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Selected AbstractsThe state of residential care for people with mental illness; insights from an audit of the screening tool for entry to licensed residential facilitiesAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2 2009Lauren J. Bailey Abstract Objective: To describe the medical and psychiatric profile of people assessed with the ,Screening Tool for Entry to Licensed Residential Centres' (Boarding House Screening Tool), examine the impact on their accommodation and the screening process. Methods: Copies of all of the Boarding House Screening Tools completed by the Camperdown Aged Care Assessment Team in 2003 and 2004 were examined. Accommodation status in 2006 was obtained from the Boarding House Team, GP or hospital database. A structured telephone survey of Aged Care Assessment Team staff was performed. Results: Thirty-nine Boarding House Screening Tools were reviewed. The mean age of the screened population was 43 yrs (range 22-76 yrs), most were men (36M: 3F). Eighty-two per cent had a listed psychiatric diagnosis, 23% a recent history of substance abuse, 10% a diagnosis of intellectual disability/cognitive impairment and 28% had more than two listed medical diagnoses. Seven people (18%), diagnosed with Schizophrenia, were not approved by the Boarding House Screening Tool because of high care needs and/or violent behaviour, however, only one remained in a high care facility in 2006. Forty-two per cent of people approved by the Boarding House Screening Tool were living in Licensed Boarding Houses in 2006. Conclusion and implications: People being assessed for entry to Licensed Boarding Houses are young with high levels of psychiatric illness, medical co-morbidity and drug and alcohol use. The Boarding House Screening Tool is effective in keeping people who are not approved out of Licensed Boarding Houses; however, even if approved this accommodation is short-term in the majority of cases. [source] ,Out of Hospital': a scoping study of services for carers of people being discharged from hospitalHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 4 2009Rachel Borthwick BSc (Hons) RM RN Abstract Successive government policies have highlighted the need to inform and involve carers fully in the hospital discharge process. However, some research suggests that many carers feel insufficiently involved and unsupported in this process. This paper summarises a scoping review to identify what the UK literature tells us about the service provision for carers, and its effectiveness, around the time of hospital discharge of the care recipient, and also describes a mapping exercise of the work currently being done by Princess Royal Trust for Carers Centres in England to support carers around the time of hospital discharge. The restriction to UK literature was dictated by the nature of the project; a modest review carried out for a UK-based voluntary sector organization. Fifty-three documents were reviewed, of which 19 papers (representing 17 studies) were reporting on primary research. As only five of these studies actually involved an intervention, it appears there is very little research from the UK which evaluates specific interventions to support carers around the time of hospital discharge of the care recipient. While the mapping exercise showed that in some areas there are services and/or initiatives in place which have been designed to improve the process of discharge for carers, in many places there is still a gap between what policy and research suggest should happen and what actually happens to carers at this time. Even where services and initiatives to support carers through the discharge process exist, there is only limited evidence from research or evaluation to demonstrate their impact on the carer's experience. Further research, both quantitative and qualitative, is required to address these areas and enable commissioners, providers and carers' organizations to work together towards a service in which patients and carers alike receive the support and help they need at this significant time of transition. [source] Prevalence of disruptive behaviour displayed by older people in community and residential respite care settingsINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 2 2007Christine C. Neville ABSTRACT:, The aim of this study was to determine the prevalence of disruptive behaviour displayed by older people in community and residential respite care settings. The specific objectives were to (i) obtain an estimate of the frequency of disruptive behaviour displayed by older people in the community setting before residential respite care; (ii) characterize older people being admitted for residential respite care; and (iii) obtain an estimate of the frequency of disruptive behaviour displayed by older people in residential respite care. A quantitative approach using a cross-sectional survey was employed in the community and in the residential aged care facilities. The older people (n = 100) had a mean age of 81.8 years (range 66,96 years). The older people were being admitted from their homes for booked respite care at residential aged care facilities in a regional Australian city. Home caregivers and nurses rated disruptive behaviour using the Dementia Behaviour Disturbance Scale (DBDS). Reliability data for the DBDS are provided. As expected, in both community and residential respite settings, older people with dementia (29%) scored significantly higher on the DBDS than people without dementia. In addition, DBDS scores were unexpectedly higher in the community setting than in the respite setting. These findings should be taken into consideration by primary health-care professionals when offering treatment options to the home caregivers and by staff in the residential aged care facilities that offer respite. [source] Institutional Trust and Subjective Well-Being across the EUKYKLOS INTERNATIONAL REVIEW OF SOCIAL SCIENCES, Issue 1 2006John Hudson SUMMARY This paper analyzes the impact of institutions upon happiness through their intermediary impact upon individual trust. The empirical work is based on Eurobarometer data covering the 15 countries of the EU prior to its expansion in 2004. With respect to trust, we present evidence that, although it is endogenous with respect to the performance of the institution, changes in the individual's personal circumstances can also have an impact, indicating that