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Residential Settings (residential + setting)
Selected AbstractsA new approach to the qualitative evaluation of functional disability in dementiaINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 11 2003X. Kurz Abstract Background Dementia patients suffer from the progressive deterioration of cognitive and functional abilities. Instrumental disabilities usually appear in the earlier stages of the disease while basic disabilities appear in the more advanced stages. In order to differentiate between mild, moderate and severe patients both instrumental and basic functional disabilities should be taken into account simultaneously. Objectives The objective of this study was to find a new method for classifying dementia patients based on their disabilities by using a basic and an instrumental Activities of Daily Living (ADL) scale. Methods Functional disability was assessed in a Belgian cohort of dementia patients using the Katz and Lawton Instrumental Activities of Daily Living (IADL) scales. A k -means derived clustering method allocated patients to disability clusters according to their Katz and Lawton scores. In order to validate the classification, we compared socio-demographic, clinical and costs parameters between the groups. Results The clustering method allocated patients between three clusters: dependent, non-dependent with instrumental functional disability (ND-IFD) and non-dependent. Dependence, as defined by these clusters, significantly correlates with age, residential setting, MMSE, patient's quality of life and costs. Conclusion This new classification of patients suffering from dementia will provide better understanding of functional disabilities and will complement the evaluation of disease severity based on cognitive function. Copyright © 2003 John Wiley & Sons, Ltd. [source] Lifestyle and health behaviours of adults with an intellectual disabilityJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 7 2007B. E. McGuire Abstract Background There is currently no published research in Ireland on the health behaviours of adults with an intellectual disability (ID). With an increasing age profile and similar patterns of morbidity to the general population, the ID population would benefit from baseline data from which to establish risk factors. Methods A questionnaire survey was carried out with 157 carers of people with an ID in the west of Ireland. Results The results of this survey were compared with results of a health survey for the general population in the same region. The present survey found that 68% of the ID sample was overweight or obese. Levels of smoking (2.6%) and regular alcohol consumption (10.3%) were relatively low in comparison with the general population. However, participation in exercise and adherence to a healthy diet were poor. The level of resident choice and decision-making did not have any relationship to health behaviours nor did residential setting. Finally, there were no gender differences in health and lifestyle profiles. Conclusion The results of this study have important implications for health promotion interventions for people with an ID. [source] A Pilot Study Analyzing Mortality of Adults With Developmental Disabilities Residing in Nursing Homes in ConnecticutJOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 3 2010Gerard J. Kerins Abstract A review of mortality cases for persons with intellectual disabilities (ID) in the state of Connecticut (USA) revealed that the majority of deaths in residential settings occurred in nursing homes. However, it was not clear why individuals with ID were residing in nursing homes, or what brought them there. The authors conducted a preliminary study to elicit better understanding of the circumstances resulting in nursing home residency for people with ID. Charts for a small sample of deaths occurring in nursing homes were examined and select data extracted, including basic demographic data, the previous residential setting, the length of stay, medical conditions, case management intensity, and documented rationale for continued nursing home residency. The data revealed that many individuals were admitted to nursing homes at an earlier age than for the nondisabled general population. People with ID stayed in these residences longer, and died later than the general population of nondisabled individuals admitted to nursing homes. About half the sample received case management on at least an annual basis; a third had no documented case management. Lack of appropriate alternate residential settings, lack of support services for families, and lack of case management resources for adults with ID residing in nursing homes in Connecticut are all apparent from the findings. Failure to use existing resources such as group homes to their potential capacity, and other similar policies should be re-examined. [source] Restraint safety in a residential setting for persons with intellectual disabilitiesBEHAVIORAL INTERVENTIONS, Issue 2 2009David M. Tilli The primary purpose of this study was to estimate the risks associated with the use of emergency personal restraints at a residential facility for persons with intellectual and developmental disabilities. A secondary purpose was to determine if correlates of restraint-related injury could be determined. One in three restraints resulted in an injury, but all of the injuries were minor. In terms of prediction, frequency of aggressive behavior use was the best single predictor of restraint-related injury. Copyright © 2009 John Wiley & Sons, Ltd. [source] Medical and psychiatric problems among men and women in a community corrections residential settingBEHAVIORAL SCIENCES & THE LAW, Issue 5 2009Tracy D. Gunter M.D. Though the medical and mental health morbidity