Resilience Processes Supporting Adolescents With Intellectual Disability: A Multiple Case Study

2016 ◽  
Vol 54 (1) ◽  
pp. 45-62 ◽  
Author(s):  
Anna-Marié Hall ◽  
Linda C. Theron

Abstract Resilience, or the process of adjusting well to risk, relies on constructive collaboration between youths and their social ecologies. Although the literature details the risks of an intellectual disability (ID), there is little explanation of why some young people cope well despite these risks. Accordingly, we report a multiple case study that affords insight into the resilience of 24 adolescents with ID. Using a draw-and-talk methodology, these young people explained their resilience as enabled primarily by supportive social ecologies (which facilitated behavioral and emotional regulation, encouraged mastery, treated them as agentic beings, and offered safe spaces). Adolescents' positive orientation to their life-worlds co-facilitated their resilience. These insights advance effective ways to champion the resilience of young people with ID.

2021 ◽  
Author(s):  
Amy Jongkind ◽  
Michelle Hendriks ◽  
Koen Grootens ◽  
Aartjan Beekman ◽  
Berno van Meijel

UNSTRUCTURED Background Around one-third of all patients with schizophrenia are classified as "treatment-resistant". Across the globe, there is under-treatment with clozapine and other effective treatment options for people with treatment-resistant schizophrenia (TRS). In this respect, it appears that regular healthcare models do not optimally fit this particular patient group. The Collaborative Care model (CC) has proven to be effective for patients with severe mental illness, both in primary care and in specialized mental healthcare facilities. The key principles of the CC model is that both patients and informal caregivers are part of the treatment team, that a structured treatment plan is put in place with planned evaluations by the team, and that the treatment approach is both multidisciplinary in nature and uses evidence-based interventions. We have developed a tailored CC-program for patients with TRS (CC-TRS). In this paper, we provide an overview of the research design for a potential study that seeks to gain insight into both the process of implementation and the preliminary effects of CC-TRS. Moreover, we will aim to gain insight into the experiences of professionals, patients and informal caregivers with the program. Methods The study will be underpinned by a multiple case-study design (N = 20) that utilizes a mixed-methods approach. These case studies will focus on one Early Intervention in Psychosis Team (EIT) and two Flexible Assertive Community treatment (FACT) teams in the Netherlands. Data will be collected from patients’ records as well as through questionnaires, individual interviews and focus groups. We began the process of recruiting patients in October 2020. Discussion The research design is discussed in line with the aims of the study, which are framed within the process of developing and testing innovative interventions. The limitations in clinical practice as well as their specific consequences for this study are explained. Trial registration AsPredicted (#62738), pre-registration titled 'Collaborative care for patients with treatment-resistant schizophrenia', registered 13 April 2021. https://aspredicted.org/gk958.pdf.


Author(s):  
Helen Perks ◽  
Dominic Medway

This article investigates the nature of resource-based processes in the development of new ventures, adopting a business duality lens. Business duality occurs where a new venture is developed alongside an established business. The research employs a multiple case study methodology situated in the farming sector. The details of resource assembly and deployment are examined and presented through four stages of the entrepreneurial process: initiation, experimentation, mature and late stage. The findings offer insight into the manner in which resource ties between the businesses relate to processes of resource assembly and deployment and in addition, inform a business duality-based taxonomy. This depicting three generic approaches to managing resource-based processes in the development of new ventures in the farming sector: holistic innovators, reactive innovators and cautious innovators. We conclude by considering the implications of our arguments for new venture activity in other business duality contexts.


2019 ◽  
Vol 26 (6) ◽  
pp. 1-15 ◽  
Author(s):  
Leigh Hale ◽  
Emile Vollenhoven ◽  
Lisa Caiman ◽  
Alice Dryselius ◽  
Yvette Buttery

Background/AimsMany people with intellectual disability fall frequently. Understanding fall prevention intervention characteristics will assist efficacy trials to target appropriate people. An exploration of two exercise-based fall prevention interventions is reported, focusing on viability and acceptability.MethodsA multiple case study of adults with intellectual disability completing either the group Otago Exercise Programme or the Prevention of Falls for Adults with Intellectual Disability intervention was performed. Integrated data sources were used: semi-structured interviews with participants and support workers, observations, attendance/adherence, falls, adverse events and balance measures.ResultsIn total, seven adults with varying intellectual disability levels participated. Overall, three themes enabled understanding of suitability of people to each intervention: suitability of the exercises; role of the environment; and benefits to participants.ConclusionsEducating adults with intellectual disability and their support workers of the importance of regular exercise is key to participation. Both programmes required high levels of support and prioritisation to ensure exercises occurred and were carried out safely.


