The effect of a novel ADL-based training program on performance of activities of daily living and physical fitness

The purpose of this study was to determine the degree to which a novel training program based on activities of daily living (ADL) would affect performance of ADLs, as well as the fitness of older adults. Fourteen individuals (mean age 82 years) took part in a 10-week control period followed by a 10-week ADL-based training program. Pre- and posttests included the Physical Performance Test (PPT), the Physical Functional Performance-10 (PFP-10), and the Senior Fitness Test (SFT). After the training period, improvements ranging from 7% to 33% (p<.05) were seen on the PPT and PFP-10 and on three items of the SFT. After conversion to standard scores, the magnitude of change in the PPT and the PFP10 was significantly greater (p<.05) than the magnitude of change in the SFT. These data support the idea that this novel ADL-based training program was able to facilitate improved performance of ADLs, as well as select measures of fitness among older adults.     

Complexities in attracting and retaining direct support professionals

Recruiting and retaining direct support professionals (DSPs) remains essential to the full inclusion for persons with disabilities. Using a mixed-evaluation model, we measured DSPs' views versus those of their supervisors. DSPs expressed lower perceptions concerning their supervisors, satisfaction with their work situation, and environmental and safety factors. Focus groups provided insights into resolving issues related to compensation, work environment, and recruiting and retaining future DSPs. Motivating factors included wanting to be part of a helping community where all are valued. To improve their performance, DSPs stated their desire to understand the roles of managers and of the consumer. DSPs indicated that having career paths that provided advancement opportunities and direct contact with persons with disabilities were primary motivators.     

“It’s Not My Fault!” Status,Attributions, and Perceptions of Injustice: The Case of Custodians and Teachers

Perceptions of injustice rely upon a sense-making process in which individuals attempt to understand why and how it occurs. We draw from the attribution-of-blame model of justice judgments to examine how two work groups of disparate status make sense of the treatment and outcomes engendered by their interactions. Data from 27 in-depth interviews with custodians and teachers reveal that when custodians perceive disrespect from teachers and teachers perceive that custodians do not fulfill properly their duties, their attributions are shaped by their status position. Although both make internal attributions to each other for their injustice, teachers do not recognize how they perpetrate injustice against custodians and custodians perceive greater injustice by identifying how external factors affect their performance and blame. This unjustified blame fosters counterproductive work behaviors, illustrating how interdependencies fuel a cycle of injustice. We discuss the implications of these findings for the school and justice processes.     

Unanticipated ethical issues in a participatory research project with individuals with intellectual disability

The conduct of a participatory research investigation into the everyday literacy of adults with intellectual disability within the context of a PhD thesis highlighted issues related to the ethics of participatory research and the need to revisit and reconsider ethical guidelines around working with individuals with intellectual disability. Tensions were identified between participatory research ideology and the reality of research experiences, with additional issues arising due to disability in the first author.     

Care without coercion – mental health rights,personal recovery and trauma‐informed care

Australian mental health services continue to use involuntary measures in response to consumers' mental distress. Regardless of the intent behind these practices, the experience of being forced to receive treatment, be secluded or restrained is traumatic and can cause further distress and harm. Other parts of the health or social service system have shifted to approaches that emphasise agency, social context, prevention, and rights. Three frameworks currently used in mental health services – human rights, personal recovery, and trauma‐informed – are consistent with a shift away from the use of force. We applied these frameworks to the text of the National Standards for Mental Health Services 2010 to analyse the degree to which it reflects a shift. We also analysed the public text of speakers' notes from the Care Without Coercion Conference 2012 concerning lived experiences of force in mental health services. The analysis highlights force in many aspects of policy. The findings have implications for directions of change, including freedom from violence; support for decision making; access and choice about community and inpatient options; safety and risk management; and greater understanding of current policy frameworks through engagement with people with lived experience about the options and impact of support processes that exclude the use of force.     

Reports of Conferences,Institutes, and Seminars

This installment of "Serials Spoken Here" covers events that transpired between late September and late October 2008. Reported herein are two Webinars, one on ONIX for Serials, the other on SUSHI, and two conferences: the eighty-fourth annual Meeting of the Potomac Technical Processing Librarians and the New England Library Association's Annual Conference.     

Medicare and Amyloid PET Imaging: The Battle Over Evidence

We examine a recent dispute regarding the Centers for Medicare and Medicaid Services’ (CMS) refusal to unconditionally pay for amyloid positron emission tomography (PET) imaging for Medicare beneficiaries being assessed for Alzheimer’s disease. CMS will only pay for amyloid PET imaging when patients are enrolled in clinical trials that meet certain criteria. The dispute reflects CMS’s willingness in certain circumstances to require effectiveness evidence that differs from the Food and Drug Administration’s standard for pre-market approval of a medical intervention and reveals how stakeholders with differing perspectives about evidentiary standards have played a role in attempting to shape the Medicare program’s coverage policies.