bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors associated with expressed satisfaction among people with intellectual disability receiving residential supports
Authors: Gregory N. , Robertson J. , Kessissoglou S. , Emerson E. , Hatton C. 
Published: March 2003

AbstractThe aim of the present study was to identify factors associated with variations in the levels of expressed satisfaction among adults with intellectual disability (ID) receiving residential supports. Semi‐structured interviews were conducted with 96 people with ID. Forty‐five subjects lived in village communities and 51 received community‐based residential supports. Ratings were made of the participants' expressed levels of satisfaction in seven domains: (1) their home; (2) daytime activities; (3) social and recreational activities; (4) support from services; (5) friendships and relationships; (6) choices available to them; and (7) risks. The data indicated that: (1) interviewees living in village communities expressed greater satisfaction with friendships and relationships than interviewees living in community‐based residential supports; (2) in the other six domains of life satisfaction which were investigated, there were no statistically significant differences between groups; (3) interviewees expressed greater satisfaction with their accommodation and day activities than with friendships, risks and support received; and (4) a wide range of variables relating to the personal characteristics of the interviewees and support received were associated with variations in levels of expressed satisfaction. Variation in the levels of expressed satisfaction was reliably associated with variables relating to the personal characteristics of the interviewees and the nature of the support received.
Bullying and people with severe intellectual disability
Authors: Sheard C. , Clegg J. , Standen P. , Cromby J. 
Published: March 2003

AbstractAlthough bullying has been shown to reduce quality of life in many spheres, anti‐bullying strategies have yet to be incorporated into services for adults with severe intellectual disability (ID). The present study employed a survey of staff and parent concerns about 54 previously surveyed students who had left a school for pupils with severe ID. A content analysis of follow‐up interviews was performed in 10 cases. Staff identified 19% of the survey sample as bullying others and 11% as being picked on. Neither gender nor communication ability had an impact. There was no significant change in bully or victim status over time, although some people did change. Parents or staff raised bully/victim problems in more than half of the interviews. There is sufficient evidence of bullying behaviour to warrant the adoption of anti‐bullying strategies.
Prevalence of visual and hearing impairment in a Dutch institutionalized population with intellectual disability
Authors: Evenhuis H. M. , Theunissen M. , Denkers I. , Verschuure H. , Kemme H. 
Published: March 2003

AbstractA screening of hearing and visual function was performed using clinical assessment methods in a Dutch institutionalized population of 672 people with mild to profound intellectual disability (ID). Because the studied population was not comparable to the total Dutch population with ID, subgroups were distinguished according to level of ID, age younger and older than 50 years, and the presence or absence of Down's syndrome (DS). The prevalences of both hearing and visual impairment were considerably increased in all subgroups, as compared with the general population. In the least affected group, i.e. those < 50 years with a mild or moderate ID by other causes than DS, the prevalences of hearing and visual impairment were 21% and 4%, respectively (as opposed to 2–7% and 0.2–1.9% in the general Dutch population <50 years, respectively). The prevalence of hearing impairment showed a sharp and highly significant increase in individuals with DS and subjects ≥ 50 years. To a lesser extent, young adults with severe or profound ID had an increased risk of hearing impairment. Visual impairment and blindness were specifically highly prevalent in people with severe or profound ID (51% < 50 years of age). Down's syndrome and an age ≥ 50 years were also significant risk factors for visual impairment. There was an alarmingly high prevalence of combined sensory impairment, especially in those with severe or profound ID (20%). Although hearing impairment had been diagnosed prior to this screen in 138 people and visual impairment in 65 individuals, a first diagnosis of hearing impairment was made in 128 subjects and of visual impairment in 90 cases. This highlights the tendency for sensory impairments to go unnoticed in people with ID, which is not restricted to those with severe or profound ID. Therefore, the present authors stress the importance of regular screening as outlined in the existing IASSID international consensus statement.
Injury risk in young people with intellectual disability
Authors: Sherrard J , Tonge B. J , Ozanne‐Smith J 
Published: March 2003

