Residential Provision for People with Intellectual Disabilities in England,Wales and Scotland

The nature and extent of residential provision for people with intellectual disabilities in 1991 in England, Scotland and Wales is described. In summary, the data from the OPCS Census suggest that: (1) there existed substantial regional and national variation in the extent of residential provision for people with intellectual disabilities in England, Scotland and Wales; (2) overall, the level of provision was significantly lower than Department of Health targets for 1991 of 1.55 places per 1000 of the adult population; (3) the majority of people with intellectual disabilities were living in relatively large-scale congregate care settings; (4) the majority of residents were younger and middle-aged adults, although a significant minority were either late adolescents or very elderly; (5) young black men were significantly more likely to be placed in residential provision than their peers from other ethnic groups; (6) young Asian men, young Chinese/Other men and young Asian women were significantly less likely to be placed in residential provision than their peers from other ethnic groups; (7) rates of employment and marriage among residents were markedly lower than for the general population. The results are discussed in relation to national policy aims and existing and future demand for residential provision.     

The Disclosure Process and its Impact on South Asian Families with a Child with Severe Intellectual Disabilities

Background Although several research studies have investigated parental experiences of the disclosure process in White families with a child with severe disabilities, little work has focused on the experiences of South Asian families. Materials and methods This study aimed to provide a rich picture of the disclosure experiences of South Asian parents of a child with severe intellectual disabilities, using semi‐structured qualitative interviews with 26 parents over two time points, and structured quantitative interviews with 136 parents. Results Parents reported variable experiences of the disclosure process, with many parents experiencing disclosure in the wrong language for them and most parents reporting little post‐disclosure support. Parents identified good practice in disclosure as prompt disclosure in the appropriate language, with the partner present (where possible), with emotional support as part of the process, with clear and practical information, and linked to post‐disclosure support from a keyworker. Conclusions Good practice in disclosure was also associated with parental understanding of their child, and parents being more likely to mobilize informal and formal supports. The implications of these findings are discussed.     

Giant hyperplastic polyposis of the colon

Summary A patient with multiple large hyperplastic (metaplastic) polyps of the colon is reported. Hundreds of polyps, some over 3 cm in size, were distributed uniformly throughout the large bowel. There was no evidence of polyps in the stomach or small intestine. The polyps, except for their large size, had the histologic features of hyperplastic polyps. This condition can be clinically confused with adenomatous polyposis coli.     

The form and presentation of tuberculosis over a 10-year interval in Leeds

Over the 10-year period 1973-82 1958 cases of tuberculosis were notified in Leeds (population 728 000). Records were traced for 1673 patients and analysed for age, race, sex, sputum status, site of tuberculosis, route of diagnosis and occupation. These results are presented. The tuberculosis screening service at the Leeds Chest Clinic diagnosed 172 cases of tuberculosis from 13 794 contacts screened and 41 cases from 12 572 newly arrived immigrants representing 10.3% and 2.4% respectively of the cases for whom records could be traced. Of these cases discovered by the tuberculosis screening service 25 were sputum positive. A further 15 cases were diagnosed from 2638 contacts screened by the static Mass Miniature Unit. The cost of the screening service at the Leeds Chest Clinic is estimated to be a minimum of 2000 pounds for every case of tuberculosis diagnosed.     

On the interaction of rabbit antithrombin III with the luminal surface of the normal and deendothelialized rabbit thoracic aorta in vitro

Pure rabbit antithrombin III was isotope labeled (with 125I or 3H) by two different methods; neither procedure caused a loss of antithrombin activity although both methods affected the affinity of the protein for Sepharose-heparin. From segments from freshly excised rabbit aorta, the uptake of isotope-labeled antithrombin III by the endothelium was rapid and saturable, although relatively small compared to the uptake of thrombin; binding of 3H-antithrombin III to the endothelium resembled that of 125I-antithrombin III. Transendothelial passage of antithrombin III into the subendothelial layers (intima-media) was slow and progressive. Endothelium binding was not affected by pretreating the vessel with either heparin, thrombin, or glycosaminoglycan-specific enzymes. Endothelium-bound antithrombin III was not selectively displaced by either heparin or thrombin. In contrast, endothelium-bound thrombin was rapidly dislodged by antithrombin III as a thrombin- antithrombin III complex. The surface of the deendothelialized aorta (ie, subjected to a balloon catheter) bound antithrombin III avidly. Pretreatment of the deendothelialized vessel with glycosaminoglycan- specific enzymes, particularly heparitinase, decreased intima-media binding by up to 80%. 125I-antithrombin III, when bound to the deendothelialized vessel surface, was actively displaced by either heparin, thrombin, or by unlabeled antithrombin III. The relatively poor binding of antithrombin III compared with that of thrombin by the endothelium in vitro supports an earlier proposal (Lollar P, Owen WG: J Clin Invest 66:1222-1230, 1980) that thrombin bound to high-affinity sites, possibly pericellular proteoglycan, of the endothelium is inactivated by plasma antithrombin III in vivo. Such a situation probably holds for large arteries at least.