of incarcerated offenders has been discussed in a number of recent reports, very few data have been published concerning medical and mental health problems facing those on community corrections supervision. In this study of community corrections offenders utilizing residential facilities, we found that frequencies of substance use disorders, other mental health disorders, and medical problems exceeded frequencies found in the community and, in some cases, were higher than frequencies found in incarcerated individuals. Of particular concern were the high frequencies of substance use disorders, traumatic brain injury, anxiety states, suicidal ideation, and prior self-harm. While the level of self-reported medical and mental health service utilization was higher than expected, it appeared low relative to the disease burden reported by this special population. We conclude that concurrent evaluation and treatment of medical and psychiatric problems during the process of community supervision is indicated in this population. Copyright © 2009 John Wiley & Sons, Ltd. [source] Disabled children living away from home in foster care and residential settingsDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 12 2008Hilary Hart No abstract is available for this article. [source] Enhancing the effectiveness of residential treatment for substance abusing pregnant and parenting women: Focus on maternal reflective functioning and mother-child relationshipINFANT MENTAL HEALTH JOURNAL, Issue 5 2006Marjukka Pajulo Substance abuse during early motherhood has become a significant problem and has led to accelerated efforts to develop specific treatment facilities for these mothers and children. Despite the often intensive treatment efforts in residential settings, there is surprisingly little evidence of their efficacy for enhancing the quality of caregiving. The situation of these mother-child pairs is exceptionally complex and multilevel, and has to be taken into account in the content and structuring of treatment. Intensive work in the "here and now" focusing on the mother-child relationship from pregnancy onwards in an effort to enhance maternal reflective capacity and mindedness is considered a key element for better treatment prognosis, in terms of both abstinence and quality of parenting. Pioneering work with such a focus is described in this article. [source] Factors associated with constructive staff,family relationships in the care of older adults in the institutional settingINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 4 2006Emily Haesler BN PGradDipAdvNsg Abstract Background, Modern healthcare philosophy espouses the virtues of holistic care and acknowledges that family involvement is appropriate and something to be encouraged due to the role it plays in physical and emotional healing. In the aged care sector, the involvement of families is a strong guarantee of a resident's well-being. The important role family plays in the support and care of the older adult in the residential aged care environment has been enshrined in the Australian Commonwealth Charter of Residents' Rights and Responsibilities and the Aged Care Standards of Practice. Despite wide acknowledgement of the importance of family involvement in the healthcare of the older adult, many barriers to the implementation of participatory family care have been identified in past research. For older adults in the healthcare environment to benefit from the involvement of their family members, healthcare professionals need an understanding of the issues surrounding family presence in the healthcare environment and the strategies to best support it. Objectives, The objectives of the systematic review were to present the best available evidence on the strategies, practices and organisational characteristics that promote constructive staff,family relationships in the care of older adults in the healthcare setting. Specifically this review sought to investigate how staff and family members perceive their relationships with each other; staff characteristics that promote constructive relationships with the family; and interventions that support staff,family relationships. Search strategy, A literature search was performed using the following databases for the years 1990,2005: Ageline, APAIS Health, Australian Family and Society Abstracts (FAMILY), CINAHL, Cochrane Library, Dare, Dissertation Abstracts, Embase, MEDLINE, PsycINFO and Social Science Index. Personal communication from expert panel members was also used to identify studies for inclusion. A second search stage was conducted through review of reference lists of studies retrieved during the first search stage. The search was limited to published and unpublished material in English language. Selection criteria, The review was limited to studies involving residents and patients within acute, subacute, rehabilitation and residential settings, aged over 65 years, their family and healthcare staff. Papers addressing family members and healthcare staff perceptions of their relationships with each other were considered for this review. Studies in this review also included those relating to interventions to promote constructive staff,family relationships including organisational strategies, staff,family meetings, case conferencing, environmental approaches, etc. The review considered both quantitative and qualitative research and opinion papers for inclusion. Data collection and analysis, All retrieved papers were critically appraised for eligibility for inclusion and methodological quality independently by two reviewers, and the same reviewers collected details of eligible research. Appraisal forms and data extraction forms designed by the Joanna Briggs Institute as part of the QARI and NOTARI systematic review software packages