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Lifting Limits: The Impact of Strength Training in Down Syndrome—A Systematic Review and Meta-Analysis 举重极限:力量训练对唐氏综合症的影响——系统回顾和荟萃分析。
IF 2 2区 医学 Q1 EDUCATION, SPECIAL Pub Date : 2025-06-09 DOI: 10.1111/jir.13259
Luis Iglesias-Díaz, Susana López-Ortiz, Celia García-Chico, Alejandro Santos-Lozano, Javier González-Lázaro

Background

People with Down syndrome (DS) may exhibit several musculoskeletal disorders, including alterations in muscle tone and activation. Strength training could mitigate the loss of muscle strength and, therefore, improve strength values in this population. Additionally, it may influence health-related outcomes such as physical function, body composition and biochemical markers.

Objective

This systematic review and meta-analysis of randomised controlled trials (RCTs) aimed to analyse the characteristics and effects of strength training in people with DS.

Methods

A search was conducted from inception to 22 April 2025. The methodological quality of the included RCTs was assessed using the 15-item Tool for the assEssment of Study qualiTy and reporting in EXercise (TESTEX). In addition, the risk of bias was assessed using the Cochrane's risk of bias 2 (RoB2).

Results

A total of 10 RCTs (n = 233 participants) were included in the systematic review, of which three (n = 111 participants) could be meta-analysed. The pooled effect showed statistically significant benefits for upper (mean difference [MD] = 5.66 kg, 95% CI 2.42–8.91) and lower (MD = 20.43 kg, 95% CI 1.76–39.10) body strength. The TESTEX scores for most RCTs ranged from 3 to 12 points. The risk of bias analysis indicated that eight RCTs had a low risk of bias, whereas the remaining studies were classified as high risk.

Conclusion

Strength training may significantly improve muscle strength in people with DS. However, further research is needed to assess the long-term effects on physical function, body composition and biochemical markers.

背景:唐氏综合征(DS)患者可能表现出几种肌肉骨骼疾病,包括肌肉张力和激活的改变。力量训练可以减轻肌肉力量的损失,从而提高该人群的力量值。此外,它还可能影响与健康相关的结果,如身体功能、身体成分和生化指标。目的:对随机对照试验(RCTs)进行系统回顾和荟萃分析,旨在分析退行性椎体滑移患者力量训练的特点和效果。方法:从开始到2025年4月22日进行检索。采用15项研究质量评估工具(TESTEX)评估纳入的随机对照试验的方法学质量。此外,采用Cochrane's risk of bias 2 (RoB2)评估偏倚风险。结果:系统评价共纳入10项rct (n = 233名受试者),其中3项(n = 111名受试者)可进行meta分析。综合效应显示,较高(平均差异[MD] = 5.66 kg, 95% CI 2.42-8.91)和较低(MD = 20.43 kg, 95% CI 1.76-39.10)的身体力量有统计学意义的益处。大多数随机对照试验的TESTEX分数在3到12分之间。偏倚风险分析显示,8项rct为低偏倚风险,其余研究为高风险。结论:力量训练可显著提高退行性椎体滑移患者的肌力。然而,需要进一步的研究来评估对身体功能、身体成分和生化指标的长期影响。
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引用次数: 0
Co-Occurring Medical Conditions in Over 2300 Children With Down Syndrome at a Down Syndrome Multispecialty Clinic 唐氏综合征多专科门诊2300多名唐氏综合征儿童的共同发病情况
IF 2.1 2区 医学 Q1 EDUCATION, SPECIAL Pub Date : 2025-06-04 DOI: 10.1111/jir.13257
Francis Hickey, Liz Maastricht, Kristine Wolter-Warmerdam, Dee Daniels, Bailey Herfindahl, Karen Kelminson

Background

Children with Down syndrome (DS) have an increased frequency of co-occurring medical complications compared to the typically developing population; however, incidence rates of co-occurring medical conditions in a large paediatric population-based study are limited. The goal of this study was to further investigate the frequencies of concomitant medical conditions, as well as newborn complications in children with DS.

Methods

This is a retrospective, large cohort review of children with DS (n = 2321) receiving care at a referral centre specialising in DS to identify common patterns of co-occurring conditions in children and young adults with DS. Participants from birth to 24 years of age received care from the Anna and John J. Sie Center for Down Syndrome at Children's Hopsital Colorado, which serves 88% of the State of Colorado’s paediatric population with DS. Records reviewed included demographics, birth history, and medical conditions of each patient.

Results

Neonatal complications requiring admission to the neonatal intensive care unit (NICU) were present in 80.0% of the population. Complications leading to these admissions include oxygen requirement (53.7%), feeding problems (49.7%), respiratory distress syndrome (14.7%), and persistent pulmonary hypertension of the newborn (12.6%). Incidence of medical complications for children and young adults with DS includes obstructive sleep apnea (56.8%), cardiac defect requiring surgical repair (48.9%), feeding problems (42.3%), and dysphagia (26.2%). Recently identified co-occurring conditions lacking in the literature, such as keratoconus (3.6%) and Wolff–Parkinson–White syndrome (3.4%), are also reported. Testing, labs and procedures were also common amongst children to meet American Academy of Pediatrics (AAP) DS Guidelines.

