Men with intellectual disabilities and sexual offending histories: an exploration of their experiences of living within a secure hospital setting

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Stacey Heppell ◽  
John Rose

Purpose There is a national drive to transform services for individuals with intellectual disabilities (ID), to provide care within the community rather than hospital settings. However, there are limited community provisions for those with more complex care needs such as sexual offending. There has been limited research focussing on this client group’s experiences of inpatient services and the treatment they have received from their own perspective. This study aims to explore their experiences of living in a secure service focussing on treatment for sex offences. Design/methodology/approach In total, 10 men with ID and sexual offending histories took part in an interview designed to explore their experiences of living within a secure hospital setting. The data were analysed using thematic analysis. Findings Three key themes relating to the participants’ experiences within the hospital were identified. These were, namely, “hospital environment”, “personal journey through secure services” and “closeness to home”. Practical implications Men’s experiences at a secure hospital were generally positive in terms of a supportive staff approach. Difficulties existed around the hospital organisation affecting the support they received. Originality/value Some participants experienced a struggle to become more independent and move to less restrictive environments due to their perceived risk levels. Some participants found being away from home to be hard and longed to be closer to their families. Around half of the participants did not want to live near their hometown due to family difficulties, negative peer influences or fears of consequences for their sexual offending. Implications for community service planning are considered.

2021 ◽  
Vol 7 (9) ◽  
Author(s):  
Marie Petitjean ◽  
Paulo Juarez ◽  
Alexandre Meunier ◽  
Etienne Daguindau ◽  
Hélène Puja ◽  
...  

The biological features that allow a pathogen to survive in the hospital environment are mostly unknown. The extinction of bacterial epidemics in hospitals is mostly attributed to changes in medical practice, including infection control, but the role of bacterial adaptation has never been documented. We analysed a collection of Pseudomonas aeruginosa isolates belonging to the Besançon Epidemic Strain (BES), responsible for a 12year nosocomial outbreak, using a genotype-to-phenotype approach. Bayesian analysis estimated the emergence of the clone in the hospital 5 years before its opening, during the creation of its water distribution network made of copper. BES survived better than the reference strains PAO1 and PA14 in a copper solution due to a genomic island containing 13 metal-resistance genes and was specifically able to proliferate in the ubiquitous amoeba Vermamoeba vermiformis. Mutations affecting amino-acid metabolism, antibiotic resistance, lipopolysaccharide biosynthesis, and regulation were enriched during the spread of BES. Seven distinct regulatory mutations attenuated the overexpression of the genes encoding the efflux pump MexAB-OprM over time. The fitness of BES decreased over time in correlation with its genome size. Overall, the resistance to inhibitors and predators presumably aided the proliferation and propagation of BES in the plumbing system of the hospital. The pathogen further spread among patients via multiple routes of contamination. The decreased prevalence of patients infected by BES mirrored the parallel and convergent genomic evolution and reduction that affected bacterial fitness. Along with infection control measures, this may have participated in the extinction of BES in the hospital setting.


2015 ◽  
Vol 60 (2) ◽  
pp. 1121-1128 ◽  
Author(s):  
J. Chase McNeil ◽  
Eric Y. Kok ◽  
Jesus G. Vallejo ◽  
Judith R. Campbell ◽  
Kristina G. Hulten ◽  
...  

ABSTRACTOne of the strategies utilized to decrease infections in the hospital setting relies on topical antimicrobials and antiseptics. While their use is beneficial, concerns arise over the potential to develop resistance or tolerance to these agents. We examined nosocomialStaphylococcus aureusisolates from 2007 to 2013 for the presence of genes associated with tolerance to chlorhexidine. Isolates and patients were identified from anS. aureussurveillance study at Texas Children's Hospital. NosocomialS. aureusisolates (those causing infection at ≥72 h of hospitalization) were identified and underwent PCR for theqacAorqacB(qacA/B) andsmrgenes associated with elevated minimum bactericidal concentrations of chlorhexidine. Molecular typing with pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), andagrtyping and a review of the medical record were performed. Two hundred forty-seven nosocomialS. aureusinfections were identified. Overall, 111 isolates carried one or both genes (44.9%); 33.1% were positive forsmr, 22.7% were positive forqacA/B, and 10.9% of the isolates possessed both genes. Thesmr-positive isolates were more often resistant to methicillin, ciprofloxacin, and/or clindamycin. The isolates positive forqacA/Bwere more often associated with indwelling central venous catheters and a vancomycin MIC of ≥2 μg/ml. Isolates carrying eithersmrorqacA/Bwere associated with a diagnosis of bacteremia. Thesmr-positive isolates more often belonged to sequence type 8 (ST8) than the isolates that were positive forqacA/B. Mupirocin resistance was detected in 2.8% of the isolates. Antiseptic-tolerantS. aureusstrains are common in our children's hospital and are associated with decreased susceptibility to other systemic antimicrobials and with bloodstream infections. Further work is needed to understand the implications that these organisms have on the hospital environment and antiseptic use in the future.


