Objective-To compare general practitioners' care of adult patients with learning disability with that of control patients in the same practice. Design-Case-control study of patients and controls by a structured interview study of general practitioners. Setting-Avon. Patients-78 adult patients with learning disability and 78 age and sex matched controls -cared for by 62 general practitioners. Main measures-Number and content of consultations and opinions of the general practitioners.Results-There were more consultations for diseases of the central nervous system and of the skin among the patients than the controls (15 v 3 for central nervous system disease and 15 v 4 skin disease). There were also significantly fewer recordings of blood pressure and cervical cytology tests (34 v 51 for blood pressure and 2 v 18 for cytology). Although more patients were taking drugs affecting the central nervous system (33 v 6), more controls were taking drugs for musculoskeletal complaints (17 v 7). Conclusions-Although adult patients with learning disability consult with their general practitioners at equivalent rates to other patients, they get less preventive care and consult for different types of problems than do other patients. The reasons for these differences in preventive care are not clear. Carers and general practitioners should be informed of these differences to ensure that appropriate care is given.
To a large extent the health care needs of people with learning disabilities living in the community have been neglected by policy makers, purchasers and providers. One result is that the role of carers, paid and unpaid, in monitoring and promoting health has been ignored. This article reports on interviews with carers and is drawn from a study which examined the delivery of primary health care to people with learning disabilities. A range of topics was covered during interview including: carers' perceptions of their role, contact with and assessment of general practitioners' (GPs') skills, difficulties experienced during consultations, views about medication, health promotion and health screening. Results indicated that insufficient attention is paid to the needs of people with learning disabilities in respect of health promotion, health screening and regular hearing and sight tests. Whilst generally satisfied with the care provided by GPs, carers made many suggestions about how to improve the standard of care offered. Suggestions for supporting paid and unpaid carers in order to fulfil their role are made. The need for joint strategies at the operational level and strategic level is also discussed.
The Gaussian product inequality is a long-standing conjecture. In this paper, we investigate the three-dimensional inequality E] for any centered Gaussian random vector (X 1 , X 2 , X 3 ) and m 2 , m 3 ∈ N. First, we show that this inequality is implied by a combinatorial inequality. The combinatorial inequality can be verified directly for small values of m 2 and arbitrary m 3 . Hence the corresponding case of the three-dimensional inequality is proved. Second, we show that the three-dimensional inequality is equivalent to an improved Cauchy-Schwarz inequality. This observation leads us to derive some novel moment inequalities for bivariate Gaussian random variables.
The long-standing Gaussian product inequality (GPI) conjecture states that E[ n j=1 X] for any centered Gaussian random vector (X 1 , . . . , X n ) and m 1 , . . . , m n ∈ N. In this note, we describe a computational algorithm involving sums-of-squares representations of multivariate polynomials that can be used to resolve the GPI conjecture. To exhibit the power of this novel method, we apply it to prove two special GPIs: E
The long-standing Gaussian product inequality (GPI) conjecture states thatfor any centered Gaussian random vector (X 1 , . . . , X n ) and any non-negative real numbers α j , j = 1, . . . , n. In this note, we prove a novel "opposite GPI" for centered bivariate Gaussian random variables when −1 < α 1 < 0 and α 2 > 0:This completes the picture of bivariate Gaussian product relations.
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