic CP, n=496; other, n=112; Gross Motor Function Classification System [GMFCS] level: I, 181; II, 563; III, 123; IV, 82; IV, 276). Of those with 'early-onset' CP (n=1268), 36% had motor speech problems, 21% had swallowing ⁄ chewing difficulties, 22% had excessive drooling, and 42% had communication impairments (excluding articulation defects). All impairments were significantly related to poorer gross motor function and intellectual impairment. In addition, motor speech problems were related to clinical subtype; swallowing ⁄ chewing problems and communication impairments to early mortality; and communication impairments to the presence of seizures.Of those with CP in GMFCS levels IV to V, a significant proportion showed a decline in the rate of motor speech impairment (p=0.008) and excessive drooling (p=0.009) over time.

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Physiotherapists' management of CRF includes recommending and using exercise and teaching energy-conservation techniques. Therapists recommend and/or use exercise with a variety of cancer populations, across all stages of the disease trajectory, in particular during advanced stages of the disease. Findings show therapists feel their practice is affected by the lack of exercise guidance for the cancer population. CRF management and physiotherapy practice would benefit from further research testing the efficacy of exercise in understudied patient groups, in all stages of the disease trajectory.

Findings suggest that women diagnosed with gynecological cancer perceive participation in physical activity as important and participation provides benefits in terms of psychological well-being and improved physical functioning. Support for continuation of many of the current features of the home-based programme was provided. Findings provide insight and rationale for the selection of components for future home-based physical activity interventions. Findings also support further research into the development of multidimensional interventions for the gynecological cancer population.

Although the aetiology of psychotic symptoms in Alzheimer's disease (AD) is multi-factorial, alterations in serotonergic neurotransmission are often implicated. Polymorphisms of the serotonin receptor 5HT-2A are associated with hallucinatory symptoms and delusions in demented and non-demented cohorts. This study examined the role of the 5HT-2A T102C polymorphism in influencing psychotic symptoms in a large Northern Ireland AD population (n ¼ 406, mean MMSE 13/ 30). Forty-eight percent of patients experienced delusional symptoms and 28% experienced hallucinations during the course of their dementia. No significant association was found either in frequency of genotype or allelic variation for either set of symptoms. Furthermore, the mean delusional and hallucinatory severity scores did not differ significantly among the three genotype groups. The lack of influence of the T102C polymorphism of the 5HT-2A receptor on the emergence of psychotic symptoms in AD contrasts with previous reports in other cohorts involving smaller numbers of subjects. ß

The role of healthcare support workers (HCSWs) in sexual health is as invaluable tools of the trade in providing and developing flexible, client-focused frontline services ( Meek et al, 2014 ). Long client waits within a central Glasgow clinic setting have emphasised the need for change and provided a platform for extending the options available for clients. This article highlights the extended roles of HCSWs in provision of client-centred care within integrated sexual and reproductive health services in Glasgow. This service provision is underpinned by a defined protocol, incorporating inclusion criteria for asymptomatic screening, which allows a low-risk, self-selection process for the client, deeming them eligible to be seen within a test-only clinic (TOC).

Aims and MethodTo establish the proportion of psychiatrists in Northern Ireland who currently work part-time and the proportion of those working fulltime who wish to work part-time. A postal questionnaire was forwarded to psychiatrists and repeated 30 months later.ResultsIn 2004, only 18.3% of respondents were working part-time, and 26.8% in 2006. A great majority stated their intent was to always work part-time, the most frequent reason being to achieve work–life balance.Clinical ImplicationsA significant number of staff working part-time will have implications for the staffing of the service. Policy makers must plan for the adequate provision of part-time working arrangements.

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