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1.
J Appl Behav Anal ; 34(3): 341-4, 2001.
Article in English | MEDLINE | ID: mdl-11678530

ABSTRACT

We attempted to increase one aspect of self-determination among 3 supported workers with multiple disabilities. Following Baer's (1998) self-determination conceptualization, the workers were exposed to two conditions that involved working more versus less independently based on availability of assistive devices. Next, their condition preferences were assessed and honored. All participants consistently chose the more independent condition. Results reflect how self-determination may be enhanced by giving workers increased control over work situations.


Subject(s)
Disabled Persons/psychology , Employment, Supported , Personal Autonomy , Adult , Aged , Choice Behavior , Disability Evaluation , Female , Humans , Male , Middle Aged
2.
Am J Ment Retard ; 106(5): 460-9, 2001 Sep.
Article in English | MEDLINE | ID: mdl-11531464

ABSTRACT

Many adults with severe disabilities spend considerable amounts of time in segregated day programs. We evaluated the degree to which these programs support purposeful and age-appropriate activity. Observations in 100 congregate community and institutional program sites indicated that approximately half of consumer time was spent in purposeful activity, 75% of which was age-appropriate. In 20% of the sites, though, most activity was age-inappropriate. These results, which were similar across community and institutional settings, are discussed in terms of respective program administrators evaluating their supports through comparisons with activity involvement in other programs and the need for changes in programs providing primarily age-inappropriate activities.


Subject(s)
Activities of Daily Living , Day Care, Medical , Intellectual Disability/rehabilitation , Adult , Community Mental Health Services , Education of Intellectually Disabled , Female , Humans , Male , Occupational Therapy , Program Evaluation , Residential Facilities , Self Care
3.
Res Dev Disabil ; 22(2): 151-64, 2001.
Article in English | MEDLINE | ID: mdl-11325162

ABSTRACT

Adults with severe multiple disabilities constitute a very small percentage of individuals in supported work. When these persons do obtain community jobs, considerable assistance is usually required. We evaluated an off-site/on-site program for reducing job coach assistance provided for three adults with severe multiple disabilities in a part-time community job. Following observations of the supported workers' job performance in a publishing company, the job support reduction program was implemented while the individuals received more traditional day services when not at work. The program involved assessing the amount and type of assistance provided for each step in a worker's job tasks, and then reducing the assistance through environmental adaptations and instruction. After implementation in the nonwork setting, the adaptations and instruction were extended to the work site. Immediate reductions occurred in the amount of assistance provided by job coaches for each supported worker while on the job. No adverse effects on productivity were observed. These results suggest that an off-site/on-site approach to reducing work assistance represents a viable alternative to current supported work models. Social validity observations in 10 job sites highlighted the need to demonstrate ways to reduce work assistance provided for workers with severe multiple disabilities. Future research areas are noted, focusing on evaluating other models for enhancing supported work opportunities for people with highly significant disabilities.


Subject(s)
Disabled Persons/psychology , Employment, Supported , Extinction, Psychological , Rehabilitation, Vocational , Adaptation, Psychological , Adult , Aged , Female , Humans , Male , Middle Aged , Severity of Illness Index , Workplace
4.
Lancet ; 356(9234): 1035, 2000 Sep 16.
Article in English | MEDLINE | ID: mdl-11041433
5.
Fertil Steril ; 73(1): 157-61, 2000 Jan.
Article in English | MEDLINE | ID: mdl-10632432

ABSTRACT

OBJECTIVE: To evaluate the ability of collagen film, collagen gel, sodium hyaluronate/carboxymethylcellulose film, and fibrin glue to prevent adhesion formation. DESIGN: Randomized trial using a rat model of a standardized abdominal wound and cecal wound. SETTING: University research laboratory. ANIMAL(S): Sprague-Dawley female rats. INTERVENTION(S): Resorbable barriers or no barrier (controls) were placed between an abdominal wall wound (1 cm x 2 cm) and a similarly sized cecal wound. MAIN OUTCOME MEASURE(S): Adhesion formation between wounds was assessed and quantitated 7 days after surgery. RESULT(S): Without treatment, 34 of 35 untreated rats (97%) developed adhesions. Treatment with collagen gel (3 of 33 rats), collagen film (3 of 10 rats), or sodium hyaluronate/carboxymethylcellulose film (2 of 10 rats) significantly reduced the incidence of adhesion formation. Treatment with fibrin sealant resulted in 9 of 10 animals having adherent wounds 7 days after surgery. CONCLUSION(S): Resorbable barriers of collagen gel, collagen films and sodium hyaluronate/carboxymethylcellulose film were effective in significantly reducing adhesion formation. Fibrin sealant at 7 days had an incidence of adhesion formation similar to that in untreated control animals.


