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Background  An important question in community living is what factors influence the extent to which staff provide 'active support'.Methods  Engagement, care practices and a range of staff and organizational characteristics were studied in 72 residential homes serving 359 adults with intellectual disabilities. Managers in 36 settings were trained in person‐centred active support (PCAS). A group comparison design and multivariate analysis was used to investigate the relationship between variables.Results  The PCAS group showed more active support, assistance, other contact from staff and engagement in meaningful activity but no difference in choice‐making or assessment of participation in activities of daily living. The PCAS group had more staff with a professional qualification, were more likely to think that challenging behaviour was caused by lack of stimulation, had attitudes more in line with a policy of community care, rated most care tasks as less difficult, and were more organized to deliver active support. The comparison group were more likely to think that challenging behaviour was learned negative behaviour, showed more teamwork and were more satisfied. Multivariate analysis identified a range of staff and organizational variables associated with engagement and active support.Conclusions  The results suggest that some variables which have not hitherto been studied in relation with active support are associated with it. Professional qualification, knowledge and experience appear to be important as do some staff attitudes, clear management guidance, more frequent supervision and team meetings, training and support for staff to help residents engage in meaningful activity.

Background: With increasing reductions in funding for social care across many countries, the need to ensure that resources are used to best effect is becoming increasingly important, in particular for those with severe and complex needs. Methods: In order to explore the outcomes and costs of skilled support for this group of people, quality of life was assessed for 110 people in 35 services in England. Information on costs was also collected. Results: People who received consistently good active support experienced better outcomes in terms of several quality of life domains. Good support did not require significantly more staff time and there was no evidence of higher total costs for those receiving good support. Conclusions: The inclusion of active support in government guidance and local commissioning practices related to people with severe intellectual disabilities is likely to improve user outcomes. Observation should be an important element in measuring service quality.

Changing opportunities for active citizenship in europe : understanding the lived experiences of persons with disabilities -- Connecting lived lives and disability policy : active citizenship from a life-course perspective -- Life-course interviews on disability and active citizenship : collecting and analysing big qualitative data -- Changes and diversity in community living in europe : the experiences of persons with disabilities -- Diversity and change in the labour market careers of persons with disabilities -- Identity and political participation throughout the life course : the experiences of persons with disabilities in european countries -- Active citizenship in using accessible technology : the experiences of three generations -- How do persons with psychosocial disabilities experience and practice active citizenship in education and work? -- The role of the family in structuring the opportunities for exercising active citizenship among persons with disabilities -- Gendering active citizenship: experiences of women with disabilities -- Transitions to active citizenship for young persons with disabilities : virtuous and vicious cycles of functionings -- Technologies for active citizenship and the agency of objects -- Rethinking active citizenship: lessons from life-course interviews in nine european countries -- Index

"Over the last three decades, a number of reforms have taken place in European social policy with an impact on the opportunities for persons with disabilities to be full and active members of society. The policy reforms have aimed to change the balance between citizens' rights and duties and the opportunities to enjoy choice and autonomy, live in the community and participate in political decision-making processes of importance for one's life. How do the reforms influence the opportunities to exercise Active Citizenship? This volume presents the findings from the first cross-national comparison of how persons with disabilities reflexively make their way through the world, pursuing their own interests and values. The volume considers how their experiences, views and aspirations regarding participation vary across Europe. Based on retrospective life-course interviews, the volume examines the scope for agency on the part of persons with disabilities, i.e. the extent to which men and women with disabilities are able to make choices and pursue lives they have reasons to value. Drawing on structuration theory and the capability approach, the volume investigates the opportunities for exercising Active Citizenship among men and women in nine European countries. The volume identifies the policy implications of a process-oriented and multi-dimensional approach to Active Citizenship in European disability policy. It will appeal to policymakers and policy officials, as well as to researchers and students of disability studies, comparative social policy, international disability law and qualitative research methods."--Provided by publisher

Kvalita veřejných služeb, včetně sociálních služeb je tématem často diskutovaným mezi tvůrci sociálních politik, poskytovateli sociálních služeb a těmi, kteří zastupují uživatele služeb. Cílem této studie bylo zjistit, jak respondenti – zástupci veřejné správy, poskytovatelé sociálních služeb a uživatelé vnímají kvalitu sociálních služeb, se zvláštním zaměřením na to: (1) co hodnotí respondenti jako důležité; (2) jaká je relativní vnímaná důležitost každé domény a jak se tato vnímaná důležitost liší mezi kategoriemi respondentů a (3) jak se tato důležitost liší v závislosti na charakteristikách respondentů. Speciálně navržený dotazník vyplnilo 217 poskytovatelů služeb, 249 zástupců veřejné správy a 205 uživatelů sociálních služeb. Subjektivní kvalita života uživatelů služeb byla všemi třemi kategoriemi respondentů hodnocena jako nejdůležitější ukazatel kvality služeb. Obzvláště důležité pak byly položky, které se týkaly povahy vztahů a interakcí mezi zaměstnanci a uživateli služeb. Existovaly určité rozdíly mezi kategoriemi respondentů a také podle jejich charakteristik. Respondenti veřejné správy, starší uživatelé služeb a poskytovatelé rezidenční péče hodnotili zdravotní péči mnohem důležitěji než ostatní respondenti. V článku jsou diskutovány také některé přístupy k hodnocení kvality. ; Quality of public services including social services is an issue frequently discussed by policy makers, service providers, and by those who represent service users. The aim of this study was to explore how stakeholders perceive quality of social services, with a particular focus on (1) what did participants rate as important; (2) what is the relative importance of each domain and how does that differ across stakeholder groups and (3) does importance vary by participant characteristics. A specially designed questionnaire was completed by 217 service providers, by 249 public administration representatives and 205 service users of residential care and in-home support. The subjective quality of life of service users was rated as the most important indicator of service quality by all three stakeholder groups. Particularly important were items that related to the nature of the relationships and interactions between staff and service users. There were some differences between stakeholder groups and also by respondent characteristics – public administration respondents, older service users and providers of residential care were more likely to rate health care as more important than other respondents. Implications for how quality is measured are discussed.

