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Psychometric properties of the Beliefs About Adults with ID Scale in American physicians: Application of classical test and Rasch measurement theories 美国医生对智障成人的看法量表的心理计量特性:经典测试和 Rasch 测量理论的应用。
IF 2.1 2区 医学 Q1 EDUCATION, SPECIAL Pub Date : 2024-05-13 DOI: 10.1111/jir.13143
A. Bacherini, P. Anselmi, S. M. Havercamp, G. Balboni

Background

Physicians' erroneous assumptions about individuals with intellectual disability (ID) negatively impact the quality of care provided to this population. This study aimed to investigate the psychometric properties of the Beliefs About Adults with ID (BAID), an instrument we developed for measuring physicians' erroneous assumptions about adults with ID.

Methods

Two hundred ninety-two American physicians participated. Classical test theory and Rasch measurement theory were used to refine the scale (through item analysis, exploratory factor analysis, infit and outfit mean-squares statistics, and differential item functioning) and investigate its psychometric properties (functioning of the response scale, reliability, and validity).

Results

The BAID provided a unidimensional, reliable, valid, and precise measure in assessing high levels of erroneous assumptions. It showed convergent and divergent validity with the different factors of a scale measuring attitudes towards ID. The BAID items were discriminant, non-redundant, unambiguous, and invariant across gender and previous ID training. The BAID response scale was found to be appropriate for measuring physicians' erroneous assumptions about adults with ID.

Conclusions

BAID is a brief instrument with good psychometric properties to assess erroneous assumptions about adults with ID in physicians of different genders and who have/have not previously received ID training. Therefore, it might be helpful for research and medical education purposes.

