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To determine whether the onset of physical health problems/sensory impairments is associated with incident challenging behaviours.
A retrospective, population-based cohort study using longitudinal data from primary care records. HRs were estimated using Cox proportional hazards models accounting for recurrent events and time-varying exposures.
UK primary care data sourced from the Clinical Practice Research Datalink (CPRD) Aurum and Gold databases, covering over 850 000 person-years between 2009 and 2019.
166 989 individuals with recorded intellectual disabilities were included in the cohort.
Incident identification of challenging behaviours before or after a recorded incident of physical health problems/sensory impairment. Physical health problems/sensory impairments assessed included constipation, epilepsy, pain, visual impairment, hearing impairment, bowel incontinence, urinary incontinence and sleep problems.
21.21% (n=35 415) of the cohort had challenging behaviour recorded at least once in primary care records over the 11-year study period, equating to an incidence rate of 0.10 per person-year. 40.9% of episodes of challenging behaviour were associated with an incident physical health problem/sensory impairment. All eight physical health problems/sensory impairments were significantly associated with higher HRs for challenging behaviours after full adjustment for demographic and mental health covariates. These associations held across multiple sensitivity analyses. The strongest associations were found for bowel incontinence (HR=2.24; 95% CI 2.01 to 2.50), urinary incontinence (HR=1.93; 95% CI 1.77 to 2.11), constipation (HR=1.89; 95% CI 1.74 to 2.05) and sleep problems (HR=1.74; 95% CI 1.58 to 1.90).
This is the first longitudinal study to establish a temporal association between the onset of physical health problems/sensory impairments and challenging behaviours in people with intellectual disabilities. These findings highlight the need for proactive identification and management of physical health problems/sensory impairments as part of assessment processes to prevent or reduce the impact of challenging behaviours.
by Priya Mori, Ishita Modasiya, Mehul Chauhan, Hina Maniya, Vijay Kumar, Apurba Kumar Sarkar
Protein-energy malnutrition (PEM) remains a critical global health challenge, characterized by impaired nutrient absorption and chronic gut inflammation. While probiotics offer a potential therapeutic avenue, the efficacy of single-strain interventions is often limited. This study aimed to formulate and evaluate a Bacillus-based multi-strain probiotic consortium (MSPC) specifically tailored for PEM. Three strains—Bacillus spizizenii BAB 7915, Bacillus tequilensis, and Bacillus rugosus-were selected based on their non-antagonistic, synergistic growth profiles. The MSPC demonstrated superior functional attributes compared to individual strains, exhibiting significant proteolytic activity (0.52 ± 0.03 U/mL) and robust anti-inflammatory potential (5.33 ± 0.06 U/mL). Additionally, the consortium showed high tolerance to gastrointestinal conditions and strong antioxidant properties. These results suggest that the MSPC can effectively enhance protein hydrolysis and mitigate gut inflammation, providing a scientifically validated, low-cost formulation for the nutritional rehabilitation of PEM patients.
FreshRSS 