Conclusion

Children with DS have unique phenotypic clinical patterns of co-occurring conditions and medical complications. Some conditions present clinically in the neonatal period and require close monitoring and anticipation for a higher level of care for newborns with DS. Our results, using a large sample of over 2300 patients, provide information to improve evidence-based early identification and timely intervention for children and young adults with DS.

背景:与典型发展人群相比,唐氏综合征(DS)儿童并发医学并发症的频率增加;然而,在一项基于儿童人群的大型研究中,共同发生的医疗状况的发病率是有限的。本研究的目的是进一步调查退行性椎体滑移患儿的伴随医疗条件和新生儿并发症的频率。方法:这是一项回顾性的大型队列研究,研究对象是在专门治疗退行性痴呆的转诊中心接受治疗的退行性痴呆儿童(n = 2321),以确定退行性痴呆儿童和年轻人共同出现的疾病模式。从出生到24岁的参与者接受科罗拉多州儿童医院安娜和约翰J.西唐氏综合症中心的护理,该中心为科罗拉多州88%的儿童唐氏症患者提供服务。审查的记录包括每位患者的人口统计、出生史和医疗状况。结果:80.0%的人口出现新生儿并发症,需要入院新生儿重症监护病房(NICU)。导致这些入院的并发症包括需氧量(53.7%)、喂养问题(49.7%)、呼吸窘迫综合征(14.7%)和新生儿持续性肺动脉高压(12.6%)。儿童和年轻人退行性痴呆的医疗并发症发生率包括阻塞性睡眠呼吸暂停(56.8%)、需要手术修复的心脏缺陷(48.9%)、喂养问题(42.3%)和吞咽困难(26.2%)。最近发现的文献中缺乏的共同发生的疾病,如圆锥角膜(3.6%)和沃尔夫-帕金森-怀特综合征(3.4%),也有报道。为了满足美国儿科学会(AAP)的DS指南,测试、实验室和程序在儿童中也很常见。结论:退行性椎体滑移患儿具有独特的临床表型,并发疾病和医学并发症。有些情况在新生儿期临床出现,需要密切监测,并预期对患有退行性滑移的新生儿进行更高水平的护理。我们的研究结果使用了2300多名患者的大样本,为改善儿童和青少年退行性痴呆的循证早期识别和及时干预提供了信息。
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引用次数: 0
Reliability of the Dutch Version of the Matson Evaluation of Drug Side Effects in People With Intellectual Disabilities 智障人士药物副作用的荷兰文版Matson评估的可靠性。
IF 2.1 2区 医学 Q1 EDUCATION, SPECIAL Pub Date : 2025-05-31 DOI: 10.1111/jir.13256
Maria Louise Dieudonnée Hoekstra-van Duijn, Maureen Bernardina Gerardus Wissing, Patrick Jan Eugène Bindels, Dederieke Anne Maria Maes-Festen

Background

People with intellectual disabilities often use psychotropic medications. Recognising side effects in this population can be challenging while they can negatively impact the quality of life. An accurate screening instrument is crucial to identify side effects of psychotropic medication in people with intellectual disabilities. For this purpose, the Matson Evaluation of Drug Side Effects (MEDS) is the most reliable and well-researched instrument. We translated the MEDS into Dutch, considering that the Dutch version of the MEDS must be accurate and aligned with its intended meaning, avoiding multiple interpretations; this study aimed to assess its intrarater and interrater reliabilities in people with intellectual disabilities using psychotropic medication.

Methods

A certified medical translation agency performed translation and back-translation of the MEDS. Two researchers administered the MEDS three times on the same day. Participants were people with intellectual disabilities using psychotropic medication. Demographic and medical data were collected via questionnaires. Scoring and calculation of total domain scores, severity domain scores, duration domain scores and composite scale scores followed the MEDS manual. Intraclass correlation coefficients (ICC) and 95% confidence intervals of these scores were used to assess intrarater and interrater reliabilities.

Results

The study sample included 40 adults with intellectual disabilities. Intrarater reliability was good to excellent for total domain scores (ICCs ranging from 0.873 to 1.000) and excellent for the total composite scale score (ICC = 0.945). Interrater reliability was moderate to excellent for total domain scores (ICCs ranging from 0.713 to 0.922) and good for the total composite scale score (ICC = 0.894).

Conclusions

This study demonstrated moderate to excellent intrarater and interrater reliabilities for the Dutch version of the MEDS. This confirms its potential as a valuable instrument for clinicians to identify and monitor side effects in people with intellectual disabilities using psychotropic medication. We recommend the use of the Dutch version of the MEDS in both Dutch clinical practice and research for this purpose.