Subject(s)
Postoperative Complications/prevention & control , Surgical Equipment , Tissue Adhesions/prevention & control , Animals , Biomedical and Dental Materials , Carboxymethylcellulose Sodium , Collagen , Female , Fibrin Tissue Adhesive , Hyaluronic Acid , Random Allocation , Rats , Rats, Sprague-Dawley
6.
Sex Health Exch ; (1): 4-5, 2000.
Article in English | MEDLINE | ID: mdl-12295989

ABSTRACT

The prevalence of HIV infection in Indonesia is generally held to be low. Since the first case was officially identified in 1987, only 1146 people have been diagnosed with HIV, 293 of them reported as having AIDS. The latest estimate from WHO (June 1999) is that 250,000 Indonesians are infected, giving a prevalence among this 200+ million population of around 120/100,000 population. This figure is generally agreed to be in the correct range--for sexual transmission of the virus. It is probable, however, that the total figure may be several times higher as a result of the sudden explosion of injecting drug use, with no surveillance and little outreach yet having been undertaken among this group.


Subject(s)
Acquired Immunodeficiency Syndrome , HIV Infections , Prevalence , Risk Factors , Asia , Asia, Southeastern , Biology , Developing Countries , Disease , Indonesia , Research , Research Design , Virus Diseases
7.
J Appl Behav Anal ; 33(4): 639-42, 2000.
Article in English | MEDLINE | ID: mdl-11214041

ABSTRACT

We investigated a brief, embedded assessment for evaluating preferences sampled from person-centered plans. After developing person-centered plans for individuals with multiple disabilities, systematic assessments were conducted with preferences sampled from the plans. An assessment of sampled preferences was then embedded within the participants' daily routines. The two assessments identified similar preferences based on participant approach responses. Both assessments also indicated inconsistencies with reported preferences in the person-centered plans. Overall, results suggested the embedded assessment may be an alternative means of evaluating some preferences reported through person-centered planning.


Subject(s)
Choice Behavior , Disabled Persons , Intellectual Disability/psychology , Mental Health Services/statistics & numerical data , Adult , Female , Humans , Intellectual Disability/diagnosis , Male , Middle Aged , Severity of Illness Index
8.
Lancet ; 354(9178): 601-2, 1999 Aug 14.
Article in English | MEDLINE | ID: mdl-10470735
9.
J Appl Behav Anal ; 32(2): 137-46; quiz 146-7, 1999.
Article in English | MEDLINE | ID: mdl-10396767

ABSTRACT

A program was developed to reduce indices of unhappiness that accompanied therapeutic exercise routines among people with profound multiple disabilities. Indices of unhappiness were recorded, using an observation system that had been validated through previous research involving happiness-related variables, while support personnel conducted exercises with 3 participants. A multicomponent program was then implemented that involved presenting highly preferred stimuli before, during, and after each exercise session. Results indicated that the program was accompanied by reduced indices of unhappiness for each participant relative to the traditional method of conducting the exercises, although changes in the preferred stimuli used with 1 participant were required before consistent reductions occurred. Results are discussed regarding the importance of reducing unhappiness indices as a means of enhancing aspects of the daily quality of life for people with profound multiple disabilities. Areas for future research are also discussed, focusing on expanding the unhappiness-reduction procedures to other routine events that may occasion indices of unhappiness.


Subject(s)
Disabled Persons/psychology , Happiness , Intellectual Disability/psychology , Quality of Life , Adult , Aged , Choice Behavior , Communication , Humans , Intellectual Disability/diagnosis , Intellectual Disability/therapy , Middle Aged , Severity of Illness Index
10.
J Biomed Mater Res ; 48(4): 479-81, 1999.
Article in English | MEDLINE | ID: mdl-10421690

ABSTRACT

Heat treatment of the ears of knotted sutures markedly enhances knot security. Using coated polyester sutures commonly used in arthroscopic surgery, heat treatment of the knot ears allows secure knot construction to be achieved with a two throw granny (1 x 1) or square (1 = 1) knot. A heat source is being designed for secure knot construction in arthroscopic surgery.


