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Aim To investigate the views of people with a learning disability on their experiences of the community team for people with a learning disability (CTPLD ) that is designed to meet their health and social care needs. Method Two focus groups were held with people who have learning disabilities. A flip chart with photographs of the CTPLD members, pictures and vignettes about how people use the team's services and a semi-structured interview schedule were used to ask participants about which healthcare professionals they had seen, what they had found helpful about the CTPLD and ideas for changes to the service. Findings Participants identified positive areas of practice as well as areas for improvement. Participants reflected on their relationship with the team as well as individual professionals. Conclusion The involvement of people with learning disabilities in the planning and development of the services that they receive should be an important focus for organisations. Participants' suggestions enable the team members to improve the services they provide to people with a learning disability. [ABSTRACT FROM AUTHOR]

Background Behaviours of concern restrict opportunities and choices for some people with learning disabilities and autism spectrum conditions and often lead to potentially harmful, restrictive and costly interventions. Immediate interventions, for example de-escalation, to manage behaviours of concern are required to complement behaviour support plans which may take some time to be effective. Low arousal is one de-escalation approach, which is attuned to the needs of people with learning disabilities. A low arousal approach relies on a change in the beliefs, emotional responses, opinions about the cause of the behaviour and practices of direct support staff. Aim To explore the internal consistency and concurrent validity of the Staff Perceptions of Challenging Behaviour Questionnaire (SPCBQ) -- a measure of low arousal. Method A cross-sectional survey of direct support staff included measures of mindfulness, the belief that people can control behaviours of concern (attribution of controllability), self-efficacy and a measure of physical and non-physical interventions used to manage behaviours of concern. Results Staff attitudes to low arousal approaches were associated positively with mindfulness and associated negatively with attribution of controllability. Staff perceptions were not associated with self-efficacy. One form of restrictive intervention was used less by staff who showed more positive attitudes to low arousal approaches. The staff perceptions measure showed weak internal consistency. Conclusion Further development of the SPCBQ, as a measure of low arousal approaches, has the potential to support interventions and understanding of staff practice that limit the use of restrictive approaches. [ABSTRACT FROM AUTHOR]

This study offers evidence that co-production and the delivery of person-centred care are good for staff. The researchers surveyed 466 professionals who care for people with profound learning disabilities in residential and day settings. [ABSTRACT FROM AUTHOR]

Keratoconus is a potentially sight-threatening condition in which the cornea distorts and becomes fragile, and without treatment can lead to severe visual impairment. The condition is much more common in people with Down's syndrome and likely to be more common in people with other types of learning disability. Since the advent of a new treatment, corneal cross-linkage, which is only applicable in the early stages of the condition, early diagnosis has become imperative. However, people with learning disabilities are less likely to complain of poor vision and more likely to have poor vision and astigmatism which can mask early changes, so keratoconus can be missed. It is essential that those caring for and supporting people with a learning disability appreciate the risk of keratoconus and ensure that clients have regular and appropriate eye examinations from the age of ten years. When keratoconus is diagnosed it is important to discuss treatment options and for carers to understand the effects of the condition to minimise sight loss and maximise quality of life. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand the vulnerability of people with learning disabilities to coronavirus disease 2019 (COVID-19) • To find out about COVID-19-related deaths in patients with learning disabilities at one hospital • To enhance your awareness of the need to obtain more clinical awareness of the needs of the learning disability population There is evidence that people with learning disabilities are more vulnerable to coronavirus disease 2019 (COVID-19) than the general population, but there is a need to understand better how COVID-19 has affected that patient group. This article details a retrospective comparison study exploring the response of one acute hospital to COVID-19 in the learning disability population. A wide range of data were collected for the period between March 2020 and March 2021 about patients with learning disabilities, including admissions and deaths, do not attempt cardiopulmonary resuscitation (DNACPR) orders, ceilings of care and input from the learning disabilities acute liaison team. Data from the five years preceding the study were also collected. These data were compared with data about the general population, in the hospital and nationally. The data show that there had been no significant increase in the number of deaths of people with learning disabilities at the hospital during the first 13 months of the pandemic. However, this could be because fewer people attended hospital and more died in the community. Wider and more in-depth investigation is needed to understand the factors that may increase the risk of COVID-19-related death for people with learning disabilities. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To be aware that transitions from child to adult services are often challenging • To identify the importance of early transition planning for successful outcomes • To recognise that young people's views, preferences and wishes should be reflected in transition plans Transition to adult services for young people with learning disabilities and complex needs should be a purposeful and planned process that begins at the age of 14. However, it is often fraught with challenges. This article explores the story of a young person's transition from child to adult services. It shares the lessons learned and how a collaborative, person-centred approach can result in positive outcomes for young people with autism, learning disabilities and complex needs. Recommendations are made for good practice in person-centred transition planning. Although the article explores one family's experiences, the recommendations are applicable to learning disability practice in developing improved pathways for transition for young people with complex needs. [ABSTRACT FROM AUTHOR]