were used for this review. Findings, Family members' perceptions of their relationships with staff showed that a strong focus was placed on opportunities for the family to be involved in the patient's care. Staff members also expressed a theoretical support for the collaborative process, however, this belief often did not translate to the staff members' clinical practice. In the studies included in the review staff were frequently found to rely on traditional medical models of care in their clinical practice and maintaining control over the environment, rather than fully collaborating with families. Four factors were found to be essential to interventions designed to support a collaborative partnership between family members and healthcare staff: communication, information, education and administrative support. Based on the evidence analysed in this systematic review, staff and family education on relationship development, power and control issues, communication skills and negotiating techniques is essential to promoting constructive staff,family relationships. Managerial support, such as addressing workloads and staffing issues; introducing care models focused on collaboration with families; and providing practical support for staff education, is essential to gaining sustained benefits from interventions designed to promote constructive family,staff relationships. [source] A French, abridged version of the Hospitals and Hostels Practices Profile ScheduleINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 4 2001Marc Corbière Abstract This study aims to validate the Hospitals and Hostels Practices Profile Schedule (HHPPS) in the French version according to the statistical requirements of factor analysis and internal consistency, and to arrive at as parsimonious a version of the questionnaire as possible. As no validation of the original English instrument exists to our knowledge, the most parsimonious factor structure suggested by hypothetical constructs was used. Analyses of variance of six categories of residential settings served to underscore their points of convergence and divergence in terms of degree of autonomy allowed to patients. The following seven scales emerged from the analyses: ,activities: house rules', ,activities: morning wake-up', ,health and hygiene', ,activities: curfew', ,personal effects', ,activities: night-time surveillance' and ,meals'. These accounted for 65% of the cumulative explained variance. Of the residential settings considered, supervised apartments allowed patients the most autonomy, compared with psychiatric hospital wards, hostels, nursing homes, foster families and group homes. Aside from its primary role of measuring the degree of autonomy that residential settings allow patients, this questionnaire seems suitable for gauging the adequacy of fit between a patient's needs and available residential facilities. This should help to direct persons with severe and persistent mental disorders towards facilities better tailored to their needs. Copyright © 2001 Whurr Publishers Ltd. [source] Developing person-centred practice: nursing outcomes arising from changes to the care environment in residential settings for older peopleINTERNATIONAL JOURNAL OF OLDER PEOPLE NURSING, Issue 2 2010BSc (Hons) Nursing, Brendan McCormack D.Phil (Oxon), PGCEA mccormack b., dewing j., breslin l., coyne-nevin a., kennedy k., manning m., peelo-kilroe l., tobin c. & slater p. (2010) Developing person-centred practice: nursing outcomes arising from changes to the care environment in residential settings for older people. International Journal of Older People Nursing 5, 93,107 Aim., To present the nursing outcomes from the evaluation of developments in the care environment in residential settings for older people. Design., The evaluation data reported here is derived from a larger national programme of work that focused on the development of person-centred practice in residential services for older people using an emancipatory practice development framework. A multi-method evaluation framework was utilised. Outcome data were collected at three time points between December 2007 and September 2009. The data reported here were collected using an instrument called the ,Person-Centred Nursing Index'. Findings., Heavy workload was the main cause of stress among nurses. Personal and professional satisfaction with the job was scored highest by the total sample of nurses. Nineteen factors were examined using the Person-Centred Nursing Index. Statistically significant changes were observed in 12 of these. In addition, there were statistically significant changes in nurses' perceptions of caring, indicating a shift from a dominant focus on ,technical' aspects of care, to one where ,intimate' aspects of care were more highly valued. Relevance to clinical practice., The findings highlight the importance of the development of effective teamwork, workload management, time management and staff relationships in order to create a culture where there is a more democratic and inclusive approach to practice and space for the formation of person-centred relationships. [source] Mortality and Adverse Health Events in Newly Admitted Nursing Home Residents with and without DementiaJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 11 2005Jay Magaziner PhD Objectives: To evaluate the association between dementia and mortality, adverse health events, and discharge disposition of newly admitted nursing home residents. It was hypothesized that residents with dementia would die at a higher rate and develop more adverse health events (e.g., infections, fevers, pressure ulcers, falls) than residents without dementia because of communication and self-care difficulties. Design: An expert clinician panel diagnosed an admission cohort from a stratified