2020 ◽  
Author(s):  
◽  
Evgeniya Lupova

This research develops insight into the functioning of self-aware and organised clusters seeing these as ‘context-embedded meta-organisations’. Specifically, it builds a theoretical framework for strategy-making in organised clusters, elaborates on their ‘agentic’ nature and ability to shape their environments. Contrary to a more ‘traditional’, determinist, approach in cluster studies, viewing clusters solely as ‘geographic concentrations’ of organisations, the perspective adopted in this research conceptualises clusters as ‘organisations of organisations’. This suggests a more voluntarist stance where self-aware and organised clusters are perceived as intentional actors within their environments implementing deliberate strategies and pursuing system-level goals. This perspective is rather novel in cluster studies and opens up interesting research directions. This thesis explores two major implications of the ‘meta-organisational’ view of clusters: (1) the deliberate nature of collective strategy-making in these and (2) clusters’ ‘actorhood’ and their interactions with their contexts. First, seeing clusters as ‘organisations of organisations’, suggests that these can be deliberately managed and calls for the application of management studies to the cluster context. However, to date, most strategy tools and frameworks have been developed with an individual firm in mind. As a consequence, these cannot reflect the complexity of the ‘meta-organisational’ setting where a number of interests are at play, and strategy-making is a collective exercise. Thus, the ‘meta-organisational’ perspective on clusters calls for the adaptation of the extant strategy frameworks to account for the specifics of the setting. To answer the need for strategy tools and approaches adapted to the context of clusters seen as meta-organisations, this thesis proposes a novel framework of the ‘cluster business model’. This topic is addressed in Article 1 adopting a design science approach to develop a practical tool for strategy- and decision-making in clusters. The article proposes a model describing value creation in the cluster context, develops a method for its application in practice as well as a visual representation of both. Moreover, as clusters are increasingly seen as drivers of innovations and mechanisms for a transition towards the knowledge economy, this thesis develops a set of interventions for cluster business model design fostering the innovativeness of its members. Article 2 addresses this topic and applies a mixed methodology combining a systematic literature review with a design-oriented synthesis. This allows to uncover the generative mechanisms of cluster innovativeness and formulate a set of interventions aimed at shaping cluster business model elements with a view to fostering its innovativeness. Second, the meta-organisational perspective on clusters raises important questions about their intentionality and ‘actorhood’. Indeed, seeing clusters as ‘organisations of organisations’ implies that these can deliberately act, just as individual organisations. This view, again, has not yet been explored in the cluster studies, still dominated by the ‘traditional’, determinist, approach. Recent research in the field of organisation studies suggests that organisations may display different levels of ‘organisationality’ depending on the extent to which the attributes of formal organisations are present. Applying this knowledge to clusters allows uncovering the yet unexplored mechanisms of cluster ‘actorhood’ and its limitations. Article 3 explores this topic and applies a theory-elaborating multiple case study method to gather insight into the clusters’ ability to shape their environments mediated by their level of ‘organisationality’. The article develops a set of theoretical propositions based on the case studies of two clusters in Australia. It suggests that clusters can deliberately ‘construct’ themselves both as organisations and social actors. However, their ‘organisationality’ design choices influence the locus of their actorhood resulting in more or less collaborative approaches to social action. Finally, and related to the previous point, viewing clusters as intentional actors capable of interaction with their environments, suggests that these can adopt deliberate strategies in response to external pressures. Going further, clusters can be seen as change agents or institutional entrepreneurs in unsupportive institutional settings. Article 4 explores this topic and adopts a theory-elaborating embedded multiple case study method. It studies two clusters in the context of a transition economy (Russia) presenting a range of institutional barriers to innovation. The article uncovers the dual role of clusters as institutional entrepreneurs. It suggests that clusters may both act collectively due to their powerful position grouping a number of players, and, at the same time, these can contribute to creating enabling conditions for the individual acts of institutional entrepreneurship. While this thesis offers a range of implications for research and practice in the cluster field, its most broad and significant contribution lies in the further development of the novel ‘meta-organisational’ perspective on self-aware and organised clusters. This research thus contributes to the consolidation of the ‘meta-organisational’ perspective and coins new language for addressing the topic of ‘managed’ or ‘organised’ clusters. This perspective has not yet drawn wide attention in cluster research and practice but can be valuable for empowering clusters and giving them practical tools to exercise their collective power and shape their environments. In a way, this ‘meta-organisational’ view of clusters might become ‘self-fulfilling’ by contributing to shaping the perception of clusters as deliberate and organised actors, triggering a reflection of cluster practitioners and providing them with adapted conceptual frameworks and practical tools


Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3058
Author(s):  
Michał Skrzypek ◽  
Wojciech Koch ◽  
Karolina Goral ◽  
Klaudia Soczyńska ◽  
Olga Poźniak ◽  
...  

