How parents describe the positive aspects of parenting their child who has intellectual disabilities: A systematic review and narrative synthesis.

Background: Identifying what parents describe to be positive about parenting their child who has intellectual disabilities is important for professional practice and how parents can be supported over a lifespan.

Methods: Studies in which parents describe the positive aspects of parenting their child with intellectual disabilities were identified via electronic databases searches and analysed in a narrative synthesis.

Results: Twenty-two studies were included.

A pedometer-based walking intervention in 45- to 75-year-olds, with and without practice nurse support: the PACE-UP three-arm cluster RCT.

Background: Guidelines recommend walking to increase moderate to vigorous physical activity (MVPA) for health benefits.

Objectives: To assess the effectiveness, cost-effectiveness and acceptability of a pedometer-based walking intervention in inactive adults, delivered postally or through dedicated practice nurse physical activity (PA) consultations.

Design: Parallel three-arm trial, cluster randomised by household.

Interventions to Reduce Adult Nursing Turnover: A Systematic Review of Systematic Reviews.

Background: Nurse turnover is an issue of concern in health care systems internationally. Understanding which interventions are effective to reduce turnover rates is important to managers and health care organisations. Despite a plethora of reviews of such interventions, strength of evidence is hard to determine.

The determinants and consequences of adult nursing staff turnover: a systematic review of systematic reviews.

Background: Nurses leaving their jobs and the profession are an issue of international concern, with supply-demand gaps for nurses reported to be widening. There is a large body of existing literature, much of which is already in review form. In order to advance the usefulness of the literature for nurse and human resource managers, we undertook an overview (review of systematic reviews).

Preventable Emergency Hospital Admissions Among Adults With Intellectual Disability in England.

Purpose: Adults with intellectual disabilities experience poorer physical health and health care quality, but there is limited information on the potential for reducing emergency hospital admissions in this population. We describe overall and preventable emergency admissions for adults with vs without intellectual disabilities in England and assess differences in primary care management before admission for 2 common ambulatory care-sensitive conditions (ACSCs).

Methods: We used electronic records to study a cohort of 16,666 adults with intellectual disabilities and 113,562 age-, sex-, and practice-matched adults without intellectual disabilities from 343 English family practices.

'I'm sure we made it a better study…': Experiences of adults with intellectual disabilities and parent carers of patient and public involvement in a health research study.

Patient and public involvement is considered integral to health research in the United Kingdom; however, studies documenting the involvement of adults with intellectual disabilities and parent carers in health research studies are scarce. Through group interviews, this study explored the perspectives and experiences of a group of adults with intellectual disabilities and a group of parent carers about their collaborative/participatory involvement in a 3-year study which explored the effectiveness of annual health checks for adults with intellectual disabilities. Thematic analysis identified five key themes consistent across both groups; authenticity of participation, working together, generating new outcome measures, dissemination of findings and involvement in future research.

'You started something … then I continued by myself': a qualitative study of physical activity maintenance.

Background: Most mid-life and older adults are not achieving recommended physical activity (PA) targets and effective interventions are needed to increase and maintain PA long-term for health benefits. The Pedometer And Consultation Evaluation (PACE-UP) trial, a three-armed primary care pedometer-based walking intervention in those aged 45-75 years, demonstrated increased PA levels at 12 months. A three-year follow-up was conducted to evaluate long-term PA maintenance, including a qualitative component.

What factors support older people to increase their physical activity levels? An exploratory analysis of the experiences of PACE-Lift trial participants.

Background: Physical Activity (PA) has significant health benefits for older adults, but nearly all UK over 60's are not achieving recommended levels. The PACE-Lift primary care-based walking intervention for 60-75 year-olds used a structured, theoretically grounded intervention with pedometers, accelerometers, handbooks and support from practice nurses trained in behaviour change techniques. It demonstrated an objective increase in walking at 3 and 12 months.

Are parents identifying positive aspects to parenting their child with an intellectual disability or are they just coping? A qualitative exploration.

Although acknowledging the stress of raising their child with intellectual disabilities, parents also report that their child has brought about many positive changes in themselves and family. This study reports what parents perceive to be a positive aspect of parenting their child, as currently what constitutes a 'positive' is unclear. Seven key themes were identified; an increased sense of personal strength and confidence, changed priorities, greater appreciation of life, pleasure in the child's accomplishments, increased faith/spirituality, more meaningful relationships and the positive effect that the child has on the wider community.

Do health checks for adults with intellectual disability reduce emergency hospital admissions? Evaluation of a natural experiment.

Background: Annual health checks for adults with intellectual disability (ID) have been incentivised by National Health Service (NHS) England since 2009, but it is unclear what impact they have had on important health outcomes such as emergency hospitalisation.

