This qualitative study explored the views of family carers about the support that their adult children with an intellectual disability had received in relation to their behaviour that challenged. There was a particular focus on positive behavioural support (PBS), although some participants spoke more generally in terms of positive approaches.Semi-structured interviews with eight family carers were analysed using inductive thematic analysis. Four key themes were identified. Good support, of which PBS was an example, was seen as both having reduced behaviours that challenged and having a wider positive impact on the quality of life of the individual and their families. Key features highlighted were: technical knowledge and skill; a strong value base of warmth, acceptance and respect; a collaborative, consistent approach; open communication;and the extension of support to the family carer when needed. It was recognised that there is a need for broad systemic change and for the application of a workforce development model that takes account of the needs of staff, carers and those working in wider systems that have contact with people with an intellectual disability. K E Y W O R D Sadult learning disability services, behaviour change, carers, challenging behaviour | INTRODUCTIONBehaviours that challenge are thought to be prevalent among 10%- There is, however, to the authors' knowledge, no research which explores the views of family carers in relation to their adult family member receiving PBS. The present study aims to address this gap in the literature. Specifically, the study aimed to understand more about how family carers conceptualised PBS and how they had experienced this in relation to their family member. | METHODS | DesignThe study adopted a contextualist approach which gives weight to individuals' subjective experiences within the social context that shapes how they give meaning to them (Willig, 1999). Inductive thematic analysis was chosen because it is largely non-theoretical and is not underpinned by a particular epistemological stance (Braun & Clarke, 2006). The study received ethics approval from the first author's educational establishment. | ParticipantsParticipants were recruited using purposive sampling via support and advocacy organisations in the North of England which provide support to people with intellectual disability. Purposive sampling was chosen because we were interested in particular characteristics of the participants, i.e. their experiences of support that their family member had received. Three interviews and one focus group were conducted, based on the expressed preferences of the participants. Five of the participants (three interviewees and two focus group members) had adult children with intellectual disability and behaviour that challenged. The remaining three focus group members had experience of support for a family member with intellectual disability which was not specifically named as PBS, but was viewed as "positive" and contrasted with past experiences of unhelpfu...

These results have implications for socio-emotional interventions, such as universal school programmes.

Accessible Summary People with a learning disability do not always get good support We wanted to know what they thought about positive behavioural support They told us many important things about good and bad support Good support included being treated as a human being, having a good and full life and being helped with behaviour and skills. Abstract BackgroundThere is a growing evidence base about the effectiveness of positive behavioural support (PBS) in relation to behaviours that challenge (CB). There is, however, limited research from the perspective of individuals receiving this support. The objective of this qualitative study was to obtain the views of participants with an intellectual disability about what was important to them in relation to receiving PBS. Materials and methodsSeven participants with an intellectual disability, recruited via support organisations in the North East of England, gave their views about their support through interviews (n = 3) and a focus group (n = 4). Data were collected between April and June 2016 and were analysed using thematic analysis. ResultsFour themes were identified: the importance of being treated as a human being; the wider impact of PBS; the contrast of PBS with previous experiences of support; and the beneficial impact of positive support. PBS was valued for its wide impact on quality of life, with a reduction in CB being just one of many important aspects. ConclusionThis study highlights the importance of including service user perspectives and quality‐of‐life indicators in research which evaluates service provision and support.

AimsEstrogen and progesterone hormone receptor (ER and PR) expression in invasive breast cancer predicts response to hormone disruptive therapy. Pygopus2 (hPYGO2) encodes a chromatin remodelling protein important for breast cancer growth and cell cycle progression. The aims of this study were to determine the mechanism of expression of hPYGO2 in breast cancer and to examine how this expression is affected therapeutically.MethodshPYGO2 and ER protein expression was examined in a breast tumour microarray by immunohistochemistry. hPYGO2 RNA and protein expression was examined in ER+ and ER− breast cancer cell lines in the presence of selective estrogen hormone receptor modulator drugs and the specificity protein-1 (SP1) inhibitor, betulinic acid (BA). The effects of these drugs on the ability for ER and SP1 to bind the hPYGO2 promoter and affect cell cycle progression were studied using chromatin immunoprecipitation assays.ResultshPYGO2 was expressed in seven of eight lines and in nuclei of 98% of 65 breast tumours, including 3 Ductal carcinoma in situ and 62 invasive specimens representing ER-negative (22%) and ER-positive (78%) cases. Treatment with either 4-Hydroxytamoxifen (OHT) or fulvestrant reduced hPYGO2 mRNA 10-fold and protein 5–10-fold within 4 h. Promoter analysis indicated an ER/SP1 binding site at nt −225 to −531 of hPYGO2. SP1 RNA interference and BA reduced hPYGO2 protein and RNA expression by fivefold in both ER- and ER+ cells. Further attenuation was achieved by combining BA and 4-OHT resulting in eightfold reduction in cell growth.ConclusionsOur findings reveal a mechanistic link between hormone signalling and the growth transcriptional programme. The activation of its expression by ERα and/or SP1 suggests hPYGO2 as a theranostic target for hormone therapy responsive and refractory breast cancer.

Background: The life span nature of anxiety and depression has led to an interest in whether assessments designed for use with children and young people are also valid for adults. The Revised Children's Anxiety and Depression Scales (RCADS) is a commonly used measure and we aimed to explore its structural validity in adults. Methods: We examined the factorial validity of the original and two short form versions of the Revised Children's Anxiety and Depression Scales (RCADS) adapted for adults, using confirmatory factor analysis with a convenience sample (n = 371) aged 18-67. Results: All versions of the RCADS were found to provide reliable measures of general anxiety and depression in adults and of most subdimensions of anxiety corresponding to the original version of the RCADS. However, anxiety subdimension reliability was primarily driven by the strong general anxiety dimension, due to the high comorbidity between anxiety subtypes. Limitations: We did not include data for children as well as adults in our analyses and small changes were made to the wording of five RCADS items to make them appropriate for adults. Conclusions: Results suggest that all versions could be helpful for longitudinal and comparative research and evaluation of clinical outcomes, in situations where the focus is on general anxiety and depression, rather than clinical subtypes.

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.

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.

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. 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. 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. 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.