背景:医生对智障人士(ID)的错误假设对为该群体提供的医疗服务质量产生了负面影响。本研究旨在调查 "关于智障成人的信念"(BAID)的心理测量特性,这是我们为测量医生对智障成人的错误假设而开发的一种工具:共有 292 名美国医生参加。采用经典测试理论和 Rasch 测量理论对量表进行了改进(通过项目分析、探索性因子分析、infit 和 outfit 均方统计以及差异项目功能),并对其心理测量特性(反应量表的功能、信度和效度)进行了研究:结果:BAID 在评估高水平错误假设方面提供了一种单维度、可靠、有效和精确的测量方法。它与测量对智障者态度的量表中的不同因子之间具有收敛和发散效度。BAID 项目具有区分性、非冗余性、明确性,并且在不同性别和以前接受过 ID 培训的情况下保持不变。BAID反应量表适用于测量医生对智障成人的错误假设:BAID是一种简短的工具,具有良好的心理测量特性,可用于评估不同性别、接受过或未接受过智障培训的医生对智障成人的错误假设。因此,它可能有助于研究和医学教育。
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引用次数: 0
Implementation of the International Classification of Diseases 11th revision behavioural indicators for disorders of intellectual development with co-occurring autism spectrum disorder 实施《国际疾病分类》第 11 次修订版中关于并发自闭症谱系障碍的智力发育障碍行为指标。
IF 2.1 2区 医学 Q1 EDUCATION, SPECIAL Pub Date : 2024-05-11 DOI: 10.1111/jir.13146
K. R. Lemay, C. S. Kogan, T. Rebello, J. W. Keeley, R. Bhargava, S. Buono, S. Cooray, P. Ginige, M. T. Kishore, J. V. S. Kommu, M. Recupero, A. Roy, P. Sharan, G. M. Reed
<div> <section> <h3> Background</h3> <p>The classification of mental, behavioural and neurodevelopmental disorders in the World Health Organization's International Classification of Diseases 11th revision (ICD-11) includes a comprehensive set of behavioural indicators (BIs) within the neurodevelopmental disorders grouping. BIs can be used to assess the severity of disorders of intellectual development in situations in which standardised measures of intellectual functioning and adaptive behaviours are not available or feasible. This international study examines the implementation characteristics of the BIs and compares them to standardised measures for assessing the severity of intellectual impairment and adaptive behaviours in disorders of intellectual development and autism spectrum disorder (ASD). The clinical utility of the ICD-11 and the fidelity of its application in international clinical settings were also assessed.</p> </section> <section> <h3> Methods</h3> <p>A total of 116 children and adolescents (5–18 years old) with a suspected or established diagnosis of disorders of intellectual development were included across four sites [Italy (<i>n</i> = 18), Sri Lanka (<i>n</i> = 19) and two sites in India (<i>n</i> = 79)]. A principal component analysis was conducted to evaluate the application of the ICD-11 guidance for combining severity levels.</p> </section> <section> <h3> Results</h3> <p>Assessment using the BIs showed a higher proportion of individuals classified with mild severity, whereas the standardised measures indicated a higher proportion of severe ratings. Additionally, individuals with co-occurring ASD tended to have more severe impairments compared with those without ASD, as indicated by both BIs and standardised measures. Overall, the BIs were considered clinically useful, although more time and consideration were required when applying the guidelines for individuals with a co-occurring disorder of intellectual development and ASD. The principal component analysis revealed one principal component representing overall disorders of intellectual development severity levels.</p> </section> <section> <h3> Conclusions</h3> <p>The ICD-11 BIs can be implemented as intended in international clinical settings for a broad range of presentations of individuals with neurodevelopmental disorders. Use of the BIs results in similar severity diagnoses to those made using standardised measures. The BIs are expected to improve the reliability of severity assessments in settings where appropriate standardised measures for intellectual and adaptive
背景:世界卫生组织《国际疾病分类》第 11 版(ICD-11)对精神、行为和神经发育障碍的分类包括神经发育障碍分组中的一整套行为指标(BIs)。在没有或无法对智力功能和适应行为进行标准化测量的情况下,行为指标可用于评估智力发育障碍的严重程度。这项国际性研究考察了智力发育障碍和自闭症谱系障碍(ASD)中智力障碍和适应行为严重程度的标准化测量方法,并将其与标准化测量方法进行了比较。此外,还评估了 ICD-11 的临床实用性及其在国际临床环境中应用的忠实性:共有 116 名儿童和青少年(5-18 岁)被疑似或确诊为智力发育障碍,他们来自四个地方[意大利(n = 18)、斯里兰卡(n = 19)和印度的两个地方(n = 79)]。我们进行了主成分分析,以评估 ICD-11 指南在合并严重程度等级方面的应用:结果:使用生物统计学指标进行的评估显示,被归类为轻度严重程度的患者比例较高,而标准化测量结果显示,被归类为重度严重程度的患者比例较高。此外,BIs 和标准化测量结果均显示,与无 ASD 的患者相比,合并 ASD 的患者往往有更严重的障碍。总体而言,虽然在对同时患有智力发育障碍和 ASD 的个体应用指南时需要更多的时间和考虑,但 BIs 被认为在临床上是有用的。主成分分析显示,一个主成分代表了智力发育障碍的整体严重程度:结论:在国际临床环境中,ICD-11 BIs 可按预期用于神经发育障碍患者的各种表现。使用 BIs 所得出的诊断结果与使用标准化测量方法得出的诊断结果相似。在没有适当的智力和适应行为标准化测量方法或这些方法不可行的情况下,《国际功能、残疾和健康分类》有望提高严重程度评估的可靠性。
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引用次数: 0
Assessment of dental and periodontal indices and Streptococcus mutans virulence in fragile X syndrome patients 评估脆性 X 综合征患者的牙齿和牙周指数以及变异链球菌的毒力。
IF 2.1 2区 医学 Q1 EDUCATION, SPECIAL Pub Date : 2024-05-08 DOI: 10.1111/jir.13142
Cristhiane Olivia Ferreira do Amaral, Kamila Rosamilia Kantovitiz, V. C. de Araújo, T. Marega, L. N. Teixeira, E. F. Martinez

Introduction

Fragile X syndrome (FXS) is the most common cause of hereditary genetic disorder in a single gene characterised by intellectual disability. Behavioural features such as autism, hyperactivity and anxiety disorder may be present. Biofilm development and pathogenicity of Streptococcus mutans may be altered because FXS renders the dental approach and oral hygiene more complex.

Objectives

The purpose of this study was to compare the levels of transcripts for VicRK and CovR of S. mutans isolated from FXS patients with the levels of transcripts for VicRK and CovR of standard strain ATCC, using a quantitative polymerase chain reaction (qPCR).

Methods

The caries experience index was assessed by the International Caries Detection and Assessment System (ICDAS), Periodontal Condition Index (PCI) and Invasive Dental Treatment Need Index (INI).

Results

The clinical index findings revealed a high rate of caries cavities and bleeding on probing of FXS patients. When VicRK and CovR transcript levels were compared with the reference strain, Fragile X patients were found to have significantly higher values.

Conclusion

The present study demonstrated that FXS patients have more adverse clinical conditions, with increased biofilm accumulation and virulence. When combined with behavioural abnormalities, these patients become even more vulnerable to dental caries.

