Vulnerable Group Of Individuals Research Articles

Exploring Syrian Refugees' Access to Medical and Social Support Services Using a Trauma-Informed Analytic Framework.

Even after arrival in new countries, refugees may be exposed to traumatic events. This state is exacerbated by contextual stressors, including the resettlement process, asylum proceedings and threats of deportation. This paper is rooted in a trauma-informed framework. We interviewed 16 male Syrian refugee migrant workers employed on a Jordanian farm during crop harvesting season to explore the quality and level of medical care and mental health services they received in light of the framework's principal dimensions (e.g., safety, trust, intersectionality). We found that this vulnerable group of individuals is living a marginal and marginalized existence and depends on the goodwill of the growers for whom they work to treat them with a modicum of dignity and respect. Second, their itinerancy makes it difficult for this population to take advantage of available medical and mental health services at the nation's major refugee camps. Finally, our interlocutors preferred their current lives, as isolating and limiting as they are, as superior to full-time residence in the camps, because they perceive their present way of life as according a measure of dignity, self-direction and autonomy they could not enjoy in the camps.

Investigating the epidemiological factors responsible for malaria transmission dynamics

Despite concerted efforts by the World Health Organization (WHO) to control malaria, it is still being diagnosed in patients visiting hospitals in Tropical Countries of the World. Hence, this study investigated the risk factors responsible for malaria transmission dynamics through a hospital case study. Data of patients that presented with malaria from June 2019 to December 2020 were acquired from Covenant University Medical Centre in Ota, South West Nigeria. Descriptive statistical analyses were carried out so as to examine the factors associated with malaria incidence rate such as age, gender and travel history using the R programming platform. 14% of the total outpatient visits from June 2019 to December 2020 presented with malaria. Furthermore, the mean of the ages of those that presented with malaria, was 23.10 whereas the median of their ages was 22.0. Out of the total malaria cases, 57.7% were males whereas 42.3% were females. Results also showed that there was a significant positive correlation between malaria and travel. In conclusion, it is recommended that malaria control policy formulators should focus on the most vulnerable group of individuals as identified in this study. Further, more efforts should be geared towards curbing malaria importation as a result of human travel, by the different health authorities across the globe.

Benefits of a psychosocial intervention programme using volunteers for the prevention of loneliness among older women living alone in Spain.

This study aims to analyse the effectiveness of a psychosocial intervention programme in preventing loneliness and increasing self-efficacy and social participation among older women living alone in Spain. A sequential, nested experimental design was used, with a primary quantitative quasi-experimental pre-post study with a control group (CG) and a secondary qualitative study. A total of 48 women participated, and 34 of them (the experimental group, EG) received a 25-hour psychosocial support intervention delivered by volunteers who focused on three aspects: conversation, attribution retraining and behavioural activation. The other women remained on the waiting list (CG=14). The women (EG and CG) were all interviewed before and after the intervention and a follow-up of the EG was performed at 6months (N=25). Semi-structured interviews were used to collect sociodemographic and health-related data, as well as data on satisfaction with the programme and its benefits. Validated instruments were used to collect data on the dependent variables (self-efficacy in ageing, subjective social participation and loneliness). Quantitative and qualitative methods were used for data analysis. Compared to the pre-test results, women in the EG improved their self-efficacy in ageing (t-test: -2.246; p: 0.031; d: 0.30), and, more specifically, their self-efficacy in managing socio-emotional problems such as loneliness (t-test: -1.995; p: 0.054; d: 0.25) and in managing their health (t-test: -2.450; p: 0.020; d: 0.47). No significant differences were observed between the follow-up and the post-test results, meaning that the changes identified after the intervention remained stable. Four additional categories of benefits were identified in the participants' discourses. In conclusion, the intervention appears to be beneficial and effective in improving self-efficacy, which is a well-established predictor of loneliness in old age, in a group of vulnerable individuals. Further studies on this type of community intervention are necessary to prevent loneliness among older people.