Strengthening the Commitment, the Modernising Learning Disabilities Nursing Review, highlighted the importance of learning disability nurses providing support across the lifespan. This article describes an activity undertaken at the Living the Commitment Conference in Cardiff in November 2016, at which delegates were asked to identify the roles of learning disability nurses at different lifespan stages. The article examines the responses, which were thematically analysed, and highlights a range of support, some of which is provided across all lifespan stages, and some at specific periods. Responses also identified new and emerging roles across a range of settings, and the importance of influencing policy and commissioning of services. It is not possible to determine whether these roles are fulfilled across the UK, and the article recommends scoping these roles, and using the findings to inform development of learning disability nursing practice, education and research. [ABSTRACT FROM AUTHOR]

Three years ago, following surgery to remove all her teeth, a Worcestershire nursing home resident died at the age of 49. Rachel Johnston, who had 'significant learning disabilities', struggled to breathe after discharge back to her home after the procedure in 2018, but staff failed to carry out vital observations or seek emergency assistance. An inquest later concluded that neglect by nursing home staff had contributed to Ms Johnston's death. [ABSTRACT FROM AUTHOR]

The role of the registered nurse in intellectual disability (RNID) includes networking, which is an important aspect of supporting people with an intellectual disability with their health and social care needs. Networking involves RNIDs communicating with various people in intellectual disability services, mainstream health services and local communities. The advent of coronavirus disease 2019 (COVID-19) resulted in RNIDs having to use their networking competences to support clients and their families, particularly in accessing the services they needed to maintain their health during the pandemic. This article examines this networking role and discusses the developments required for RNIDs to support people with an intellectual disability effectively during a pandemic. The article also calls for further research and clarification of the networking aspect of the RNID role. This will provide knowledge that can underpin intellectual disability nursing education and practice. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand how physical health deterioration in people with learning disabilities is often missed • To improve your knowledge of the challenges involved in detecting deterioration in adults with learning disabilities • To familiarise yourself with the need for a personalised tool that detects physical deterioration Opportunities to detect physical health deterioration early in people with learning disabilities are often missed, which can lead to suboptimal health outcomes including death. There are several challenges involved in detecting deterioration in adults with learning disabilities. One challenge is that tools such as the National Early Warning Score 2 (NEWS2) may not be suitable for this population. Another challenge is that those people who care for adults with learning disabilities in the community often do not have the skills, training, equipment and confidence to undertake physical observations and escalate any concerns to healthcare professionals in a timely manner. There is therefore a need for a personalised tool to detect and report physical deterioration in adults with learning disabilities in community settings. This article describes a project undertaken by a learning disability nursing student to develop such a tool. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To enhance your awareness of the barriers that pregnant women with learning disabilities may experience in accessing maternity care • To identify reasonable adjustments that can be made to improve the care of pregnant women with learning disabilities • To learn about a service improvement initiative designed to raise healthcare professionals' awareness of the needs of women with learning disabilities during pregnancy An increasing number of women with learning disabilities are forming relationships and having children. These women are likely to have additional needs during pregnancy and to experience barriers in their access to maternity services. This article details a literature review on maternity care for women with learning disabilities during pregnancy and explains how the findings were used to inform the planning of a service improvement initiative. The literature review identified that this patient population is inconsistently and ineffectively supported by maternity services. Based on these findings, a service improvement initiative was designed to raise awareness of the needs of women with learning disabilities during pregnancy among healthcare professionals working in maternity services in Devon, England. It was decided that a one-day conference be held for up to 120 delegates in the summer of 2021. Its outcomes will be used to advance the service improvement initiative, create learning disability champions and provide practical suggestions on how reasonable adjustments can be made for women with learning disabilities during pregnancy. [ABSTRACT FROM AUTHOR]