Author(s):  
Shaw Tearle ◽  
Rachel R. Holt

PurposeThere is a pressing need to develop community forensic support for adults with intellectual disabilities and a high risk to others. Equipping youth to help one another (EQUIP) was developed for juvenile offenders in the USA and is used across Europe and North America. The purpose of this paper is to evaluate an adapted community model of EQUIP for men with intellectual disabilities and a history of sexual offending.Design/methodology/approachA case series design was used. The adapted EQUIP group ran for one session per week over ten months, with each participant accompanied by a support worker. Six men living in the community with intellectual disabilities and a history of sexual offending completed the programme.FindingsAnalysis of the results suggests that this adapted version of EQUIP produced similar results to the programme delivered in an inpatient setting. Participants’ reasoning and problem-solving abilities were improved post-intervention. Satisfaction levels from participant and their support workers were high. There was no evidence of recidivism during the ten months the group ran.Research limitations/implicationsThe case series design utilised only allows the conclusion that the changes above occurred at the same time as the group. Further research is needed to ascertain whether it is likely that the intervention resulted in the changes.Practical implicationsThere is a pressing need to develop the evidence base for interventions offered in the community to people with intellectual disabilities and a history of offending. This study provides some evidence that EQUIP can be adapted to suit this population.Social implicationsThe availability of community interventions may, over time, decrease the need for detention in inpatient settings. This is in line with the transforming care agenda.Originality/valueThis is the first published research into use of EQUIP in the community with adult participants with intellectual disabilities.


2017 ◽  
Vol 3 (3) ◽  
pp. 154-162 ◽  
Author(s):  
Priscilla Burnham Riosa ◽  
Andrea Greenblatt ◽  
Barbara Muskat

Purpose Youth with autism spectrum disorder (ASD) often have co-occurring health care needs and are likely to come into contact with several health care professionals over their lives. At the hospital, youth with ASD may require specialized supports to optimize health care experiences and for medical services to be delivered safely. At present, there is a limited understanding of how to best support this patient population. The purpose of this paper is to develop, implement, and evaluate an online training module for hospital staff about ASD. Design/methodology/approach To evaluate participants’ perceived utility of the learning tool, a post-module survey was administered. Findings In all, 102 health care professionals and other hospital staff completed the training and evaluation measure. Majority of participants had prior ASD-focused education (66 percent) and had experience working with at least 20 youths with ASD (57 percent). Majority of participants (88 percent) perceived the information from the module to be helpful in their daily work and reported that they learned something new (63 percent). Participants were interested in receiving additional ASD online module training opportunities on topics including: hands-on behavior management strategies, in-hospital resources, guidance on treatment adherence, and ASD training geared specifically to protection services staff. Originality/value The results from this evaluation have important practice implications for hospital staff working with patients with ASD and their families. Evidence-based strategies were easily accessible for staff and the module can be feasibly built upon and expanded as well as disseminated beyond the current hospital setting.


Microbiome ◽  
2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Clarisse Marotz ◽  
Pedro Belda-Ferre ◽  
Farhana Ali ◽  
Promi Das ◽  
Shi Huang ◽  
...  