Subject(s)
Suture Techniques , Sutures , Arthroscopy , Biocompatible Materials , Hot Temperature , Humans , In Vitro Techniques , Materials Testing , Polyesters , Tensile Strength
11.
Behav Modif ; 23(2): 280-93, 1999 Feb.
Article in English | MEDLINE | ID: mdl-10224953

ABSTRACT

This investigation evaluated a behavioral means of identifying sources of happiness and unhappiness among individuals with profound multiple disabilities. Indices of happiness and unhappiness were defined, and a corresponding observation system was developed and implemented with five students in an adult education classroom. Each student was observed while participating in two separate classroom activities. Results indicated the definitions and the observation system reliably identified different frequencies of happiness and/or unhappiness indices for each student across separate activities. Results are discussed regarding routine use of the observation system to evaluate classroom activities for effects on student happiness as a measure of quality of life. Future research needs are discussed in terms of determining means to alter certain classroom procedures that are accompanied by indices of student unhappiness.


Subject(s)
Disabled Persons/psychology , Education, Special/methods , Quality of Life , Adult , Female , Happiness , Humans , Male , Nonverbal Communication
12.
Lancet ; 353(9150): 412, 1999 Jan 30.
Article in English | MEDLINE | ID: mdl-9950476
13.
J Appl Behav Anal ; 32(4): 467-77, 1999.
Article in English | MEDLINE | ID: mdl-10641301

ABSTRACT

Person-centered planning is becoming a popular means of designing supports for people with disabilities. However, very little research evaluating person-centered planning exists. We evaluated the degree to which items and activities reported to be preferred in person-centered plans represented accurate preferences based on how individuals responded when presented with the items and activities. Person-centered planning meetings were conducted with 4 individuals with profound multiple disabilities to develop preference maps and to identify leisure-related preferences. A sample of the reported preferences in the plans was then systematically assessed by observing each participant's approach and avoidance responses to the items and activities. Of the sampled items and activities reported to be preferred in the plans, 42% represented moderate preferences based on the latter assessment process and 33% represented strong preferences. With 2 participants, several preferences identified in the plans were nonpreferred items and activities based on the preference assessments, and some were frequently avoided. These results suggested that although person-centered plans may identify some accurate preferences for people with profound multiple disabilities, this approach should be used cautiously. Results also suggested that such plans should be supplemented with systematic preference assessments to ensure the accuracy of identified preferences. Future research areas focus on evaluating other aspects of person-centered planning.


Subject(s)
Behavior Therapy , Disabled Persons/rehabilitation , Intellectual Disability/rehabilitation , Motivation , Patient Care Planning , Adult , Disabled Persons/psychology , Education of Intellectually Disabled , Female , Humans , Individuality , Intellectual Disability/psychology , Male , Patient Care Team , Token Economy
14.
J Emerg Med ; 16(4): 635-9, 1998.
Article in English | MEDLINE | ID: mdl-9696184

ABSTRACT

Lactomer and the Polyglactin 910 are coated synthetic braided absorbable sutures commonly used for dermal wound closure. Biomechanical performance tests demonstrated superior performance characteristics of the Lactomer sutures. Using narrow diameter sutures, the Lactomer sutures exhibited superior knot holding forces over the Polyglactin 910 sutures. Moreover, knot security could be reliably achieved with asymmetric and symmetric knots using the Lactomer sutures.


Subject(s)
Sutures , Biomechanical Phenomena , Polyglactin 910 , Polymers
15.
J Appl Behav Anal ; 31(2): 281-5, 1998.
Article in English | MEDLINE | ID: mdl-9652103

ABSTRACT

We evaluated a prework assessment for predicting work-task preferences among workers with severe multiple disabilities prior to beginning supported work. The assessment involved comparing worker selections from pairs of work tasks drawn from their future job duties. Results of workers' choices once they began their jobs in a publishing company indicated that the assessment predicted tasks that the workers preferred to work on during their job routines. Results are discussed regarding other possible means of determining preferred types of supported work.


Subject(s)
Developmental Disabilities/rehabilitation , Employment, Supported , Job Satisfaction , Vocational Guidance/methods , Adult , Aged , Female , Humans , Male , Middle Aged , Task Performance and Analysis
16.
J Long Term Eff Med Implants ; 8(3-4): 225-31, 1998.
Article in English | MEDLINE | ID: mdl-10186968

ABSTRACT

The purpose of this study was to quantitate the effect of two monofilament synthetic absorbable sutures as well as a new monofilament synthetic absorbable suture, glycomer 631, in healing musculoaponeurotic incisions in rats. Because these three monofilament synthetic absorbable sutures provided secure closure of laparotomy incisions, their clinical use in laparotomy incisions is recommended.