Background The Research Active Programme (RAP) was an eight-week group-based research training programme designed to promote disability rights in research by providing opportunities for people with intellectual disabilities to become co-researchers. This article presents an evaluation of the effectiveness of the RAP from the perspectives of 14 students. Methods Data collection involved individual pre- and post-programme interviews and weekly post-session group feedback with all 14 RAP students. Interviews were transcribed and analysed. Results Students' interests, abilities and learning styles were identified and used alongside continual feedback to guide the curriculum design. Students' perspectives are presented under four domains: foundations to learning, responsive curriculum development, content learning and complementary learning. Conclusions From the students' perspectives, the RAP was a worthwhile investment for them. Participating in the programme provided access to a wider social network in a third-level educational environment and created opportunities for lifelong learners interested in becoming co-researchers. [ABSTRACT FROM AUTHOR]

Physical intervention techniques must continue to be refined and developed to ensure they are safe and fit for purpose. However, it could be argued that innovation in this area has plateaued, partly because training providers build their business around fixed techniques, which leads to stasis. Further, the drive to eliminate restrictive practices has placed a focus on prevention of physical restraint and physical intervention, rather than evolution of the techniques. This article considers martial arts, the origin of most physical restraint techniques, and examines how they have been modernised, using Christensen's failure framework, to instigate critical debate about how physical intervention techniques need to improve. [ABSTRACT FROM AUTHOR]

This article explores the lived experiences of five nursing students who participated in the Erasmus+ programme, an initiative -- funded by the European Union -- which aims to support projects that enhance, modernise and innovate education and training in Europe. The project discussed here focused on meeting the needs of children and young people with complex intellectual and developmental disabilities. The students, from across Europe, were from a variety of disciplines, including nursing, education and social education. [ABSTRACT FROM AUTHOR]

Sleep problems in children with learning disabilities are common and affect their health and learning, and the health and well-being of their parents and carers. The use of melatonin in this population is growing, but research on its efficacy and safety is conflicting. This article discusses the role of learning disability nurses in supporting children with learning disabilities wit h sleep problems, describes the prevalence and relevance of sleep issues, introduces some behavioural interventions and gives an overview of the use of melatonin. [ABSTRACT FROM AUTHOR]

Visual impairments are common in people with learning disabilities, but identification, treatment and care can be difficult. Learning disabilities health professionals who have been trained as vision champions can ensure that the vision needs of their clients are being supported and met. This service evaluation aimed to learn about post-training outcomes for vision champions in their work teams and for their clients with learning disabilities. Vision champion training was delivered to ten community learning disabilities healthcare professionals and, three months later, training outcomes were evaluated with qualitative interviews. Vision champion training increased the professionals' confidence and efficacy in their abilities to assess and meet the vision needs of their clients with learning disabilities. The training enabled the professionals to create more vision-friendly environments for their clients. The champion role can be effective in meeting the health needs of clients. Further development of the champion role and its evaluation are recommended. [ABSTRACT FROM AUTHOR]

'It's never too late to start over in life, because I didn't come into learning disability nursing until I was nearly 40. Our first son was born with Down syndrome in 2000 and at the time I was working as a research scientist in the pharmaceutical industry. [ABSTRACT FROM AUTHOR]

Over the past two decades person-centred planning has been used to support people with learning disabilities to fulfil their personal aspirations. This has been backed up by national policies that have adopted the principles of person-centredness. However, widespread barriers to the implementation of person-centred planning for people with learning disabilities have been reported and the literature suggests that implementing person-centred planning is particularly challenging for people with more complex needs. This article discusses the findings of a literature review that explored the barriers and facilitators to the implementation of person-centred planning for people with learning disabilities and complex needs and their carers. The article identifies barriers such as limited funding and resources, challenges in accessing services and communication difficulties. It also describes initiatives that appear to have successfully engaged service users and their carers in person-centred planning. Further research is needed into the long-term effects of person-centred planning for people with learning disabilities and complex needs, notably to measure its effectiveness in enhancing their quality of life, while strategies to enable them to engage in person-centred planning need to be developed. [ABSTRACT FROM AUTHOR]