AbstractEpidemiological studies have established injury as a major public health problem for young people in the general population, but minimal population‐based injury information exists on those with intellectual disability (ID). The present study investigated risk factors for injury to subjects in the Australian Child and Adolescent Development (ACAD) programme, which is examining emotional and behavioural problems in young people with ID. Extensive biopsychosocial data for the ACAD programme were collected at two time intervals (i.e. 1990–1991 and 1995–1996). Carer report of medically attended injury over one year was collected for the first time period (1995–1996) on a sample of 465 ACAD subjects (aged 5–29 years) representative of young people with ID (IQ < 70) to determine risk factors for injury using the ACAD biopsychosocial data. Psychopathology [odds ratio (OR) = 3.4] epilepsy (OR = 2.4) and an overly sociable temperament (OR = 2.2) are associated with injury in young people with ID. Social and family factors had minimal influence on injury risk in this population. Those who are highly disruptive, self‐absorbed, anxious, have problems relating socially, have communication disturbance or have attention deficit hyperactivity symptoms are particularly at increased risk for injury. The present study demonstrates a largely under‐recognized public health problem of a high unintentional injury risk for young people with ID, and identifies substantial and important risk factors for injury. Injury prevention programmes, with a particular focus on those with highly disturbed behaviours or epilepsy, are warranted in this population.
A survey of the prevalence of stereotypy, self‐injury and aggression in children and young adults with Cri du Chat syndrome
Authors: Collins M. S. Ross , Cornish K. 
Published: March 2003

AbstractBackgroundThe aim of the present study was to determine the prevalence and frequency of stereotypy, self‐injurious behaviour (SIB), and aggression in children and adults with Cri du Chat syndrome (CCS), and to investigate the relationship between SIB, aggressive behaviour and stereotypy in these individuals.MethodsSixty‐six families of children and adults diagnosed with CCS completed the Behaviour Problems Inventory. Additional information relating to gender, chronological age, type of school/post‐school occupation and medication was also included in the survey.ResultsStereotyped behaviour was reported for 82% of subjects, more than half the sample displaying it on a daily basis. The occurrence percentage of 15 topographies of SIB suggested that head banging, hitting the head against body parts, self‐biting and rumination are the most frequently occurring behaviours in CCS. Aggressive behaviour was reported for 88%, with a statistically significant negative correlation between age and the number of aggressive behaviours reported.ConclusionsThe present findings suggest that specific types of stereotypy and SIB are observed frequently in CCS.
Religious and secular students’ sense of self‐efficacy and attitudes towards inclusion of pupils with intellectual disability and other types of needs
Authors: Lifshitz H. , Glaubman R. 
Published: March 2003

AbstractBackgroundThe aim of the present study was to investigate whether Judaism’s positive attitudes toward people with disabilities would influence greater willingness towards inclusion of such people in regular classes and a greater sense of self‐efficacy in working with them.MethodsThe present authors compared religious (n = 175) and secular (n = 420) Jewish students at a teacher’s college with regard to these variables. The authors used the Regular Education Initiative questionnaire, which investigates teachers’ self‐efficacy and attitudes towards including pupils with different types of disabilities in regular education. They analysed the results according to the college students’ major and the type of disability (five types at three levels of severity).ResultsThe results indicate that religious students are more willing than non‐religious students to consider the inclusion of people with four types of disabilities and have a greater sense of efficacy for dealing with all types of disabilities. The hypothesis that the milder the disability, the higher would be the teacher’s sense of self‐efficacy and her/his willingness for such children to be included in a regular class was sustained. The religious special education students were the only ones who exhibited willingness to include pupils with intellectual disability, and moderate and severe emotional disturbances. Students who majored in special education scored higher than all their counterparts on both measures. The results also sustain the hypothesis that there would be a positive correlation between both measures.ConclusionsTo facilitate inclusive education amongst teachers and students, the present authors recommend an intervention programme designed to help students acquire knowledge and strategies about inclusion. They also suggest enriching this programme with Jewish religious sources, which reflect positive attitudes toward people with disabilities.
Responsiveness to staff support: evaluating the impact of individual characteristics on the effectiveness of active support training using a conditional probability approach
Authors: Smith C. , Felce D. , Jones E. , Lowe K. 
Published: March 2003

