No abstract

The present study examined the knowledge of 116 health and social care staff working in learning disability services about the symptoms of mental health problems in this client group, using the Mini PAS-ADD as a comparator. Seventy-one percent of participants currently supported a client with mental health problems and learning disabilities; however, only 47 percent had received any training in this area. The health staff scored significantly higher than the residential and day care staff in relation to knowledge of symptoms for anxiety, depression and psychosis, but overall levels were low for all three groups. Those individuals who had received training in the area had significantly greater knowledge about symptoms, and higher confidence levels in supporting this client group, than those who had not. The staff also reported a range of behavioural symptoms, which were not included in the Mini PAS-ADD. Implications of the study are discussed.

The effect of pH on the initial-rate kinetic behaviour of BVR-A (biliverdin-IXalpha reductase) exhibits an alkaline optimum with NADPH as cofactor, but a neutral optimum with NADH as cofactor. This has been described as dual cofactor and dual pH dependent behaviour; however, no mechanism has been described to explain this phenomenon. We present evidence that the apparent peak of activity observed at neutral pH with phosphate buffer and NADH as cofactor is an anion-dependent activation, where inorganic phosphate apparently mimics the role played by the 2'-phosphate of NADPH in stabilizing the interaction between NADH and the enzyme. The enzymes from mouse, rat and human all exhibit this behaviour. This behaviour is not seen with BVR-A from Xenopus tropicalis or the ancient cyanobacterial enzyme from Synechocystis PCC 6803, which, in addition to being refractory to activation by inorganic phosphate, are also differentiated by an acid pH optimum with both nicotinamide nucleotides.