背景:智力障碍患者经常使用精神药物。认识到这些人群的副作用可能具有挑战性,因为它们会对生活质量产生负面影响。一种准确的筛选工具对于识别精神药物对智力障碍患者的副作用至关重要。为此,Matson药物副作用评估(MEDS)是最可靠和研究最充分的工具。我们将med翻译成荷兰语,考虑到荷兰语版本的med必须准确并与其预期含义一致,避免多种解释;本研究旨在评估使用精神药物的智障人士的内部和相互信度。方法:由经认证的医学翻译机构对医学文献进行翻译和反译。两名研究人员在同一天三次给药。参与者是使用精神药物的智障人士。通过问卷收集人口统计和医疗数据。总域分、严重域分、持续域分和综合量表分的评分和计算参照MEDS评分手册。使用这些分数的类内相关系数(ICC)和95%置信区间来评估内部和内部的信度。结果:研究样本包括40名成人智力障碍患者。总体域评分的内部信度为良至优(ICC范围为0.873 ~ 1.000),总体复合量表评分的内部信度为优(ICC = 0.945)。总体域评分的量表间信度为中至优(ICC = 0.713 ~ 0.922),总体复合量表评分的量表间信度为好(ICC = 0.894)。结论:本研究显示荷兰版MEDS评分具有中等至优异的内部和内部信度。这证实了它作为临床医生识别和监测智力残疾者使用精神药物副作用的一种有价值的工具的潜力。我们建议在荷兰的临床实践和研究中使用荷兰版的MEDS。
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引用次数: 0
Prevalence and Incidence of Cardiovascular Disease in Adults With Intellectual Disabilities: A Systematic Review 智力残疾成人心血管疾病的患病率和发病率:一项系统综述。
IF 2 2区 医学 Q1 EDUCATION, SPECIAL Pub Date : 2025-05-28 DOI: 10.1111/jir.13254
Marleen J. de Leeuw, Thessa I. M. Hilgenkamp, Dederieke A. M. Maes-Festen, Patrick J. E. Bindels, Roy G. Elbers, Alyt Oppewal
<div> <section> <h3> Background</h3> <p>Given the high risk of cardiovascular diseases (CVD) in adults with intellectual disabilities (ID), there is a strong need for accurate understanding on CVD prevalence and incidence in this population. This information is important to ensure optimal care and resource allocation. However, systematic reviews on this topic are limited. Therefore, this systematic review aimed to provide a comprehensive synthesis of studies on the prevalence and incidence of CVD in adults with ID, including subgroup data.</p> </section> <section> <h3> Method</h3> <p>We performed a systematic search in Embase, Medline ALL, Web of Science, Cochrane Central, PsycINFO and Google Scholar up to 21 January 2025, including peer-reviewed articles on CVD prevalence or incidence in adults with ID. Article screening and data extraction were independently performed by two researchers. Data were synthesised by CVD diagnosis. When available, data were reported separately for different subgroups. The methodological quality was assessed by two independent researchers. This review followed the PRISMA guidelines.</p> </section> <section> <h3> Results</h3> <p>In 55 articles, prevalence and incidence rates were identified for coronary artery disease (prev 0%–12.9%; inc 2.0–2.8 per 1000py), myocardial infarction (prev 0%–7.9%; inc 0.3–2.8 per 1000py), heart failure (prev 0.8%–18.6%; inc 12.5 per 1000py), cerebrovascular disease (prev 0.7%–15.0%; inc 2.55 per 1000py), stroke (prev 1.3%–17.2%; inc 2.7–3.2 per 1000py), peripheral arterial disease (prev 0.4%–20.7%; inc 1.1 per 1000py), venous thrombosis (prev 0.6%–12.4%; inc 0.8–4.1 per 1000py) and atrial fibrillation (prev 0.8%–6.3%). Subgroup data have been reported based on age, sex, level of ID, aetiology of ID, living circumstances, CVD risk factors, data collection methods and source populations. Overall, higher prevalence and incidence rates were reported in older people and in studies that used physical measurements for diagnosis.</p> </section> <section> <h3> Conclusions</h3> <p>Due to variability in methodological quality, clinical characteristics and high statistical heterogeneity, drawing conclusions about CVD prevalence and incidence in adults with ID is challenging. Therefore, the subgroup data presented in this review are valuable for identifying rates within specific subgroups. Longitudinal studies along with research employing valid and reliable data collection methods (preferably objective measurements) aligned with studies in the general population, clear reporting of individual CVD diag
背景:鉴于成人智力障碍(ID)心血管疾病(CVD)的高风险,迫切需要准确了解该人群的CVD患病率和发病率。这些信息对于确保最佳护理和资源分配非常重要。然而,关于这一主题的系统评论是有限的。因此,本系统综述旨在提供有关ID成人心血管疾病患病率和发病率的综合研究,包括亚组数据。方法:系统检索Embase、Medline ALL、Web of Science、Cochrane Central、PsycINFO和谷歌Scholar数据库,检索截止到2025年1月21日,包括有关ID成人心血管疾病患病率或发病率的同行评议文章。文章筛选和数据提取由两位研究者独立完成。通过CVD诊断综合数据。当有数据时,分别报告不同亚组的数据。方法学质量由两名独立研究人员评估。本次审查遵循PRISMA指南。结果:55篇文章确定了冠状动脉疾病的患病率和发病率(既往为0%-12.9%;(每1000py 2.0-2.8),心肌梗死(先前为0%-7.9%;Inc . 0.3-2.8 / 1000py),心力衰竭(先前为0.8%-18.6%;12.5% / 1000py),脑血管疾病(前0.7%-15.0%;Inc . 2.55 / 1000py),冲程(以前1.3%-17.2%;(2.7-3.2 / 1000py),外周动脉疾病(先前为0.4%-20.7%;(1.1 / 1000py),静脉血栓形成(前期为0.6%-12.4%;(0.8-4.1 / 1000py)和房颤(先前为0.8%-6.3%)。根据年龄、性别、ID水平、ID病因学、生活环境、心血管疾病危险因素、数据收集方法和来源人群报告了亚组数据。总体而言,在老年人和使用物理测量进行诊断的研究中报告了较高的患病率和发病率。结论:由于方法学质量、临床特征和统计异质性的差异,得出关于ID成人心血管疾病患病率和发病率的结论是具有挑战性的。因此,本综述中提供的亚组数据对于确定特定亚组中的发病率是有价值的。纵向研究以及采用有效和可靠的数据收集方法(最好是客观测量)的研究与普通人群的研究相一致,明确报告个体心血管疾病诊断和亚组分析将为未来的研究提供有价值的额外见解。
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引用次数: 0
Fracture Characteristics Among Adults With Intellectual Disabilities and Autism Spectrum Disorders to Inform Fracture Prevention Strategies: A Descriptive Study 成人智力障碍和自闭症谱系障碍的骨折特征为骨折预防策略提供信息:一项描述性研究。
IF 2 2区 医学 Q1 EDUCATION, SPECIAL Pub Date : 2025-05-21 DOI: 10.1111/jir.13255
Sahil A. Jha, Shannen M. Bolde, Edward A. Hurvitz, Michelle S. Caird, Daniel G. Whitney