random sample of 59 Maryland nursing homes, between 1992 and 1995. The cohort was followed for up to 2 years or until discharge. Setting: Fifty-nine Maryland nursing homes. Participants: Two thousand one hundred fifty-three newly admitted residents aged 65 and older not having resided in a nursing home for 8 or more days in the previous year. Measurements: Mortality, infection, fever, pressure ulcers, fractures, and discharge home. Results: Residents with dementia had significantly lower overall rates of infection (relative risk (RR)=0.77, 95% confidence interval (CI)=0.70,0.85) and mortality (RR=0.61, 95% CI=0.53,0.71) than those without dementia, whereas rates of fever, pressure ulcers, and fractures were similar for the two groups. These results persisted when rates were adjusted for demographic characteristics, comorbid conditions, and functional status. During the first 90 days of the nursing home stay, residents with dementia had significantly lower rates of mortality if not admitted for rehabilitative care under a Medicare qualifying stay (RR=0.25, 95% CI=0.14,0.45), were less often discharged home (RR=0.33, 95% CI=0.28,0.38), and tended to have lower fever rates (RR=0.78, 95% CI=0.63,0.96) than residents without dementia. Conclusion: Newly admitted nursing home residents with dementia have a profile of health events that is distinct from that of residents without dementia, indicating that the two groups have different long-term care needs. Results suggest that further investigation of whether residents with dementia can be well managed in alternative residential settings would be valuable. [source] The Effect of Active Support Interactive Training on the Daily Lives of Adults with an Intellectual DisabilityJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 2 2010Vasiliki Totsika Background, Interactive training (IT) is one of the two staff training components of the active support (AS) model. The present study explores how effective IT is when offered to staff divorced in time from the AS workshops, the other training component. We explored the effects of IT on resident activity engagement, challenging behaviours and staff assistance. Materials and Methods, Twenty-one adults with an intellectual disability living in residential settings participated. Observations and ratings of staff and resident behaviours were obtained before, immediately after the training sessions, and at 6 months follow-up. Results, Group-level analyses indicated a short-lived improvement in quality of staff support but, in general, there was an overall lack of change in staff behaviours, resident engagement and , observed and rated , challenging behaviours. However, subgroup analyses indicated that there was a significant improvement in engagement immediately after IT for a distinct subgroup of participants; those who had significantly higher aggressive behaviour ratings at the beginning of the study. Conclusions, Findings support the combination of the training components of AS for improvements in the quality of life for people with intellectual disability. IT may also be worthy of future study as a potential stand-alone intervention for people with the most difficult challenging behaviours. [source] Quality of Life Outcomes for People with Intellectual Disabilities Living in Staffed Community Housing Services: a Stratified Random Sample of Statutory, Voluntary and Private Agency ProvisionJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 1 2003Jonathan Perry Background, Small scale, community-based, staffed housing is a significant form of residential provision for people with intellectual disabilities. Such services are provided by health and local authorities, and voluntary and private agencies, yet little is known about how provision varies between provider sectors. Methods, This study compared sectors in terms of the processes operating within residential services, and objectively and subjectively assessed quality of life (QOL) resident outcomes. Measures of setting structure and processes and resident outcomes were undertaken on a stratified random sample of 47 small scale, community-based residential settings which accommodated a total of 154 people with intellectual disabilities. Results, In general, provider agencies did not differ in terms of the characteristics of the residents they served, the structure of settings, the processes underlying service operation or resident outcomes. However, across agencies there was considerable variation in residents' life conditions when they were measured objectively. Better outcome tended to be significantly correlated with the ability of residents. This was not the case with results on subjective measures (which were also higher than those on objective measures). Conclusions, The results reinforce the need to design services which effectively support people across the ability spectrum. Also, an argument is made for the continued utility of objective measurement in the assessment of service quality. [source] Captan: Transition from ,B2' to ,not likely'.JOURNAL OF APPLIED TOXICOLOGY, Issue 5 2007How pesticide registrants affected the EPA Cancer Classification Update Abstract On 24 November 2004 EPA changed the cancer classification of captan from a ,probable human carcinogen' (Category B2) to ,not likely' when used according to label directions. The new cancer classification considers captan to be a potential carcinogen at prolonged high doses that cause cytotoxicity and regenerative cell hyperplasia. These high doses of captan are many orders of magnitude above those likely to be consumed in the diet, or encountered by individuals in occupational or residential settings. This revised cancer classification reflects EPA's implementation of their new cancer guidelines. The procedures involved in