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Accessible summary: To feel safe and to keep well, all of us need to stay in touch with our friends—most of all in the pandemic, and even more if we have a disability.In these times of COVID‐19, we have kept a community group for men with learning disabilities going online.In the gaps between lockdowns, we have met in a mixed online and face‐to‐face group—with the face‐to‐face part happening in a library.The men say that they have been helped by both kinds of meeting, but that they liked the mixed or "hybrid" one the best.This article shows what we have learned from running the group in these ways, and it gives advice for anyone who might want to have a go themselves. Background: Social contact and belonging are among the most important keys to health and wellbeing, especially for the most vulnerable during the current global pandemic. Method: This reflective paper describes the authors' efforts to sustain an online version of a well‐established community psychology‐oriented group for men with learning disabilities, in challenging times. Drawing upon the learning disability literature and upon theories from community and embodied‐dialogical psychology, it explores the most salient shared issues, our joint efforts to address them and possible implications for future clinical practice. Findings: To take advantage of the discovered benefits of online working, we envisage that, post‐lockdown, the group will continue to meet in a "hybrid" (combined face‐to‐face and online form) as described herein: and with some pointers for anyone who might wish to create a similar group. [ABSTRACT FROM AUTHOR]

Accessible Summary: This paper reviews the present educational needs of children and young people and autistic spectrum disorder (ASD) in Egypt.Children with ASD are largely unrecognised by the educational provision in Egypt.This paper highlights the need for an improved educational programme for children with ASD who also experience an associated learning disability and learning difficulties.It is crucial to develop teacher support programmes and empower teachers to enable children and young people with ASD develop their fullest potential. This paper outlines, through a transnational discourse between partners in Egypt and the UK, an overview of the literature on the definition and features of autistic spectrum disorder (ASD) with associated learning needs and health conditions as applied to children and young people in Egypt. As a low‐ to middle‐income country, Egypt has a poor and underdeveloped health, education and social service to support children with ASD and very little research has investigated this phenomenon. This paper adds to the discussion through the shared knowledge and practice in the educational curriculum of children with ASD in Egypt. [ABSTRACT FROM AUTHOR]

Accessible summary We wanted to know what people with learning disabilities know about dementia. We asked service users what the word meant to them, if they knew anyone with dementia, and what it was like to share a house with someone who has dementia. We learnt that: • Service users can know a lot about dementia. • Living with someone with dementia can be really hard – and staff do not always have enough time for everyone else. • Services should think more about how dementia affects everyone – not just the person who has the dementia. This paper reports on research that illuminates how people with a learning disability understand dementia and indicates the implications of these understandings for developing appropriate models of care. As this new policy and practice area struggles to provide appropriate and effective models of care for people with a learning disability and dementia, an awareness of service users’ understandings of dementia leads to a number of important insights. The wider research programme from which this paper is drawn aims to identify best practice in supporting people with learning disabilities to stay in their own homes as they grow older and develop dementia. A combination of focus groups, ethnography and individual interviews were conducted at eight sites across England. Participants were people with a learning disability who had dementia, and those who have lived with someone with dementia. The findings have the potential to improve support to this population as they grow older. [ABSTRACT FROM AUTHOR]

Accessible summary • This paper is about a workshop held by researchers from the University of Leeds. • The researchers looked at one area to see if people were doing things about health that the Government said they should in Valuing People. • The research found out that there is still a lot of work to do in the area to meet these targets. People came to a workshop to talk about this. They thought that: • Learning disability services should lead the way and draw up a plan about what needs to happen. • People who run health services should make sure they set targets for GPs and hospitals that fit in with the plan. • Government should make sure that the targets they set for GPs also fit in with Valuing People targets. • This research is important because it can show what helps health services improve for people with learning disabilities and what gets in the way. Research at the University of Leeds has evaluated how well changes to healthcare proposed in the Government White Paper Valuing People ( Department of Health 2001 ) were being implemented in one locality and their impact on people with learning disabilities. The project had a developmental aspect and incorporated two workshops over the course of the study to disseminate preliminary findings. These were used to help key stakeholders evaluate progress and to inform discussions about what should happen next in the fieldwork area. This paper discusses recommendations from the first research workshop at which preliminary findings from the study were presented. The workshop involved health and social care providers and managers, people with learning disabilities, voluntary and community organizations. It gives an overview of local issues relevant to the White Paper health targets and highlights those that need to be resolved before these targets can be achieved. These issues are likely to be replicated in other areas of England and Wales and have implications for leadership, strategy, the allocation of resources and structures of accountability in health and social care agencies. [ABSTRACT FROM AUTHOR]