Background

Adults with intellectual disabilities (ID) and autism spectrum disorders (ASD) have a higher risk of fracture; yet little is known about key fracture characteristics that may inform fracture prevention efforts. The objective was to describe the reported activities that lead to a fracture event, the energy of fractures (e.g., low-energy such as fragility fractures and high-energy such as fractures from a motor vehicle accident) and the location of fractures for adults with ID and ASD.

Methods

In this retrospective cohort study from the United States, medical records from a single clinical site were abstracted to gather information on fracture characteristics (i.e., fracture location, energy of fracture and activities that lead to the fracture event) from adults ≥ 18 years old with intellectual disabilities (ID) and/or autism spectrum disorders (ASD) that sustained ≥ 1 fracture between 1 November 2012 and 2 November 2021. The fracture characteristics were described for the entire cohort and by the following subgroups: ID only, ASD only and ID + ASD.

Results

Of the 126 adults with ID and/or ASD, there were a total of 147 fractures for analysis: 84.9% had one fracture, 13.5% had two fractures and 1.6% had three fractures. For the entire cohort, 32.0% were defined as high-energy fractures, but this varied by subgroup: 24.1% for ID only (n = 69 participants, n = 87 fractures), 50.0% for ASD only (n = 35 participants, n = 36 fractures) and 33.3% for ID + ASD (n = 22 participants, n = 24 fractures). The remaining fractures were defined as low-energy or unknown energy. The most common activities that lead to a fracture event were broadly categorised as ‘low-impact falls, unwitnessed falls, transfers’ for ID only (47.1%), ASD only (27.8%) and ID + ASD (41.7%). The most common skeletal region of fractures occurred in the lower extremities for ID only (42.5%) and ID + ASD (50.0%) and in the upper extremities for ASD only (33.3%).

Conclusions

Despite the age being 18 years and older (i.e., not exclusively elderly), most fractures were considered to be low-energy and occurred in the extremities, but this varied by subgroup. This study identified the activities that led to a fracture event, which may inform fracture prevention efforts such as adjunct therapies.

背景:成人智力障碍(ID)和自闭症谱系障碍(ASD)有较高的骨折风险;然而,人们对裂缝的关键特征知之甚少,这些特征可能有助于预防裂缝的发生。目的是描述已报道的导致骨折事件的活动,骨折的能量(例如,低能骨折,如易碎性骨折和高能量骨折,如机动车事故造成的骨折)以及患有ID和ASD的成人骨折的位置。方法:在这项来自美国的回顾性队列研究中,从单个临床站点提取医疗记录,收集2012年11月1日至2021年11月2日期间发生≥1次骨折的智力残疾(ID)和/或自闭症谱系障碍(ASD)≥18岁成人的骨折特征信息(即骨折位置、骨折能量和导致骨折事件的活动)。整个队列的骨折特征被描述为以下亚组:仅ID、仅ASD和ID + ASD。结果:在126例成人ID和/或ASD中,共有147例骨折进行分析:84.9%为1例骨折,13.5%为2例骨折,1.6%为3例骨折。在整个队列中,32.0%被定义为高能骨折,但这一比例因亚组而异:仅ID为24.1% (n = 69名参与者,n = 87例骨折),仅ASD为50.0% (n = 35名参与者,n = 36例骨折),ID + ASD为33.3% (n = 22名参与者,n = 24例骨折)。剩余的骨折被定义为低能量或未知能量。最常见的导致骨折事件的活动大致分为“低冲击跌倒、未目击跌倒、转移”,仅为ID(47.1%)、仅为ASD(27.8%)和ID + ASD(41.7%)。最常见的骨折发生在下肢,仅为ID(42.5%)和ID + ASD(50.0%),仅为ASD的上肢(33.3%)。结论:尽管年龄在18岁及以上(即不完全是老年人),大多数骨折被认为是低能性的,发生在四肢,但这在亚组中有所不同。该研究确定了导致骨折事件的活动,这可能为骨折预防工作(如辅助治疗)提供信息。
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引用次数: 0
Accelerometer Output and Oxygen Uptake in Adults With and Without Down Syndrome: METs vs. Percent VO2Reserve 有和没有唐氏综合症的成年人的加速度计输出和氧摄取:METs与VO2Reserve百分比。
IF 2.1 2区 医学 Q1 EDUCATION, SPECIAL Pub Date : 2025-05-20 DOI: 10.1111/jir.13253
S. Agiovlasitis, B. K. Ballenger, P. Choi, M. Haider, Q. Du, R. W. Motl