Positive behaviour support (PBS) is considered an effective and ethical approach to supporting people with learning disabilities who are at risk of behaviour that challenges. Many people with learning disabilities are supported in the community by staff with varying levels of PBS skills and practice, and training is important to ensure PBS is used consistently. In 2019, a community learning disability team in Staffordshire, England, developed a PBS skills training programme and delivered it to 57 senior staff from 16 local community services. In an evaluation of the training programme, participants reported some improvements in their PBS knowledge and practice, as well as some benefits for service users, after the training. However, no follow-up data could be obtained from participants six months after the training. This article describes the training programme, reports the findings of its evaluation and discusses how the findings will inform a future PBS skills development project. [ABSTRACT FROM AUTHOR]

Bowel or colorectal cancer is the third most common cancer and the second most common cause of death from cancer in Scotland. People with learning disabilities have higher rates of mortality associated with cancer of the colon and the rectum than the general population. Data for 2016 suggest that in the NHS Highland health board area less than half of all people known to specialist learning disability services, who were eligible for bowel screening, participated in the Scottish national bowel screening programme. To address the low uptake of bowel screening among people with learning disabilities, a peer-led educational intervention was developed and delivered to 109 adults with learning disabilities in the health board area. Its aims were to increase participants' knowledge of bowel health and bowel screening and reduce the barriers to their participation in the bowel screening programme. This article describes the intervention and discusses the findings from its evaluation. The intervention appears to have increased participants' knowledge of bowel health [ABSTRACT FROM AUTHOR]

In May 2019 a scandal about the care of people with learning disabilities emerged when the BBC broadcast secret footage of abuse perpetrated at Whorlton Hall, a specialist unit for vulnerable adults. This was another case in a list of abuse in care settings for people with learning disabilities, including systematic abuse uncovered at Ely Hospital in 1967 and Winterbourne View in 2011. This article reflects on the parallels that can be drawn between the cases at Ely Hospital, Winterbourne View and Whorlton Hall, suggests explanations for these recurrent patterns of abuse and makes recommendations for how to address them. [ABSTRACT FROM AUTHOR]

The Transforming Care programme was devised by NHS England in 2015 with the aim of supporting people with a learning disability and/or autism who exhibit behaviour that challenges, including those with a mental health condition, to move out of long-stay hospitals and live in the community. The driving factor behind the programme was abuse and neglect experienced by people in long-stay settings, including those living at Winterbourne View, a private hospital near Bristol that was closed in 2011 after revelations that patients had been ill-treated. By March 2019, when the programme ended, the target to reduce inpatient bed capacity by 50% had not been met. This article discusses the author's experience as a dual-qualified social worker and mental health nurse employed by a Transforming Care Partnership. In this role, the author coordinated the discharge process for five people with learning disabilities and/or autism, often with co-morbid mental health issues, who had lived in hospital for 7-21 years. The complex multiagency work that enabled these successful discharges is explored and the article considers how this work can be built on in future to ensure more people with learning disabilities are able to live in their own homes. [ABSTRACT FROM AUTHOR]

This article describes one learning disability nurse's experience of being seconded to work on a research project in a university setting. The nurse Tracey Rose and her academic manager Irene Tuffrey-Wijne argue that the benefits of such a secondment go beyond the obvious advantages for the nurse, who gained research skills. The delivery of evidence-based care and support is enhanced when learning disability nurses are engaged in research. Creating opportunities for a secondment can support nurses' career progression and may also help promote staff retention. For the academic partner, a close link with clinical practice can keep the research grounded and help to clarify the impact of research on practice. The authors also discuss the challenges in making this type of secondment work. [ABSTRACT FROM AUTHOR]

There has been a move in children's services to encourage greater participation by children themselves in how those services are designed and run. This is equally important in services used by those who find it difficult to express their views, yet children with complex needs appear to have less involvement in their care than other groups. Encouraging children with intellectual disabilities to express their views requires creativity, and this article describes the development and use of the child-friendly questionnaire, which uses various methods to support children in communicating their emotions and provide feedback about the service they have received. [ABSTRACT FROM AUTHOR]

Purple Patch Arts is an organisation based in Bradford, West Yorkshire. It works with adults and children to provide innovative education using the creative arts. In 2014, it was awarded a grant from the Heritage Lottery Fund to undertake a project that would uncover the social history of learning disabilities and record it in a way that was accessible to a range of target audiences. This article describes the process that was followed and some of the challenges that ensued. [ABSTRACT FROM AUTHOR]

