scholarly journals Sleep: the neglected life factor in adults with intellectual disabilities

2021 ◽  
pp. 1-7
Author(s):  
Laura Korb ◽  
David O'Regan ◽  
Jane Conley ◽  
Emma Dillon ◽  
Rachel Briggs ◽  
...  
Keyword(s):  
Intellectual Disabilities ◽  
Sleep Disorders ◽  
Evidence Base ◽  
Current Evidence ◽  
Physical And Mental Health ◽  
Current Evidence Base ◽  
High Prevalence ◽  
Health Studies ◽  
Collaborative Working ◽  
Adults With Intellectual Disabilities

Sleep is vital for our physical and mental health. Studies have shown that there is a high prevalence of sleep disorders and sleep difficulties amongst adults with intellectual disabilities. Despite this, sleep is often overlooked or its disorders are considered to be difficult to treat in adults with intellectual disabilities. There is a significant amount of research and guidance on management of sleep disorders in the general population. However, the evidence base for sleep disorders in adults with intellectual disabilities is limited. In this review paper, we look at the current evidence base for sleep disorders in adults with an intellectual disability, discuss collaborative working between intellectual disabilities psychiatrists and sleep medicine specialists to manage sleep disorders, and provide recommendations for future directions.

scholarly journals What outcomes should be measured to evaluate the benefits of exercise for maternal mental health?

2019 ◽  
Vol 7 (9) ◽  
pp. 442-454
Author(s):  
Dawn Brenchley ◽  
Gilly Mancz
Keyword(s):  
Mental Health ◽  
Postnatal Depression ◽  
Maternal Mental Health ◽  
Methodological Approach ◽  
Evidence Base ◽  
Primary Outcome Measure ◽  
Depression Score ◽  
Current Evidence ◽  
Physical And Mental Health ◽  
Current Evidence Base

The physical and mental health of women antenatally and postnatally has been described as fundamentally important to the development of children and the family. Exercise was proposed as a strategy to support maternal mental health, such as postnatal depression with an emphasis on structured and supervised activities. However, a recent systematic review by Saligheh et al (2017) revealed inconsistencies in the evidence base and could not confirm that exercise reduced symptoms of postnatal depression. This study aims to analyse the current evidence base to determine what outcomes should be measured to evaluate the benefits of exercise to maternal mental health. The research concludes that using a quantitative methodological approach, predominantly using the Edinburgh Postnatal Depression Score as a primary outcome measure, does not appear to capture the effects of exercise on postnatal depression and anxiety. Further research using a qualitative approach is recommended to identify outcomes that should be measured to demonstrate the benefits of exercise to maternal mental health.

Drug therapy in ADHD in people with intellectual disabilities

2016 ◽  
Vol 10 (1) ◽  
pp. 27-35 ◽  
Author(s):  
Kenneth Courtenay ◽  
Samuel Elstner
Keyword(s):  
Drug Therapy ◽  
Side Effects ◽  
Drug Treatment ◽  
Intellectual Disabilities ◽  
Evidence Base ◽  
Current Evidence ◽  
Content Type ◽  
General Review ◽  
Current Evidence Base ◽  
People With Intellectual Disabilities

Purpose – Attention disorders in people with intellectual disabilities (ID) is common. Current drug treatments are based on the literature in people without ID. The purpose of this paper is to present a review of the drug treatment of Attention Deficit Hyperactivity Disorder (ADHD) in people with ID in the German and English languages literature with the aim of exploring the current evidence base. Design/methodology/approach – The paper provides a general review of the evidence base on drug treatment of ADHD in people with ID from the German and English language literature. Findings – Studies and practice guidance on ADHD in both languages are similar with more information published in English. Much of the evidence on drug therapy to treat ADHD in people with ID is based on studies in children. The literature on ADHD in children without ID is helpful but not specific to all people with ID who have ADHD. The response rates to medication to treat ADHD in people with ID are lower than in people without ID. The occurrence of side effects from medication is more common in people with ID. Co-morbid disorders are often present in people with ADHD that could affect study findings. Practical implications – Medication used to treat ADHD is effective when treating ADHD in people with ID. Prescribers should be aware of guidelines on medication and their potential drug interactions and side effects. Newer drugs could offer more effective treatments because of fewer adverse effects than current medications. Originality/value – The general review offers an insight in to the literature in German and English on ADHD in ID comparing what is published in both languages.

