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The Deprivation of Liberty Safeguards are an extension to the Mental Capacity Act (2005). They provide protection for those who lack capacity to make a decision about residing in…
Abstract
The Deprivation of Liberty Safeguards are an extension to the Mental Capacity Act (2005). They provide protection for those who lack capacity to make a decision about residing in a hospital or care home and require a deprivation of their liberty. The following paper is a summary of the safeguards.
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Simon Bonell and Jane McCarthy
This case report highlights the complex factors in prescribing psychotropic medication for people with intellectual disability with significant co‐morbid physical and mental…
Abstract
This case report highlights the complex factors in prescribing psychotropic medication for people with intellectual disability with significant co‐morbid physical and mental health problems. The case study is of a young man with a mitochondrial disorder, secondary sensory impairments, mild intellectual disability, epilepsy and autism spectrum disorder who developed a psychotic illness. The report focuses on the use of psychotropic medication in this man and discusses the issues regarding psychotropic medication that need to be considered with service users and their carers.
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Hayley Starkey, Shelley Bevins and Simon Bonell
People with Down's syndrome are at increased risk of developing early onset Alzheimer's disease. It has been recommended that all adults with Down's syndrome receive baseline…
Abstract
Purpose
People with Down's syndrome are at increased risk of developing early onset Alzheimer's disease. It has been recommended that all adults with Down's syndrome receive baseline neuropsychological testing for dementia. In certain areas prospective screening of people with Down's syndrome takes place to ensure the early diagnosis of the condition. However, little has been published on the value of this type of screening. The purpose of this paper is to report on a prospective screening programme and asks whether the programme is effective in identifying dementia-related changes in people with Down's syndrome and whether the current screening intervals are appropriate.
Design/methodology/approach
All adults with Down's syndrome in Plymouth (UK) are identified and offered a comprehensive test battery at baseline at the age of 20 and then have testing biennially from 40 to 50 and annually after 50. All individuals diagnosed with dementia between 2001 and 2013 were identified and their case notes examined. The symptoms at the time of diagnosis were identified and whether these symptoms had been identified through the screening programme or by other routes were recorded. Prevalence data and age at diagnosis were also recorded.
Findings
In total, 26 people were diagnosed with dementia during the study period. Of these, the diagnosis of dementia followed concerns being identified during the routine screening programme in 54 per cent of cases. In the younger age group (age 40-49) 63 per cent of people were identified through the screening programme. At the time of diagnosis a mean of 5.5 areas of concern were in evidence.
Research limitations/implications
Limited by small sample size, however service development not original research. Implications for the use of prospective dementia screening in people with Down's syndrome.
Practical implications
Implications for how services choose to run their Down's syndrome and dementia screening programmes, including the frequency of screening.
Originality/value
The paper adds to a growing evidence base around the value of prospective dementia screening in people with Down's syndrome. It is also one of a few studies exploring the frequency of screening. Additionally, it adds further data about prevalence of dementia in people with Down's syndrome.
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Francesca Caló, Michael James Roy, Cam Donaldson, Simon Teasdale and Simone Baglioni
As the provision of public services in many advanced welfare states has increasingly come to be marked by competition, social enterprises have actively been encouraged by…
Abstract
Purpose
As the provision of public services in many advanced welfare states has increasingly come to be marked by competition, social enterprises have actively been encouraged by governments to become involved in the delivery of public services. While the evaluation of complex public health interventions has arguably become increasingly more sophisticated, this has not been the case where social enterprise is concerned: evaluation of the actual impacts of social enterprises remains significantly underdeveloped by comparison. This study aims to support the establishment of a robust evidence base for the use of social enterprise as a policy instrument.
Design/methodology/approach
This paper assesses the potential of three methodological approaches common in the evaluation of complex public health interventions and applies them to the complex realm of community-led social enterprise.
Findings
Only through the involvement of different comparator groups, based on the research questions addressed, would it be possible to disentangle the embedded characteristics of organisations such as social enterprises. Each of the methods adopted in this research is time-consuming and resource-intensive and requires the researcher to possess advanced skills. Public officials should recognise the complexity and resource-intensive nature of such evaluation and resource it accordingly. If the aim of policymakers is to understand the added value of social enterprise organisations, an integrative research approach combining different research methods and design should be implemented to improve generalisability.
Originality/value
This study applies a range of favoured approaches to evaluate “complex” public health interventions include systematic reviews, realist evaluation and quasi-experimental investigation. However, such evaluation approaches have rarely been applied before in the context of social enterprise.