简介脆性 X 综合征(FXS)是最常见的单基因遗传性疾病,以智力障碍为特征。患者可能存在自闭症、多动和焦虑症等行为特征。由于 FXS 使牙科治疗方法和口腔卫生变得更加复杂,突变链球菌的生物膜发育和致病性可能会发生改变:本研究的目的是使用定量聚合酶链反应(qPCR)比较从FXS患者中分离出的变异链球菌的VicRK和CovR转录本水平与标准菌株ATCC的VicRK和CovR转录本水平:方法:采用国际龋病检测和评估系统(ICDAS)、牙周状况指数(PCI)和牙科有创治疗需求指数(INI)评估龋病经历指数:临床指数结果显示,FXS 患者的龋洞率和探诊出血率很高。将 VicRK 和 CovR 转录水平与参考株进行比较,发现脆性 X 患者的数值明显更高:本研究表明,FXS 患者的临床症状更为严重,生物膜积累和致病力都有所增强。结论:本研究表明,FXS 患者的临床状况更为不利,其生物膜积累和致病力都有所增强,如果再加上行为异常,这些患者就更容易患龋齿。
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引用次数: 0
Mortality in French people with polyhandicap/profound intellectual and multiple disabilities 法国多重残疾/智力和多重残疾人士的死亡率。
IF 2.1 2区 医学 Q1 EDUCATION, SPECIAL Pub Date : 2024-05-01 DOI: 10.1111/jir.13138
I. Hamouda, K. Baumstarck, M.-A. Aim, A. Beltran Anzola, A. Loundou, T. Billette de Villemeur, L. Boyer, the EVAL-PLH group, P. Auquier, M.-C. Rousseau

Background

In recent decades, progress has been made in the care of people with polyhandicap/profound intellectual and multiple disabilities (PIMD) through a better understanding of the pathophysiology and the development of new care management and rehabilitation strategies adapted to these extreme pathologies. Although there is a lack of knowledge about the health status and care management of the oldest people, a better understanding of the natural course of life of people with polyhandicap/PIMD would consequently allow the optimisation of preventive and curative care management strategies. Few robust data on mortality and life expectancy have been documented for this population in France. Our aims are to estimate the median survival time and assess the factors associated with mortality in people with polyhandicap/PIMD receiving care in France.

Methods

This study included people with polyhandicap/PIMD, followed by the French national cohort ‘Eval-PLH’ since 2015. These individuals were included in specialised rehabilitation centres and residential institutions. The people included in the first wave of the cohort (2015–2016) were eligible for the present study. Vital status on 1 January 2022 (censoring date) was collected in two ways: (1) spontaneous reporting by the participating centre to the coordinating team and (2) systematic checking on the French national death platform. According to the vital status, survival was calculated in years from the date of birth to the date of death or from the date of birth to the censoring date. The factors associated with mortality were evaluated using the Cox proportional regression hazards model.

Results

Data from 780 individuals aged between 3 and 67 years were analysed. At the censoring date, 176 (22.6%) had died, and the mean survival was 52.8 years (95% confidence interval: 51.1–54.5). Mortality was significantly associated with a progressive aetiology, recurrent pulmonary infections, drug-resistant epilepsy and a higher number of medical devices.

Conclusions

This study shows for the first time the survival and impact of factors associated with mortality in people with polyhandicap/PIMD in France.

