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Selected AbstractsCommunity-Based Day Services for Adults With Intellectual Disabilities in the United Kingdom: A Review and DiscussionJOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 4 2007Murray K. Simpson Abstract, Recent policy statements about services for adults with intellectual disabilities in the UK have pushed for a reoriented day services model. However, there is comparatively little research into new models of day service provision. Drawing on the findings of an evaluation of a "dispersed" or "center-less" service, the author discusses the potential contribution such services might play. These findings showed that services based on accessing mainstream community amenities and facilities, rather than scheduled attendance at special day services centers, are popular with service users, staff, and parents. However, such conclusions can mask longer-term and deeper tensions and problems. One notable feature is a failure to articulate clearly specific objectives for individuals and for the service. This elasticity and multiplicity of aims is what allows different constituent parties to appear to concur in their evaluations when in fact they have altogether different registers of success. These and a number of other questions are raised and need to be addressed before any further expansion of dispersed services is considered, such as their contribution to social inclusion and potential longer-term implications,running out of new activities, boredom, and so forth. More significant is the question of the symbolic role day services centers played as a physical and fiscal commitment to public service provision. There are reasons to suspect that an increased shift toward dispersed services may lead to a declining commitment by local authorities to provide for others than those persons with severe or complex disabilities. [source] Keeping the spirit high: why trauma team training is (sometimes) implementedACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 3 2008T. WISBORG Background: Systematic and multiprofessional trauma team training using simulation was introduced in Norway in 1997. The concept was developed out of necessity in two district general hospitals and one university hospital but gradually spread to 45 of Norway's 50 acute-care hospitals over the next decade. Implementation in the hospitals has varied from being a single training experience to becoming a regular training and part of quality improvement. The aim of this study was to better understand why only some hospitals achieved implementation of regular trauma team training, despite the intentions of all hospitals to do so. Methods: Focus group interviews were conducted with multiprofessional respondents in seven hospitals, including small and large hospitals and hospitals with and without regular team training. Interviews were transcribed and analyzed using a Grounded Theory approach. Results: ,Keeping the spirit high' appeared to be the way to achieve implementation. This was achieved through ,enthusiasm,',strategies and alliances,' and ,using spin-offs.' It seems that the combination of enthusiasts, managerial support, and strategic planning are key factors for professionals trying to implement new activities. Conclusions: Committed health professionals planning to implement new methods for training and preparedness in hospitals should have one or more enthusiasts, secure support at the administrative level, and plan the implementation taking all stakeholders into consideration. [source] Report of the Council for the session 2006,2007JOURNAL OF THE ROYAL STATISTICAL SOCIETY: SERIES A (STATISTICS IN SOCIETY), Issue 4 2007Council Report President's foreword., This year's annual report shows another very successful year for the Society. The range of the Society's new initiatives bears testament to our vigour and to the energy and enthusiasm of Fellows and staff. It is difficult to summarize all of these but I offer a brief overview of some of the highlights. This year we have awarded the first annual prize for ,Statistical excellence in journalism'. It is too easy to bemoan the general quality of coverage of statistical issues in the press and other media. But simply moaning does not improve the situation. As a positive step, on the instigation of Sheila Bird and Andrew Garratt, the Society decided to initiate an award for the best journalistic coverage of a statistical issue. This year first prize was awarded to Ben Goldacre of The Guardian. I hope that these annual awards will offer a positive focus on good coverage and help us to promote best practice. This year, also, we have set up the Professional Development Centre to act as a focus for statistical training both for statisticians and for others who use statistical methods as part of their work. It thus reflects our support for continuing professional development for our Fellows and at the same time provides outreach to members of the statistical user community who want to improve their statistical skills. We welcome Nicola Bright as the Director of the Centre and wish her every success. I am pleased to say that it is not just the Society centrally that has taken new activities this year. The Manchester Local Group have initiated a prize for final year undergraduates from any higher education institute in the north-west. At a time when there are concerns about the number of well-qualified graduates coming into the statistics profession this seems an excellent way to attract the attention of final year undergraduates. I wish this initiative every success. Another development to which the Society has contributed is the Higher Education Funding Council for England project ,more maths grads' which is designed to promote participation in undergraduate degrees in the mathematical sciences. A good supply of mathematically trained graduates is essential to the UK economy in general and to the health of the statistics discipline in particular. It is good that the Society is involved in practical developments that are aimed at increasing participation. The final new initiative that I shall draw attention to is the ,first-in-man' report which is concerned with the statistical design of drug trials aimed at testing novel treatment types. The working party was set up as a result of the adverse reactions suffered by healthy volunteers to a first-in-man trial of monoclonal antibodies and who were subsequently admitted to Northwick Park hospital. The report makes a series of recommendations about the design of such trials and will, I hope, contribute to the safety of future trials. I would like to thank Stephen Senn and the members of the working party for their considerable efforts. As well as these new initiatives there were, of course, many other continuing activities that are noteworthy. The annual conference in Belfast was a great success with many lively sessions and a good number of participants. In particular it was good to see a high number of young statisticians participating in the conference, reflecting the continuing