Background

The estimation of physical activity (PA) and sedentary behaviour with accelerometers is typically based on the relationship between accelerometer output and metabolic equivalents (METs)—an index of PA intensity. But for adults with Down syndrome (DS), PA intensity may be better reflected in the percent oxygen uptake reserve (%VO2Reserve), as it accounts for their lower aerobic fitness. This study examined if the relationship between accelerometer output and METs or %VO2Reserve across various PAs and sedentary behaviours differs between adults with and without DS.

Methods

Forty-one adults with DS (age 35 ± 9 years; 18 women) and 41 adults without DS (age 24 ± 5 years; 18 women) performed 17 tasks of varying intensity. We estimated aerobic fitness with a submaximal treadmill test. We measured oxygen uptake with portable calorimetry and expressed it as METs and %VO2Reserve. Output from triaxial accelerometers on the nondominant hip and wrist was determined as Vector Magnitude (VM). We used multilevel modelling to evaluate the relationships of METs or %VO2Reserve with VM, controlling for body mass index (BMI) and age.

Results

For the hip accelerometer, VM and the group-by-VM interaction significantly predicted METs (p < 0.001; conditional R2 = 0.82), but between-group differences were small. For the wrist accelerometer, VM and age significantly predicted METs (p < 0.035; conditional R2 = 0.76). For both the hip and the wrist accelerometer, VM, the group-by-VM interaction and BMI significantly predicted %VO2Reserve (p ≤ 0.047; conditional R2 = 0.82 and 0.74, respectively). Between-group differences in the response to VM were larger for VO2Reserve than METs models.

Conclusion

The relationship between accelerometer output and %VO2Reserve across PAs and sedentary behaviours is different between adults with and without DS. Calibrating accelerometer output against %VO2Reserve may be preferable to METs.

背景:用加速度计估计身体活动(PA)和久坐行为通常是基于加速度计输出和代谢当量(METs)之间的关系——代谢当量是PA强度的一个指标。但对于患有唐氏综合症(DS)的成年人,PA强度可能更好地反映在氧气摄取储备百分比(%VO2Reserve)上,因为它解释了他们较低的有氧适应性。本研究考察了加速度计输出与不同PAs和久坐行为之间的METs或%VO2Reserve之间的关系是否在有和没有DS的成年人之间有所不同。方法:41例成人退行性椎体滑移(年龄35±9岁;女性18例),无退行性痴呆的成人41例(年龄24±5岁;18名女性)完成了17项不同强度的任务。我们用亚极限跑步机测试来估计有氧适能。我们用便携式量热仪测量了摄氧量,并用METs和%VO2Reserve表示。非优势髋关节和腕部三轴加速度计的输出被确定为矢量大小(VM)。在控制体重指数(BMI)和年龄的情况下,我们使用多水平模型来评估METs或%VO2Reserve与VM的关系。结果:对于髋关节加速度计,VM和组间VM相互作用显著预测METs (p 2 = 0.82),但组间差异较小。对于手腕加速度计,VM和年龄显著预测METs (p 2 = 0.76)。对于髋部和腕部加速度计,VM、组间VM交互作用和BMI显著预测%VO2Reserve (p≤0.047;条件R2分别为0.82和0.74)。VO2Reserve模型对VM反应的组间差异大于METs模型。结论:加速度计输出和%VO2Reserve与久坐行为之间的关系在有和没有DS的成年人中是不同的。根据%VO2Reserve校准加速度计输出可能比METs更可取。
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引用次数: 0
Judging Offenders With Intellectual Disabilities: Systematic Review of Criminal Justice System Professionals' Expressed Views and Attitudes Towards Offenders With Intellectual Disabilities 审判智障罪犯:系统回顾刑事司法系统专业人士对智障罪犯的看法和态度。
IF 2 2区 医学 Q1 EDUCATION, SPECIAL Pub Date : 2025-05-19 DOI: 10.1111/jir.13252
Georgia Powell, Kate Blake-Holmes, Adela Petrache, Rebecca Turrell, Peter Beazley

Background

The diagnosis of an intellectual disability is suggested to have particularly stigmatising connotations, particularly within the criminal justice system (CJS). This paper aims to synthesise qualitative studies investigating the attitudes of CJS professionals to people with intellectual disabilities (PWID), specifically offenders with intellectual disabilities, and to appraise their methodological quality.

