Protocol for assessing services for people with severe mental illness

1998 ◽  
Vol 172 (2) ◽  
pp. 121-129 ◽  
Author(s):  
John Wing ◽  
Susannah Rix ◽  
Roy H. Curtis ◽  
Paul Lelliott ◽  
Alan Beadsmoore
Keyword(s):  
Mental Illness ◽  
Service Provision ◽  
Rank Order ◽  
Local Level ◽  
Clinical Care ◽  
Advisory Group ◽  
Good Service ◽  
Excellent Performance ◽  
Key Points ◽  
The Mean

BackgroundThe Clinical Standards Advisory Group was asked by UK health ministers to advise on the standards of clinical care being achieved for people with schizophrenia. A subcommittee commissioned a review of standards, followed by research into how far these were reflected in contracts and met by providers.MethodNo comprehensive but practical set of standards was found. A protocol of 143 items of good service practice was constructed, and applied by teams visiting services in 11 UK districts. The team appraisals were summarised in 20 key points, each scored 0 (absent) to 4 (excellent performance). Seven points were used to assess standards of commissioning and 13 for standards of service provision.ResultsWhen placed into rank order, the mean key point scores for commissioners and providers in the same district tended to be very similar. Total district scores were then used to assign districts to one of three groups. Four performed reasonably well, five were moderate and two were poor.ConclusionsOne of the key elements associated with these differences was the local level of morale. After wide consultation, a revised protocol of 26 key points for direct rating was drawn up and has since been further tested.

Autism and Neurodiversity: Addressing Concerns and Offering Implications for the School-Based Speech-Language Pathologist

2020 ◽  
pp. 1-7
Author(s):  
Laura S. DeThorne ◽  
Kelly Searsmith
Keyword(s):  
Service Provision ◽  
Individualized Education Program ◽  
Institutional Constraints ◽  
Individualized Education ◽  
Existing Structures ◽  
Eligibility Determination ◽  
Speech Language Pathologist ◽  
School Based ◽  
Key Points ◽  
C Center

Purpose The purpose of this article is to address some common concerns associated with the neurodiversity paradigm and to offer related implications for service provision to school-age autistic students. In particular, we highlight the need to (a) view first-person autistic perspectives as an integral component of evidence-based practice, (b) use the individualized education plan as a means to actively address environmental contributions to communicative competence, and (c) center intervention around respect for autistic sociality and self-expression. We support these points with cross-disciplinary scholarship and writings from autistic individuals. Conclusions We recognize that school-based speech-language pathologists are bound by institutional constraints, such as eligibility determination and Individualized Education Program processes that are not inherently consistent with the neurodiversity paradigm. Consequently, we offer examples for implementing the neurodiversity paradigm while working within these existing structures. In sum, this article addresses key points of tension related to the neurodiversity paradigm in a way that we hope will directly translate into improved service provision for autistic students. Supplemental Material https://doi.org/10.23641/asha.13345727

Quality of Life for Children with Persistent Sinonasal Symptoms

2003 ◽  
Vol 128 (1) ◽  
pp. 17-26 ◽  
Author(s):  
David J. Kay ◽  
Richard M. Rosenfeld
Keyword(s):  
Quality Of Life ◽  
Clinical Care ◽  
Longitudinal Change ◽  
Good Test ◽  
Routine Clinical Care ◽  
Before And After ◽  
The Mean ◽  
The Individual ◽  
Sinonasal Symptoms

OBJECTIVE: The goal was to validate the SN-5 survey as a measure of longitudinal change in health-related quality of life (HRQoL) for children with persistent sinonasal symptoms. DESIGN AND SETTING: We conducted a before and after study of 85 children aged 2 to 12 years in a metropolitan pediatric otolaryngology practice. Caregivers completed the SN-5 survey at entry and at least 4 weeks later. The survey included 5 symptom-cluster items covering the domains of sinus infection, nasal obstruction, allergy symptoms, emotional distress, and activity limitations. RESULTS: Good test-retest reliability ( R = 0.70) was obtained for the overall SN-5 score and the individual survey items ( R ≥ 0.58). The mean baseline SN-5 score was 3.8 (SD, 1.0) of a maximum of 7.0, with higher scores indicating poorer HRQoL. All SN-5 items had adequate correlation ( R ≥ 0.36) with external constructs. The mean change in SN-5 score after routine clinical care was 0.88 (SD, 1.19) with an effect size of 0.74 indicating good responsiveness to longitudinal change. The change scores correlated appropriately with changes in related external constructs ( R ≥ 0.42). CONCLUSIONS: The SN-5 is a valid, reliable, and responsive measure of HRQoL for children with persistent sinonasal symptoms, suitable for use in outcomes studies and routine clinical care.