Minority statuses and mental health outcomes among young gay, bisexual and queer men in Singapore

Minority gay, bisexual and queer (GBQ) men face not only stigma from the general population based on their sexual orientation, but stigma as well based on their race, body type and their gender identity. Results of this study were derived from baseline data of the Pink Carpet Y Cohort Study in Singapore comprising a sample of 570 GBQ men aged 18 to 25 years old. Controlling for key demographic variables, being non-Chinese was associated with depression severity (aPR = 1.21, 95%CI [1.01,1.45]), experienced homophobia (aPR = 1.13, 95%CI [1.05,1.22]) and a past suicide attempt (aPR = 1.77, 95%CI [1.08,2.92]); being non-cisgender male was associated with depression severity (aPR = 1.27, 95%CI [1.05,1.55]) and experienced homophobia (aPR = 1.20, 95%CI [1.09,1.32]); reporting a BMI of 25 or more was associated with depression severity (aPR = 1.20, 95%CI [1.00,1.44]). Reporting one minority status was associated with depression severity (aPR = 1.23, 95%CI [1.05,1.45]) experienced homophobia (aPR = 1.08, 95%CI [1.01,1.15]), and a past suicide attempt (aPR = 1.61, 95%CI [1.01,2.56]), while reporting at least two minority statuses was associated with depression severity (aPR = 1.47, 95%CI [1.17,1.83]), experienced homophobia (aPR = 1.26, 95%CI [1.14,1.40]), and past suicide ideation (aPR = 1.28, 95%CI [1.01,1.62]), compared to participants in the general sample. Interventions are needed to buffer the effects of stigma in this vulnerable group of individuals.

Is there evidence for using anticonvulsants in the prevention and/or treatment of delirium among older adults?

<h3>Introduction</h3> Delirium is an acute neuropsychiatric syndrome characterized by impaired attention, awareness and cognition. It develops over a short period of time (hours to days), represents a change from baseline attention and awareness, and tends to fluctuate in severity during the course of a day. The highest prevalence of delirium is found in the older adults, being particularly high in the hospitalized older adults. The highest incidence rates for delirium among the older adults are observed in the intensive care units, and in postoperative and palliative care settings. Delirium is associated with poorer clinical outcomes including a worsening of nutritional status, cognition and medical co-morbidities. It is associated with greater lengths and costs of hospitalization, and greater burden of care on the nursing staff. Delirium also increases the risk for developing cognitive impairment, institutionalization and death. The average medical care cost for individuals with delirium is more than two-and-a half times the cost for individuals without. Both non-pharmacologic and pharmacologic treatments are used in the management of delirium. Non-pharmacologic treatments that benefit older adults with delirium include frequent reorientation, making eye contact, frequent touching and using clear verbal instructions when talking to patients. Additionally, minimizing of sensory impairments including vision and hearing loss by use of assistive devices, reducing the use of physical restraints, providing treatment in a non-stimulating environment and minimizing staff and room changes, have proven beneficial as well. Pharmacotherapy is often used to treat the underlying causes of delirium in older adults, especially in the management of behaviors that are not managed by non-pharmacological strategies. Agents that have shown benefit among older adults with delirium include antipsychotics, cholinesterase inhibitors and benzodiazepines. Valproic acid derivatives have been used in the treatment of delirium among younger adults with some success. Many different mechanisms have been proposed for this, including the actions of valproic acid derivatives on the glutamatergic system, dopaminergic system, GABAergic system, Kynurenine Pathway. Oral or intravenous valproic acid preparations appear to be efficacious in delirium when antipsychotics and/or benzodiazepines are ineffective, the management requires large and/or frequent dosing of medications, or the medications cause significant adverse effects. Valproic acid derivatives have been beneficial in over 70% of the cases, with benefits noted in the first week of treatment, and the medication was well tolerated. Given the emerging evidence for the efficacy of valproic acid preparations among individuals with delirium, we decided to conduct a systematic review that examined the current evidence for using anticonvulsants in the prevention and/or treatment of delirium among older adults from published randomized control trials (RCTs). If there is good evidence for their use in the older adult population, then it would broaden the pharmaceutic options available to manage this serious condition among a vulnerable group of individuals. <h3>Methods</h3> A comprehensive search of databases: MEDLINE ALL (Ovid), Embase (Ovid), PsycINFO (Ovid), Web of Science Core Collection and Cochrane Central Register of Controlled was conducted. <h3>Results</h3> The search identified four RCTs that evaluated the use of anticonvulsants among older adults with delirium. One RCT evaluated the perioperative use of gabapentin among patients undergoing spinal surgery and the development of postoperative delirium. One RCT evaluated the relationship between the use of perioperative gabapentin and the development of postoperative delirium among patients undergoing spinal surgery and hip and knee arthroplasty. Two post-hoc analyses of RCTs that evaluated the use of gabapentin and pregabalin among patients undergoing total knee replacement (TKA) and total hip replacement (THA). The perioperative use of gabapentin reduced the incidence of postoperative delirium among older adults undergoing spinal surgery. The perioperative use of gabapentin did not reduce the rates, severity or duration of postoperative delirium among older adults who were undergoing spine and hip and knee arthroplasty. The perioperative use of gabapentin did not reduce the incidence or duration of postoperative delirium among older adults undergoing elective TKA. The perioperative use of pregabalin did not reduce the incidence of postoperative delirium among older adults undergoing elective THA. Gabapentin and pregabalin were well tolerated among the patients enrolled in these trials. There were no RCTs identified that evaluated the use of other anticonvulsants for the prevention and/or treatment of delirium among older adults. <h3>Conclusions</h3> Based on current evidence, the routine use of anticonvulsants for the prevention and/or treatment of delirium among older adults cannot be recommended.

