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The study evaluated the quality and costs of services for 16 young adults with dual sensory impairments and mental retardation before and during their placement at a specialist community-based residential further education facility. The results indicated that, overall, both the quality and costs of services were higher than in previous placements. However, there were wide variations among clients on all the dimensions studied, and there was no overall relationship between the costs and quality of services.

COVID-19 has exacerbated pre-existing difficulties children and adults with disability face accessing quality health care. Some people with disability are at greater risk of contracting COVID-19 because they require support for personal care and are unable to physically distance, e.g. those living in congregate settings. Additionally, some people with disability have health conditions that put them at higher risk of poor outcomes if they become infected. Despite this, governments have been slow to recognise, and respond to, the unique and diverse health care needs of people with disability during COVID-19. While some countries, including Australia, have improved access to high-quality health care for people with disability others, like England, have failed to support their citizens with disability. In this Commentary we describe the health care responses of England and Australia and make recommendations for rapidly improving health care for people with disability in the pandemic and beyond.

AbstractAspects of the treatment and management of challenging behaviour were investigated among 500 adults with intellectual disabilities receiving various forms of residential supports. The present results indicated that: (1) 53% of participants were reported to have shown at least one 'moderately serious' or 'severe' form of challenging behaviour in the previous month; (2) the most commonly employed management strategies were physical restraint (used with 44% of people showing challenging behaviour), sedation (35%), seclusion (20%) and mechanical restraint (3%); (3) the most commonly employed 'treatment strategies' were goal setting within individual programme plans (used with 62% of people showing challenging behaviour), antipsychotic medication (49%), written intervention programmes (23%) and written behaviourally orientated intervention programmes (15%); and (4) factors identified through logistic regression analyses to be associated with the use of specific treatment and management strategies included personal characteristics of the person with intellectual disabilities (e.g. age and diagnosis of autism), resources (e.g. type of accommodation, cost of provision and staffing levels), the organization of resources (e.g, planning of support to residents) and the nature of the challenging behaviour (e.g. more sustained episodes of challenging behaviour).

Background:- The UK Equality Act 2010 requires providers of health services to make changes or 'reasonable adjustments' to their practices in order to protect disabled people from discrimination or disadvantage when accessing care. Existing evidence suggests that despite this legislation, health services are not always providing reasonably adjusted care for disabled people. This paper presents the perspectives of disabled people themselves in relation to their experiences of accessing reasonable adjustments in hospitals in England. Methods:- Twenty-one semi-structured interviews were held with disabled people who had a recent experience of hospital care in England. Participants were asked about the extent to which the hospital provided reasonably adjusted care, and if necessary, how they thought the provision of reasonable adjustments could be improved. Each interview was anonymised and transcribed, and the data analysed using thematic analysis. Results:- Participants reported mixed experiences about whether and how reasonable adjustments were provided: some shared positive examples of good practice; others spoke about difficult encounters and limited provision. Recommendations made include a need for culture change in how reasonable adjustments are perceived and enacted; improvements in identifying the needs of disabled people; improvements to the hospital environment and the provision of information; and the need to involve disabled people themselves in the process of change. Conclusions:- Gaps remain in how reasonable adjustments are provided for disabled people accessing hospital care. It is important for hospital staff to listen to the perspectives of disabled people about the provision of reasonable adjustments, and make improvements as necessary. Hospital staff could also do more to share good practice in relation to the provision of reasonable adjustments to effectively inspire and embed positive change.

The Statues and Legacies of Combat Athletes in the Americas brings together an interdisciplinary team of scholars to explore the layered histories and meanings associated with public monuments to combat athletes from a variety of sporting backgrounds.