背景:近几十年来,通过更好地了解病理生理学,并针对这些极端病症制定新的护理管理和康复策略,在护理多重残疾/完全智障和多重残疾(PIMD)患者方面取得了进展。虽然对最年长者的健康状况和护理管理缺乏了解,但如果能更好地了解多重残疾/多重智障人士的自然生命过程,就能优化预防和治疗护理管理策略。在法国,有关这一人群死亡率和预期寿命的可靠数据很少。我们的目的是估算在法国接受治疗的多手部畸形/多发性肌萎缩症患者的中位生存时间,并评估与死亡率相关的因素:这项研究纳入了自2015年起由法国国家队列 "Eval-PLH "跟踪调查的多重手部残疾/PIMD患者。这些患者被纳入专业康复中心和寄宿机构。第一波队列(2015-2016 年)中的患者有资格参与本研究。2022年1月1日(剔除日)的生命状态通过两种方式收集:(1)参与中心向协调小组自发报告;(2)在法国国家死亡平台上进行系统检查。根据生命体征,计算从出生日期到死亡日期或从出生日期到剔除日期的生存年数。使用考克斯比例回归危险模型评估了与死亡率相关的因素:结果:分析了 780 名年龄在 3 岁至 67 岁之间儿童的数据。在普查日期,有 176 人(22.6%)死亡,平均存活时间为 52.8 年(95% 置信区间:51.1-54.5)。死亡率与进展性病因、反复肺部感染、耐药性癫痫和较多的医疗设备有明显关系:这项研究首次显示了法国多手畸形/多指并指畸形患者的存活率及其死亡率相关因素的影响。
{"title":"Mortality in French people with polyhandicap/profound intellectual and multiple disabilities","authors":"I. Hamouda,&nbsp;K. Baumstarck,&nbsp;M.-A. Aim,&nbsp;A. Beltran Anzola,&nbsp;A. Loundou,&nbsp;T. Billette de Villemeur,&nbsp;L. Boyer,&nbsp;the EVAL-PLH group,&nbsp;P. Auquier,&nbsp;M.-C. Rousseau","doi":"10.1111/jir.13138","DOIUrl":"10.1111/jir.13138","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In recent decades, progress has been made in the care of people with polyhandicap/profound intellectual and multiple disabilities (PIMD) through a better understanding of the pathophysiology and the development of new care management and rehabilitation strategies adapted to these extreme pathologies. Although there is a lack of knowledge about the health status and care management of the oldest people, a better understanding of the natural course of life of people with polyhandicap/PIMD would consequently allow the optimisation of preventive and curative care management strategies. Few robust data on mortality and life expectancy have been documented for this population in France. Our aims are to estimate the median survival time and assess the factors associated with mortality in people with polyhandicap/PIMD receiving care in France.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included people with polyhandicap/PIMD, followed by the French national cohort ‘Eval-PLH’ since 2015. These individuals were included in specialised rehabilitation centres and residential institutions. The people included in the first wave of the cohort (2015–2016) were eligible for the present study. Vital status on 1 January 2022 (censoring date) was collected in two ways: (1) spontaneous reporting by the participating centre to the coordinating team and (2) systematic checking on the French national death platform. According to the vital status, survival was calculated in years from the date of birth to the date of death or from the date of birth to the censoring date. The factors associated with mortality were evaluated using the Cox proportional regression hazards model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data from 780 individuals aged between 3 and 67 years were analysed. At the censoring date, 176 (22.6%) had died, and the mean survival was 52.8 years (95% confidence interval: 51.1–54.5). Mortality was significantly associated with a progressive aetiology, recurrent pulmonary infections, drug-resistant epilepsy and a higher number of medical devices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study shows for the first time the survival and impact of factors associated with mortality in people with polyhandicap/PIMD in France.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16163,"journal":{"name":"Journal of Intellectual Disability Research","volume":"68 8","pages":"985-996"},"PeriodicalIF":2.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jir.13138","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association of behavioural and social–communicative profiles in children with 16p11.2 copy number variants: a multi-site study 16p11.2拷贝数变异儿童的行为和社会交流特征:一项多站点研究
IF 2.1 2区 医学 Q1 EDUCATION, SPECIAL Pub Date : 2024-04-24 DOI: 10.1111/jir.13141
J. Verbesselt, L. K. Walsh, M. W. Mitchel, C. M. Taylor, B. M. Finucane, J. Breckpot, I. Zink, A. Swillen

Background

Despite the established knowledge that recurrent copy number variants (CNVs) at the 16p11.2 locus BP4–BP5 confer risk for behavioural and language difficulties, limited research has been conducted on the association between behavioural and social–communicative profiles. The current study aims to further delineate the prevalence, nature and severity of, and the association between, behavioural and social–communicative features of school-aged children with 16p11.2 deletion syndrome (16p11.2DS) and 16p11.2 duplication (16p11.2Dup).

Methods

A total of 68 individuals (n = 47 16p11.2DS and n = 21 16p11.2Dup) aged 6–17 years participated. Standardised intelligence tests were administered, and behavioural and social–communicative skills were assessed by standardised questionnaires. Scores of both groups were compared with population norms and across CNVs. The influence of confounding factors was investigated, and correlation analyses were performed.

Results

Compared with the normative sample, children with 16p11.2DS showed high rates of social responsiveness (67%) and communicative problems (69%), while approximately half (52%) of the patients displayed behavioural problems. Children with 16p11.2Dup demonstrated even higher rates of social–communicative problems (80–90%) with statistically significantly more externalising and overall behavioural challenges (89%). In both CNV groups, there was a strong positive correlation between behavioural and social–communicative skills.

Conclusions

School-aged children with 16p11.2 CNVs show high rates of behavioural, social responsiveness and communicative problems compared with the normative sample. These findings point to the high prevalence of autistic traits and diagnoses in these CNV populations. Moreover, there is a high comorbidity between behavioural and social–communicative problems. Patients with difficulties in both domains are vulnerable and need closer clinical follow-up and care.

