BackgroundApproximately 18% of adults with intellectual disabilities living in the community display behaviours that challenge. Intensive support teams (ISTs) have been recommended to provide high-quality responsive care aimed at avoiding unnecessary admissions and reducing lengthy in-patient stays.
AimsTo identify and describe the geographical distribution and characteristics of ISTs, and to develop a typology of IST service models in England.
MethodWe undertook a national cross-sectional survey of 73 ISTs. A hierarchical cluster analysis was performed based on six prespecified grouping factors (mode of referrals, size of case-load, use of outcome measures, staff composition, hours of operation and setting of service). A simplified form of thematic analysis was used to explore free-text responses.
ResultsCluster analysis identified two models of IST provision: (a) independent and (b) enhanced provision based around a community intellectual disability service. ISTs aspire to adopt person-centred care, mostly use the framework of positive behaviour support for behaviour that challenges, and report concerns about organisational and wider context issues.
ConclusionsThis is the first study to examine the delivery of intensive support to people with intellectual disability and behaviour that challenges. A two-cluster model of ISTs was found to have statistical validity and clinical utility. The clinical heterogeneity indicates that further evaluation of these service models is needed to establish their clinical and cost-effectiveness.
Declaration of interestNone.
In the face of accelerating biodiversity loss it is more important than ever to identify important areas of biodiversity and target limited resources for conservation. We developed a method to identify areas of important plant diversity using known species' distributions and evaluations of the species importance. We collated distribution records of vascular plants and developed a scoring method of spatial prioritisation to assign conservation value to the island of Ireland at the hectad scale (10km × 10km) and at the tetrad scale (2km × 2km) for two counties where sufficient data were available. Each plant species was assigned a species conservation value based on both its conservation status and distribution in Ireland. For each cell, the species conservation values within the cell were summed, thereby differentiating between areas of high and low conservation value across the landscape. Areas with high conservation value represent the most important areas for plant conservation. The protected area cover and the number of species present in these important areas were also examined by first defining threshold values using two different criteria. Species representation was high in the important areas; the identified important areas of plant diversity maintained high representation of species of conservation concern and achieved high species representation overall, requiring a low number of sites (<8%) to do so. The coincidence of protected areas and important areas for plant diversity was found to be low and while some important areas of plant diversity might benefit from the general protection afforded by these areas, our research highlights the need for conservation outside of protected areas.
Cool-temperate reef fish assemblages are often poorly described below 20m because of depth limitations of conventional diver-based visual census. The recent development of baited remote underwater video systems (BRUVs) provide an alternative quantitative sampling method. Despite being used in warmer temperate and tropical waters and cool-temperate waters in Victoria, initial trials of vertical BRUVs in Tasmania, Australia, provided poor results. Our study explored possible reasons for this, including using horizontal BRUVs and various baits across a depth gradient. We examined the fish fauna in, and adjacent to, a small, but long-established, no-take marine reserve to assess the potential for BRUVs to enhance monitoring programs in exposed coastal environments. Significant differences in the fish assemblage were described relating to location, depth and bait type, with pilchards being an effective bait type. Fish abundance and species richness increased with depth. The research validated BRUVs for monitoring deep-reef systems in Tasmania, reinforced the importance of depth in structuring fish assemblages and identified the range of observable species in this region that may not be fully captured with diver-based surveys alone. Power analyses were conducted using the data generated here to inform the amount of replication needed to detect biologically meaningful differences in targeted fish assemblages in subsequent studies examining the response of no-take marine reserves to protection. This facilitates future assessments of the effectiveness of Tasmanian no-take reserves and allows for more broad-scale studies that can address a range of ecological and conservation questions.
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