Accessible summary People with learning disabilities do not live as long as other people or as long as many should., Nationally, people with learning disabilities do not get as good help when they do get ill., This paper looks at work that was conducted in Lincolnshire to see how the health of people with learning disabilities compared to the rest of the population., The report recommended changes which could be made to make things better., Summary The NHS Constitution requires all NHS organisations to provide high-quality comprehensive services, based on clinical need, which do not discriminate between patients (DH 2010a). Together with its health and social care partners, the NHS also has a statutory duty of care to meet the needs of all patients with dignity and compassion. Recent evidence has revealed sharp failures in the NHS to meet these goals in relation to people with learning disabilities nationally. This article considers the well-established evidence that the latter group have worse health experiences and worse health outcomes than the population as a whole, which significantly contributes to marked inequalities both in morbidity and mortality. The public sector equality duty of the Equality Act 2010 imposes a statutory requirement on health and social care agencies to address such inequalities. This article draws on the first systematic health needs assessment ( HNA) of adults with learning disabilities in the county of Lincolnshire, established in 2011 to identify their health needs and make recommendations for improvement. [ABSTRACT FROM AUTHOR]

Accessible summary •People with a learning disability can have epilepsy and can have long seizures. •The treatment for long seizures is rectal diazepam given up the back passage. •Some carers and people with epilepsy do not like this. •Buccal midazolam is a treatment for long seizures that is given by mouth. •Buccal midazolam seems to work as well as rectal diazepam in children with epilepsy. •New guidance to doctors says they can use buccal midazolam in adults for long seizures. •People with learning disabilities and carers can ask their doctor to prescribe buccal midazolam instead of rectal diazepam to treat long seizures. Background Buccal midazolam is widely used in children for the emergency treatment of epilepsy, and these children are graduating into adult learning disability services. Aims The aim of this paper was to appraise the evidence for buccal midazolam as a treatment for prolonged seizures in adults with learning disabilities. Method A literature search was performed and the identified papers appraised. Results The literature search identified only one randomized trial for buccal midazolam as emergency treatment of seizures, and this was in children and adolescents. It showed that buccal midazolam was as effective as rectal diazepam. Conclusions There is evidence that buccal midazolam is effective, but it is unlicensed for this purpose. Rectal diazepam should remain the first choice, but buccal midazolam should be discussed with patients and carers as an alternative. Declaration of interest nil. [ABSTRACT FROM AUTHOR]

Accessible summary • People with learning disabilities have more health needs than the general population, and those health needs are different and require more specialised services. There is evidence of poorer outcomes and less effective health interventions for people with learning disabilities in Scotland, and elsewhere. • Reducing health inequalities is currently a key priority for the Scottish Government and National Health Service (NHS) policy has encouraged patient involvement in healthcare planning and delivery. This article reports on an NHS initiative to involve people with learning disabilities as ‘expert patient’ reviewers in national review teams, looking at the quality of inpatient and community services for people with learning disabilities. All 15 Health Boards in Scotland were reviewed, using a set of quality indicators. Details of the planning and support arrangements are reported. The success of the initiative was evaluated. • This involvement of people with learning disabilities as reviewers of NHS services has tested traditional assumptions and challenged the power imbalance in patient-provider relationships. Recommendations are made for the future success of similar schemes. Reducing health inequalities is a key priority for the Scottish Government. Health authorities are expected to meet quality targets. The involvement of people with learning disabilities in health service review teams has been one of the initiatives used in by National Health Service Quality Improvement Scotland to empower patients and improve health services. This paper describes this initiative, how it was planned, and an evaluation by health staff, carers and people with learning disabilities. Recommendations are made to ensure the future success of this type of initiative in Scotland and elsewhere. This initiative was evaluated positively and tested traditional assumptions, challenging the power imbalance in patient-provider relationships. The theory and the practice of including people with learning disabilities as ‘expert patient’ reviewers are discussed. [ABSTRACT FROM AUTHOR]

Accessible summary • Many people with learning disability have poor health, compared with other people. • Each person taking part in this study told their health story and set themselves health targets. • Some of the things they learnt were: what to do when they are in pain; how to make appointments with the doctor; and how to make their needs clear when they are in the doctor’s surgery. • This research is important in helping people feel more confident when they visit their doctor, and in making it more likely that they are able to stay healthy. • The health of people with learning disabilities is poor when compared with the general population but this difference is not reflected in higher rates of access to primary healthcare. • This paper will report on a study undertaken to run and evaluate a 12-week programme to enable people with learning disabilities to better access primary healthcare. • The importance of this research lies in the successful outcomes achieved, and in the distinctive properties of the programme, which used practice-based groups, and focussed on the development of health skills as well as health knowledge. [ABSTRACT FROM AUTHOR]