the reclassification effort were agreed upon with EPA and involved an Independent Transparent Review as it related to four components that formed the basis of the original 1986 B2 classification: mouse tumors; rat tumors; mutagenicity; and structural similarity to other carcinogens. A Peer Review Panel organized and administered by Toxicology Excellence for Risk Assessment (TERA) met on 2,3 September 2003. The Panel concluded that captan acted through a non-mutagenic threshold mode of action that required prolonged irritation of the duodenal villi as the initial key event. EPA's Cancer Assessment Review Committee (CARC) met on 9 June 2004 and endorsed the Peer Review findings. EPA intended to have the FIFRA Scientific Advisory Panel (SAP) consider the basis for this reclassification but found the science was robust and judged that a SAP review was not warranted. Using the revised classification, the margin of exposure is approximately 1,200,000, supporting the ,not likely' characterization. Copyright © 2007 John Wiley & Sons, Ltd. [source] Management of night-time urinary incontinence in residential settings for older people: an investigation into the effects of different pad changing regimes on skin healthJOURNAL OF CLINICAL NURSING, Issue 3 2003Mandy Fader BSc Summary ,,Absorbent pads are the main method of managing urinary incontinence in residential settings for older people. ,,Improvements in technology have resulted in highly absorbent products which may be worn all night, but the effects of prolonged pad wearing on aged skin are unknown. ,,The aim of this study was to examine the effects of two different pad changing regimes on skin health. ,,A cross-over design was used. ,,Subjects from residential settings were randomly allocated to one of two pad changing regimes: a frequent pad changing regime or a less frequent pad changing regime. Each regime lasted 4 weeks and was followed by the alternative regime. ,,Skin measurements were taken twice during each regime using (i) the Diastron Erythema meter, (ii) a visual grading scale, (iii) the Servomed evaporimeter, and (iv) a pH meter. The primary outcome variable was the Diastron Erythema meter index. ,,Eighty-one subjects completed the study. ,,No significant differences were found in the severity of erythema, or skin pH, between regimes. Measurements of trans-epidermal water loss were significantly higher in the less frequent pad changing regime indicating that skin was ,wetter' (P = 0.01; 95% CI: 2.89,21.39). ,,Five subjects developed grade 2 pressure ulcers (abrasions) during the less frequent pad changing regime, but none in the frequent pad changing regime; this result was not significant (P = 0.1; 95% CI: 0,1.09). ,,No evidence was found that a less frequent pad changing regime has an effect on skin erythema or pH. ,,There is evidence that skin is wetter which may make it more vulnerable to friction and abrasion. ,,The statistically non-significant finding of greater incidence of grade 2 pressure ulcers is a cause for concern and merits further investigation because of the clinical significance of loss of skin integrity. [source] Significant improvement in sleep in people with intellectual disabilities living in residential settings by non-pharmaceutical interventionsJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 8 2009T. Hylkema Abstract Background Although about 15 to 50 percent of people with intellectual disabilities (ID) living in residential settings suffer from sleep problems, scant attention is paid to these problems. Most available studies focus on pharmaceutical solutions. In this study we focus on improving sleep in people with intellectual disabilities living in residential settings by non-pharmaceutical interventions. Method The design is a multiple case study using actigraphy. Following a baseline measurement of people with ID, we recommended an intervention such as bedtime scheduling. This was followed by an effect measurement. Results Sleep efficiency, sleep latency and rising latency improved significantly. The time spent in bed also decreased significantly and the hours of sleep while in bed increased significantly. Conclusion For people with ID, sleep can be improved by non-pharmaceutical interventions. A multidisciplinary approach is helpful in selecting an adequate intervention. [source] Relationship between diagnostic criteria, depressive equivalents and diagnosis of depression among older adults with intellectual disabilityJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 11 2008L. Langlois Abstract Background Depression is more common among persons with an intellectual disability (ID) than the general population, and may be expected to increase with age just as in the general population. However, little is known about depression among older adults with ID. The literature has questioned the use of standard diagnostic criteria for depression among both older adults and persons with ID, and behavioural depressive equivalents have been suggested. This study uses the interRAI ID assessment instrument to investigate the relationship between standard diagnostic criteria for depression, depressive equivalents and a diagnosis of depression among older and younger adults with ID in community and institutional settings in Ontario, Canada. Method Items in the interRAI ID assessment instrument that were representative of The Diagnostic and Statistical Manual of Mental Disorders 4th Edition (DSM-IV) criteria and depressive equivalents were examined among persons with ID in institutional (census-level data) and in community-based (sample) residential settings. Bivariate logistic regression was used to examine the relationship between depressive symptoms and a diagnosis of depression. Descriptive statistics were used to examine the prevalence of