impact of the Young Statisticians Forum on which I commented in the previous annual report. Another continuing activity for the Society is the statistical legislation going through Parliament as I write. The Society has long campaigned for legislation for official statistics. The issue now is to try to get good legislation which will have the required effect and will help the Government Statistical Service and other statistical producers to produce high quality, authoritative statistics in an environment that commands public confidence. As first published, the Society was disappointed with the Bill but we have worked to build support for amendments that, in our view, are essential. Time alone will tell how effective the final legislation will be in meeting our aims. I would like to draw attention to the success of the Membership Services team. We, although with other statistical Societies, have experienced a decline in membership in recent years but the team have turned this round. They are helping to recruit new Fellows and to retain the commitment of existing Fellows. This is a fine achievement and I would like to thank Nicola Emmerson, Ed Swires-Hennessy and the whole team. Finally we have, at last, reached a conclusion in our dealings with the Privy Council and will implement the second phase of constitutional changes. In future our business year, financial year and year for elected appointments will all coincide on a calendar year basis. There will be transitional arrangements but in due course all our administrative arrangements will coincide and will improve efficiency and co-ordination. This has been a long journey, steered effectively by our Director General, Ivor Goddard, and I congratulate him for a successful outcome on your behalf. As you read this report, I hope that you will share my impression of a Society that is lively and spawning many new programmes. We have a dual commitment: to the well-being of statistics as a discipline and to the promotion of statistical understanding and practice to the benefit of Society at large. In both respects I feel that the Society is in good health. This is due to the unstinting efforts of a large number of individual volunteers, including in particular our Honorary Officers and also, of course, the staff at Errol Street. On behalf of all Fellows, I wish to express my thanks to everyone involved. Tim Holt [source] A pilot study of the activity patterns of five elderly persons after a housing adaptationOCCUPATIONAL THERAPY INTERNATIONAL, Issue 1 2006Bernt Niva Abstract The importance of an accessible home environment for occupational performance has been emphasized in occupational therapy, but knowledge about how accessibility can affect a person's activity patterns is limited. The purpose of this study was to describe the activity patterns of five elderly persons aged between 70 and 84 years and their views about accessibility and usability of their homes before and after a housing adaptation. Two different questionnaires, ,Accessibility in My Home' and the ,Occupational Questionnaire' were used for data collection. Adaptations in the home included: removing thresholds, installing new taps in the bathroom and kitchen and broadening doorways. After the adaptations the five participants reported that they increased their outside activities, reduced naps during the day and slept better at night. The results showed that the participants performed more and new activities when their home environment had become accessible. Activities performed were also perceived as more important after the housing adaptation. There is a need to replicate the study with a larger sample. Further research is needed on the impact of home adaptations on the activity patterns of elderly people. Copyright © 2006 John Wiley & Sons. Ltd [source] State of the Art: Addressing the INGO ,Legitimacy Deficit'POLITICAL STUDIES REVIEW, Issue 2 2005Vivien Collingwood While the numbers and competencies of international non-governmental organisations (INGOs) have increased dramatically in the past few decades, questions have been raised about the legitimacy of their new activities. A number of scholars have identified significant tensions between INGOs' legitimacy claims and the realities of their working practices. We examine the current state of the debate on INGO legitimacy in two contrasting literatures: normative work on global governance and its implications for the role of INGOs, and policy-oriented work on INGOs' legitimacy. The first shows how INGO involvement in global governance opens the door to a range of alternative conceptions of world order, rooted in notions of universal human rights, democracy, and theories of redistributive justice. The latter set of voices is concerned less with locating INGOs' roles as agents in global normative structures than with analysing concrete problems arising from increased INGO participation in the development process. Future research might take into account key questions concerning the sources and the scope and nature of INGO legitimacy. [source] Structured treatment interruption in patients with alveolar echinococcosisHEPATOLOGY, Issue 2 2004Stefan Reuter In human alveolar echinococcosis (AE), benzimidazoles are given throughout life because they are only parasitostatic. It has been a longstanding goal to limit treatment, and recent reports suggest that, in selected cases, benzimidazoles may be parasitocidal. Previously, we showed that positron ,emission tomography (PET) using [18F]fluoro-deoxyglucose discriminates active from inactive lesions in AE. We have now performed a 3-year prospective study in 23 patients and conducted a structured treatment interruption in those without signs of PET activity. Disease progression was further assessed by ultrasound, computerized tomography, laboratory parameters, and clinical examination. We found PET-negative lesions in 15 of 23 patients and benzimidazoles were discontinued in these patients. After 18 months, patients were reevaluated, and, of the 15 initially PET-negative patients, 8 showed either new activity on PET (n = 6) or signs of clinical progression (n = 2). Reinitiation of benzimidazoles halted parasite growth again. No further progression was detected after 36 months. PET had a sensitivity of 91% for the detection of active lesions. In conclusion, despite successful suppression of metabolic activity, in most cases benzimidazoles do not kill the parasite. PET is a reliable tool for assessing metabolic activity and for timely detection of relapses. Neither duration of treatment, kind of treatment, lesion size, calcifications, or regressive changes reliably indicate parasite death. We discourage the discontinuation of benzimidazoles in inoperable AE even after many years of treatment. However, patients with a poor compliance of benzimidazole intake or patients suffering from side effects to benzimidazoles might be assessed for PET negativity. If permanent discontinuation of benzimidazoles is attempted, the course of disease should be followed by PET. (HEPATOLOGY 2004;39:509,517.) [source] | ||||||||||