Raising a child with a profound learning disability and complex health and behavioural problems can be very difficult at times. However, when this is coupled with being a learning disability nurse, it brings about its own unique challenges. In this article I describe what life is like having Nia, and the emotions involved in being her mum and being a nurse. I also discuss the particular difficulties faced by parents of individuals who have a dual diagnosis of Down's syndrome and autism spectrum disorder. [ABSTRACT FROM AUTHOR]

The University of East Anglia has announced it is closing its learning disability undergraduate degree programme. This comes after similar moves by other institutions in recent years, including London South Bank University. [ABSTRACT FROM AUTHOR]

In May 2011 BBC Panorama aired its exposé of poor care at the Winterbourne View hospital near Bristol. The undercover filming at the inpatient unit sent shockwaves across the sector and wider society. It revealed a regime of physical and psychological abuse, neglect, and mistreatment, prompting prosecutions of the staff involved. [ABSTRACT FROM AUTHOR]

Status epilepticus (SE) is a complication of epilepsy characterised by prolonged or repeated seizures. It is a life-threatening condition that requires the immediate administration of a rescue medicine. If given promptly, rescue medicines can reduce the duration of seizures and support SE cessation. Buccal midazolam is the recommended first-line treatment for SE in the community in people who have had a previous episode of prolonged or serial convulsive seizures. Therefore, it is crucial that all those who care for people with learning disabilities who have epilepsy in the community – including family members, friends and professional carers – receive support, training and guidance in the administration of buccal midazolam. This article provides an overview of the treatment of SE in the community, including the administration of buccal midazolam. [ABSTRACT FROM AUTHOR]

The evidence is becoming ever clearer that the COVID-19 pandemic has had a devastating effect on the mental health of children. Data from NHS Digital show the number of children with a probable mental health disorder rose from one in nine in 2017 to one in six in 2021. [ABSTRACT FROM AUTHOR]

We all react differently to bereavement and that is as true for people with learning disabilities as for anyone else. Yet assumptions are often made. As a result, when a person with a learning disability loses someone close, the reality of death may be denied. Grieving may then stall or never begin. In a briefing based on the work of Keele University professor of learning disability nursing Sue Read, the bereavement charity Sudden refers to this as 'disenfranchised grief'. This occurs when someone's loss is not recognised and they are left unsupported. [ABSTRACT FROM AUTHOR]

Aim To examine whether there is a relationship between the temperament and character of university students and their attitude towards people with disabilities. Methods The study investigated the views of nursing students in their second year of university who had elected to take a course on disability. Questionnaires were distributed to 100 people and 81 filled in the forms completely, 75 of whom (92.6%) were women. The study data were collected in January 2014. Data were analysed using the Temperament and Character Inventory (TCI) and Attitudes Toward Disabled Persons (ATDP) scale. Results The mean attitude score of the students was 68.77 ± 12.71 (min: 39, max: 102). The correlation between the mean scores for the ATDP scale and the subdimensions of the TCI was evaluated. A significant correlation was determined between positive attitudes towards people with disabilities and the reward dependence dimension and the sentimentality sub-scale of reward dependence. Conclusion A relationship was determined between reward dependence and positive attitudes towards people with disabilities. People high in reward dependence are compassionate, sensitive, dependent on others' approval and sociable. Education to improve nursing students' attitudes towards disabled people and their social communication skills should be incorporated into nurse training. Future studies should investigate the effects of temperament and character on attitudes, as well as sociodemographic factors. Sample groups should be selected from a range of social groups to see if nursing students who will be caring for people with disabilities have a more positive attitude towards them. [ABSTRACT FROM AUTHOR]

Attending healthcare appointments can be challenging for people with learning disabilities, prompting anxiety that can keep them away. [ABSTRACT FROM AUTHOR]

This article outlines the difficulties that people with severe and profound intellectual and multiple disabilities may have when swallowing. The article explains the prevalence, causes and nature of swallowing difficulties for people with intellectual disabilities and discusses the assessment of swallowing, eating and drinking problems. It also examines management of swallowing problems in this cohort, and uses a case study to consider how to support someone with such difficulties in the context of Orem's self-care deficit theory. The article concludes with broad recommendations for care. [ABSTRACT FROM AUTHOR]

This article details how a conceptual tool, the semantic wave, can be used to support intellectual disability nursing students to access and apply theories, concepts and evidence to inform their practice. The semantic wave can enable nurse preceptors in Ireland – and practice supervisors and practice assessors in the UK – to articulate the links between theory and practice when supporting nursing students to develop foundational competences on their practice placements. This article uses a case study of a nurse preceptor supporting a first-year intellectual disability nursing student to develop their competence in communication and interpersonal relationships, demonstrating how the semantic wave can be used to apply nursing theory to context-specific practice situations. [ABSTRACT FROM AUTHOR]