背景尽管已经知道 16p11.2 位点 BP4-BP5 的复发性拷贝数变异(CNVs)会带来行为和语言障碍的风险,但有关行为和社会交流特征之间关联的研究还很有限。本研究旨在进一步明确16p11.2缺失综合征(16p11.2DS)和16p11.2重复(16p11.2Dup)学龄儿童的行为和社会交往特征的发生率、性质、严重程度及两者之间的关联。方法共有68名6-17岁的儿童(n = 47 16p11.2DS和n = 21 16p11.2Dup)参与研究。他们接受了标准化智力测验,并通过标准化问卷评估了行为和社会交往能力。将两组的得分与人群常模和不同 CNV 进行了比较。结果与常模样本相比,16p11.2DS 患儿的社会反应能力(67%)和沟通问题(69%)较高,而大约一半(52%)的患者表现出行为问题。16p11.2Dup患儿的社交-沟通问题发生率更高(80%-90%),外化和整体行为问题的发生率(89%)也明显更高。结论与正常样本相比,16p11.2 CNVs 学龄儿童的行为、社会反应能力和沟通问题发生率较高。这些发现表明,在这些 CNV 群体中,自闭症特征和诊断的发病率很高。此外,行为问题和社交-沟通问题之间存在高度共病性。在这两个领域都有困难的患者很脆弱,需要更密切的临床跟踪和护理。
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引用次数: 0
Focused attention and intrinsic motivation using animations for instruction of fundamental motor skills in children with Down syndrome 利用动画对唐氏综合征儿童的基本运动技能进行集中注意力和内在动力教学
IF 2.1 2区 医学 Q1 EDUCATION, SPECIAL Pub Date : 2024-04-21 DOI: 10.1111/jir.13140
D. Bridi, N. C. Valentini, A. C. Deslandes, F. Copetti

Background

Children with Down syndrome (DS) demonstrate poorer performance in locomotor and ball skills than children with typical development. During motor assessment, keeping children's attention and motivation is challenging, especially for children with DS, which may affect the test outcomes. This study aimed first to examine the impact of examiner and App-animation demonstrations during the assessment on the performance of fundamental motor skills, focus of attention and intrinsic motivation for children with DS and neurotypical development (NTD). The secondary aim was to examine the differences in those outcomes between children with DS and neurotypical development.

Methods

A sample of 24 children (10 with DS and 14 with NTD) aged between 3 and 10 years were subjected to two motor performance assessment protocols: a traditional protocol using the Gross Motor Development Test-3 (TGMD-3) and a protocol using animations from an application as support for TGMD-3 (AppP). The focus of attention was obtained from video recordings during protocol instruction (number of eye shifts, eye shift time, instruction focus time, number of instructions required and total instruction time). Intrinsic motivation was assessed by the Intrinsic Motivation Inventory (IMI) at the end of each protocol.

Results

The results showed no significant differences between the protocols for locomotor skills, ball skills and gross motor index. However, children with NTD outperformed those with DS in these skills. When analysing the focus of attention, children with DS showed greater ocular deviations and longer instruction time requested in the traditional protocol compared with AppP, even when compared with NDT children. When comparing protocols in both groups, AppP demonstrated fewer ocular deviations and shorter ocular deviation times. Regarding intrinsic motivation, children with DS in the traditional protocol had lower motivation scores than those with NTD. Regarding the purchase of protocols, in both groups, the AppP presented higher scores for interest/pleasure, perceived competence and general motivation, with lower pressure/tension.

Conclusion

The animated application (AppP) proved effective as a visual support during the TGMD-3 assessment, particularly benefiting children with DS by enhancing motivation and attention.

背景唐氏综合症(DS)儿童在运动和球类技能方面的表现不如发育正常的儿童。在运动评估过程中,保持儿童的注意力和动机是一项挑战,尤其是对唐氏综合征儿童而言,这可能会影响测试结果。本研究首先旨在考察考官和应用程序在评估过程中的动画演示对 DS 儿童和神经发育异常(NTD)儿童的基本运动技能表现、注意力集中和内在动机的影响。方法对 24 名年龄在 3 到 10 岁之间的儿童(10 名 DS 儿童和 14 名 NTD 儿童)进行了两种运动表现评估方案:一种是使用粗大运动发育测试-3(TGMD-3)的传统方案,另一种是使用应用程序动画作为 TGMD-3 的辅助方案(AppP)。在方案指导过程中,通过视频记录(眼球移动次数、眼球移动时间、指导集中时间、所需指导次数和总指导时间)获得注意力的集中情况。结果表明,在运动技能、球类技能和粗大运动指数方面,不同方案之间没有显著差异。然而,在这些技能方面,NTD 儿童的表现优于 DS 儿童。在分析注意力焦点时,与 AppP 相比,DS 儿童在传统方案中表现出更大的眼球偏离,所需的指导时间也更长,即使与 NDT 儿童相比也是如此。在比较两组的方案时,AppP 显示出较少的眼球偏离和较短的眼球偏离时间。在内在动机方面,传统方案中的 DS 儿童的动机得分低于 NTD 儿童。结论动画应用程序(AppP)在 TGMD-3 评估中作为视觉支持被证明是有效的,特别是通过增强动力和注意力使 DS 儿童受益。
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引用次数: 0
Measurement protocols and determinants of peak oxygen consumption in adults with Down syndrome: a systematic review 唐氏综合征成人峰值耗氧量的测量方案和决定因素:系统综述
IF 2.1 2区 医学 Q1 EDUCATION, SPECIAL Pub Date : 2024-04-10 DOI: 10.1111/jir.13137
T. I. M. Hilgenkamp, V. D. Y. Beck, F. Azar, M. Maloy-Robertson, A. Matthews, M. Shahani, X. Goodman, A. Oppewal