Change in Service Provision Networks: The Case of Animal Welfare Services

2021 ◽  
pp. 0160323X2110092
Author(s):  
Laura A. Reese ◽  
Xiaomeng Li
Keyword(s):  
Service Provision ◽  
Survey Design ◽  
Participant Observation ◽  
Local Level ◽  
Major Change ◽  
Network Evolution ◽  
Political Factors ◽  
Before And After ◽  
Organizational Ties ◽  
The Impact

This research focuses on change within informal service provision networks, specifically examining the impact that changes within a key organization can have on the larger network. Employing a before and after survey design with a treatment at the midpoint and participant observation, it asks: What is the impact of a major change within one organization on the larger external network? What is the nature of the organizational ties? and, How do political factors exogenous to the network impact the network evolution process? The findings suggest that internal change within a focal actor can have ripple effects throughout the network increasing density. Public service provision at the local level can be enhanced through an increase in partnerships between the public and nonprofit sectors. However, network evolution can be limited by the larger political environment and lack of a coordinating role on the part of local government.

Plasma clearance and tissue distribution of labelled insulin-like growth factor-I (IGF-I), IGF-II and des(1–3)IGF-I in rats

1991 ◽  
Vol 128 (2) ◽  
pp. 197-204 ◽  
Author(s):  
F. J. Ballard ◽  
S. E. Knowles ◽  
P. E. Walton ◽  
K. Edson ◽  
P. C. Owens ◽  
...  
Keyword(s):  
Growth Factor ◽  
Binding Proteins ◽  
Rank Order ◽  
Insulin Like Growth Factor ◽  
Plasma Binding ◽  
Factor I ◽  
Igf I ◽  
The Mean ◽  
Growth Factor I ◽  
Sites Of Action

ABSTRACT Incubation of 125I-labelled insulin-like growth factor-I (IGF-I) with rat plasma at 4 °C led to the transfer of approximately half the radioactivity to 150 kDa and smaller complexes with IGF-binding proteins. The extent of association was greater with labelled IGF-II and essentially absent with the truncated IGF-I analogue, des(1–3)IGF-I. A greater degree of binding of IGF peptides with binding proteins occurred after i.v. injection of the tracers into rats, but most of the des(1–3)IGF-I radioactivity remained free. Measurement of the total plasma clearances showed the rapid removal of des(1–3)IGF-I compared with IGF-I and IGF-II; the mean clearances were 4·59, 1·20 and 1·34 ml/min per kg respectively. The mean steadystate volume of distribution was larger for des(1–3)IGF-I than for IGF-I and IGF-II (461, 167 and 181 ml/kg respectively), probably because of the differences in plasma protein binding. With all tracers, radioactivity appeared in the kidneys to a greater extent than in other organs. The amount of radioactivity found in the adrenals, brain, skin, stomach, duodenum, ileum plus jejunum and colon was in rank order, des(1–3)IGF-I > IGF-I > IGF-II. Since this ranking is the opposite of the abilities of the three IGF peptides to form complexes with plasma binding proteins, we propose that the plasma binding proteins inhibit the transfer of the growth factors to their tissue sites of action. Moreover, we suggest that IGF analogues that are cleared rapidly from blood may have greater biological potencies in vivo. Journal of Endocrinology (1991) 128, 197–204

The effect of sickle cell anemia on the linear growth of Nigerian children

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Ugo Nnenna Chikani ◽  
Adaobi Bisi-Onyemaechi ◽  
Ijeoma Ohuche ◽  
Justus Onu ◽  
Shalewa Ugege ◽  
...  
Keyword(s):  
Sickle Cell ◽  
Linear Growth ◽  
Clinical Care ◽  
Growth Failure ◽  
Age At Diagnosis ◽  
Height Velocity ◽  
Prospective Longitudinal Study ◽  
High Prevalence ◽  
The Mean ◽  
Prospective Longitudinal

Abstract Objectives Despite the high prevalence of children with sickle cell anaemia (SCA) in West Africa, there is paucity of data on the height velocity and prevalence of growth failure in SCA patients. With advances in clinical care of SCA patients, could there be a spatial and secular trend in the growth pattern of these children? Hence, the compelling needs to embark on this study. The objectives of the study were to determine the prevalence of growth failure among patients with SCA and its correlation with age, gender and age at diagnosis. Methods A Prospective longitudinal study of a cohort of sickle cell anaemic paediatric patients from Pediatrics SCA Clinic, University of Nigeria Teaching Hospital, Ituku Ozalla. Patients were enrolled over a period of two years using a non-parametric convenient sampling method. Their heights were measured at baseline, three months, six months and at 12 months intervals and subsequently plotted on a standard WHO growth chart. The height velocities at different monthly intervals were calculated and compared with the WHO standard normal linear growth rates) for children (used as control) to identify those with GF. (i.e. <10th percentile). The main outcome measures were the mean height velocities at different months' intervals calculated and compared using the repeated measurement analysis of variance (ANOVA) and the Wilcoxon signed test. Results A cohort of 316 children aged 1–18 years with SCA was evaluated with a male preponderance of 161 (57.4%). The mean age and age at diagnosis were 11.04 ± 5.56 and 4.2 ± 1.7 years, respectively. The prevalence of growth failure and short stature was 84.7%. The burden of GF was highest among post-pubertal participants (94.1%). The most important predictor of growth velocity deficit was age (R2=0.045, standard β coefficient = −0.22, t=−03.51, p=0.001). Conclusions The study demonstrated high prevalence of growth failure in children and adolescents with SCA which intensified with advancement in age and older age at diagnosis.