AbstractBackground Active support training was fully conducted in 38 community houses accommodating 106 adults with intellectual disabilities (ID; group 1), but not in a further 36 accommodating 82 adults with ID (group 2). The aims of the present study were to analyse whether staff became more effective in supporting resident activity after the implementation of active support, and whether there was evidence of differential responsiveness by people with differing status in relation to adaptive behaviour, psychiatric diagnosis, challenging behaviour or autism.Methods Observations of staff:resident interaction and resident engagement in activity were taken before and after active support training. Changes in Yule's Q statistics, indicating the likelihood that resident engagement in activity followed staff giving residents verbal instruction or non‐verbal assistance, were compared for the two groups. In addition, changes in similar statistics were compared for residents within group 1: (1) with Adaptive Behaviour Scale (ABS) scores above and below 180; and (2) with and without severe challenging behaviour, the triad of social impairments and mental illness.Results Yule's Q for engagement given non‐verbal assistance significantly increased post‐training among group 1, but not among group 2. Similar significant increases were found among group 1 residents with ABS scores below 180 without challenging behaviour, with and without the triad of social impairments, and without mental illness, but not with an ABS score above 180, with challenging behaviour and with mental illness.Conclusion The present analysis reinforces previous studies on the effectiveness of active support training for adults with more severe ID (i.e. with ABS scores below 180). Active support was as effective for people with the triad of social impairments as for those without it. However, the effectiveness of support offered to people with challenging behaviour or mental illness did not significantly increase.
Glasgow Anxiety Scale for people with an Intellectual Disability (GAS‐ID): development and psychometric properties of a new measure for use with people with mild intellectual disability
Authors: Mindham J. , Espie C. A. 
Published: March 2003

AbstractBackground  Self‐rating scales are widely used in general adult practice; however, there is no reliable and valid method for assessing state anxiety in people with intellectual disability (ID). The present study describes the development and psychometric evaluation of a new scale, the Glasgow Anxiety Scale for People with an Intellectual Disability (GAS‐ID).Methods  First, an item pool was generated from focus groups, a review of the literature and clinician feedback. Secondly, a draft scale was administered to 19 anxious and 16 non‐anxious people with ID for further validation and appraisal of reliability. Thirdly, the scale was completed by 19 anxious, non‐ID people for cross‐validation with the Beck Anxiety Inventory (BAI). Finally, physiological concomitants were validated by pulse‐oximetry.Results  The 27‐item GAS‐ID discriminated anxious from non‐anxious participants, had good test–retest reliability (r = 0.95) and internal consistency (α = 0.96), and was reasonably correlated with the BAI (ρ = 0.75). The correlation between the physiological subscale of the GAS‐ID and changes in pulse rate was moderately significant (ρ = 0.52).Conclusions  This preliminary study suggests that the GAS‐ID offers a psychometrically robust and practical (5–10 min) approach to the appraisal of anxiety in this population.
Resistance to activated protein C, highly prevalent amongst users of oral contraceptives with venous thromboembolism
Authors: Bennet L. , Odeberg H. 
Published: March 2003

Bennet L, Odeberg H (Blekinge Hospital, Karlskrona, Sweden). Resistance to activated protein C, highly prevalent amongst users of oral contraceptives with venous thromboembolism. J Intern Med 1998; 244: 27–32.ObjectiveInherited resistance to activated protein C (APC resistance), which is caused by a single point mutation in the factor V gene, is a frequent risk factor for venous thromboembolism. The aim of this study was to determine the prevalence of APC resistance and other coagulation disorders in fertile women with venous thromboembolism and also the risk factors these women had been exposed to in connection with thromboembolic events.DesignA retrospective, case‐control study of 36 month duration.SettingThe study was carried out at Blekinge Hospital, Karlskrona, Sweden.SubjectsThe study population comprised 27 fertile women age 16–47 years with thromboembolic complications, referred to the department of Internal Medicine at Blekinge Hospital in Karlskrona during a 36‐month period.ResultsAPC resistance was found in 10 out of 27 women. APC resistance was associated with treatment with oral contraceptives in five out of six women and with pregnancy in one of seven women.All women with resistance to APC developed venous thrombosis in association with a predisposing situation (risk situation) such as surgery, trauma, immobilization, pregnancy, inflammatory state or the use of oral contraceptives. Amongst women not resistant to APC, all but one developed thrombosis in connection with a risk situation.ConclusionAPC resistance was found to be highly prevalent amongst fertile women with a history of thromboembolic complication occurring during their use of oral contraceptives.
Low recurrence rate after deep calf‐vein thrombosis with 6 weeks of oral anticoagulation
Authors: Astermark J. , Björgell O. , Lindén E. , Lethagen S. , Nilsson P. , Berntorp E. 
Published: March 2003

