Suchergebnisse

Das Problem der Bewertung von Bildungsprogrammen in Südafrika wird als zentral angesehen. Vorgestellt wird die Entwicklung verschiedener Formen und Methoden mit dem Ziel, Bildungsprogramme während ihres Ablaufs zu korrigieren. (DÜI-Wsl)

This study identifies the underlying patterns of persistent biblical allusion in the work of renowned playwright Bertolt Brecht. Rather than reducing Brecht's use of the Bible to the purely satirical, the author interprets the full dramatic function of Brecht's complex use of scripture. Using examples from plays written throughout the span of Brecht's career, Murphy shows how Brecht invokes the stories of Old Testament figures such as Job and Isaiah as well as the crucifixion accounts of the New Testament in order to build sympathetic characters and explore his more political themes.

BackgroundPrevious studies and national reports have all noted that a significant proportion of the young people who display harmful sexual behaviours have intellectual disabilities. However, research on the topic has been scarce. This study presents a systematic review of the literature relating to clinical instruments specifically developed or adapted for adolescents with intellectual disabilities who display harmful sexual behaviours.MethodAn electronic search of databases was completed for published articles in English from the earliest possible date to the end of 2013.ResultsNo published articles met the full search criteria. This confirmed the lack of published clinical measures, apart from two risk assessment instruments.ConclusionsGiven the lack of measures, it is recommended that the focus of future research needs to be on developing or adapting instruments that will offer researchers' and clinicians' empirical as well as clinical data on this all‐too‐often‐overlooked population of vulnerable youth.

BackgroundIn other populations, the psychological impact of abuse has been conceptualized as Post Traumatic Stress Disorder (PTSD, DSM‐IV, American Psychiatric Association (APA), 1994), but little is known about whether this is appropriate for adults with severe intellectual disabilities and very limited communication skills.MethodsAn informant interview, based on the framework provided by PTSD, but supplemented with additional questions, was developed and was used to elicit the emotional, behavioural and physiological symptoms of alleged abuse in 18 people with intellectual disabilities at three time points: in the 3 months immediately prior to the alleged abuse (Time 1), in the 3 months immediately after the abuse (Time 2) and in the last 3 months prior to interview (Time 3).ResultsThe reports of the family and carer informants indicated that, following their alleged abuse, the victims experienced marked increases in the frequency and severity of emotional, physiological and behavioural symptoms of psychological distress. Over time, there was some alleviation of these difficulties, but psychological functioning remained severely compromised.ConclusionsWhile the established PTSD framework is appropriate for examining the psychological impact of abuse, some amendments are required to enable clinicians to examine fully the distress of alleged victims with severe intellectual disabilities.

Twenty‐six people with mild intellectual disabilities and challenging behaviour, who had all been service‐users at a specialist, hospital‐based unit, were interviewed after they had left the service for an average of four and a half years, about their current quality of life and their memories of the service. On the whole, people were still living in the community though many had had a large number of placement moves (and some had returned to hospital or prison). The service‐user's overall quality of life in their current placement was as good as that of the general population in the less restrictive environments but fell increasingly short of this standard as the placements became more restrictive. Even in the best placements people's social relationships appeared impaired when compared to the general population. With respect to their memories of the specialist service, it appeared that, despite the time period, service‐users had a clear memory of the service, appreciated many aspects of it (such as the help staff provided, the therapy and education), were divided about some aspects (such as having to be in hospital, being detained under the Mental Health Act 1983, taking medication) and had very strongly negative feelings about aspects of the care which directly restricted their liberty (such as the locking of the front door, the use of restraint and seclusion). It is argued that there may be a need to re‐think services for service‐users with challenging behaviour and mild intellectual disabilities.

The purpose of this presentation is to describe an ongoing research programme in Kenya, which seeks to take a multidisciplinary approach to understanding the current state of care for sick newborns and how sustainable changes can be made. This work engages potentially influential professionals, as well as political groupings from the outset to help inform the design of contextually relevant strategies based on a broad understanding of stakeholder positions.

Background: Improving the quality of facility based neonatal care is central to tackling the burden of neonatal mortality in Low and Middle Income Countries (LMIC). Quality neonatal care is highly dependent on nursing care but a major challenge facing health systems in LMICs is human resource shortage. In Kenya, task-shifting among professional care cadres is being discussed as one potential strategy of addressing the human resource shortage, but little attention is being paid to the potential for task-shifting in the provision of in-patient sick newborn care. This study identified key neonatal policy-making and implementation stakeholders in Kenya and explored their perceptions of task-shifting in newborn units. Methods: The study was exploratory and descriptive, employing qualitative methods including: document review, stakeholder analysis, observation of policy review process meetings and stakeholder feedback. A framework approach was used for analysis. Results: In Kenya, guidelines for the care of sick neonates exist but there are few specialized neonatal nurses and no policy documents outlining the nurse to patient ratio required in neonatal care or other higher dependency areas. The Ministry of Health, Nursing Council of Kenya and international agencies were identified as playing key roles in policy formulation while County governments, the National Nurses Association of Kenya and frontline care providers are central to implementation. Newborns were perceived to be highly vulnerable requiring skilled care but in light of human resources challenges, most expressed some support for shifting 'unskilled' tasks. However, a few of the key implementers were concerned about the use of unqualified staff and all stakeholders emphasized the need for training, regulation and supervision. Conclusions: Task-shifting has the potential to help address human recourse challenge in low-income settings. However, any potential task-shifting intervention in neonatal care would require a carefully planned process involving all ...