trust is not simply learned at an early age. Hence unemployed people tend to have lower levels of trust not only in the main economic institutions , government and the Central Bank , but in other state institutions too such as the police and the law. Trust also differs in a systematic manner with respect to education and household income, increases (decreases) in either increase (decrease) trust in most institutions. If we assume that more educated people make better judgments, this suggests that on average people tend to have too little trust in institutions. However, it is also possible that both of these variables impact on the interaction between institutions such as the police and other government agencies and the citizen, with prosperous, well educated people being at an advantage and possibly able to command more respect. Age too impacts on institutional trust. For the UN, the unions, big business, voluntary organizations and the EU, trust first declines and then increases with the estimated turning points ranging between 44 and 56 years. For most other organizations trust significantly increases with age. Turning to subjective well-being, we find the standard set of socio-economic variables to be significant. But the focus here is on the impact of institutional trust. We find that trust (mistrust) in the European Central Bank, the EU, national government, the law and the UN all impact positively (negatively) on well-being. Hence overall our results support the conclusion that happiness does not solely lie within the realm of the individual, but that institutional performance also has a direct impact upon subjective well-being. [source] ,It's magic stuff': The experiences of patients with ankylosing spondylitis taking anti-TNF-, medicationMUSCULOSKELETAL CARE, Issue 3 2009J. Stockdale MSc MCSP Abstract Introduction:,Several studies have identified the efficacy of anti-tumour necrosis factor-alpha (anti-TNF-,) treatment in ankylosing spondylitis (AS). However, few studies have explored the perceptions of patients taking this new medication. The aim of this study was to explore the impact of anti-TNF-, on the quality of life of people with AS. Methods:,A qualitative approach was adopted to provide a holistic understanding of participants' views and experiences in the context of their overall lives. Semi-structured interviews were undertaken and transcribed verbatim. Data were analysed using thematic analysis. Ethical approval and informed consent were obtained. Results:,Eight people participated and described a significant improvement in their physical and psychological status, leading to a more positive outlook on their life. Specific areas highlighted were employment, activities of daily living, hobbies and relationships with partners and family, some of which are not captured by current AS-specific outcome measures. Negative aspects of anti-TNF-, use were described as the inconvenience of monitoring and issues relating to travelling abroad. All participants expressed concern about the possibility of being withdrawn from treatment and the perceived impact this would have on their lives. Conclusions:,Anti-TNF-, treatment has a positive impact on the lives of people with AS, such that a major concern is being withdrawn from treatment, highlighting the need to provide tailored support to people being withdrawn from treatment. To capture the full impact of anti-TNF-, treatment, further consideration needs to be given to the choice of appropriate outcome measures. Copyright © 2008 John Wiley & Sons, Ltd. [source] Biohistorical approaches to "race" in the United States: Biological distances among African Americans, European Americans, and their ancestors,AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue 1 2009Heather J.H. Edgar Abstract Folk taxonomies of race are the categorizations used by people in their everyday judgments concerning the persons around them. As cultural traditions, folk taxonomies may shape gene flow so that it is unequal among groups sharing geography. The history of the United States is one of disparate people being brought together from around the globe, and provides a natural experiment for exploring the relationship between culture and gene flow. The biohistories of African Americans and European Americans were compared to examine whether population histories are shaped by culture when geography and language are shared. Dental morphological data were used to indicate phenotypic similarity, allowing diachronic change through United States history to be considered. Samples represented contemporary and historic African Americans and European Americans and their West African and European ancestral populations (N = 1445). Modified Mahalanobis' D2 and Mean Measure of Divergence statistics examined how biological distances change through time among the samples. Results suggest the social acceptance for mating between descendents of Western Europeans and Eastern and Southern European migrants to the United States produced relatively rapid gene flow between the groups. Although African Americans have been in the United States much longer than most Eastern and Southern Europeans, social barriers have been historically stronger between them and European Americans. These results indicate that gene flow is in part shaped by cultural factors such as folk taxonomies of race, and have implications for understanding contemporary human variation, relationships among prehistoric populations, and forensic anthropology. Am J Phys Anthropol 2009. © 2009 Wiley-Liss, Inc. [source] Children's participation in the policy process: some thoughts on policy evaluation based on the Irish National Children's StrategyCHILDREN & SOCIETY, Issue 2 2004John Pinkerton Prompted by Article 12 of the UN Convention on the Rights of the Child, there is a growing number of examples of children and young people being involved in the policy process. To date this had not been matched by evaluation of the practice. This situation needs to change to ensure that existing experience provides learning for more widespread and more effective involvement. Using the development of the Irish National Children's Strategy for illustration, this article argues that the evaluation required must be more than monitoring. There is a need to get below the formal documented surface of participatory initiatives through developing analysis based in a critical perspective on both policy and evaluation. [source] |