Assessment of Delirium Using the Confusion Assessment Method in Older Adult Inpatients in Malaysia.

The detection of delirium in acutely ill older patients is challenging with the lack of informants and the necessity to identify subtle and fluctuating signs. We conducted a cross-sectional study among older patients admitted to a university hospital in Malaysia to determine the presence, characteristics, and mortality outcomes of delirium. Consecutive patients aged ≥65years admitted to acute medical wards were recruited from August to September 2016. Cognitive screening was performed using the mini-mental test examination (MMSE) and the Confusion Assessment Method (CAM). The CAM-Severity (CAM-S) score was also performed in all patients. Of 161 patients recruited, 43 (26.7%) had delirium. At least one feature of delirium from the CAM-S short and long severity scores were present in 48.4% and 67.1%, respectively. Older age (OR: 1.07, 95% CI: 1.01–1.14), immobility (OR: 3.16, 95% CI: 1.18–8.50), cognitive impairment (OR: 5.04, 95% CI: 2.07–12.24), and malnutrition (OR: 3.37; 95% CI: 1.15–9.85) were significantly associated with delirium. Older patients with delirium had a higher risk of mortality (OR: 7.87, 95% CI: 2.42–25.57). Delirium is common among older patients in our setting. A large proportion of patients had altered mental status on admission to hospital although they did not fulfill the CAM criteria of delirium. This should prompt further studies on strategies to identify delirium and the use of newer, more appropriate assessment tools in this group of vulnerable individuals.

The Last of the Lost Generations? Formal and Non-Formal Education in Ghana during Times of Economic Decline and Recovery

AbstractUsing a cohort approach, this paper examines educational attainment in Ghana and its potential determinants considering both educational attainment in the formal education system and participation in non-formal education in the form of adult literacy programs. The results indicate an overall substitution between formal and non-formal education across the generations, with participation in adult literacy programs decreasing as the formal education system expanded its coverage across space and time in Ghana. Individuals who completed any formal education were also much less likely to participate in adult literacy programs, by about 10 percentage-points per year of formal education completed. Additionally, the generations subject to the declining education system during the 1970s were substantially disadvantaged, with the cohort that was roughly of primary school age at the time of the economic breakdown in 1983 and the first few years thereafter being the last of the disadvantaged cohorts—the “lost generations.” This is especially true for the particularly vulnerable group of individuals who never received any formal education, where the crisis cohort peaked in terms of adult literacy program participation relative to later (and earlier) cohorts, possibly in response to a decrease in the quality of the formal education system as well as increased competition from returning refugees. We perform a simple test for the declining quality of the formal education system in the 1970s and find evidence consistent with a decrease in the quality in the education system during the 1970s, followed by an increase in quality thereafter.

A novel mHealth application for improving HIV and Hepatitis C knowledge in individuals with opioid use disorder: A pilot study

AimsThere is a critical need to reduce infectious disease transmission among individuals with opioid use disorder (OUD). Here we examine the ability of a novel, automated educational intervention, delivered via iPad in a single visit, to improve human immunodeficiency virus (HIV) and Hepatitis C (HCV) knowledge among adults with OUD. MethodsParticipants were 25 adults enrolled in a 12-week trial evaluating the efficacy of an Interim Buprenorphine Treatment for reducing illicit opioid use and other risk behaviors during delays to opioid treatment. Participants completed baseline HIV and HCV knowledge assessments with corrective feedback. They then completed an interactive HIV flipbook and HCV video followed by a second administration of the knowledge assessments. The knowledge assessments were repeated at post-intake Weeks 4 and 12. ResultsAt baseline, participants answered 69% and 65% of items correctly on the HIV and HCV assessments, respectively. The educational intervention was associated with significant increases in knowledge (86% and 86% correct on the HIV and HCV assessments, respectively; p’s<.001). These improvements persisted throughout the study, with scores at Week 4 and 12 significantly greater than baseline (p’s<.001). ConclusionThis HIV+Hepatitis Education intervention was associated with significant and sustained improvements in knowledge of HIV + HCV transmission and risk behaviors in this vulnerable group of individuals with OUD. Given the continuing opioid epidemic, efforts are urgently needed to reduce HIV and HCV contraction and transmission among individuals with OUD. Mobile health educational interventions may offer a time- and cost-effective approach for addressing these risks.

