Reasonable adjustments to the application of the comprehensive care standard within an Australian mainstream internal medicine outpatient clinic attended by adults with Down syndrome.

Background: The Australian Commission on Safety and Quality in Health Care recommends the development of reasonable adjustments to Comprehensive Care Standard to better suit the needs of people with intellectual disability.

Method: An audit of adults with Down syndrome attending a mainstream internal medicine outpatient clinic was undertaken to describe their biopsychosocial profile, identify previously developed reasonable adjustments to clinical service and to consider their alignment with comprehensive care.

Results: Of 54 adults, 31 (57%) male, average age 36 years (17.

Pain management challenges in a patient with mucopolysaccharidosis IVA.

It is important to consider all potential pain management modalities including alternative treatment on managing complex pain presentations. Acupuncture is a treatment modality that may result in reduction of pain in patients with significant medical comorbidities due to MPS IVA.

A system for developing reasonable adjustments to the application of the National Safety and Quality Health Service Standards for adult patients with intellectual disability in Australian hospital settings.

The Australian Commission of Safety and Quality in Health Care mandates the application of the eight National Safety and Quality Health Service Standards to minimise high-risk adverse events in hospital settings for all Australian patients. It acknowledges that adults with intellectual disability require reasonable adjustments to the application of the standards to optimise the impact of the quality and safety measures for this group. The paper proposes a system whereby reasonable adjustments can be developed for this population.

Assessing flexion-extension quality of motion after cervical disc arthroplasty: a pilot study.

Background: The quality of flexion-extension motion after cervical disc arthroplasty has been a subject of interest due to the number of available devices with different designs and kinematics. Previous studies of motion quality have been limited to measuring the range of motion using two radiographs taken at the extremes of flexion and extension. This is the first study evaluating the quality of index segment motion using fluoroscopic images collected over the arc of flexion-extension after M6-C cervical disc arthroplasty surgery.

Palliative care for adults with intellectual disability.

Contemporary disability principles and values suggest that adults with intellectual disability should be able to access and participate in any mainstream service rather than having a separate service for them. In the case of healthcare services, achievement of optimal access to and participation in healthcare by adults with intellectual disability requires the presence of both adequate disability supports for the person and reasonable adjustments to generic health systems to enable a person-centred approach to care. Development of an interface between people with lived experience of intellectual disability, disability and health sectors help clarify the required nature of disability supports and types of adjustments to mainstream health services.

Bayes' theorem, COVID19, and screening tests.

The COVID19 crisis has provided a portal to revisit and understand qualities of screening tests and the importance of Bayes' theorem in understanding how to interpret results and implications of next actions.