Epilepsy in People with Intellectual Disability

It is well recognized that both Intellectual Disability (ID) and epilepsy individually have higher rates of premature mortality. Thus, the two conditions in combination will be more likely to lead to premature mortality than either individually. People with ID and epilepsy have a higher likelihood of communication, psychiatric, behavioural, and drug sensitivity problems that makes their treatment difficult. This is not a homogenous group. At one end of the spectrum are patients with mild ID, 10–12% of who have epilepsy and treatment is mainly focused on areas like compliance and risky behaviours. At the other end are patients with severe ID, up to 50% of who have epilepsy and treatment is more focused on factors such as the co-morbidity, impact of medications, recognition of side effects, treatment resistance, and informed consent. This chapter looks to collate and provide an overview of epilepsy diagnosis and management and the current good practice on its applicability to people with ID.

Developing a tool to support diagnostic delivery of dementia

It is increasingly recognised that there are challenges affecting the current delivery of dementia diagnoses. Steps are required to address this. Current good practice guidelines provide insufficient direction and interventions from other healthcare settings do not appear to fully translate to dementia care settings. This project has taken a sequential two-phase design to developing a tool specific to dementia diagnostic delivery. Interviews with 14 participants explored good diagnostic delivery. Thematic analysis produced key themes (overcoming barriers, navigation of multiple journeys and completing overt and covert tasks) that were used to inform the design of a tool for use by clinicians, patients and companions. The tool was evaluated for acceptability in focused group discussions with 13 participants, which indicated a desire to use the tool and that it could encourage good practice. Adaptations were highlighted and incorporated to improve acceptability. Future research is now required to further evaluate the tool.

Constructive conservation – a model for developing heritage assets

Purpose – The purpose of this paper is to outline a conceptual model for adaptive reuse of heritage assets which has been produced in an effort to fill a gap in information, address the complexity of developing heritage assets and encourage more responsible and responsive treatment of heritage assets. The purpose of the model is to visually articulate the various elements that must be considered to successfully develop a heritage asset. Design/methodology/approach – Based on six years of observation and industry practice, the model reflects a previously undocumented process for developing and adapting built heritage assets employed by many professionals across the UK. The model is further strengthened by drawing from other international theories, concepts, and principles. Findings – The redevelopment of heritage assets is a “wicked problem”. The model established visually articulates current good practice in the field and provides a simplified version of the process. Originality/value – Presently, there is insufficient contemporary literature which adequately describes or visualizes the complex adaptive reuse of built heritage in a coherent and holistic way. This model is the first to try to visually capture and communicate current good practice for widespread use. It is hoped that the documentation and dissemination of this process will help to advance creative problem solving, increase the appeal of developing heritage assets and elevate the quality of work produced.