The Last of the Lost Generations? Formal and Non-Formal Education in Ghana During Times of Economic Decline and Recovery

Using a cohort approach, this paper examines educational attainment in Ghana and its potential determinants considering both educational attainment in the formal education system and participation in non-formal education in the form of adult literacy programs. The results indicate an overall substitution between formal and non-formal education across the generations, with participation in adult literacy programs decreasing as the formal education system expanded its coverage across space and time in Ghana. Individuals who completed any formal education were also much less likely to participate in adult literacy programs, by about 10 percentage-points per year of formal education completed. Additionally, the generations subject to the declining education system during the 1970s were substantially disadvantaged, with the cohort that was roughly of primary school age at the time of the economic breakdown in 1983 and the first few years thereafter being the last of the disadvantaged cohorts-the lost generations. This is especially true for the particularly vulnerable group of individuals who never received any formal education, where the crisis cohort peaked in terms of adult literacy program participation relative to later (and earlier) cohorts, possibly in response to a decrease in the quality of the formal education system as well as increased competition from returning refugees. We perform a simple test for the declining quality of the formal education system in the 1970s and find evidence consistent with a decrease in the quality in the education system during the 1970s, followed by an increase in quality thereafter.

Antecedents of depression in children and adolescents.

Depression in children and adolescents is a growing health problem in the 21st century. There is growing evidence that depression poses a significant risk in the developmental trajectory of children and adolescents. It is important to identify the antecedents of depression in this vulnerable group of individuals so as to develop specific and effective preventable techniques and strategies. In this brief review, we have tried to highlight the specific antecedents of childhood and adolescence depression on which evidence is available in a structured manner. Antecedents identified in childhood and adolescent depression were categorized into biological factors, temperament, cognitive vulnerability, family factors, sociodemographic factors, academic factors, changing social milieu, school factors, and peer group influence along with the emergence of the recentproblem of excessive social networking use. Biological and psychosocial factors are equally important in the development of depression in this age group. Antecedents of childhood and adolescence depression can be targeted both to prevent and intervene depression in this population.

Depression and associated physical co-morbidities in elderly prison inmates

ABSTRACTElderly prisoners constitute a group of vulnerable individuals in correctional institutions with more propensities for the negative effect of incarceration with its attendant public health problems. Many studies had explored and confirmed a higher rate of psychiatric morbidity among elderly prison inmates in most part of the globe; however, data in this part of the globe is practically unavailable. This study aims at determining the prevalence and pattern of major depressive disorder and physical co-morbidity among elderly inmates aged 50 and above in the Ogun State Prisons. This is a cross-sectional descriptive study of the population of elderly male prisoners aged 50 and above across a state in Nigeria. They were assessed using a proforma incorporating a sociodemographic, medical/forensic questionnaire, designed by the authors, and depression modules of the structured clinical interview schedule for axis I DSM-IV Disorder (SCID). Diagnosis of depression was made according to the DSM–IV criteria. Depression severity was measured using Montgomery–Asberg Depression Rating Scale (MADRS). All the eighty-five elderly inmates studied were male with mean age of 58.65 years. Majority had none or primary education, were from a polygamous background, and 43.5 percent were on current medicare. The prevalence of Major Depressive Disorder was 24.7 percent. Depression was significantly associated with prison locations, perceived condition of the prisons, and current medical care. Prevalence of Major Depressive disorders and physical morbidity among elderly male inmates were high. The presence of physical co-morbidity as well as the inmate’s perception of the prison were major predictor of depression and hence the need for modalities to detect and treat both emotional and physical disorders and to upgrade the prison environment in order to improve the quality of life of the inmates.

Qualitative Research with Participants Suffering From Ostracism: A Practical Guide For the Novice Researcher

Being ostracized can be painful for most people, but for those who experience this persistently it can lead to severe levels of psychological distress. At present, there is a scarcity of qualitative research which focuses on this group of vulnerable individuals. This paper acts as a guide for the novice researcher who plans to research this population.