Intersibling Agreement for Goldberg's Big Five Adjective Markers

2000 ◽  
Vol 86 (2) ◽  
pp. 400-406 ◽  
Author(s):  
Richard P. Lanthier
Keyword(s):  
College Students ◽  
Relationship Quality ◽  
Big Five ◽  
Rank Order ◽  
Sibling Relationship ◽  
Peer Ratings ◽  
The Mean

In a sample of 240 college students intersibling agreement was examined for Goldberg's 100 unipolar Big Five adjective markers. Participants showed self-enhancement by rating themselves more favorably on three of the five traits (Agreeableness, Conscientiousness, and Culture/Intellect); however, self-ratings on Neuroticism were higher than siblings' ratings. Correlations among raters were moderate (mean r = .41) and comparable to values obtained in studies using peer ratings. The type of the sibling relationship, based on ratings of relationship quality, moderated the rank-order measures but not the mean agreement.

Word Associations and Meaningfulness Values for Grade-School-Aged Children

1964 ◽  
Vol 15 (2) ◽  
pp. 447-455 ◽  
Author(s):  
Sydelle Stone Shapiro
Keyword(s):  
Word Association ◽  
Rank Order ◽  
Group Analysis ◽  
The Other ◽  
Grade School ◽  
Word Associations ◽  
Significant Agreement ◽  
School Aged Children ◽  
The Mean ◽  
Group Sex

Multiple word associations to 65 words, 52 of which were CVCs, were obtained from 100 boys and 100 girls in Grades 4, 6, and 8, aged respectively, 9 and 10, 11 and 12, 13 and 14. Conventional word-association norms were developed for each of these grade-sex groups for first, second, and third responses, separately and pooled. Meaningfulness values for each word, defined as the mean number of associations, were also determined for each group. Analysis of the primaries disclosed that approximately half the set of words had primaries which were the same across all groups and that such primaries were on the average of much higher frequencies than primaries which differed among groups. Primaries which differed among groups very often occurred as secondaries or tertiaries of the other groups. Frequency of primaries did not vary between sexes or across grade-age levels. While m values for the set of words increased with grade and age, the rank ordering of these values was essentially the same within each grade-age-sex group. Sex was not related to m values. Values of m when compared with Noble's m′ showed significant agreement both for rank-order comparisons and values dichotomized into high and low categories.

scholarly journals Reference Standards for Cardiorespiratory Fitness by Cardiovascular Disease Category and Testing Modality: Data From FRIEND

2021 ◽  
Author(s):  
James E. Peterman ◽  
Ross Arena ◽  
Jonathan Myers ◽  
Susan Marzolini ◽  
Philip A. Ades ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cardiorespiratory Fitness ◽  
Clinical Care ◽  
Cardiopulmonary Exercise Testing ◽  
Age Groups ◽  
Reference Standards ◽  
National Database ◽  
Disease Category ◽  
Men And Women ◽  
The Mean

Background The importance of cardiorespiratory fitness for stratifying risk and guiding clinical decisions in patients with cardiovascular disease is well‐established. To optimize the clinical value of cardiorespiratory fitness, normative reference standards are essential. The purpose of this report is to extend previous cardiorespiratory fitness normative standards by providing updated cardiorespiratory fitness reference standards according to cardiovascular disease category and testing modality. Methods and Results The analysis included 15 045 tests (8079 treadmill, 6966 cycle) from FRIEND (Fitness Registry and the Importance of Exercise National Database). Using data from tests conducted January 1, 1974, through March 1, 2021, percentiles of directly measured peak oxygen consumption (VO 2peak ) were determined for each decade from 30 through 89 years of age for men and women with a diagnosis of coronary artery bypass surgery, myocardial infarction, percutaneous coronary intervention, or heart failure. There were significant differences between sex and age groups for VO 2peak ( P <0.001). The mean VO 2peak was 23% higher for men compared with women and VO 2peak decreased by a mean of 7% per decade for both sexes. Among each decade, the mean VO 2peak from treadmill tests was 21% higher than the VO 2peak from cycle tests. Differences in VO 2peak were observed among the age groups in both sexes according to cardiovascular disease category. Conclusions This report provides normative reference standards by cardiovascular disease category for both men and women performing cardiopulmonary exercise testing on a treadmill or cycle ergometer. These updated and enhanced reference standards can assist with patient risk stratification and guide clinical care.

