Accessible summary• The government and NHS say it is important for people with learning disabilities to be able to take part in research if they want to.• We asked five people with learning disabilities about participating in research.They said they wanted to participate in research to help make things better for other people with learning disabilities. They also said if research is not easy to understand, it can be hard for people with learning disabilities to take part.• We also sent a questionnaire to clinicians working in a learning disabilities service.Thirty-four clinicians replied. They said research with people with learning disabilities was important to help improve services. They said, sometimes it is difficult to find the time, money and support to do research.
Parkinson's disease (PD) is characterized by movement disorders, including bradykinesia. Analysis of inherited, juvenile PD, identified several genes linked via a common pathway to mitochondrial dysfunction. In this study, we demonstrate that the larva of the Drosophila parkin mutant faithfully models the locomotory and metabolic defects of PD and is an excellent system for investigating their inter-relationship. parkin larvae displayed a marked bradykinesia that was caused by a reduction in both the frequency of peristalsis and speed of muscle contractions. Rescue experiments confirmed that this phenotype was due to a defect in the nervous system and not in the muscle. Furthermore, recordings of motoneuron activity in parkin larvae revealed reduced bursting and a striking reduction in evoked and miniature excitatory junction potentials, suggesting a neuronal deficit. This was supported by our observations in parkin larvae that the resting potential was depolarized, oxygen consumption and ATP concentration were drastically reduced while lactate was increased. These findings suggest that neuronal mitochondrial respiration is severely compromised and there is a compensatory switch to glycolysis for energy production.parkin mutants also possessed overgrown neuromuscular synapses, indicative of oxidative stress, which could be rescued by overexpression of parkin or scavengers of reactive oxygen species (ROS). Surprisingly, scavengers of ROS did not rescue the resting membrane potential and locomotory phenotypes. We therefore propose that mitochondrial dysfunction in parkin mutants induces Parkinsonian bradykinesia via a neuronal energy deficit and resulting synaptic failure, rather than as a consequence of downstream oxidative stress.
The role and future of assessment and treatment units for people with intellectual disabilities is once again the focus of debate and government policy. Reviewing the admissions to inpatient services can provide useful information about the characteristics, needs and clinical outcomes of clients. Data were collected retrospectively for all 36 referrals accepted to an inpatient assessment and treatment unit for people with intellectual disability, between January 2013 and April 2014. Clinical and demographic characteristics of service users were identified through descriptive analysis. Male service users, mild intellectual disability and diagnosis of autistic spectrum disorder were frequent, and a high proportion of admissions had complex and multiple needs. The Health of the Nation Outcome Scale-Intellectual Disabilities was used as a clinical outcome measure. We conclude with recommendations for service development following closure of our inpatient service.
Purpose The purpose of this paper is to explore the characteristics of adults with intellectual disabilities supported by a Community Forensic Learning Disability Team (CFT) and interventions delivered. It discusses the clinical implications of these and examines outcomes such as recidivism. Design/methodology/approach A retrospective case note review of all 70 service users open to the CFT during June 2013 was carried out, using a structured service evaluation tool. Findings The majority of service users (74.3 per cent) had a mild intellectual disability. Multiple mental health and/or physical health diagnoses were common, and 28 per cent had problematic drug or alcohol abuse. Almost half of service users had been victims of physical or sexual abuse, or neglect. Sexual offences were the most common index offence, followed by assault and fire-setting. A wide range of multi-disciplinary interventions were delivered within the Community Forensic Team. Following CFT involvement there was an increase in service users living in supported living in the community and a decrease in people in secure or out of area placements. Over half of service users engaged in no further offending behaviour since their referral, and those who did offend generally showed a decrease in the severity of offending behaviours. There was a large decrease in the number of convictions received. Practical implications The study shows the benefits of a multi-disciplinary Community Forensic Team for offenders with intellectual disabilities in terms of reduced recidivism and range of interventions delivered. It highlights the importance of clinicians within such a team having the skills to work with people with co-morbid diagnoses (e.g. autism) and people with trauma backgrounds and problematic substance use. Originality/value This paper demonstrates the complexity of the service users who are supported by the CFT, as well as the integral role played in supporting individuals to move to less restrictive settings, with positive outcomes.
Accessible summary• We ran a new group for people with learning disabilities who heard voices.• We interviewed people who came to the group to see whether they liked the group. We also interviewed people who decided not to come to the group, to find out why.• We also asked family members and professionals what they thought about the group.• People thought the group would help them cope with their voices. • People who came enjoyed meeting other people who heard voices. • We found that some things stopped people coming to the group. We want to change these things for the next group so that more people will be able to come. SummaryGroup work for people who experience voice hearing in the mainstream population has been shown to have various benefits; however, there is little research describing hearing voices groups for people with learning disabilities. This study describes perceptions of a new hearing voices group for people with mild learning disabilities. Semi-structured interviews with twelve participants were conducted. This included three clients who attended the hearing voices group, three of their family members/ carers and one professional. In addition, of those who were referred to the group but chose not to attend, one client, two family members/carers and two professionals were interviewed. Interview data were transcribed verbatim and thematic analysis was used to identify three overarching themes; the first 'benefits of our hearing voices group' described participants' evaluations and perceptions of the hearing voices group. The second 'making the decision to attend' covers factors that influence clients when deciding whether or not to attend a hearing voices group. In the final theme 'positive and negative contributors to the voice-hearing experience', participants reflected on factors that affect the voice-hearing experience. The hearing ª The Official Journal of the British Institute of Learning Disabilities voices group was valued by participants; however, services should consider the barriers to attendance faced by some clients. Strategies for addressing these are discussed.
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