Provision of specialist continuing care services for older adults across the UK.

Older people with mental health problems who meet needs based criteria for National Health Service (NHS) continuing care funding may be cared for in a variety of settings. These services have evolved due to socio-economic and political pressure, with the extent of movement of care from traditional NHS run long stay units into the private sector being unclear. Little attention has been paid to the best model of service provision for this group in terms of quality of care, patient outcomes, and cost effectiveness. A literature review was conducted in order to explore what is known about service models for long-term psychiatric care for older people and their cost effectiveness. Following this review, an online survey was conducted in order to establish current specialist continuing care service provision by provider organizations, as well as any planned developments in services. The way specialist mental health continuing care services are provided in the United Kingdom (UK) varies, with just 45% (33) of NHS providers still operating their own services. Specialist mental health continuing care is an area of current service review for a number of organizations. Specialist care services for older adults with mental health problems in the UK are changing, but there is a lack of research on models of service delivery for this group of vulnerable individuals with complex needs. In the context of financial pressures within the NHS, and an increasing awareness of the need to develop and improve quality of services both for those with dementia and other mental illnesses, an urgent need for further research in this area is identified.

Food insufficiency, housing and health-related quality of life: results from the Positive Spaces, Healthy Places study

Studies of people living with HIV who are homeless or unstably housed show a high prevalence of food insufficiency (>50%) and associated poor health outcomes; however, most evidence is in the form of cross-sectional studies. To better understand this issue, we conducted a longitudinal study to examine the impact of food insufficiency and housing instability on overall physical and mental health-related quality of life (HRQoL) among people living with HIV in Ontario. Six hundred and two adults living with HIV were enrolled in the Positive Spaces, Healthy Places study and followed from 2006 to 2009. Interviewer-administered questionnaires were used, and generalized linear mixed-effects models constructed to examine longitudinal associations between food insufficiency, housing instability and physical and mental HRQoL. At baseline, 57% of participants were classified as food insufficient. After adjusting for potential confounders, longitudinal analyses revealed a significant, negative association between food insufficiency and physical and mental HRQoL outcomes, respectively [effect size (ES) with 95% confidence interval (CI): (ES = −2.1, CI = −3.9,−0.3); (ES = −3.5, CI = −6.1,−1.5)]. Furthermore, difficulties meeting housing costs were shown to have additional negative impacts on mental HRQoL. Food insufficiency is highly prevalent among people living with HIV in Ontario, particularly for those with unstable housing. This vulnerable group of individuals is in urgent need of changes to current housing programmes, services and policies, as well as careful consideration of their unmet nutritional needs.

Pro: Are we ready to translate Alzheimer's disease modifying therapies to people with Down syndrome?

BackgroundDown Syndrome (DS) is caused by trisomy of chromosome 21, which includes the gene for the amyloid precursor protein (APP) and leads to overproduction of beta-amyloid. Clinical-pathological studies indicate that individuals with DS begin demonstrating Alzheimer’s disease (AD) pathology during adolescence and that 100% exhibit such changes by age 40. Individuals with DS therefore represent a highly enriched population for AD. Additionally, owing to their baseline intellectual disability, people with DS represent a more vulnerable group of individuals as compared with other populations. Given the recent developments in AD biomarkers, combined with the prospect of achieving greater efficacy with earlier therapeutic intervention, it is logical to include adults with DS in prevention trials for AD.DiscussionThe US Food and Drug Administration has released draft guidance on drug development for early-stage AD, based on the understanding that AD is a progressive disease with symptoms developing decades after the disease process has begun. New biomarkers now permit detection of AD pathology in asymptomatic individuals such that there now exists an opportunity to conduct clinical trials of potentially disease-modifying drugs in the earliest stages of the disease and perhaps have the greatest chance of demonstrating efficacy. As such, clinical trials are being actively planned or conducted in individuals with causative mutations in the APP, presenilin-1 (PSEN1), and presenilin-2 (PSEN2) genes.SummaryIndividuals with DS comprise perhaps the largest group of people with genetically determined AD, with a worldwide population of about 6 million people. Only by inclusion can we provide access to rational therapies that offer the greatest chance of benefiting this highly at-risk population.