10.3201/eid0703.017320 ; Emerging infectious diseases ; 7 ; 3 ; 463-465

BackgroundPeople with severe and profound intellectual disabilities often spend substantial time isolated and disengaged. The nature and quality of the support appears to be important in determining quality of life.MethodsStructured observations and staff questionnaires were used to explore the quality of life and quality of support for 110 people with severe and profound disabilities and complex needs.ResultsOn average, people spent approximately 40% of their time engaged in meaningful activities, received contact from staff 25% of the time (6% in the form of assistance to be engaged). Just over one‐third received consistently good active support, which was associated with other measures of quality of support and emerged as the strongest predictor of outcomes.ConclusionsQuality of life and quality of support were relatively poor, although with about one‐third of people receiving skilled support. Consistently good active support was the best predictor of outcome and proposed as a good indicator of skilled support.

BackgroundThis study reports the experiences of developing and pre‐testing an Easy Read version of the Adult Social Care Outcomes Toolkit (ASCOT) for self‐report by people with intellectual disabilities.MethodsThe study has combined survey development and pre‐testing methods with approaches to create accessible information for people with intellectual disabilities. A working group assisted researchers in identifying appropriate question formats, pictures and wording. Focus groups and cognitive interviews were conducted to test various iterations of the instrument.ResultsSubstantial changes were made to the questionnaire, which included changes to illustrations, the wording of question stems and response options.ConclusionsThe process demonstrated the benefits of involving people with intellectual disabilities in the design and testing of data collection instruments. Adequately adapted questionnaires can be useful tools to collect information from people with intellectual disabilities in survey research; however, its limitations must be recognized.

This is the final version. Available from the publisher via the DOI in this record. ; There is an on-going need to develop new insecticides that are not compromised by resistance and that have improved environmental profiles. However, the cost of developing novel compounds has increased significantly over the last two decades. This is in part due to increased regulatory requirements, including the need to screen both pest and pollinator insect species to ensure that pre-existing resistance will not hamper the efficacy of a new insecticide via cross-resistance, or adversely affect non-target insect species. To add to this problem the collection and maintenance of toxicologically relevant pest and pollinator species and strains is costly and often difficult. Here we present Fly-Tox, a panel of publicly available transgenic Drosophila melanogaster lines each containing one or more pest or pollinator P450 genes that have been previously shown to metabolise insecticides. We describe the range of ways these tools can be used, including in predictive screens to avoid pre-existing cross-resistance, to identify potential resistance-breaking inhibitors, in the initial assessment of potential insecticide toxicity to bee pollinators, and identifying harmful pesticide-pesticide interactions. ; European Research Council (ERC) ; European Union's Horizon 2020 research and innovation programme ; Biotechnology and Biological Sciences Research Council (BBSRC)

It is increasingly recognised that instead of relying on top-down commands or leaving individuals to their own devices, communities should be given a role in tackling challenges exacerbated by global crises. Written by a team of leading experts with in-depth knowledge and on-the-ground experience, this book sets out why and how people's lives can be positively transformed through diverse forms of community involvement. This book critically explores examples from around the world of how communities can become more collaborative and resilient in dealing with the problems they face, and provides an invaluable guide to what a holistic policy agenda for community-based transformation should encompass

This is the final version of the article. Available from the publisher via the DOI in this record. ; The impact of neonicotinoid insecticides on the health of bee pollinators is a topic of intensive research and considerable current debate [1]. As insecticides, certain neonicotinoids, i.e., N-nitroguanidine compounds such as imidacloprid and thiamethoxam, are as intrinsically toxic to bees as to the insect pests they target. However, this is not the case for all neonicotinoids, with honeybees orders of magnitude less sensitive to N-cyanoamidine compounds such as thiacloprid [2]. Although previous work has suggested that this is due to rapid metabolism of these compounds [2, 3, 4, 5], the specific gene(s) or enzyme(s) involved remain unknown. Here, we show that the sensitivity of the two most economically important bee species to neonicotinoids is determined by cytochrome P450s of the CYP9Q subfamily. Radioligand binding and inhibitor assays showed that variation in honeybee sensitivity to N-nitroguanidine and N-cyanoamidine neonicotinoids does not reside in differences in their affinity for the receptor but rather in divergent metabolism by P450s. Functional expression of the entire CYP3 clade of P450s from honeybees identified a single P450, CYP9Q3, that metabolizes thiacloprid with high efficiency but has little activity against imidacloprid. We demonstrate that bumble bees also exhibit profound differences in their sensitivity to different neonicotinoids, and we identify CYP9Q4 as a functional ortholog of honeybee CYP9Q3 and a key metabolic determinant of neonicotinoid sensitivity in this species. Our results demonstrate that bee pollinators are equipped with biochemical defense systems that define their sensitivity to insecticides and this knowledge can be leveraged to safeguard bee health. ; his study received funding from Bayer AG. C.B. received funding from the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation programme (grant agreement no. 646625 ). C.B. and K.B. received funding from Biotechnology and Biological Sciences Research Council (BBSRC, award number 15076182 ). The work at Rothamsted forms part of the Smart Crop Protection (SCP) strategic programme ( BBS/OS/CP/000001 ) funded through the Biotechnology and Biological Sciences Research Council's Industrial Strategy Challenge Fund.