Methods

A systematic search was conducted using PsychINFO, Web of Science, MEDLINE, EMBASE, CINAHL Complete and EThOS databases. Articles were screened for inclusion by title, abstract and full text to ensure predefined inclusion criteria were met. Individual study quality was rated using the 10-item Critical Appraisal Skills Programme (CASP) checklist, with the addition of an eleventh item to capture included studies' theoretical underpinnings and optimise the value of the quality appraisal. Thematic synthesis was then used to explore and synthesise the findings of the included studies.

Results

Ten papers were included in the review, spanning 766 participants. Studies included utilised mixed methods surveys (n = 3), qualitative surveys (n = 1), semistructured interviews (n = 3), semistructured focus groups (n = 1), unstructured interviews (n = 1) and secondary analysis of previously collected research data (n = 1). Methodological quality was broadly of a high standard; however, all included papers failed to reflect on the relationship between the researchers and participants. Five themes were identified: conflating diagnoses, perceptions of PWID as offenders, procedural issues affecting PWID, development and maintenance of perceptions, and impact of training.

Conclusions

This review highlights pervasive negative perceptions of offenders with intellectual disabilities within CJS staff groups. Clinician- and system-level factors are considered in the development and maintenance of such attitudes and suggestions made for improving CJS staff perceptions and knowledge of offenders with intellectual disabilities.

背景:智力残疾的诊断被认为具有特别污名化的内涵,特别是在刑事司法系统(CJS)内。本文旨在综合质性研究,调查CJS专业人员对智障人士(特别是智障罪犯)的态度,并评估其方法学质量。方法:系统检索PsychINFO、Web of Science、MEDLINE、EMBASE、CINAHL Complete和EThOS数据库。文章通过标题、摘要和全文进行筛选,以确保符合预定义的纳入标准。使用10项关键评估技能计划(CASP)清单对个人研究质量进行评级,并增加了第11项,以捕获包括研究的理论基础并优化质量评估的价值。然后使用主题综合来探索和综合纳入研究的结果。结果:纳入10篇论文,766名受试者。研究包括使用混合方法调查(n = 3)、定性调查(n = 1)、半结构化访谈(n = 3)、半结构化焦点小组(n = 1)、非结构化访谈(n = 1)和对先前收集的研究数据的二次分析(n = 1)。方法质量大体上是高标准的;然而,所有纳入的论文都没有反映研究人员和参与者之间的关系。确定了五个主题:合并诊断,将PWID视为罪犯的看法,影响PWID的程序问题,看法的发展和维持以及培训的影响。结论:本综述突出了CJS工作人员群体中普遍存在的对智力障碍罪犯的负面看法。临床医生和系统层面的因素在发展和维持这种态度和建议,以提高CJS工作人员对智力残疾罪犯的认识和认识。
{"title":"Judging Offenders With Intellectual Disabilities: Systematic Review of Criminal Justice System Professionals' Expressed Views and Attitudes Towards Offenders With Intellectual Disabilities","authors":"Georgia Powell,&nbsp;Kate Blake-Holmes,&nbsp;Adela Petrache,&nbsp;Rebecca Turrell,&nbsp;Peter Beazley","doi":"10.1111/jir.13252","DOIUrl":"10.1111/jir.13252","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The diagnosis of an intellectual disability is suggested to have particularly stigmatising connotations, particularly within the criminal justice system (CJS). This paper aims to synthesise qualitative studies investigating the attitudes of CJS professionals to people with intellectual disabilities (PWID), specifically offenders with intellectual disabilities, and to appraise their methodological quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search was conducted using PsychINFO, Web of Science, MEDLINE, EMBASE, CINAHL Complete and EThOS databases. Articles were screened for inclusion by title, abstract and full text to ensure predefined inclusion criteria were met. Individual study quality was rated using the 10-item Critical Appraisal Skills Programme (CASP) checklist, with the addition of an eleventh item to capture included studies' theoretical underpinnings and optimise the value of the quality appraisal. Thematic synthesis was then used to explore and synthesise the findings of the included studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ten papers were included in the review, spanning 766 participants. Studies included utilised mixed methods surveys (<i>n</i> = 3), qualitative surveys (<i>n</i> = 1), semistructured interviews (<i>n</i> = 3), semistructured focus groups (<i>n</i> = 1), unstructured interviews (<i>n</i> = 1) and secondary analysis of previously collected research data (<i>n</i> = 1). Methodological quality was broadly of a high standard; however, all included papers failed to reflect on the relationship between the researchers and participants. Five themes were identified: conflating diagnoses, perceptions of PWID as offenders, procedural issues affecting PWID, development and maintenance of perceptions, and impact of training.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This review highlights pervasive negative perceptions of offenders with intellectual disabilities within CJS staff groups. Clinician- and system-level factors are considered in the development and maintenance of such attitudes and suggestions made for improving CJS staff perceptions and knowledge of offenders with intellectual disabilities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16163,"journal":{"name":"Journal of Intellectual Disability Research","volume":"69 11","pages":"1185-1204"},"PeriodicalIF":2.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jir.13252","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101951","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
Characterisation of Challenging Behaviours and Associated Genetic and Neurological Features in Cardiofaciocutaneous Syndrome 心皮肤综合征的挑战性行为特征及相关遗传和神经学特征。
IF 2.1 2区 医学 Q1 EDUCATION, SPECIAL Pub Date : 2025-05-19 DOI: 10.1111/jir.13247
Dante J. Rogers, Rebekah L. Hudock, Adele F. Dimian, Josue Collazo-Lopez, Ryan Shanley, Elizabeth I. Pierpont