Abstract Background SARS-CoV-2 is an RNA virus responsible for the coronavirus disease 2019 (COVID-19) pandemic. Viruses exist in complex microbial environments, and recent studies have revealed both synergistic and antagonistic effects of specific bacterial taxa on viral prevalence and infectivity. We set out to test whether specific bacterial communities predict SARS-CoV-2 occurrence in a hospital setting. Methods We collected 972 samples from hospitalized patients with COVID-19, their health care providers, and hospital surfaces before, during, and after admission. We screened for SARS-CoV-2 using RT-qPCR, characterized microbial communities using 16S rRNA gene amplicon sequencing, and used these bacterial profiles to classify SARS-CoV-2 RNA detection with a random forest model. Results Sixteen percent of surfaces from COVID-19 patient rooms had detectable SARS-CoV-2 RNA, although infectivity was not assessed. The highest prevalence was in floor samples next to patient beds (39%) and directly outside their rooms (29%). Although bed rail samples more closely resembled the patient microbiome compared to floor samples, SARS-CoV-2 RNA was detected less often in bed rail samples (11%). SARS-CoV-2 positive samples had higher bacterial phylogenetic diversity in both human and surface samples and higher biomass in floor samples. 16S microbial community profiles enabled high classifier accuracy for SARS-CoV-2 status in not only nares, but also forehead, stool, and floor samples. Across these distinct microbial profiles, a single amplicon sequence variant from the genus Rothia strongly predicted SARS-CoV-2 presence across sample types, with greater prevalence in positive surface and human samples, even when compared to samples from patients in other intensive care units prior to the COVID-19 pandemic. Conclusions These results contextualize the vast diversity of microbial niches where SARS-CoV-2 RNA is detected and identify specific bacterial taxa that associate with the viral RNA prevalence both in the host and hospital environment.


2020 ◽  
Vol 41 (S1) ◽  
pp. s409-s409
Author(s):  
Emily Feyes ◽  
Dixie Mollenkopf ◽  
Thomas Wittum ◽  
Dubraska Diaz-Campos ◽  
Rikki Horne

Emily Feyes, The Ohio State University College of Veterinary Medicine; Dixie Mollenkopf, The Ohio State University College of Veterinary Medicine; Thomas Wittum, The Ohio State University College of Veterinary Medicine; Dubraska Diaz-Campos, The Ohio State University College of Veterinary Medicine; Rikki Horne, The Ohio State University College of Veterinary MedicineBackground: The Ohio State University College of Veterinary Medicine (OSU-CVM) Antimicrobial Stewardship Working Group (ASWG) uses monthly environmental surveillance to understand the effectiveness of our veterinary medical center (VMC) infection control and biosecurity protocols in reducing environmental contamination with multidrug resistant organisms. Monthly surveillance allows us to monitor trends in the recovery of these resistant organisms and address issues of concern that could impact our patients, clients, staff, and students. Methods: The OSU-CVM ASWG collects samples from >100 surfaces within the companion animal, farm animal, and equine sections of our hospital each month. Sampling has been continuous since January 2018. Samples are collected from both human–animal contact and human-only contact surfaces using Swiffer electrostatic cloths. These samples are cultured for recovery of Salmonella spp, extended-spectrum cephalosporin-resistant Enterobacteriaceae, carbapenemase-producing Enterobacteriaceae (CPE), and methicillin-resistant Staphylococcus spp. Results: The recovery of these antibiotic resistant target organisms is low in the environment of our hospital. Recovery from human-only contact surfaces (19.8%) is very similar to recovery from human–animal contact surfaces (25.5%). We commonly recover Enterobacteriaceae (E.coli, Klebsiella spp, and Enterobacter spp) that are resistant to extended-spectrum cephalosporins (496 of 2,016; 24.6%) from the VMC environment. These antibiotic-resistant indicator bacteria are expected in a veterinary hospital setting where use the of β-lactam drugs is common. Recovery of both Salmonella spp and CPE has remained very low in our hospital environment over the past 19 months: 16 of 2,016 (0.7%) for Salmonella and 15 of 2,016 (0.8%) for CPE. Discussion: The active environmental surveillance component of our antimicrobial stewardship program has allowed us to reduce the threat of nosocomial infections within our hospital and address environmental contamination issues before they become a problem. Our consistently low recovery of resistant organisms indicates the effectiveness of our existing cleaning and disinfection protocols and biosecurity measures. Due to the nature of our patient population, we do expect to find resistant organisms in the patient-contact areas of the hospital environment. However, our similar rates of resistant organisms from human-only surfaces (eg, computer keyboards, door handles, telephones, and Cubex machines) indicates a need to improve our hand hygiene practices. These data are now supporting the implementation of a new hand hygiene campaign in our veterinary hospital.Funding: NoneDisclosures: None