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Jeremy Segrott, Jo Holliday, Simon Murphy, Sarah Macdonald, Joan Roberts, Laurence Moore and Ceri Phillips
The teaching of cooking is an important aspect of school-based efforts to promote healthy diets among children, and is frequently done by external agencies. Within a limited…
Abstract
Purpose
The teaching of cooking is an important aspect of school-based efforts to promote healthy diets among children, and is frequently done by external agencies. Within a limited evidence base relating to cooking interventions in schools, there are important questions about how interventions are integrated within school settings. The purpose of this paper is to examine how a mobile classroom (Cooking Bus) sought to strengthen connections between schools and cooking, and drawing on the concept of the sociotechnical network, theorise the interactions between the Bus and school contexts.
Design/methodology/approach
Methods comprised a postal questionnaire to 76 schools which had received a Bus visit, and case studies of the Bus’ work in five schools, including a range of school sizes and urban/rural locations. Case studies comprised observation of Cooking Bus sessions, and interviews with school staff.
Findings
The Cooking Bus forged connections with schools through aligning intervention and schools’ goals, focussing on pupils’ cooking skills, training teachers and contributing to schools’ existing cooking-related activities. The Bus expanded its sociotechnical network through post-visit integration of cooking activities within schools, particularly teachers’ use of intervention cooking kits.
Research limitations/implications
The paper highlights the need for research on the long-term impacts of school cooking interventions, and better understanding of the interaction between interventions and school contexts.
Originality/value
This paper adds to the limited evidence base on school-based cooking interventions by theorising how cooking interventions relate to school settings, and how they may achieve integration.
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Camilla Lawaetz Wimmelmann, Kathrine Vitus and Signe Smith Jervelund
The purpose of this paper is to examine any unanticipated effects of an educational intervention among newly arrived adult immigrants attending a language school in Denmark.
Abstract
Purpose
The purpose of this paper is to examine any unanticipated effects of an educational intervention among newly arrived adult immigrants attending a language school in Denmark.
Design/methodology/approach
A qualitative case study was conducted including interviews with nine informants, observations of two complete intervention courses and an analysis of the official intervention documents.
Findings
This case study exemplifies how the basic normative assumptions behind an immigrant-oriented intervention and the intrinsic power relations therein may be challenged and negotiated by the participants. In particular, the assumed (power) relations inherent in immigrant-oriented educational health interventions, in which immigrants are in a novice position, are challenged, as the immigrants are experienced adults (and parents) in regard to healthcare. The paper proposes that such unexpected conditions for the implementation – different from the assumed conditions – not only challenge the implementation of the intervention but also potentially produce unanticipated yet valuable effects.
Research limitations/implications
Newly arrived immigrants represent a hugely diverse and heterogeneous group of people with differing values and belief systems regarding health and healthcare. A more detailed study is necessary to fully understand their health seeking behaviours in the Danish context.
Originality/value
Offering newly arrived immigrants a course on health and the healthcare system as part of the mandatory language courses is a new and underexplored means of providing and improving newly arrived immigrants knowledge and use of the Danish healthcare system.
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Gulshan Tajuria, Sue Read and Helena M. Priest
People with intellectual disabilities experiencing loss or bereavement are at risk of developing additional mental health problems, and may struggle to access suitable support…
Abstract
Purpose
People with intellectual disabilities experiencing loss or bereavement are at risk of developing additional mental health problems, and may struggle to access suitable support. The purpose of this paper is to present the adaptations done while using Photovoice as a creative method for bereaved people with intellectual disabilities participating in a research exploring loss and support. This paper will further briefly add information on how the use of Photovoice supported the development of whole research project.
Design/methodology/approach
This paper explores the use of Photovoice as a method of research engagement for bereaved adults with intellectual disabilities. Photovoice enables participants to take and discuss photographs illustrating their loss and support experiences. The paper focusses on a preparatory Photovoice workshop with the research participants, outlining the processes and activities used to maximise involvement, promote learning and achieve shared understanding.
Findings
Preparation was the key to the effectiveness of this workshop and it recommends that appropriate adaptions are useful in Photovoice with adults with intellectual disabilities effectively. The paper outlines principles of good practice for using Photovoice in this research context, which may transfer to other similar research settings. Using Photovoice facilitated later one-to-one interviews with the participants, where their photographs were discussed together.
Originality/value
This paper illustrates the innovative use of Photovoice methodology in research involving bereaved people with intellectual disabilities. Photovoice has not previously been used with this specific population within the bereavement and loss context, so this paper adds to the developing evidence base.
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