This systematic review aimed to provide an overview of test protocols used to measure peak oxygen uptake (VO2peak) in adults with Down syndrome (DS) and to determine how generalisable the outcomes are for the entire population of adults with DS by describing the sample characteristics of these studies and their impact on VO2peak. A literature search (PROSPERO CRD42022309560) was performed (18 July 2023) using the following databases: PubMed, CINAHL, APA PsycINFO, Web of Science, Embase and SPORTDiscus. For articles to be included, they had to be peer-reviewed pubications, reporting VO2peak or VO2max for individuals with DS separately, with a sample of n ≥ 5 and a mean age ≥18 years. Systematic reviews and meta-analyses were excluded but their reference lists were searched for additional papers to include. Studies were evaluated for risk of bias following the guidelines of Kmet et al. The results were summarised with frequency statistics. Forty-three studies were included in this systematic review. Sample sizes of included adults with DS ranged from n = 4–226, with a total of n = 1498 adults with DS being included. Most studies (29/43) used the same standardised maximal exercise treadmill protocol to measure VO2peak in adults with DS, and 33 out of 43 studies used at least one objective criterion to determine a valid maximal effort. Participants were predominantly male, under 40 years old, and overweight or obese. Additionally, the diversity of study samples was lacking or not reported. The most widely used, standardised, maximal exercise test treadmill protocol is recommended for future use in research and practice, including objective criteria to determine valid maximal effort. The current study samples are not representative of the population of adults with DS in terms of sex, age and diverse backgrounds and therefore likely overestimate VO2peak of this population.

本系统性综述旨在概述用于测量唐氏综合症(DS)成人峰值摄氧量(VO2peak)的测试方案,并通过描述这些研究的样本特征及其对 VO2peak 的影响来确定其结果在整个唐氏综合症成人群体中的通用性。我们使用以下数据库进行了文献检索(PROSPERO CRD42022309560)(2023 年 7 月 18 日):PubMed、CINAHL、APA PsycINFO、Web of Science、Embase 和 SPORTDiscus。纳入的文章必须是经同行评审的出版物,分别报告了 DS 患者的 VO2peak 或 VO2max,样本数 n ≥ 5,平均年龄 ≥ 18 岁。排除了系统综述和荟萃分析,但在参考文献列表中搜索了其他可纳入的论文。根据 Kmet 等人的指南对研究进行了偏倚风险评估。本系统综述共纳入 43 项研究。纳入的成年 DS 患者样本量从 n = 4 到 226 不等,总共纳入了 n = 1498 名成年 DS 患者。大多数研究(29/43)使用相同的标准化最大运动量跑步机方案来测量 DS 成人的 VO2 峰值,43 项研究中有 33 项使用了至少一个客观标准来确定有效的最大努力。参与者主要为男性、40 岁以下、超重或肥胖。此外,缺乏研究样本的多样性或未报告研究样本的多样性。建议在今后的研究和实践中采用最广泛使用的标准化最大运动量测试跑步机方案,包括确定有效最大运动量的客观标准。目前的研究样本在性别、年龄和不同背景方面并不能代表 DS 成人群体,因此很可能高估了该群体的 VO2 峰值。
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引用次数: 0
Impact of the emotional development approach on psychotropic medication in adults with intellectual and developmental disabilities: a retrospective clinical analysis 情绪发展法对智力和发育障碍成人精神药物治疗的影响:回顾性临床分析。
IF 2.1 2区 医学 Q1 EDUCATION, SPECIAL Pub Date : 2024-03-28 DOI: 10.1111/jir.13136
B. F. Barrett, M. Wehmeyer, J. Kolb, T. Ostermann, T. Sappok

Background

Compared with the general population, adults with an intellectual developmental disorder (IDD) are more likely to develop mental health problems and to receive high levels of psychotropic medication, particularly antipsychotics. The emotional development (ED) approach may help to better understand the nature of challenging behaviour (CB) and tailor treatment and support accordingly. The aim of this retrospective study was to investigate the impact of the ED approach on the prescription of psychotropic medication during inpatient psychiatric treatment.