2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Sri Rahayu Hijrah Hati ◽  
Sigit Sulistiyo Wibowo ◽  
Anya Safira

Purpose The purpose of this study is to examine the impacts of product knowledge, perceived quality, perceived risk and perceived value on customers’ intention to invest in Islamic Banks. This study specifically examines an Islamic bank’s term deposits. Design/methodology/approach Structural equation modeling was used to analyze the data collected from 217 customers of an Islamic bank in Indonesia using an online survey. Findings This study highlights the central and dual roles of perceived risk as both the independent and the intervening variable that mediates the relationship between product knowledge and Muslim customer intention to invest in an Islamic bank’s term deposits. Research limitations/implications This study only investigates term deposits as one type of investment in Islamic banks. This study contributes to the literature by examining the role of product knowledge, perceived quality, perceived risk and perceived value on Muslim customer intention to invest in Islamic term deposits. Practical implications The results of this study highlight the requirement for Islamic banks to educate customers to improve the depositors’ product knowledge because Muslim customers’ risk and value perception and intention are strongly influenced by product knowledge. Originality/value The investigation of perceived risk is particularly relevant for Islamic financial products because of the inherent nature of risk sharing in Islamic finance. This study investigates the role of product knowledge in influencing the Muslim customers’ perception of risk, quality, value and their intention to invest in Islamic bank term deposits. Ideally, the profit loss sharing concept (PLS) should be applied; however, in this context, revenue sharing is applied because of Indonesia’s central bank regulation.


2019 ◽  
Vol 13 (3) ◽  
pp. 574-602 ◽  
Author(s):  
Yixi Ning ◽  
Gubo Xu ◽  
Ziwu Long

Purpose This study aims to examine the venture capital (VC) industry in China. It has demonstrated a history of high growth with significant variations over time. The authors have examined the trends and determinants of VC investments in China over a 20-year period from 1995 to 2014. They find that the aggregate amount of VC investments, the total number of venture deals and the average amount of venture investments per deal in China are all significantly impacted by macroeconomic conditions (i.e. GDP, export, money supply), technology innovations and financial market indicators (i.e. initial public offerings (IPOs), interest rate, price-to-earnings ratio, etc.). They also find that the 2007 China A-Share stock market crash and the subsequent global financial crisis have motivated VCists in China to adjust their investment strategies and risk levels by allocating more capital to later-stage investments and securing more deals with later-round financings. However, after the 2008 global financial crisis, the China’s venture industry has recovered faster compared to the US counterpart response. Design/methodology/approach The authors first perform trend analysis of VC investments at an aggregate level, by stages of development, and across industry from 1995 to 2014.To test H1 and H2, the authors use multiple regression models with lagged explanatory variables. To test H3, the authors use univariate tests to compare the measures of VC investments at an aggregate level, stage funds ratios, stage deals ratios and financing series ratios during both a five-year and seven-year time windows around the 2007 A-Share stock market crash and the subsequent financial crisis. Findings The development of the VC industry in China has demonstrated a history of high growth with significant variation over time. The authors find that the aggregate amount of VC investments, the total number of venture deals and the average amount of venture investments per deal in China are all significantly impacted by macroeconomic conditions (i.e. GDP, export, money supply), technology innovations and financial market indicators (i.e. IPOs, interest rate, price-to-earnings ratio, etc.). The authors also find that the 2007 China A-Share stock market crash and the subsequent global financial crisis have motivated VCists in China to adjust their investment strategies and risk by allocating more capital to later-stage investments and securing more deals with later-round financings. However, the China VC industry has recovered faster compared to the USA just after the 2008 global financial crisis. Research limitations/implications There are also limitations in the study. The VC data in China in the earlier 1990s might not be very reliable due to the quality of statistics. Therefore, the trend analysis and discussions mainly focus on the time after 2000. Also, the authors cannot find VC financing sequence data for the analysis. Second, there is no doubt that the policy impact from Chinese transforming economic system and government policies on its VC industry is substantial (Su and Wang, 2013). However, they cannot find an appropriate variable to be included in the empirical models to consider this effect. Further study on this area would provide meaningful information. Third, although the authors have done comparison study between the VC industry in China in this study and the VC industry in the US documented in Ning et al. (2015) and discussed some interesting findings, more in-depth research in this area will be very useful. Practical implications The findings have meaningful implications for VCists and start-up companies seeking equity financings in China. VCists should closely monitor macroeconomic and market conditions to make appropriate adjustments to their risk and investment strategies. Entrepreneurs seeking equity financings for their business could also monitor the identified macroeconomic and market indicators, which can help them with their timing and to negotiate a better equity financing deal. VC financing is more likely to succeed when key macroeconomic and market indicators become favorable. Originality/value This paper contributes to the literature by testing the supply and demand theory on the VC market proposed by Poterba (1989) and Gompers and Lerner (1998) from the macroeconomic perspective using 20 years’ VC data from China. The authors also examine how the 2007 A-Share stock market crash and the subsequent financial crisis affected VCists to adjust their risk levels and investment strategies. It provides useful information for international academia and policymakers to understand the quick rise of China VC industry. The authors also find that the macroeconomic drivers of VC industry are somewhat different under different economic systems.