People with learning disabilities experience many barriers that prevent them from expressing their sexuality and developing loving and sexual relationships, particularly if they identify as lesbian, gay, bisexual and trans (LGBT). This article explores the challenges faced by people with learning disabilities who identify as LGBT in expressing their sexual identities and having sexual relationships, as well as the challenges faced by support workers and health and social care staff in supporting clients in those aspects of their lives. The method used consisted of combining the lived experiences of participants in a Twitter chat with an exploration of the recent literature. The themes that emerged from these combined sources included the importance of love and sexual relationships, the policy context, legal framework, barriers in practice and the concept of intersectionality. This article discusses these themes and outlines implications for practice and research, including the training needs of staff. [ABSTRACT FROM AUTHOR]

Enteral feeding is commonly used in children with intellectual disabilities for short and long periods of time, and for a variety of reasons. Traditionally, sterile, ready-to-use commercial feeds are the recommended method of enteral feeding. However, the use of blended diets – where home-made food is mixed to a smooth consistency – has been increasing, with parents preferring to use these to ensure more natural nutritional management and to control their child's gastrointestinal symptoms. This article explores the implementation of blended feeding for gastrostomy button-fed children with intellectual disabilities in the special school environment in Ireland. It presents a case study that details the multidisciplinary team approach that was adopted and the decision-making tool and risk assessment process used. Blended feeding has now been adopted in the special school environment, with the intellectual disability nurses working at the school leading its implementation. [ABSTRACT FROM AUTHOR]

Special interest groups (SIGs) create a shared space in which healthcare professionals can network and collaborate on topics of mutual interest. These groups support the development of multiprofessional expertise and knowledge sharing by providing a forum in which healthcare professionals can hold collaborative discussions on methods that will improve practice and care quality, and how to translate these into practice. Research shows that people with learning disabilities are more at risk of sexual abuse or exploitation, therefore they require support in areas such as relationship safety, emotional and sexual well-being, and sexual rights. This article describes how the North Staffordshire community learning disability team developed a SIG to support and promote safe sexual well-being for adults with learning disabilities and explains how the forum benefits staff, the organisation and service users. [ABSTRACT FROM AUTHOR]

The percentage of working age adults with learning disabilities who are in paid employment is low compared with the general population. There may also be an underlying expectation that people with learning disabilities will take on unpaid voluntary roles and assumptions are often made that this population lacks the potential to contribute to their communities. This article discusses the barriers to and complexities of employing people with learning disabilities to work on a training programme and research project. It describes the various challenges experienced by the employers and employees during the recruitment process and while working in the role, and it details the strategies that were used to overcome these issues. [ABSTRACT FROM AUTHOR]

AUTH Why you should read this article: • To understand the importance of writing for publication • To familiarise yourself with the role of peer review • To be aware of the differences between continuing professional development articles and research articles There is an expectation that nurses should use evidence to inform practice but having access to this evidence requires other nurses to write about and publish their work to generate a new evidence base. There is also an expectation that nurses should publish to improve knowledge, although for some the thought of writing can seem challenging. This article presents a reflection on the author's experience of writing, from her first attempt at publishing through to becoming a published author, and then publishing continuing professional development articles. It provides insight into the work involved in becoming a published author. [ABSTRACT FROM AUTHOR]

AUTH Why you should read this article: • To enhance your understanding of the functional needs of people with complex physical impairments • To increase your awareness of challenges and the benefits of environmental control systems • To appreciate the role of occupational therapists in the assessment of people's occupational functioning Environmental control systems (ECSs) are a form of assistive technology that can enable people with complex physical impairments to operate a range of appliances and devices by remote control, therefore enabling them to maintain a higher level of independence. The functional independence and improved communication abilities afforded by ECSs can, in turn, increase people's confidence, self-esteem and feelings of self-worth. [ABSTRACT FROM AUTHOR]

Tom Kitwood's conceptual approach has been widely used to provide person-centred care for people living with dementia, but has not previously been explored in relation to people with learning disabilities. This article discusses how Kitwood's ideas about the common behaviours by healthcare staff that undermine a person's well-being – malignant social psychology – are also found when working and interacting with people who have learning disabilities. The authors outline how adapting malignant behaviours and interactions to be more person-centred can improve relationships, self-value and worth for people with learning disabilities. [ABSTRACT FROM AUTHOR]

