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Background: Non‐communicable diseases (NCDs), also known as chronic diseases, now constitute a major proportion of ill‐health across most adult and older populations including in people with intellectual disability. The current paper is a comparative analysis of prevalence of NCDs across mid‐aged and older‐aged people with mild intellectual disability. Method: Comparative data comes from two cross‐sectional surveys using similar methodology and timeframes. The analysis sample comprises mid‐aged group (30–50 years, N = 291) and older‐aged group (≥60 years, N = 391). Results: People with mild intellectual disability start developing NCDs in early to mid‐adulthood and increases with age. The mean number of NCDs in mid‐aged group was 0.86 (SD, 0.84) compared to 3.82 in older group (SD, 2.67). Conclusion: There needs to be early identification and management of NCDs using relevant health promotion and preventative measures at optimal intervention points. The training of healthcare professionals needs improvement. [ABSTRACT FROM AUTHOR]

There is little research comparatively assessing prevalence of pain between older people either with or without intellectual disability. This paper explores health and social factors associated with chronic pain in these two groups. A cross-sectional survey was undertaken in New South Wales and Queensland, Australia. Inclusion criteria were adults either with or without intellectual disability, aged 60 years and older, and currently living in community-settings. Univariate and multivariable analyses were undertaken on a sample of 391 adults with intellectual disability and 920 adults without intellectual disability. Key findings included higher prevalence of pain in the intellectual disability group, along with higher rates of osteoarthritis, falls, oral health problems, and mood disorders. Mitigating risk factors for conditions that cause chronic pain in older adults is crucial. As longevity increases, the healthcare sector needs to prioritise chronic pain management for people with intellectual disabilities through appropriate treatment strategies. [ABSTRACT FROM AUTHOR]

Data specifically comparing outcomes for people with and without intellectual disability is limited. This paper reports perceived health and wellbeing of older Australians resident in metropolitan and rural locations in New South Wales and Queensland. Respondents were community-residing individuals with intellectual disability and mainstream age peers [age ≥ 60]. Measures included SF12; Cummings well-being scales; DSSI; Adverse Life Events; and financial hardship status. The sample was composed of 391 adults with intellectual disability and 920 age peers. Adults with intellectual disability were significantly more likely to note adverse life events, worse mental health, and lower levels of social support, but reported higher mean wellbeing scores and had higher scores for physical health. Results indicated higher likelihood of adults with intellectual disability reporting comparative disadvantage across multiple key areas when compared to age peers. [ABSTRACT FROM AUTHOR]

Changing disease patterns and improved life expectancy have resulted in a growing cohort of older Australians with an intellectual disability, with the provision of end-of-life care to this group only recently emerging as a priority area. Particularly in rural settings, where the availability of both specialist and general local services may be limited, end-of-life care support remains under-explored. The current project aimed to specifically examine end-of-life care provision in rural areas, the focus of this article being individual quality-of-life during the end-of-life stage. The study used a focus group interview model with 22 rural disability support workers from either New South Wales or Queensland, who had direct experience in providing end-of-life care. An advisory committee, composed of people with intellectual disabilities, carers, and service providers, offered overall project guidance. Participants elaborated on factors that contributed to quality-of-life during end-of-life care. Verbatim transcripts of the focus groups were thematically analysed by the team, and three thematic categories identified: availability of services; individual needs; and untreated pain. Specifically, participants noted concerns about the unavailability of health services, inflexibility of funding support, artificial government barriers, and a widespread lack of pain relief for individuals. We conclude that end-of-life support people with intellectual disabilities in rural areas has to trade off the ongoing delivery of quality-of-life activities against the increasing need for health care, which itself is subject to accessibility issues, and which is exacerbated by the more general funding challenges seen across all locations with the National Disability Health Insurance implementation. [ABSTRACT FROM AUTHOR]

Background: Although a 'person‐centred focus' is a legislated objective for both aged‐care and disability services sectors in Australia, evidence suggests limited translation into systems and practices due to entrenched silos. This paper proposes a Best Practice Framework to mitigate these silos. Methods: Mixed‐methods research comprising key informant interviews with major stakeholders across both sectors; a survey of people with/without intellectual disability aged 60+ years; qualitative in‐depth interviews; and survey of health professionals. Results: There is an urgent need to develop inter‐sectoral 'integrated care systems'. Key components include choice in accommodation; regular assessment of health and well‐being indicators; development and adoption of nationally consistent policies/standards across integrated aged‐ and disability‐care sectors; improved strategies for workforce planning; and upskilling of existing staff including place‐based collaboration. Conclusions: An integrated service model requires collaboration on broader public policy instruments, appropriate planning and resourcing. A strategic shift is required to ensure better quality person‐centred support systems. [ABSTRACT FROM AUTHOR]