2017 ◽  
Vol 23 (2) ◽  
pp. 448-466 ◽  
Author(s):  
Afrooz Moatari-Kazerouni ◽  
Ygal Bendavid

Purpose Since mid-2000s, hospitals have begun implementing radio-frequency identification (RFID) technology in order to improve their operations. The purpose of this paper is to explore the potential of RFID technology in improving the traceability of surgical instruments in a hospital environment. Design/methodology/approach A case study is conducted at a teaching hospital in Montreal, Canada. Business process reengineering approach and simulation techniques are used to assess the realistic potential of the RFID technology. The application of different scenarios and how they influence the efficiency of process flow between the central sterilization department and operating rooms of the hospital is investigated. Findings Research outcomes demonstrated how tagging individual instruments or their sets lead to reduction of the time spent in re-processing the soiled instrument as well as the reduction of costs related to staff. Furthermore, specific key performance indicators are identified and eventual issues related to implementation of the re-designed processes are discussed. Originality/value Implementing RFID-enabled solutions in hospital context is still an emerging phenomenon that involves various stakeholders in a change management project. While implementing RFID technology can benefit hospitals by improving business processes and workflows, the adoption is still slow, especially for managing surgical instruments. It is, hence, crucial to compare the advantages and drawbacks of RFID-enabled surgical instruments solutions with other well-established traceability technologies such as barcoding.


2014 ◽  
Vol 18 (1) ◽  
pp. 75-91 ◽  
Author(s):  
Heeyoung Jang ◽  
Ilsang Ko

Purpose – The objective of this study is to identify the factors that affect CoP activation and performance variables obtainable through CoP activities, and to gain greater insight into their relationships and the mechanisms. In particular, this paper intends to illustrate the role of perceived risk factor for the loss of uniqueness of one's own knowledge in terms of their influence on CoP activities. Design/methodology/approach – In this study, the human behaviours were divided into online and offline CoP activities and adopted affirmative affect and social norm from the Triandis model. In addition, the paper considered perceived expectation, perceived risk, and organization support as independent variables. These would accelerate online and offline activities in the community of practice. The paper considered relationship commitment and individual performance in the context of performance evaluations via CoP activities. A structural equation model was developed with research variables and hypotheses. Findings – As the consequence of the empirical assessment of the variables influencing the on/offline activities of a CoP, social norm, perceived expectation, perceived risk, and organizational support showed significantly influential relationships with online activities, and affirmative affect, perceived expectation, and organizational support evidenced significantly influential relationships with offline activities. However, with regard to online CoP activities, affirmative affect was not shown to be significant. As to offline activities, perceived risk was not shown to be significantly influential, while it was determined to significantly influence online activities in a negative direction. Originality/value – The results of this study demonstrated that on/offline CoP activities were significantly influential in terms both of relationship commitment and individual performance.


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