Background

Challenging behaviours such as self-injury and aggression are prevalent among individuals with intellectual disability (ID), significantly impacting quality of life. Cardiofaciocutaneous syndrome (CFCS), a rare multisystem genetic disorder caused by variants in the BRAF, MAP2K1, MAP2K2, or KRAS genes, commonly presents with ID and other neurobehavioural features. To inform effective clinical management, we aimed to characterise and quantify challenging and repetitive behaviours in CFCS, identify functions that may maintain the behaviours, and examine associations with genotype and neurological comorbidities.

Methods

In this cross-sectional cohort study, caregivers of 61 individuals with CFCS (mean age = 14.2 years; 61% female) completed an electronic survey to capture information regarding demographics, adaptive skills, and neurological history. Genotype was determined from molecular genetic testing results. The frequency, severity, topography, and function of challenging behaviours were assessed with behaviour questionnaires validated for children and adults with developmental disabilities. We evaluated trends using descriptive analyses and examined mean differences across age, genotype, and neurological variables.

Results

The cohort consisted primarily of individuals with BRAF variants (62%), followed by MAP2K1 (28%) and MAP2K2 (10%) variants. Prevalence of challenging behaviour was high (77%), and self-injurious and aggressive behaviours were most frequent and severe among adolescents with CFCS relative to younger children or adults. Escape (seeking to avoid an unwanted situation or task) was the most endorsed behavioural function to maintain self-injurious and aggressive/destructive behaviours. BRAF gene variants were associated with the most frequent and variable challenging behaviours, followed by MAP2K1, and then MAP2K2. Challenging and repetitive behaviours were most prevalent among individuals with moderate adaptive functioning, clinically significant sleep disturbance, higher levels of pain interference, and more substantial sensory modulation differences. Individuals with epilepsy also exhibited more frequent repetitive and self-injurious behaviours.

Conclusion

Caregivers reported a high prevalence of challenging behaviours among individuals with CFCS, especially in late childhood and adolescence. Therapeutic approach

背景:自我伤害和攻击等具有挑战性的行为在智力残疾(ID)个体中普遍存在,显著影响着生活质量。心皮肤综合征(CFCS)是一种罕见的多系统遗传疾病,由BRAF、MAP2K1、MAP2K2或KRAS基因变异引起,通常表现为ID和其他神经行为特征。为了告知有效的临床管理,我们旨在描述和量化CFCS的挑战性和重复性行为,确定可能维持这些行为的功能,并检查与基因型和神经合并症的关系。方法:在本横断面队列研究中,61例CFCS患者的护理人员(平均年龄= 14.2岁;(61%女性)完成了一项电子调查,以获取有关人口统计、适应技能和神经病史的信息。基因型由分子基因检测结果确定。使用针对发育障碍儿童和成人的行为问卷对挑战性行为的频率、严重程度、地形和功能进行评估。我们使用描述性分析来评估趋势,并检查了年龄、基因型和神经变量之间的平均差异。结果:该队列主要由BRAF变异个体(62%)组成,其次是MAP2K1(28%)和MAP2K2(10%)变异个体。挑战行为的患病率很高(77%),相对于年幼的儿童或成人,患有CFCS的青少年中自残和攻击行为最为频繁和严重。逃避(寻求避免不想要的情况或任务)是维持自我伤害和攻击/破坏性行为的最被认可的行为功能。BRAF基因变异与最常见和最多变的挑战行为相关,其次是MAP2K1,然后是MAP2K2。挑战性和重复性行为在具有中度适应性功能、临床显著睡眠障碍、疼痛干扰程度较高、感觉调节差异更大的个体中最为普遍。癫痫患者也表现出更频繁的重复性和自残行为。结论:照护者报告了CFCS患者中具有挑战性行为的高患病率,特别是在儿童期晚期和青春期。需要治疗方法来解决具有挑战性的行为,以最佳地支持CFCS患者及其照顾者。
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引用次数: 0
Cognitive and Behavioural Associations of Visual and Hearing Impairments Across the Lifespan in People With Down Syndrome, a Scoping Review 唐氏综合症患者一生中视觉和听觉障碍的认知和行为关联,一项范围审查。
IF 2 2区 医学 Q1 EDUCATION, SPECIAL Pub Date : 2025-05-16 DOI: 10.1111/jir.13248
Nicolo J. Betoni, Cynthia M. Okamoto, Ira T. Lott, Christy L. Hom

Background

Hearing and visual impairments are common in individuals with Down syndrome (DS), yet it remains unclear whether sensory impairments are associated with cognitive and behavioural functioning such as language, memory and socialisation. This literature review examines those associations.

Methods

A scoping review of four databases was conducted to examine associations between sensory impairments and cognitive or behavioural outcomes in individuals with DS. Study evidence was assessed based on design, sample size, assessment modalities and statistical significance.