scholarly journals Stigma associated with and attitude regarding mental health help-seeking among undergraduate nursing students in Karachi, Pakistan

2021 ◽  
Author(s):  
Salima Farooq ◽  
Yasmin Parpio ◽  
Saadia Sattar ◽  
Zahra Ali ◽  
Shirin Rahim ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Nursing Students ◽  
Living Arrangements ◽  
Help Seeking ◽  
Undergraduate Nursing Students ◽  
Undergraduate Nursing ◽  
History Of ◽  
Seeking Help ◽  
The Mean

Abstract Background Globally, the prevalence of mental illness amongst university students is a major concern; same is the case with nursing students. Unaddressed mental illness stigma contributes towards hiding of symptoms hampers timely identification of the disease, and leads to reluctance in attitude towards seeking help. This study determined personal and perceived depression stigma and attitude towards help-seeking behaviors and its associated factors, among undergraduate nursing students at a private nursing institution in Karachi, Pakistan. Methods We conducted a cross-sectional study by recruiting 246 first and second-Year undergraduate nursing students using consecutive sampling. Data were collected using the Depression Stigma Scale (DSS) and the Attitude toward Seeking Professional Psychological Help Scale (ATSPPHS), along with a demographic questionnaire. Chi-square test, Fischer’s exact test and student T test were used to determine significance of difference of each response between first and second year students. Multiple linear regression was employed to determine predictors of DSS and ATSPPHS. Approval was obtained from the university’s Ethics Review Committee. Results The study findings revealed that the mean scores of the personal and perceived stigma scales were 29.7 ± 4.9 and 24.3 ± 6.1, respectively. The mean score of ATSPPHS was 16.5 ± 3.8. The participants reported a mean openness score of7.8 ± 2.6 and a value scale score of 8.7 ± 3.0. A history of psychiatric illness, current living arrangements, and personal depression stigma were found to be significant predictors of ATSPHHS. The year of study was a significant predictor of personal depression stigma whereas both years of study and the current living arrangements were significantly associated with perceived depression stigma. Conclusion Attitude towards seeking help for mental illness was significantly influenced by personal and perceived stigma. Moreover, previous history of psychiatric illness and living arrangements also predicted attitudes towards seeking help. In order to encourage positive attitudes towards seeking help for students’ well-being, it is essential to destigmatize mental health issues by adapting context-based, individualized, and group mental health interventions.

scholarly journals Number of long-term inpatients in Japanese psychiatric care beds: trend analysis from the Patient Survey and the 630 Survey

2020 ◽  
Author(s):  
Tatsushi Okayama ◽  
Kentaro Usuda ◽  
Emi Okazaki ◽  
Yoshio Yamanouchi
Keyword(s):  
Mental Illness ◽  
Psychiatric Care ◽  
Patient Survey ◽  
Multifaceted Approach ◽  
The Past ◽  
Natural Decrease ◽  
Hospital Bed ◽  
The Mean ◽  
Using Data

Abstract BackgroundThe number of psychiatric care beds and the mean length of stay in psychiatric care beds in Japan have decreased over the past 10 years. However, as has long been indicated here and elsewhere, Japan lags behind other countries in terms of deinstitutionalization. Furthermore, the population of inpatients in psychiatric care beds is aging dramatically. In addition to the diversification of mental illness, the question of what measures to implement going forward regarding current psychiatric bed resources has emerged as a new challenge.MethodsUsing data from the Patient Survey and the 630 Survey, we examined trends in the number of long-term inpatients in psychiatric care beds in Japan through 2040. Population estimation was used for estimating long-term hospital bed demand because of small fluctuations in the admission and discharge of long-term inpatients.ResultsIn 2017, nearly one-third of all long-term hospitalized patients were aged ≥75 years, and an estimated 47% of the total are expected to die by 2040. Thus, the overall demand for long-term hospitalization is forecast to decrease sharply due to aging of currently hospitalized long-term inpatients. The number of long-term inpatients in 2017 was 167,579, and this is projected to decrease to 103,141 in 2040.ConclusionsWe believe it is necessary to adopt a multifaceted approach to promote hospital discharge and transition to the community, and to address the diversification of mental illness and the issue of psychiatric care bed supply/availability, which are forecast to decrease due to the natural decrease in long-term inpatients.

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