(1) Background: Considering the limited amount of available data on the diet quality of children, adolescents, and young adults with an intellectual disability (ID) in Poland, as well as the higher incidence of nutritional disorders among people with ID in comparison to the general population, a study was conducted to assess the quality of diet in community-dwelling young individuals with ID. (2) Methods: A multiple-case study was carried out to obtain data on anthropometric parameters and food records over a three-day observation period for 18 subjects with ID. The nutritional value of the products and dishes consumed by the subjects was calculated using the commercial computer program Kcalmar.pro (Hermax, Poland), which contains the Polish database of the nutritional value of food products and dishes. The results presented here are those of a pilot study of a wider research project. (3) Results: The study group consisted of seven women (38.9%) and 11 men (61.1%) with an average age of 12.94 years (range 4.00–22.00) and an average BMI of 25.2 (range 14.5–35.4). The obtained results confirmed the suboptimal pattern of nutrition in children and adolescents with ID. Regarding energy intake and dietary macronutrients, only in 27.8% of cases, energy intake exceeded the Estimated Energy Requirement corresponding to age, sex, body weight, and height. Most of the respondents were characterized by correct intake of proteins, fats, and carbohydrates, and 83.3% showed excessive intake of saturated fatty acids. Excessive intake of vitamins B1, B2, and B6 was observed in all subjects, and that of vitamins B3 (niacin), B12, A, and C in the vast majority of subjects, while deficiency of vitamin D was observed in all individuals and folic acid in 22.2% of individuals. Excessive intake of minerals, such as sodium, phosphorus, and magnesium was noted among most of the respondents, while the intake of calcium and iodine was found to be insufficient. Compared to people with less severe ID (grades 1 and 2), people with grade 3 ID showed significantly lower intake/reference fulfillment of dietary components such as vitamin B6, potassium, phosphorus, iron, copper, iodine, magnesium, and zinc. No significant differences were noted in the nutritional reference fulfillment for various nutrients among the groups distinguished by sex, nutritional status, or the cause of ID. (4) Conclusion: Health supervision guidelines proposed for persons with ID should take into account the dietary practices of the families caring for them, with an emphasis on the prevention and correction of irregularities that may reduce the effectiveness of rehabilitation and deteriorate the health of the affected people. Caregivers/parents of each person with ID who took part in the study were given individualized dietary advice aimed at correcting the dietary abnormalities.


Author(s):  
Melanie Elliott ◽  
Paula Gardner ◽  
Miya Narushima ◽  
Lynn McCleary

ABSTRACTAn aging population and increasing rates of dementia point to the need for alternative strategies that allow individuals to age in place. This multiple case study explored, from an insider’s perspective, the role and meaning of music for individuals with dementia who are aging in place. Methods were semi-structured interviews, observations, and videos. The study’s central theme is connection, with three types of “connectors” – self, partner, and music – as subthemes. Connection to self involves present moment awareness, accessing memories, and self-expression. Connection to partner builds on self-connection and spending time together with music. Lastly, the connection to music builds on the previous two subthemes as well as the desire to keep things “normal”. This study provides insight into the growing body of interdisciplinary literature dedicated to dementia, music, aging in place, and contemplative practices, as well as implications for aging and caring for someone with dementia.


2016 ◽  
Vol 7 (1) ◽  
pp. 62-72
Author(s):  
Martin Blok Johansen

The words ‘children’ (Danish: ’børn’) and ‘young people’ (Danish: ’unge’) are so often combined that they almost have the character of idiomatic expressions. But what differences in the use of the words can be found? This article seeks to study the prevalent, dominant discourses about children and young people. In particular, it endeavours to answer the following question: What is thematized, and how are the thematizations created and maintained? The study is theoretically inspired by Foucault’s discourse analysis. The methodological approach is that of a multiple case study. Thus, it provides examples of how children are typically referred to in positive terms such as innocent, imaginative, cheerful, spontaneous, creative and competent (a surplus discourse), while young people are typically referred to in negative terms such as irresponsible, rootless, violent, dysfunctional, hedonistic and unaccountable (a deficit discourse).


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