'Now that I am connected this isn't social isolation, this is engaging with people': Staying connected during the COVID-19 pandemic.

Background: The COVID-19 global pandemic has put adults with intellectual/developmental disabilities at greater risk of being socially excluded due to physical distancing. Technology has been looked at as a tool for adults with intellectual/developmental disabilities to stay connected, however, little is known about this topic. The purpose of this study was to explore how a grassroots disability organisation used technology to help adults with intellectual/developmental disabilities feel socially connected during the pandemic. Methods: Data were collected through questionnaires, attendance records, and field notes; and analysed through trend and thematic analysis. Findings: Four main themes emerged from the data: active leadership, mental wellbeing, technology/digital inclusion, and safety. Conclusion: These findings suggest that when participants overcome technological barriers they found it easy to socially connect online during lockdown.

Emergency department nurses' knowledge, skills, and comfort related to caring for patients with intellectual disabilities.

INTRODUCTION: Individuals with intellectual disabilities (ID) are more likely to visit the emergency department (ED) more frequently than their counterparts without ID. Nurses play an integral role in caring for all patients in the ED, including those with ID, although training to work with this population is limited. The aim of this study was to examine the self-perceived knowledge, skills, and comfort of ED nurses when caring for a patient with ID. METHODS: Questionnaires were returned from 151 nurses from a total of six EDs within Ontario, Canada. The questionnaire contained fourteen items related to knowledge, comfort, practice and skills, readiness for change, prior exposure to patients with ID, and awareness of strategies to identify patients in this population. RESULTS: Although the majority of nurses reported an interaction with a patient with a suspected ID in the past year, only 28% of respondents reported awareness of strategies to help identify if a patient may have an ID, and only half reported feeling skilled in adapting their communication and approach. DISCUSSION: ED nurses are the first point of contact in caring for patients with ID, thus it is crucial that they understand how to provide accessible and inclusive care for this population.

What is and isn't working: Factors involved in sustaining community-based health and participation initiatives for people ageing with intellectual and developmental disabilities.

As people with intellectual and developmental disabilities (I/DD) age, it is important that I/DD agencies are prepared to support healthy ageing in homes and in communities. This study explored supports and barriers to sustaining community-based health and participation initiatives (CBHPI) for people ageing with I/DD living in group homes managed by agencies. The study utilized interviews and photovoice with 70 participants-35 individuals with I/DD and 35 management/direct support agency staff. Data were analysed through content analysis and triangulation of data where five themes emerged: Agency values and policies related to healthy ageing; resources and staff competencies; communication between management and staff; community/university partnerships; and peer relations. Findings show that I/DD agencies and people with I/DD value CBHPI, but they find them difficult to sustain due to limited resources and lack of training specific to ageing with I/DD. Conducting system-level research within I/DD agencies to include first-person accounts of people with I/DD, staff and management provides insight on how to effectively support the needs of people with I/DD to improve their health and community participation as they age.

Self-management of health by people with intellectual and developmental disabilities.

BACKGROUND: Self-management of health includes people with intellectual and developmental disabilities (IDD) playing a key role in health management in collaborating with healthcare professionals. METHODS: This study analysed data from Personal Outcome Measures® surveys (n = 1,341) to explore self-management of health. We had the following research questions: Who is most likely to be supported to self-manage their health? How does being supported to self-manage impact different areas of health? and How does being supported to self-manage impact other health-related organizational supports? RESULTS: Findings revealed the impact of self-management of health can be wide-ranging, regardless of impairment severity. When supported to self-manage their health, healthcare professionals were more likely to address healthcare issues, and interventions were more likely to be effective. CONCLUSIONS: Self-management represents a paradigm shift for people with IDD because it transforms people from passive recipients to active directors of their health.

Using Photovoice as a participatory method to identify and strategize community participation with people with intellectual and developmental disabilities.

BACKGROUND: Adults with intellectual and developmental disabilities (I/DD) experience barriers to community participation, yet their insider experiences of environmental barriers and supports to participation are largely absent from the literature. AIM/OBJECTIVE: The aims of this research were to evaluate Photovoice as a participatory research method, examine environmental barriers and supports to community participation, and develop strategies to support self-determination and community participation for and with people with I/DD. MATERIAL AND METHOD: This study utilized a participatory action research (PAR) approach in which participants used Photovoice during interviews and audits of participation environments to identify high interest participation activities and document supports and barriers in these environments. Data analysis utilized an iterative, participatory approach in which researchers and participants teamed up to select, contextualize, and codify the data. Thematic analyses involved both inductive and realist approaches. RESULTS/FINDINGS: Participants included 146 community-dwelling adults with I/DD from three U.S. urban sites. We present a conceptual model of nine themes at microsystem, mesosystem, exosystem, macrosystem, and chronosystem environmental levels. CONCLUSIONS: Using Photovoice as a participatory method to strategize community participation can help ground systems change efforts in the voices of people with I/DD. SIGNIFICANCE: By including people with I/DD in conversations that concern them, researchers and practitioners can support this population in ways that they find meaningful.

"Teaches People That I'm More Than a Disability": Using Nominal Group Technique in Patient-Oriented Research for People With Intellectual and Developmental Disabilities.

Individuals with intellectual and developmental disabilities (IDD) have complex healthcare needs, which are often unmet. Nominal group technique (NGT) uses a mixed-methods approach, which may engage the IDD population in the research process in a person-centered manner and address the shortcomings of traditional research methods with this population. NGT was used with a group of 10 self-advocates to evaluate a series of healthcare tools created by and for individuals with IDD. Participants provided helpful input about the strengths of these tools and suggestions to improve them. NGT was found to be an effective way to engage all participants in the research process.

Exploring How Knowledge Translation Can Improve Sustainability of Community-based Health Initiatives for People with Intellectual/Developmental Disabilities.

Community-based health initiatives (CBHI) play an important role in maintaining the health, function and participation of people with intellectual/developmental disabilities (I/DD) living in the community. However, implementation and long-term sustainability of CBHI is challenging. The Promoting Action on Research Implementation in Health Services (PARiHS) is a knowledge translation (KT) framework that is particularly relevant to intellectual/developmental disabilities research as it identifies the barriers and facilitators of implementation and action plans. This framework provides a foundation for understanding how KT can be used to aid the implementation and sustainability of CBHI for people with intellectual/developmental disabilities. The following study explores how KT - specifically the PARiHS framework - can be used to help sustain CBHI for people with intellectual/developmental disabilities.

Exercise and the fatty liver.

Fatty liver is an increasingly prevalent condition that is associated with several metabolic derangements, thus necessitating the development of effective therapeutic interventions. Growing evidence from cross-sectional studies suggest that physical activity may be a promising therapy for fatty liver. Unfortunately, longitudinal evidence supporting this observation in humans is sparse, as the majority of intervention studies have examined the relationship between liver fat and physical activity in conjunction with caloric and dietary fat restriction. Studies in rats demonstrate a beneficial effect of exercise on liver fat, mainly in situations of high fat feeding or obesity. Thus, the independent contribution of physical activity on variations in liver fat is unknown, but remains a promising intervention that requires further investigation. There is some evidence to suggest that both physical activity and liver fat are independent correlates of cardiovascular and type 2 diabetes risk. The relative contribution of each remains unclear, but implies that both should be considered when developing therapeutic interventions for chronic metabolic disease.