Results

Of 1471 studies screened, 38 met inclusion criteria. Hearing impairments were associated with delays in language and motor development during infancy, lower overall cognitive ability and social communication difficulties in childhood and reduced adaptive functioning and intellectual decline in adulthood. Visual impairments were linked to learning difficulties in childhood and to declines in adaptive behaviour, visual-motor integration and cognitive performance in adulthood. Subdomains of cognitive functioning such as memory, reasoning or processing speed were not reported for adults.

Conclusion

Uncorrected hearing and visual impairments in individuals with DS are associated with a range of cognitive and behavioural outcomes across the lifespan. The strongest associations were observed between hearing impairments and language delays in infancy and childhood, and between visual impairments and adaptive behaviour challenges in childhood and adulthood. Sensory impairments were associated with challenges in similar domains—particularly language, adaptive functioning and learning—across the lifespan. This suggests a potential continuity of these associations over time and that long-standing uncorrected impairments may be associated with reduced cognitive reserve and increased vulnerability to decline—highlighting the need for early identification and intervention.

背景:听力和视觉障碍在唐氏综合征(DS)患者中很常见,但感觉障碍是否与认知和行为功能(如语言、记忆和社交)相关尚不清楚。这篇文献综述探讨了这些关联。方法:对四个数据库进行了范围审查,以检查退行性椎体滑移患者的感觉障碍与认知或行为结果之间的关系。根据设计、样本量、评估方式和统计显著性对研究证据进行评估。结果:在筛选的1471项研究中,38项符合纳入标准。听力障碍与婴儿期语言和运动发育迟缓、儿童期整体认知能力下降和社会沟通困难、成年期适应功能下降和智力下降有关。视力障碍与儿童时期的学习困难有关,与成年后适应行为、视觉运动整合和认知表现的下降有关。认知功能的子领域,如记忆、推理或处理速度,在成人中没有报道。结论:退行性椎体滑移患者未矫正的听力和视力障碍与一生中一系列认知和行为结果相关。在婴儿期和儿童期,听力障碍和语言障碍之间存在最强的关联,在儿童期和成年期,视力障碍和适应行为挑战之间存在最强的关联。感觉障碍与一生中类似领域的挑战有关,尤其是语言、适应功能和学习。这表明,随着时间的推移,这些关联可能具有连续性,长期未纠正的损伤可能与认知储备减少和对衰退的脆弱性增加有关,这突出了早期识别和干预的必要性。
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引用次数: 0
The Factor Structure of the Self-Determination Inventory Portuguese Translation for Persons With and Without Intellectual and Developmental Disabilities: A Confirmatory Analysis 智障人士与非智障人士自决权量表葡萄牙语翻译的因素结构:验证性分析。
IF 2.1 2区 医学 Q1 EDUCATION, SPECIAL Pub Date : 2025-05-16 DOI: 10.1111/jir.13249
Clarissa Moreira, Celeste Simões, André Oliveira, Armanda Pereira, Pedro Rosário, Mayumi Hagiwara, Karrie A. Shogren, Sofia Santos

Background

Self-determination has seen increasing interest in literature worldwide, in terms of its contextualisation, operationalisation and assessment. Developing sound and robust instruments will enable valid assessment both within individual countries and in cross-cultural comparisons.

Methods

The new Self-Determination Inventory (SDI) was translated and adapted into Portuguese, for people with intellectual and developmental disabilities (IDD) and our goal was to analyse the SDI Portuguese Translation's factorial structure. The inventory was administered to 408 participants, between 13 and 73 years old (27 ± 13.6), 246 females and 162 males, with (n = 146) and without IDD (n = 262). Factor structure, measurement invariance and latent difference between persons with and without IDD were analysed.

Results

The confirmatory factor analysis supported the SDI Portuguese Translations' psychometric properties. The data fit a unidimensional model, indicating that the 21 items represent the construct better than a three-factor model. The measurement invariance across groups confirms that the latent construct can be measured and the assessment used with both groups. However, participants with IDD experience greater variability in scores and tend to report lower levels of self-determination.

Conclusions

Findings provide support for the use of SDI Portuguese Translation for persons with and without IDD. Implications for research and practice are discussed.

背景:自决在世界范围内的文学中越来越受到关注,包括语境化、操作化和评估。发展健全和有力的工具将使在个别国家内部和跨文化比较中进行有效评估成为可能。方法:将新的自我决定量表(SDI)翻译成葡萄牙语,用于智力和发育障碍(IDD)的人群,我们的目标是分析SDI葡萄牙语译本的析因结构。调查对象408人,年龄13 ~ 73岁(27±13.6),女性246人,男性162人,有IDD (n = 146)和无IDD (n = 262)。分析了缺乏症患者和非缺乏症患者的因素结构、测量不变性和潜在差异。结果:验证性因子分析支持SDI葡萄牙语翻译的心理测量特征。数据拟合一维模型,表明21个项目比三因素模型更能代表结构。各组间的测量不变性证实了潜在构念可以被测量,并且两组都可以使用评估。然而,患有缺乏症的参与者在得分上的差异更大,并且倾向于报告较低的自我决定水平。结论:研究结果为患有和不患有IDD的人使用SDI葡萄牙语翻译提供了支持。讨论了对研究和实践的启示。
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引用次数: 0
期刊
Journal of Intellectual Disability Research
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