This paper describes how a group of five older adults with Down's syndrome decided what they wanted from their doctor. The group worked out what they meant by health. The group also looked at what it was OK for a doctor to ask or do. They made lists of these. The group decided that being healthy means being able to do things. Feelings, of being scared for example, are an important part of being ill. Older adults with Down's syndrome are able to say what they want from their doctor. They can be helped to do this by working together in a small group. [ABSTRACT FROM AUTHOR]

The appropriateness and justification of physical restraint procedures in secure learning disability settings is an emotive issue. This paper examines the views of service users ( n = 10) from secure residential facilities who are restrained frequently. Using a semi-structured interview schedule, Service users were interviewed about their restraint experiences. They reported that restraint can lead to potentially abusive situations and that staff should try other approaches before restraining someone. They were divided on whether it calmed them down and whether staff enjoyed performing restraint. Other comments included that restraint may or may not serve a purposeful goal and that there is a definite need for staff training for those involved in performing restraint. [ABSTRACT FROM AUTHOR]

Impacted earwax is extremely common in people with learning disabilities. Although it is not a serious medical condition it causes a number of very unpleasant problems. These symptoms include discomfort in and around the ear, hearing loss, dizziness and noises in the ears. It also causes secondary problems with ear infections and hearing aid use. This paper reviews the clinical symptoms of impacted earwax and investigates possible causality. Evidence shows that people with learning disabilities are twice as likely to have impacted wax than the general population. The reason for this association is unclear. In the present study, the correlation between the occurrence of chronic wax obstruction and a reduced ability to chew due to the absence of back (molar) teeth was investigated. In the current pilot we have used clinical records to establish the presence of chronic wax obstruction and postal questionnaires to ascertain participants’ dental status. The results of this study show a positive relationship between chronic earwax obstruction and the absence of back (molar) teeth. These findings have significant implications and should be considered when planning the health care of people with learning disabilities. [ABSTRACT FROM AUTHOR]

Despite the rhetoric of involvement of people with learning disabilities in health care there is a dearth of research which examines the extent to which service users are included in evaluating their own care. This paper describes a study of methods for enabling people with learning disabilities and complex health needs to comment on the specialist inpatient care they received. Six service users consented to take part in interviews using analogue scales and photographs. The participants were able to engage in all elements of the interviews even though inclusion was more challenging because of additional health problems such as manic depression and paranoid psychosis. The suitability of research tools and approaches are discussed and barriers to inclusion identified. In this investigation a gap emerged between government policy of inclusion for everyone, and the realities of frontline practice where involvement was not achieved for some users with severe/profound disabilities. The study points to implications for increased resources, education and training if meaningful user involvement is to become established for individuals within routine practice. [ABSTRACT FROM AUTHOR]

With the promotion and wider acceptance of the concept of ‘normalization’ and ‘community integration’, an increased number of adults with learning disabilities are living in the community and facing more social and health care problems. The authors describe the introduction of new guardianship laws in Hong Kong with the creation of a Guardianship Board to safeguard the interests of all those who are mentally unable to make decisions about their personal, medical or financial affairs. Some case vignettes are provided to illustrate its functions and roles. By sharing the Hong Kong experience, it is hoped that this paper can raise awareness of circumstances in countries that are planning to develop or reform their guardianship practices for people with learning disabilities. [ABSTRACT FROM AUTHOR]

The article presents an introductory statement to the March 2006 issue of the "Journal of Learning Disabilities." Three papers in the issue highlight the gap between the rhetoric of inclusion and involvement and the reality of people's experiences. Another paper reflects on the difficulties of obtaining people's views on their health care. One research highlights the hopes and dreams of policy makers, implementers and practitioners for the provision of services for older people with learning disabilities.

The aim of the present paper was to examine general practitioners' (GPs') beliefs about: the demands made on the primary care team by people with learning disability; their confidence in meeting health care needs and perceived training requirements; attitudes towards specialist or generic health service provision, and current contact with specialist teams; and attitudes towards screening in people with learning disability. A postal questionnaire was sent to a randomly selected partner from 95% of the practices in the Southampton and South-west Hampshire Health District. Forty-eight (75%) GPs responded and few were undecided about the demands placed on primary care teams, but beliefs were mixed. Most GPs were confident in dealing with the medical care needs of people with learning disability and the majority felt that training courses would not be worthwhile, except to learn more about specialist services where contact was very low and a ‘link worker’ scheme had had little apparent impact. Most respondents agreed that GPs should meet the medical needs of people with learning disability as part of general medical services and approximately half had a positive attitude towards providing regular health checks. Respondents were cautious about offering cervical cancer screening to women with learning disability. A small minority suggested that they would take no action to follow up a non-attendance for mammography. As a heterogeneous population, it is not surprising that GPs' attitudes vary widely. Further research is required to establish the nature and scale of demands made on primary health care teams, and to evaluate systematic means of addressing health care needs of people with learning disability. [ABSTRACT FROM AUTHOR]