depressive symptoms among those who did not have a diagnosis of depression. Results The results indicate that DSM-IV diagnostic criteria and depressive equivalents were significantly related to a diagnosis of depression among older and younger adults with ID, and that both types of symptoms were exhibited by a non-trivial proportion of individuals without a diagnosis of depression. Conclusions The depression rating scale embedded in the interRAI ID is helpful in identifying older adults at risk of depression. Contrary to other studies, few significant differences were found in depressive symptoms by age. [source] Self-determination, social abilities and the quality of life of people with intellectual disabilityJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 11 2007L. Nota Summary Background The international literature has documented that self-determination is impacted by environmental factors, including living or work settings; and by intraindividual factors, including intelligence level, age, gender, social skills and adaptive behaviour. In addition, self-determination has been correlated with improved quality of life (QoL). This study sought to contribute to the growing literature base in this area by examining the relationship among and between personal characteristics, self-determination, social abilities and the environmental living situations of people with intellectual disabilities (ID). Methods The study involved 141 people with ID residing in Italy. Healthcare professionals and social workers who had known participants for at least 1 year completed measures of self-determination, QoL and social skills. Analysis of variance was conducted to verify whether different levels of intellectual impairment were associated with different degrees of the dependent variables. The Pearson product,moment correlation was used to examine any relationships among dependent variables and IQ scores. Finally, discriminant function analysis was used to examine the degree to which IQ score, age, self-determination and social abilities predicted membership in groups that were formed based on living arrangement, and on QoL status (high vs. low). Results The anova determined, as expected, that participants with more severe ID showed the lowest levels of self-determination, QoL and social abilities. Discriminant function analysis showed that (a) individuals attending day centres were distinguished from those living in institutions in that they were younger and showed greater autonomy of choice and self-determination in their daily activities; (b) basic social skills and IQ score predicted membership in the high or low QoL groups; and (c) the IQ score predicted membership in the high or low self-determination groups. A manova conducted to examine gender- and age-level differences on self-determination found gender differences; women had higher self-determination scores than men. Conclusions These findings contribute to an emerging knowledge base pertaining to the role of intraindividual and environmental factors in self-determination and QoL. In general, the study replicated findings pertaining to the relative contribution of intelligence to self-determination and QoL, added information about the potential contribution of social abilities, and pointed to the potentially important role of opportunities to make choices as a particularly important aspect of becoming more self-determined, at least in the context of residential settings. [source] A Pilot Study Analyzing Mortality of Adults With Developmental Disabilities Residing in Nursing Homes in ConnecticutJOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 3 2010Gerard J. Kerins Abstract A review of mortality cases for persons with intellectual disabilities (ID) in the state of Connecticut (USA) revealed that the majority of deaths in residential settings occurred in nursing homes. However, it was not clear why individuals with ID were residing in nursing homes, or what brought them there. The authors conducted a preliminary study to elicit better understanding of the circumstances resulting in nursing home residency for people with ID. Charts for a small sample of deaths occurring in nursing homes were examined and select data extracted, including basic demographic data, the previous residential setting, the length of stay, medical conditions, case management intensity, and documented rationale for continued nursing home residency. The data revealed that many individuals were admitted to nursing homes at an earlier age than for the nondisabled general population. People with ID stayed in these residences longer, and died later than the general population of nondisabled individuals admitted to nursing homes. About half the sample received case management on at least an annual basis; a third had no documented case management. Lack of appropriate alternate residential settings, lack of support services for families, and lack of case management resources for adults with ID residing in nursing homes in Connecticut are all apparent from the findings. Failure to use existing resources such as group homes to their potential capacity, and other similar policies should be re-examined. [source] Who Cares About Disabled Victims of Crime?JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 3 2007Barriers, Facilitators for Redress Abstract, The author identified and discusses barriers and facilitators for public action after the occurrence of abuse against an adult with an intellectual disability (ID). Data were collected via a postal survey sent to guardians in one Swedish region with questions about suspected abuse against their wards (n = 978), of whom 392 had an ID (the remaining were affected by dementia or had another physical or mental disability). The rate of abuse was 4.8% (n = 19) among those