Working Memory and Distraction: Performance Differences between College Students with and without ADHD

The goal of this study was to examine potential deficits in working memory capacity for college students that had a diagnosis of ADHD. College students with ADHD may be a particularly vulnerable group of individuals, given that success on academic work required focus and working memory for a variety of problem solving activities. Performance on these assessments involved controlled processing with simultaneous memory load. Both verbal and visual complex span tasks were used to assess working memory. Additionally, students were all administered with the Brown ADD scale in order to examine self-reported issues with distractibility. Results revealed that ADHD students performed significantly lower on the verbal complex span measure of working memory. No differences in reported inattentiveness were found. Findings were discussed in context of varying task demands in working memory and executive function measures.

The changing gender gap in substance use disorder: a total population‐based study of psychiatric in‐patients

To study changes over a 25-year period in the gender gap in discharge diagnoses of alcohol use disorder (AUD) and other substance use disorder (SUD) in psychiatric in-patients. A register-based study of all admissions to psychiatric hospitals in Iceland between January 1983 and December 2007. Annual rate of admissions to psychiatric hospitals, adjusted for changes in the size of the population. Furthermore, gender-specific analysis of changes in discharge diagnoses of AUD solely and other SUD (including AUD with other SUDs). Of all psychiatric admissions, the proportion of any SUD admissions increased considerably during the study period. This increase was most pronounced in SUDs other than solely AUD. AUD increased for women and decreased for men. The male to female ratio of AUD alone decreased from 4.2 to 1.5 (P < 0.001). There was no significant change in the gender gap for other SUDs (P = 0.96). There has been a marked convergence of the gender gap in discharge diagnosis of alcohol use disorder among psychiatric in-patients in Iceland over the last decades. For other substance use disorders, the change was not as pronounced. Our results emphasize the importance of monitoring changes in substance use disorder diagnosis as this may uncover different treatment needs in this group of vulnerable individuals.

An exploration of human immunodeficiency virus (HIV) knowledge gaps among male migrant workers in Singapore

The general objective of this study is to provide a rapid assessment of HIV knowledge gaps among male migrant workers (MMWs) in Singapore. A cross-sectional pilot study was conducted in June 2011, in Singapore. A 14 multiple choice closed question self-administered questionnaire was used to collect information on current HIV knowledge among MMWs. Sixty seven MMWs participated in the survey and a total of 58 valid questionnaires were collected. Findings are reported by grouping survey responses of current knowledge of HIV. Although 84.5% of respondents have an awareness of HIV/AIDS, participants generally scored poorly in the survey and beliefs about the causes of HIV and HIV prevention strategies. 30.7% of those surveyed responded correctly to questions on HIV/AIDS knowledge, whilst 31.7% responded incorrectly and 37.7% of participants were unsure how to respond. The results indicate that there are significant HIV/AIDS knowledge gaps among male migrant workers in Singapore. We recommend that further research is required which could lead to the development of culturally appropriate peer-based HIV prevention programs, which should aim at both equipping this vulnerable group of individuals with necessary knowledge about HIV/AIDS and correcting misconceptions and misunderstandings. Key words: Male migrant workers, HIV knowledge, self-administered questionnaire.

Polypharmacy profiles and predictors among adults with autism spectrum disorders

Pharmacological interventions are frequently used to treat commonly associated mental health and behavioural issues in individuals with autism spectrum disorders (ASD). Despite high rates of psychotropic drug use documented in children with ASD, very few studies have examined medication profiles, side effects, and rates of polypharmacy in adolescents and adults with ASD. To address this, we examined medication profiles and predictors of polypharmacy among 142 adults with ASD who had experienced a psychiatric crisis. Of the 142 adults sampled, 91 (64.1%) were prescribed at least 1 psychotropic medication and 41 (28.9%) were taking 3 or more psychotropic medications. Variables associated with and predictive of polypharmacy included history of aggression, residence, and psychiatric support. Adults with ASD are a highly medicated population and polypharmacy is a significant concern in this vulnerable group of individuals.

Denture hygiene care for residents in nursing homes in North Wales

Many elderly people who reside in nursing homes are dependent on care staff for all aspects of care, including oral health and denture hygiene. The aim of this study was to investigate the provision of one aspect of oral care, denture hygiene, in nursing homes in North Wales. Out of the 20 nursing homes identified for inclusion in the study, 10 nursing homes agreed to participate. The results of the study showed that denture hygiene care for elderly residents was still far from ideal. Perceived barriers to the provision of care include lack of training and a poor understanding of the importance of denture hygiene. In general the carers were keen to have training in oral and denture hygiene. This study has highlighted that one fundamental and important aspect of oral care for elderly residents, denture hygiene, is still a problem. This vulnerable group of individuals are not receiving essential care required to enhance their quality of life.