Methods: An evaluation of a 'natural experiment', incorporating practice and individual-level designs, to assess the effectiveness of health checks for adults with ID in reducing emergency hospital admissions using a large English primary care database. For practices, changes in admission rates for adults with ID between 2009-2010 and 2011-2012 were compared in 126 fully participating versus 68 non-participating practices.

Mortality Among Adults With Intellectual Disability in England: Comparisons With the General Population.

Objectives: To describe mortality among adults with intellectual disability in England in comparison with the general population.

Methods: We conducted a cohort study from 2009 to 2013 using data from 343 general practices. Adults with intellectual disability (n = 16 666; 656 deaths) were compared with age-, gender-, and practice-matched controls (n = 113 562; 1358 deaths).

Health characteristics and consultation patterns of people with intellectual disability: a cross-sectional database study in English general practice.

Background: People with intellectual disability (ID) are a group with high levels of healthcare needs; however, comprehensive information on these needs and service use is very limited.

Aim: To describe chronic disease, comorbidity, disability, and general practice use among people with ID compared with the general population.

Design And Setting: This study is a cross-sectional analysis of a primary care database including 408 English general practices in 2012.

"It's not just about walking.....it's the practice nurse that makes it work": a qualitative exploration of the views of practice nurses delivering complex physical activity interventions in primary care.

Background: Physical activity (PA) is important for physical and mental health in adults and older adults. Interventions incorporating theory-based behaviour change techniques (BCTs) can be useful in helping people to increase their PA levels and can be delivered by practice nurses in primary care. We undertook two primary care based complex walking interventions among adults and older adults.

Evaluation of reliability and validity of the General Practice Physical Activity Questionnaire (GPPAQ) in 60-74 year old primary care patients.

Background: GPPAQ (General Practice Physical Activity Questionnaire) is a self-assessment physical activity questionnaire widely used in primary care. Reliability and validity data in older people are lacking. The study aims were: to assess GPPAQ's reliability and validity in 60-74 year olds from the PACE-Lift (Pedometer Accelerometer Consultation Evaluation-Lift) physical activity trial; and to assess whether adding brisk walking to the GPPAQ score improves its validity when assessing if physical activity guidelines are being met.

A primary care nurse-delivered walking intervention in older adults: PACE (pedometer accelerometer consultation evaluation)-Lift cluster randomised controlled trial.

Background: Brisk walking in older people can increase step-counts and moderate to vigorous intensity physical activity (MVPA) in ≥10-minute bouts, as advised in World Health Organization guidelines. Previous interventions have reported step-count increases, but not change in objectively measured MVPA in older people. We assessed whether a primary care nurse-delivered complex intervention increased objectively measured step-counts and MVPA.

Which older people decline participation in a primary care trial of physical activity and why: insights from a mixed methods approach.

Background: Physical activity is of vital importance to older peoples' health. Physical activity intervention studies with older people often have low recruitment, yet little is known about non-participants.

Methods: Patients aged 60-74 years from three UK general practices were invited to participate in a nurse-supported pedometer-based walking intervention.

Randomised controlled trial of a complex intervention by primary care nurses to increase walking in patients aged 60-74 years: protocol of the PACE-Lift (Pedometer Accelerometer Consultation Evaluation - Lift) trial.

Background: Physical activity is essential for older peoples' physical and mental health and for maintaining independence. Guidelines recommend at least 150 minutes weekly, of at least moderate intensity physical activity, with activity on most days. Older people's most common physical activity is walking, light intensity if strolling, moderate if brisker.

Onset and persistence of depression in older people--results from a 2-year community follow-up study.

Background: baseline physical health, disability and social support have been shown to predict depression onset, but findings for persistence are inconsistent. For onset and persistence of depression, the effect of changes in these risk factors over time is unclear.

Objective: to use baseline factors and change in factors over time to predict onset and persistence of depression over a 2-year period.

Linking survey data with computerised records to predict consulting by older people.

Despite high consultation rates, little is known about predictors of primary care use by older people. A survey of patients aged > or = 65 years from two London practices included details on physical health and functioning, psychological measures, social support, and socioeconomic measures. The response rate was 75% (1704/2276).

Predictors of depressive symptoms in older people--a survey of two general practice populations.

Background: Studies have shown strong associations between disability, social support and depressive symptoms in older people; but socio-economic effects are less clear and little is known about the role of health locus of control.

Objective: To examine the roles of physical health, disability, social support, socio-economic factors and health locus of control as predictors of depressive symptoms in older people.

Method: A postal survey of patients aged >/= 65 years from two London practices.

Mammography uptake predictors in older women.

Background: In women aged under 65 years, socio-economic factors and general health behaviours are important predictors of mammography uptake. Little is known about whether these factors are important in older women.

Objective: To examine a broad range of mammography uptake predictors in women aged 65 and older registered with a London (UK) practice.