scholarly journals Polyphenols and Cognition In Humans: An Overview of Current Evidence from Recent Systematic Reviews and Meta-Analyses

2020 ◽  
pp. 1-15
Author(s):  
Daniel Joseph Lamport ◽  
Claire Michelle Williams
Keyword(s):  
Systematic Reviews ◽  
Evidence Base ◽  
Epidemiological Studies ◽  
Cognitive Outcome ◽  
Current Evidence ◽  
Duration Of Treatment ◽  
Current Evidence Base ◽  
Cognitive Benefits ◽  
Meta Analyses ◽  
The Impact

There is increasing interest in the impact of dietary influences on the brain throughout the lifespan, ranging from improving cognitive development in children through to attenuating ageing related cognitive decline and reducing risk of neurodegenerative diseases. Polyphenols, phytochemicals naturally present in a host of fruits, vegetables, tea, cocoa and other foods, have received particular attention in this regard, and there is now a substantial body of evidence from experimental and epidemiological studies examining whether their consumption is associated with cognitive benefits. The purpose of this overview is to synthesise and evaluate the best available evidence from two sources, namely meta-analyses and systematic reviews, in order to give an accurate reflection of the current evidence base for an association between polyphenols and cognitive benefits. Four meta-analyses and thirteen systematic reviews published between 2017–2020 were included, and were categorised according to whether they reviewed specific polyphenol-rich foods and classes or all polyphenols. A requirement for inclusion was assessment of a behavioural cognitive outcome in humans. A clear and consistent theme emerged that whilst there is support for an association between polyphenol consumption and cognitive benefits, this conclusion is tentative, and by no means definitive. Considerable methodological heterogeneity was repeatedly highlighted as problematic such that the current evidence base does not support reliable conclusions relating to efficacy of specific doses, duration of treatment, or sensitivity in specific populations or certain cognitive domains. The complexity of multiple interactions between a range of direct and indirect mechanisms of action is discussed. Further research is required to strengthen the reliability of the evidence base.

scholarly journals P-26 Challenging the pressure on nhs resources: could 48-hour continuous subcutaneous infusions (CSCIS) help? a systematically-structured review of the current evidence base

2017 ◽  
Vol 7 (Suppl 1) ◽  
pp. A9.3-A10
Author(s):  
James Baker ◽  
Andrew Dickman ◽  
Stephen Mason ◽  
John Ellershaw ◽  
Paul Skipper ◽  
...  
Keyword(s):  
Evidence Base ◽  
Current Evidence ◽  
Current Evidence Base

scholarly journals Rates of violence in patients classified as high risk by structured risk assessment instruments

2014 ◽  
Vol 204 (3) ◽  
pp. 180-187 ◽  
Author(s):  
Jay P. Singh ◽  
Seena Fazel ◽  
Ralitza Gueorguieva ◽  
Alec Buchanan
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Risk Groups ◽  
Evidence Base ◽  
Assessment Tools ◽  
Current Evidence ◽  
Assessment Instruments ◽  
Individual Liberty ◽  
Current Evidence Base ◽  
Study Heterogeneity

BackgroundRates of violence in persons identified as high risk by structured risk assessment instruments (SRAIs) are uncertain and frequently unreported by validation studies.AimsTo analyse the variation in rates of violence in individuals identified as high risk by SRAIs.MethodA systematic search of databases (1995–2011) was conducted for studies on nine widely used assessment tools. Where violence rates in high-risk groups were not published, these were requested from study authors. Rate information was extracted, and binomial logistic regression was used to study heterogeneity.ResultsInformation was collected on 13 045 participants in 57 samples from 47 independent studies. Annualised rates of violence in individuals classified as high risk varied both across and within instruments. Rates were elevated when population rates of violence were higher, when a structured professional judgement instrument was used and when there was a lower proportion of men in a study.ConclusionsAfter controlling for time at risk, the rate of violence in individuals classified as high risk by SRAIs shows substantial variation. In the absence of information on local base rates, assigning predetermined probabilities to future violence risk on the basis of a structured risk assessment is not supported by the current evidence base. This underscores the need for caution when such risk estimates are used to influence decisions related to individual liberty and public safety.

scholarly journals Toward the diagnosis of rare childhood genetic diseases: what do parents value most?