Abstract. Astermark J, Björgell O, Lindén E, Lethagen S, Nilsson P, Berntorp E (University Hospital, Malmö, Sweden). Low recurrence rate after deep calf‐vein thrombosis with 6 weeks of oral anticoagulation. J Intern Med 1998; 244: 79–82.ObjectivesTo evaluate the recurrence rate after deep calf‐vein thrombosis treated with 6 weeks of oral anticoagulation.Design and subjectsA 2 year follow‐up of 126 consecutive patients admitted to the Department of Internal Medicine with venographically verified deep calf‐vein thrombosis.ResultsOne hundred and twenty‐six patients were treated with warfarin for 6 weeks, 18 of them having had a previous episode of venous thrombosis (DVT). Eleven patients (8.7%) suffered a recurrent thromboembolic episode within 2 years, four of which were within the first 3 months. Eight of those without a history of DVT had a recurrence (7.4%). Three of these were activated protein C (APC)‐resistant, one was protein C‐deficient and one had malignant melanoma.Eight patients (6.3%) reported minor haemorrhagic complications, but no major bleeding was seen.ConclusionOur data support the use of a 6 week regimen of secondary oral prophylaxis after a first episode of deep calf‐vein thrombosis in patients without a permanent risk factor. Whether individuals with inherited thrombophilia require prolonged treatment remains to be evaluated.
Comparison of effects of quinapril and metoprolol on glycaemic control, serum lipids, blood pressure, albuminuria and quality of life in non‐insulin‐dependent diabetes mellitus patients with hypertension
Authors: Östman  , Asplund  , Bystedt  , Dahlöf  , Jern  , Kjellström  , Lithell  ,   FOR THE SWEDISH QUINAPRIL GROUP
Published: March 2003

ObjectiveTo compare the long‐term effects of the angiotensin‐converting enzyme (ACE)‐inhibitor quinapril and the cardioselective beta‐adrenergic blocking agent metoprolol on glycaemic control, with glycosylated haemoglobin (HbA1c) as the principal variable, in non‐insulin‐dependent diabetes mellitus (NIDDM) patients with hypertension.DesignA randomized, double‐blind, double‐dummy, multicentre study during 6 months preceded by a 4 week wash‐out and a 3 week run‐in placebo period. Quinapril (20 mg) and metoprolol (100 mg, conventional tablets) were given once daily. No change was made in the treatment of diabetes (diet and hypoglycaemic agents).SubjectsSeventy‐two patients fulfilling the criteria were randomized and entered the double‐blind period. Twelve patients did not complete the study. Sixty patients, 26 on quinapril and 34 on metoprolol, were available for the final analysis.Main outcome measuresThe effect was assessed by changes in HbA1c, the fasting serum glucose and the post‐load serum glucose, C‐peptide and insulin levels during the oral glucose tolerance test.ResultsIn the quinapril group, the fasting serum glucose, oral glucose tolerance and the C‐peptide and insulin responses, determined as the incremental area under the curves (AUC), showed no change, but the mean HbA1clevel increased from 6.2 ± 1.1% to 6.5 ± 1.3% (P< 0.05). In the metoprolol group, the rise in the mean level of HbA1c, from 6.3 ± 1.0% to 6.8 ± 1.3% (P< 0.01), tended to be more marked than after quinapril, although there was no significant difference between the increments. The mean fasting serum glucose showed an increase from 9.1 ± 1.9 mm to 10.1 ± 2.8 mm (P< 0.01) which correlated significantly with the duration of diabetes (P< 0.01) and the increase in fasting serum triglycerides (P< 0.001). Moreover, in the metoprolol group we found significant decreases in the oral glucose tolerance as well as C‐peptide and insulin responses to the glucose load.ConclusionsTreatment with quinapril for 6 months appears to have advantages over metoprolol in NIDDM patients with hypertension. Although treatment with quinapril or metoprolol over 6 months was concomitant with a rise in the HbA1c, increased fasting blood glucose, decreased oral glucose tolerance and decreased C‐peptide and insulin responses to a glucose challenge were observed only in patients treated with metoprolol.
Molecular biology of the MEN2 gene
Authors: Santoro  , Melillo  , Carlomagno  , Visconti  , De Vita  , Salvatore  , Lupoli  , Fusco  , Vecchio  
Published: March 2003