wards with an ID. A range of abuses were reported, but there were no significant statistical differences attributed by sex of the wards. Facilitating examples for redress in the statutory framework were identified, but it was observed that implementation of redress was often flawed. Three alternative public actions were discussed: (1) victims' refusal to contact the public sector; (2) internal handling by the social services; and (3) reporting to police (but case closed). Findings showed that there were difficulties in understanding that passive respect for integrity and autonomy is not in line with the public ethos that demands actively caring for dependent wards, that offences in residential settings were sometimes handled internally and not reported in accord with the statutory framework, and that the ability of the criminal justice system to compensate for communicative disabilities seemed deficient. [source] Evaluation of metaflumizone granular fly bait for management of housefliesMEDICAL AND VETERINARY ENTOMOLOGY, Issue 2 2009A. AHMAD Abstract The housefly, Musca domestica L. (Diptera: Muscidae), is a pest of great veterinary and public health importance. In this study, the efficacy of metaflumizone granular fly bait was assessed on first generation (F1) housefly adults raised from flies collected at a cattle feedlot in Kansas. All bioassays were conducted as choice tests, with flies having ad libitum access to water, granular sugar and bait. A commercial methomyl-based bait (Golden MalrinTM) was used as positive control; no bait (water and granular sugar only) was used as negative control. Fly mortality was recorded on days 2, 7 and 14. The metaflumizone bait was significantly more slow-acting than the methomyl bait (mortality rates after 2 days of exposure were 49.9% and 57.9%, respectively). However, there were no significant differences in cumulative mortality later in the bioassays. Cumulative mortality rates on days 7 and 14 were 96.1% (metaflumizone), 91.4% (methomyl) and 99.0% (metaflumizone), 97.6% (methomyl), respectively. Our results demonstrate that the metaflumizone granular fly bait may be an effective modality for incorporation into management programmes for houseflies in and around livestock production facilities as well as in residential settings. [source] Delivering culturally appropriate residential rehabilitation for urban Indigenous Australians: a review of the challenges and opportunitiesAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2010Kate Taylor Abstract Objective: To review the challenges facing Indigenous and mainstream services in delivering residential rehabilitation services to Indigenous Australians, and explore opportunities to enhance outcomes. Methods: A literature review was conducted using keyword searches of databases, on-line journals, articles, national papers, conference proceedings and reports from different organisations, with snowball follow-up of relevant citations. Each article was assessed for quality using recognised criteria. Results: Despite debate about the effectiveness of mainstream residential alcohol rehabilitation treatment, most Indigenous Australians with harmful alcohol consumption who seek help have a strong preference for residential treatment. While there is a significant gap in the cultural appropriateness of mainstream services for Indigenous clients, Indigenous-controlled residential organisations also face issues in service delivery. Limitations and inherent difficulties in rigorous evaluation processes further plague both areas of service provision. Conclusion: With inadequate evidence surrounding what constitutes ,best practice' for Indigenous clients in residential settings, more research is needed to investigate, evaluate and contribute to the further development of culturally appropriate models of best practice. In urban settings, a key area for innovation involves improving the capacity and quality of service delivery through effective inter-agency partnerships between Indigenous and mainstream service providers. [source] ORIGINAL ARTICLE: Pain in people with learning disabilities in residential settings , the need for changeBRITISH JOURNAL OF LEARNING DISABILITIES, Issue 3 2010Monica Beacroft Accessible summary ,,Pain is not recognised and managed well for people with learning disabilities in residential settings , People with learning disabilities are not getting timely and appropriate ,as required' medication for their pain. ,,Staff do not use pain recognition tools or communication aids. ,,Some staff still believe that people with learning disabilities have a higher pain threshold than people without a learning disability. They also let this belief affect how they manage pain. ,,This research matters to people with learning disabilities. It is important that staff and carers recognise and manage pain well. We have developed a pain training pack for staff and carers and leaflets for both people with learning disabilities and staff and carers. Summary This audit investigated residential staff beliefs around pain thresholds and strategies they adopt to recognise and manage pain in people with learning disabilities across Surrey. A structured interview was constructed to elicit information. Results demonstrated that pain is not being effectively recognised or managed by residential staff in Surrey. It highlighted the need for training for staff in how to recognise and manage pain, as well as the need for appropriate pain recognition tools and communication aids to be utilised to support people with learning disabilities to be able to communicate their pain to others. It also indicated the need for better communication between staff and other services that the person with learning disabilities accesses. [source] | ||||||||||||||||||||||||||||||||||