Methods

The clinical data of 1758 patients were analysed within a retrospective study design over a period of 12 years. ED level was assessed (1) for the first time (INITIAL-SEO), (2) during a previous hospital stay (PAST-SEO) or (3) not at all (NO-SEO). The effects of the ED assessment and the respective intervention during the current admission on the number of psychotropics and the number and dosage of antipsychotics were analysed for the total sample, including those with CB, autism spectrum disorders and psychosis. Group differences were analysed by a chi-square test and a one-factorial analysis of variance. For analysing the impact of the application of the ED approach on psychotropic medication, a covariance model was applied. Changes between the subsamples were analysed by t-tests for dependent samples.

Results

The ED approach had a significant impact on reducing the overall amount of psychotropic medication and the dosage of antipsychotics in all patients with IDD. These effects were mainly attributable to those showing CB. In patients with autism spectrum disorders, the developmental approach reduced the number of antipsychotics. No effects could be observed in patients with psychosis; in this subsample, both the number and dosage of antipsychotics increased.

Conclusions

The application of the ED approach in the current hospital stay reduced the number of psychotropic drugs and the number and dosage of antipsychotics, especially in those patients with IDD and CB, but also in those with autism spectrum disorders.

背景:与普通人群相比,患有智力发育障碍(IDD)的成年人更容易出现心理健康问题,并接受大量的精神药物治疗,尤其是抗精神病药物。情绪发展(ED)方法可能有助于更好地了解挑战性行为(CB)的性质,并据此调整治疗和支持。这项回顾性研究旨在调查情绪发展法对精神病住院治疗期间精神药物处方的影响:方法:采用回顾性研究设计,分析了 1758 名患者 12 年来的临床数据。对急诊室水平进行了评估:(1) 首次评估(INITIAL-SEO);(2) 前次住院期间评估(PAST-SEO);(3) 完全未评估(NO-SEO)。我们对包括 CB、自闭症谱系障碍和精神病患者在内的所有样本进行了分析,以了解 ED 评估和本次入院期间的相应干预措施对精神药物使用数量以及抗精神病药物使用数量和剂量的影响。组间差异通过卡方检验和单因子方差分析进行分析。为了分析 ED 方法的应用对精神药物治疗的影响,采用了协方差模型。子样本之间的变化通过因果样本 t 检验进行分析:结果:ED 方法对减少所有 IDD 患者的精神药物总量和抗精神病药物剂量有显著影响。这些效果主要归功于那些表现为CB的患者。在自闭症谱系障碍患者中,发展疗法减少了抗精神病药物的用量。在精神病患者中未观察到任何效果;在该子样本中,抗精神病药物的数量和剂量均有所增加:结论:在目前的住院治疗中,采用发展性治疗方法减少了精神药物的数量以及抗精神病药物的数量和用量,尤其是在IDD和CB患者以及自闭症谱系障碍患者中。
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引用次数: 0
Behavioural, developmental and psychological characteristics in children with germline PTEN mutations: a carer report study PTEN基因突变患儿的行为、发育和心理特征:一项护理人员报告研究。
IF 2.1 2区 医学 Q1 EDUCATION, SPECIAL Pub Date : 2024-03-20 DOI: 10.1111/jir.13130
K. Cummings, R. P. Dias, R. Hart, A. Welham

Background

PTEN is primarily known as a tumour suppressor gene. However, research describes higher rates of difficulties including intellectual disability and difficulties relating to autism spectrum conditions (ASCs) in people with germline PTEN mutations. Other psychological characteristics/experiences are less often reported and are explored in this study.

Methods

The parents of 20 children with PTEN mutations completed an online survey exploring adaptive behaviour, ASC-associated behaviours, anxiety, mood, hypermobility, behaviours that challenge, sensory experiences, quality of life and parental wellbeing. Published normative data and data from groups of individuals with other genetic neurodevelopmental conditions were used to contextualise findings.

Results

Overall levels of adaptive behaviour were below the ‘typical’ range, and no marked relative differences were noted between domains. Higher levels of ASC-related difficulties, including sensory experiences, were found in comparison with ‘typically developing’ children, with a possible peak in restrictive/repetitive behaviour; ASC and sensory processing atypicality also strongly correlated with reported joint hypermobility. A relative preservation of social motivation was noted. Anxiety levels were found to be elevated overall (and to relate to sensory processing and joint hypermobility), with the exception of social anxiety, which was comparable with normative data. Self-injurious behaviour was common.