Santoro M, Melillo RM, Carlomagno F, Visconti R, De Vita G, Salvatore G, Lupoli G, Fusco A, Vecchio G (Università di Napoli, Naples, Italy). Molecular biology of the MEN2 gene (Minisymposium: MEN & VHL). J Intern Med 1998; 243: 505–8.Cancer is a genetic disease caused by ‘gain of function’ mutations of oncogenes and ‘loss of function’ mutations of tumour suppressors and of genes involved in DNA repair mechanisms. The RET gene encodes a tyrosine kinase receptor for molecules belonging to the glial cell line‐derived neurotrophic factor (GDNF) family. RET is a paradigmatic example of how different mutations of a single gene can lead to different neoplastic phenotypes. Indeed, gene rearrangements, often caused by chromosomal inversions, activate the oncogenic potential of RET in a fraction of human thyroid papillary carcinomas. On the other hand, different point mutations activate RET in familial multiple endocrine neoplasia syndromes familial medullary thyroid carcinoma (FMTC), MEN‐2A and MEN‐2B. Little information is so far available on the biochemical mechanisms by which the potent transforming and mitogenic signals of RET are delivered to the nucleus. However, recent data indicate coupling to the Shc‐Ras‐MAPK pathway as a necessary step in RET signal transduction.
Folate administration reduces circulating homocysteine levels in NIDDM patients on long‐term metformin treatment
Authors: Aarsand  , Carlsen  
Published: March 2003

Aarsand AK, Carlsen SM (Norwegian University of Science and Technology, Trondheim, Norway.) Folate administration reduces circulating homocysteine levels in NIDDM patients on long‐term metformin treatment. J Intern Med 1998; 244: 169–74.ObjectivesMetformin treatment increases circulating homocysteine levels. We studied whether administration of folate reduces serum total homocysteine levels in patients on long‐term metformin treatment.DesignA prospective, randomized, double‐blind, placebo‐controlled study lasting for 12 weeks and taking place in a university hospital setting.SubjectsThirty patients treated with a metformin dose of at least 1000 mg day−1 for a minimum of 1 year were included. At baseline serum total homocysteine levels were within the reference range. One patient who withdrew and one who died were excluded from the statistical evaluation. Twenty‐six of the remaining patients suffered from NIDDM, the other two from hyperlipidaemia.InterventionPatients were randomized into two groups at week 0. The folate group received 0.25 mg day−1 of folate in addition to 60 mg day−1 of Fe2+, while the placebo group received only 60 mg day−1 of Fe2+.Main outcome measuresFasting homocysteine, cysteine, cysteinylglycine, vitamin B12 and folate were measured at week 0, 4 and 12. Changes from week 0 to week 4 and from week 0 to week 12 were calculated.ResultsFolate administration reduced serum levels of total homocysteine in the folate group as compared with the placebo group by 13.9% (P < 0.01) and 21.7% (P < 0.001) at week 4 and 12, respectively. In the folate group versus the placebo group serum levels of vitamin B12 increased by 9.9% (P= 0.010) and 9.6% (P= 0.043) while folate levels increased by 96.9 and 89.9% at week 4 and 12, respectively.ConclusionThe present study indicates that the homocysteine‐increasing effect of metformin can be counteracted by folate administration.