Background:Helicobacter pylori is a bacterium that lives in the stomach's gastric mucosa layer. H. pylori is a carcinogen that increases the risk of stomach and duodenum ulcers, gastro-oesophageal reflux disease and stomach cancer. Prevalence rates of H. pylori are higher in people with a learning disability than in the general population; however, despite the increased risk of H. pylori in people with a learning disability there is a lack of literature that applies specifically to this population and their families or carers. Aim: To explore issues related to the diagnosis and treatment of H. pylori in people with a learning disability by examining the attitudes, beliefs, experiences and behaviours of staff working with people with a learning disability who are undergoing assessment and/or treatment for H. pylori. Another aim of this study was to understand the barriers to using preventive strategies, completing assessments and treating H. pylori in people with a learning disability. Method: Focus groups were conducted with 16 staff members from two learning disability services. Before the focus groups, staff members were sent an information sheet with facts about H. pylori in people with a learning disability. Transcribed focus group discussions were analysed to identify themes. Results: Staff reported issues with identifying accurate prevalence figures for H. pylori in people with a learning disability in their services due to the limited number of people who had undergone assessment. Identifying the signs and symptoms of H. pylori was also challenging for staff due to communication difficulties with people with a learning disability, or because the individual had minor symptoms or was asymptomatic. Other staff said that symptoms could be attributed to the side effects of medicines. Staff believed that people with a learning disability should be treated for H. pylori, given the associated risks of the bacterium, but that the lack of guidance on re-testing after treatment meant it was challenging to incorporate re-testing into care planning. Conclusion: Little consideration has been given to the presence of H. pylori in people with a learning disability over the past decade, despite the fact it is an important health concern that can be identified and treated. Staff, carers and people with a learning disability should discuss with their GP having a blood, stool or breath test to check for H. pylori. Adding assessment for H. pylori to annual health checks will ensure screening becomes routine and may reduce complications or signs and symptoms, such as reflux and bloating. [ABSTRACT FROM AUTHOR]

Patient satisfaction in psychiatric emergency departments (EDs) largely relies on the knowledge and training of the staff providing care, and patients report higher satisfaction when they are assessed by professionals with psychiatric experience. Patient care is negatively affected by missing or incomplete patient-specific information. People with an autism spectrum disorder (ASD) and/or an intellectual disability are often unable to communicate pertinent information when admitted to hospital, and nurses rely on family members or carers to obtain information. The aim of this quality improvement project was to evaluate whether nursing admission assessment data collected in the psychiatric ED by a nurse specialist in ASD and/or intellectual disability while family members or carers were present were more complete than nursing admission assessment data collected in the inpatient unit after triage in the psychiatric ED. Data were collected for a period of two months from patients, carers and staff on a specialist inpatient unit for ASD/intellectual disability. Completeness of assessment information and staff satisfaction were compared between the psychiatric ED and the inpatient unit. Outcome measures included location of assessment (ED or unit) and quality of information provided, which covered 17 key patient-centred items. There was a significant relationship between the source of the information and the location where it was obtained. In the psychiatric ED, nurse specialists were able to obtain more information from family/caregivers compared with the inpatient unit. Initiating the admission assessment in the psychiatric ED while the patient's family members or carers are present may provide a more complete assessment and will establish rapport, supporting an easier admission process and transition to the inpatient unit. [ABSTRACT FROM AUTHOR]

Mental health concerns are prevalent in regard to those with intellectual disability. There are many reasons for this, some of which may relate to the causation of the person's intellectual impairment. Other extraneous factors, such as the number of significant life events, may also result in compromised mental health. For many people, however, mental health problems may go untreated, which may relate to difficulties in diagnosis or in ascribing the signs and symptoms to other causes. With increasing numbers of people with an intellectual disability making use of regular community health services, and the reported unfavourable nature of such services, mental health problems may not be addressed. Registered intellectual disability nurses have a crucial role to play in ensuring that the mental health concerns of people with an intellectual disability are identified and addressed in an expeditious manner to achieve maximum well-being. This article explores such mental health concerns and, drawing on a brief case study, describes the role of nurses. [ABSTRACT FROM AUTHOR]