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Service Issues (service + issues)
Selected AbstractsEating disorders in adults with intellectual disabilityJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 6 2000S. Gravestock Abstract There is an increasing focus on the nutrition of people with intellectual disability (ID), but less interest in the range of eating disorders (EDs) that they may exhibit and the bio-psycho-social impact of these conditions. Despite diagnostic and methodological difficulties, psychopathology and ED research studies suggest that 3,42% of institutionalized adults with ID and 1,19% of adults with ID in the community have diagnosable EDs. Weight surveys indicate that 2,35% of adults with ID are obese and 5,43% are significantly underweight, but the contribution of diagnosable EDs is unknown. Such data and case reports suggest that EDs are associated with considerable physical, behavioural, psychiatric and social comorbidity. Review papers have focused on the aetiology and treatment of pica, rumination, regurgitation, psychogenic vomiting and food faddiness/refusal. Emerging clinical issues are the development of appropriate diagnostic criteria, multimodal assessment and clinically effective treatment approaches. Key service issues include staff training to improve awareness, addressing comorbidity and access issues, and maintaining support for adults with ID and EDs, and their carers. Research should confirm the multifaceted aetiology and comorbidity of EDs. Then multicomponent assessment and treatment models for EDs can be developed and evaluated. [source] PUBLIC SERVICE PERSPECTIVES ON REFORMS OF ELECTRICITY DISTRIBUTION AND SUPPLY: A MODULAR ANALYSISANNALS OF PUBLIC AND COOPERATIVE ECONOMICS, Issue 2 2010Ute Dubois ABSTRACT,:,This article analyzes organizational change in electricity distribution and retail businesses and its impact on public service issues. Organizational change has resulted from the European electricity directives, especially the EU Electricity directive 2003/54/EC, which has imposed major transformations on these activities, requiring legal unbundling of electricity distribution networks by 1 July 2007. Organizational change has also resulted from an adaptation of companies to the newly competitive environment. This has led to a diversity of organizational choices across Europe. We analyze this diversity by using a modular approach, which decomposes reforms in electricity distribution and retail into logical ,blocks'. We then examine how European countries have dealt with two policy and regulatory issues related to customer protection in that new environment: the regulation of quality of distribution, which is a task of regulators, and energy affordability policies for vulnerable customers, which are a central aspect of public service policies in the electricity sector. [source] Mental health issues and resources in rural and regional communities: An exploration of perceptions of service providersAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 2 2007Merrill Turpin Abstract Objective:,To identify service providers' and community organisations' perceptions of the resources available to support people with mental illness and the unmet needs of this client group in rural Queensland. Design:,An exploratory study was undertaken involving focus group interviews across the study sites. Setting:,Five regional towns in rural Queensland. Participants:,Ten to 14 members were recruited for each of the five focus groups. The groups represented a diverse mix of participants including health and community service providers and representatives from community organisations. Results:,Participants identified gaps in services in relation to health, employment and education, housing and accommodation, transport and social inclusion and health promotion. Inter-service communication and inappropriate funding models were themes affecting service delivery. Conclusions:,Specific service issues of housing and transport were identified to be particularly problematic for people with mental illness across all towns. Intersectoral communication and funding models require further research. [source] Healthcare professionals' views on two computer-based decision aids for women choosing mode of delivery after previous caesarean section: a qualitative studyBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 7 2009KM Rees Objective, To explore healthcare professionals' views about decision aids, developed by the DiAMOND study group, for women choosing mode of delivery after a previous caesarean section. Design/Methods, A qualitative focus group study. Data were analysed thematically. Setting, Two city maternity units, surrounding community midwife units and general practitioner (GP) practices in southwest England. Sample, Twenty-eight healthcare professionals, comprising obstetricians, hospital and community midwives and GPs, who participated in six focus groups. Results, Participants were generally positive about the decision aids. Most thought they should be implemented during early pregnancy in the community, but should be accessible throughout pregnancy, with any arising questions discussed with an obstetrician nearer to term. Perceived barriers to implementation included service issues (e.g. time pressure, cost and access), computer issues (e.g. computer literacy) and people issues (e.g. women's prior delivery preferences and clinician preference). Facilitators to implementation included access to more standardised and reliable information and empowerment of the user. Self-accessing the aids, increased awareness of decision aids among healthcare professionals and incorporation of aids into usual care were suggested as possible ways to improve implementation success. Conclusions, This study gives insight into healthcare professionals' views on the role of decision aids for women choosing a mode of delivery after a prior caesarean section. It highlights potential obstacles to their implementation and ways to address these. Such aids could be a useful adjunct to current antenatal care. [source] | ||||||||||