Targeted support and telecare in staffed housing for people with intellectual disabilities: impact on staffing levels and objective lifestyle indicators.

BACKGROUND: Increased provision of out-of-family residential support is required because of demographic changes within the intellectual disabilities population. Residential support now has to be provided in a climate requiring both financial constraint and high quality service outcomes. The aim was to evaluate the quality of life consequences of living with less intensive staff support, resulting from the introduction of more targeted staff allocation coupled with telecare. METHODS: The study comprised 91 participants who lived in 33 settings. The targeted support/telecare intervention was implemented at staggered intervals in 25 of these settings (63 participants). Data on a range of participant and setting descriptors, quality of care, and a range of objective lifestyle indicators were collected at four points in time over 2 years. Impact of the intervention was evaluated using within-group comparisons over time. RESULTS: Comparison between pre- and post-intervention showed that staffing levels were significantly reduced by 23%, whereas they were constant in the absence of intervention. One health indicator improved in the absence of intervention and another improved following intervention. There were no significant changes in any other lifestyle indicators (safety, money, social and community activity, independence or choice). CONCLUSIONS: A combination of targeted support and telecare had no adverse short-term affect on participants' quality of life, but reduced staff input so it seems that they have a role to play in the strategic development of out-of-family placements for adults with intellectual disabilities. Further research is needed to explore in more detail how efficiency is achieved in practice.

Global social identity and global cooperation.

This research examined the question of whether the psychology of social identity can motivate cooperation in the context of a global collective. Our data came from a multinational study of choice behavior in a multilevel public-goods dilemma conducted among samples drawn from the general populations of the United States, Italy, Russia, Argentina, South Africa, and Iran. Results demonstrate that an inclusive social identification with the world community is a meaningful psychological construct that plays a role in motivating cooperation that transcends parochial interests. Self-reported identification with the world as a whole predicts behavioral contributions to a global public good beyond what is predicted from expectations about what other people are likely to contribute. Furthermore, global social identification is conceptually distinct from general attitudes about global issues, and has unique effects on cooperative behavior.

Embracing the opportunity to make sustainable improvements to nutritional care in all settings.

The enactment of the Health and Social Care Act 2008 represents a watershed moment in the history of the delivery of high quality nutritional care. The problem of undernutrition has been an intractable issue in health and social care for decades. This new act comes at the same time as a range of new initiatives, such as the high impact actions for nursing and midwifery, which include an action to stop inappropriate weight loss and dehydration in NHS care. Poor nutritional care equals poor quality care; it is an expensive waste of resources that the NHS can ill afford as we meet the challenge of delivering comprehensive healthcare in this financial climate.

Physical and mental health status of Hurricane Katrina evacuees in Houston in 2005 and 2006.

OBJECTIVES: Hurricane Katrina necessitated the evacuation of over 200,000 individuals into Houston. This study compared characteristics of three samples of evacuees with those of the U.S. population and examined how evacuees' experiences have changed over time. METHODS: Sub-populations of evacuees in Houston were surveyed immediately following the hurricane, two months afterwards, and one year later. Demographic characteristics, socioeconomic status, physical and mental health status, and access to care of the most disadvantaged evacuees in Houston were analyzed. RESULTS: Predominantly, evacuees surveyed were Black, low-income, unemployed, and facing challenges accessing health care. Twenty-eight percent felt their health was worse than it was before Katrina. Almost 60% of evacuees reported nervousness, restlessness, worthlessness, hopelessness, and spells of terror or panic at least a few times a week. CONCLUSIONS: The evacuees displaced by the storm experienced loss of full-time employment, income, and deteriorating health, as well as struggles accessing necessary physical and mental health care.