The article by Andrea Grindrod on "Dying with disability: A disability and palliative care intersectoral partnership framework" provides a good opportunity to focus on some of the key underlying issues associated more broadly with death and dying within the gerontological and medical literature before focussing on policy and implementation perspectives on end-of-life care for people with intellectual disabilities. As outlined in the article by Grindrod ([6]), there is a lack of clinical expertise in the disability care sector with the near-disappearance of developmental disability as a speciality in nursing. Dying with disability: A disability and palliative care intersectoral partnership framework. [Extracted from the article]

Australia's Intergenerational Reports (2010, 2015) make a case for restraining public expenditure on an ageing population given the sizeable post-WWII baby boom cohort, increasing longevity, and uncertain economic prospects for younger generations. There also is concern for major disparities within older and younger generations resulting from cumulative advantages or disadvantages over the life course. Drawing on national survey data from the Attitudes to Ageing in Australia study, this article investigates perceptions of inequity between age cohorts at two time points (2009–10, 2015–17) focusing on variations by age and gender around lifelong opportunities for baby boomers compared to other groups, share of government benefits, and support for increasing pension age eligibility. The findings indicate a shift in attitudes between 2009–10 and 2015–17 with more in the younger cohorts in 2015–17 reporting better lifelong opportunities for baby boomers; and baby boomers receiving a fair share/more than a fair share of government benefits. With pension age eligibility, there is a small but significant shift in attitudes supporting the increase and a corresponding drop in those opposing it, however opposition is highly gendered with more women in each of the age cohorts opposing it at both time points. While there is a perceptible shift in younger cohorts' attitudes towards baby boomers' perceived advantages, overall attitudes are not totally supportive of government arguments for expenditure restraint; although a more overt public discourse on intergenerational inequity is emerging as the declining life prospects of younger cohorts are juxtaposed with tax-advantaged housing and retirement wealth of many older age Australians. [ABSTRACT FROM AUTHOR]

An editorial is presented on protecting people in resource-poor regions and reducing the risk of new viral mutations. Topics include have a globally-equitable vaccination program for many policy makers and the big pharma industry; and mitigating the physical and mental health impact of limited mobility, severe curtailment of social interactions, and short- and long-term impact for people with intellectual disability.

An editorial is presented in which editor discusses the World Health Organization that formally declared COVID-19 infections to be a global pandemic on March 11, 2020. Topics include examines the intractable aspects that have been brought into sharper focus deserve repeating and considered inequality and inequity of health and social services for vulnerable groups that are so entrenched that have come to accept them with varying degrees of reluctance.

Backgrounds: The adenoma‐carcinoma and serrated pathways offer a window of opportunity for the removal of pre‐malignant polyps and prevention of colorectal cancer (CRC) through the use of colonoscopy. The aim of this study was to investigate variation in polyp incidence in different age groups, gender and indications for undertaking colonoscopy. We also address histological types of polyps found and where in the bowel they are located. Methods: This study is based on the colonoscopy data collected prospectively over a one‐year period in multiple South Australian rural centres, 24 general surgeons contributed to this study. All histopathology results were subsequently entered into the dataset. Results: A total of 3497 colonoscopies were performed, with a total of 2221 adenomatous and serrated polyps removed. Both serrated and adenomatous polyps were more common in the distal colon. Patients of male gender, aged 70 years and over and with an indication of polyp surveillance had higher adenoma and serrated polyp detection rates (ADR and SPDR). Patients aged 40–49 years old who underwent colonoscopy for positive faecal occult blood had an ADR and SPDR of 25.0% and 6.3%, respectively. Conclusions: This study has shown variation in ADR and SPDR depending on age, gender and indication for colonoscopy. This variation will help further develop key performance indicators in colonoscopy. The high ADR and SPDR in patients aged 40–49 years old whom underwent colonoscopy for positive faecal occult blood may support lowering the age of commencement of CRC screening in Australia. [ABSTRACT FROM AUTHOR]

Medical professionals need to be equipped with competencies to provide sustainable healthcare and promote planetary health. The aims of this study were to map the presence of planetary health themes in one Australian medical program, develop and pilot a planetary health blended-learning module drawing on constructivism learning theory, and evaluate the effectiveness of the activities. A mixed methods approach was used comprising quantitative mapping of learning outcomes, measurement of pre- and post-intervention planetary health knowledge, and a feedback survey. Mapping revealed little integration of environmental issues across the medical program. Student's knowledge score increased by 2.37 points on average (95% confidence interval 1.66–3.09) (response rate 46%); 84.2% of respondents rated the activities as excellent/good. Since planetary health education is not currently required in Australian medical curricula, there is still little information for local medical educators on how to develop it, therefore studies such as this can provide some preliminary guidance. Supplemental data for this article is available online at https://doi.org/10.1080/13504622.2021.2025343. [ABSTRACT FROM AUTHOR]