Conclusions

Results suggest a wide range of possible difficulties in children with PTEN mutations, including elevated anxiety. Despite elevated ASC phenomenology, social motivation may remain relatively strong. Firm conclusions are restricted by a small sample size and potential recruitment bias, and future research is required to further explore the relationships between such characteristics.

背景:PTEN 主要是一种肿瘤抑制基因。然而,有研究表明,PTEN 基因突变的患者出现智力障碍和自闭症谱系障碍(ASCs)等困难的比例较高。其他心理特征/经历较少报道,本研究将对此进行探讨:20名PTEN基因突变儿童的父母完成了一项在线调查,调查内容包括适应行为、与自闭症谱系相关的行为、焦虑、情绪、过度活动、挑战行为、感官体验、生活质量和父母的幸福感。研究人员利用已公布的常模数据和来自其他遗传性神经发育疾病患者群体的数据对研究结果进行了综合分析:适应行为的总体水平低于 "典型 "范围,不同领域之间没有明显的相对差异。与 "典型发育 "儿童相比,ASC 相关困难(包括感官体验)的程度更高,限制性/重复性行为可能达到高峰;ASC 和感官处理不典型性还与报告的关节活动过度密切相关。他们的社交动机相对保持不变。研究发现,除社交焦虑与常模数据相当外,其他焦虑水平总体偏高(并与感觉处理和关节过度活动有关)。自伤行为很常见:结论:研究结果表明,PTEN 基因突变的儿童可能存在多种困难,其中包括焦虑症。尽管 ASC 现象升高,但社交动机可能仍然相对较强。由于样本量较小,且可能存在招募偏差,因此无法得出肯定的结论。
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引用次数: 0
Celiac disease in children and adolescents with Down syndrome: behavioural, adaptive and sleep profiles 患有唐氏综合征的儿童和青少年的乳糜泻:行为、适应和睡眠状况。
IF 2.1 2区 医学 Q1 EDUCATION, SPECIAL Pub Date : 2024-03-20 DOI: 10.1111/jir.13135
E. Fucà, F. Costanzo, P. Galassi, L. Celestini, D. Valentini, S. Vicari

Background

Individuals with Down syndrome (DS) exhibit higher risk for celiac disease (CD) than general population. Although literature suggests CD could be associated with behavioural problems in both paediatric and adult age, such association has been poorly explored in children and adolescents DS. Therefore, the current study aimed to investigate differences in emotional/behavioural difficulties, adaptive skills and sleep problems between children with DS with and without CD.

Methods

Data were retrospectively collected from a database including data from 381 individuals with DS (3–18 years). The final sample included 65 participants, 27 with co-occurring CD and 38 age, IQ, sex and body mass index-matched controls without CD. Emotional/behavioural difficulties, adaptive skills and sleep problems were assessed through parent report questionnaires.

Results

No group differences emerged in emotional/behavioural difficulties, whereas participants in the CD group showed better adaptive skills in the practical domain than control group. Weak differences emerged in sleep problems.

Conclusions

Youth with DS and co-occurring CD do not exhibit more emotional and behavioural problems than youth with DS without co-occurring CD but exhibit better adaptive skills in the practical domain.

背景:唐氏综合征(DS)患者罹患乳糜泻(CD)的风险高于普通人群。尽管有文献表明,腹腔疾病可能与儿童和成人的行为问题有关,但在儿童和青少年唐氏综合征患者中,这种关联性的研究还很少。因此,本研究旨在调查患有和未患有 CD 的 DS 儿童在情绪/行为障碍、适应能力和睡眠问题方面的差异:方法:研究人员从数据库中回顾性收集了 381 名 DS 患者(3-18 岁)的数据。最终样本包括 65 名参与者,其中 27 人同时患有 CD,38 人在年龄、智商、性别和体重指数方面与未患有 CD 的对照组相匹配。情绪/行为障碍、适应能力和睡眠问题通过家长报告问卷进行评估:结果:在情绪/行为障碍方面没有出现组间差异,而在实际领域的适应能力方面,儿童疾病组的参与者要优于对照组。睡眠问题方面的差异较小:结论:与没有合并 CD 的 DS 青少年相比,合并 CD 的 DS 青少年没有表现出更多的情绪和行为问题,但在实践领域表现出更好的适应能力。
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引用次数: 0
期刊
Journal of Intellectual Disability Research
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