2021 ◽  
Author(s):  
Samantha Pollard ◽  
Deirdre Weymann ◽  
Jessica Dunne ◽  
Fatemeh Mayanloo ◽  
John Buckell ◽  
...  
Keyword(s):  
Focus Groups ◽  
Genetic Disease ◽  
Diagnostic Yield ◽  
Management Strategies ◽  
Health Benefit ◽  
Sampling Technique ◽  
Evidence Base ◽  
Current Evidence ◽  
Genomic Testing ◽  
Current Evidence Base

AbstractGenomic testing is becoming routine for diagnosing rare childhood genetic disease. Evidence underlying sustainable implementation is limited, focusing on short-term endpoints such as diagnostic yield, unable to fully characterize patient and family valued outcomes. Although genomic testing is becoming widely available, evidentiary and outcomes uncertainty persist as key challenges for implementation. We examine whether the current evidence base reflects public tolerance for uncertainty for genomics to diagnose rare childhood genetic disease. We conducted focus groups with general population parents in Vancouver, Canada, and Oxford, United Kingdom, to discuss expectations and concerns related to genomic testing to diagnose rare childhood genetic disease. Applying a purposive sampling technique, recruitment continued until thematic saturation was reached. Transcripts were analysed using thematic analysis. Thirty-three parents participated across four focus groups. Participants valued causal diagnoses alongside management strategies to improve patient health and wellbeing. Further, participants valued expanding the evidence base to reduce evidentiary uncertainty while ensuring security of information. Willingness to pay out of pocket for testing reflected perceived familial health benefit. Diagnostic yield fails to fully capture valued outcomes, and efforts to resolve uncertainty better reflect public priorities. Evaluations of genomic testing that fully integrate valued endpoints are necessary to ensure consistency with best practices and public willingness to accept the uncertain familial benefit.

scholarly journals SSRI use in pregnancy: Evaluating the risks and benefits

2015 ◽  
Vol 21 (2) ◽  
pp. 6
Author(s):  
Elsa Du Toit ◽  
Eileen Thomas ◽  
Liezl Koen ◽  
Bavi Vythilingum ◽  
Stoffel Grobler ◽  
...  
Keyword(s):  
Antidepressant Treatment ◽  
Severe Depression ◽  
Evidence Base ◽  
Current Evidence ◽  
Benefit Analysis ◽  
Medication Effects ◽  
Current Evidence Base ◽  
Pregnancy And Lactation ◽  
Potential Risks ◽  
Risk Benefit Analysis

<p>Selective serotonin reuptake inhibitor (SSRI) antidepressants are considered the primary pharmacological treatment for moderate to severe depression during pregnancy.<span><em> </em></span>Data regarding the safety of their use during pregnancy remain controversial and conflicting. Decisions regarding the prescription of antidepressant treatment are often fraught with concern around potential harmful medication effects on the pregnancy, fetus and infant. Information on potential risks remains extremely varied and inconsistent across sources. This lack of clarity regarding drug safety brings significant uncertainty not only for treating physicians, but also for women seeking information about depression during pregnancy. This review aims to summarise and evaluate the current evidence base and to aid clinicians in performing a risk/benefit analysis for SSRI use during pregnancy and lactation.</p><div> </div>

scholarly journals Drug information update. Lithium and chronic kidney disease: Debates and dilemmas

2017 ◽  
Vol 41 (4) ◽  
pp. 216-220 ◽  
Author(s):  
Sumeet Gupta ◽  
Udayan Khastgir
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Research Evidence ◽  
Evidence Base ◽  
Current Evidence ◽  
Treatment Resistant ◽  
The Past ◽  
Current Evidence Base ◽  
Information Update ◽  
Resistant Depression

SummaryLithium is an established treatment for bipolar disorder and an augmenting agent for treatment-resistant depression. Despite awareness of renal adverse effects, including chronic kidney disease, for the past five decades, there has been a lack of research evidence. This has led to debates around the existence and magnitude of the risk. This article discusses the current evidence base regarding the link between lithium and chronic kidney disease, monitoring of renal functions and its clinical implications.

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