Subject(s)
Abdominal Muscles/surgery , Dioxanes , Polymers , Sutures , Analysis of Variance , Animals , Evaluation Studies as Topic , Female , Rats , Rats, Sprague-Dawley , Surgical Wound Dehiscence/etiology , Surgical Wound Dehiscence/prevention & control , Suture Techniques/statistics & numerical data , Sutures/statistics & numerical data
17.
Res Dev Disabil ; 17(6): 467-85, 1996.
Article in English | MEDLINE | ID: mdl-8946570

ABSTRACT

Shortcomings in the technology for training support staff in methods of teaching people with severe disabilities recently have resulted in calls to improve the technology. We evaluated a program for training basic teaching skills within one day. The program entailed classroom-based verbal and video instruction, practice, and feedback followed by on-the-job feedback. In Study I, four undergraduate interns participated in the program, and all four met the mastery criterion for teaching skills. Three teacher aides participated in Study 2, with results indicating that when the staff applied their newly acquired teaching skills, students with profound disabilities made progress in skill acquisition. Clinical replications occurred in Study 3, involving 17 staff in school classrooms, group homes, and an institution. Results of Studies 2 and 3 also indicated staff were accepting of the program and improved their verbal skills. Results are discussed regarding advantages of training staff in one day. Future research suggestions are offered, focusing on identifying means of rapidly training other teaching skills in order to develop the most effective, acceptable, and efficient technology for staff training.


Subject(s)
Community Mental Health Services , Education of Intellectually Disabled , Inservice Training , Intellectual Disability/rehabilitation , Residential Facilities , Adolescent , Adult , Curriculum , Female , Humans , Male , Middle Aged , Patient Care Team
18.
J Appl Behav Anal ; 29(1): 67-78, 1996.
Article in English | MEDLINE | ID: mdl-8881345

ABSTRACT

In this study we attempted to operationalize, measure, and increase happiness among people with profound disabilities. Happiness indices were defined and observed among 5 individuals. Validation measures indicated that (a) increases in happiness indices were observed when individuals were presented with most preferred stimuli relative to least preferred stimuli, (b) increases in unhappiness indices were observed when they were presented with least preferred relative to most preferred stimuli, and (c) practitioner ratings of participant happiness coincided with observed indices. Subsequently, classroom staff increased happiness indices through presentation and contingent withdrawal of activities. Results suggested that a behavioral approach can enhance happiness as one aspect of quality of life among people with profound disabilities. Research directions are offered that focus on using a behavioral approach to investigate other private events that are important among people with disabilities.


Subject(s)
Disabled Persons/psychology , Education of Intellectually Disabled , Happiness , Intellectual Disability/psychology , Adolescent , Adult , Behavior Therapy , Female , Humans , Intellectual Disability/rehabilitation , Male , Motivation , Personality Assessment , Quality of Life
19.
J Long Term Eff Med Implants ; 6(3-4): 181-98, 1996.
Article in English | MEDLINE | ID: mdl-10167360

ABSTRACT

The clinical and mechanical performance of a new, monofilament, synthetic absorbable suture (Biosyn) was evaluated and compared to that of a braided synthetic absorbable suture (Vicryl). The monofilament synthetic absorbable suture was significantly stronger than the braided synthetic absorbable suture over the 4 weeks of implantation. In addition, the monofilament suture potentiated less bacterial infection than did the braided suture. The handling characteristics of the monofilament suture were superior to the braided suture because the monofilament suture required fewer throws to achieve knot security, encountered lower drag forces in fascia and colon, and had a greater double-wrapped first-throw knot security. Evaluated independently in clinical settings, the monofilament sutures were found to have excellent strength, first-throw hold, knot security, passage through tissue, knot repositioning, and ease of handling.


Subject(s)
Biocompatible Materials , Polyglactin 910 , Sutures , Abdominal Muscles/surgery , Animals , Biomechanical Phenomena , Dermatologic Surgical Procedures , Dioxanes , Female , Genital Diseases, Female/surgery , Hip Prosthesis , Humans , Mice , Polymers , Prospective Studies , Rats , Rats, Sprague-Dawley , Staphylococcal Infections/physiopathology , Surgical Wound Infection/microbiology , Suture Techniques , Swine , Tensile Strength
20.
J Appl Behav Anal ; 27(3): 519-31, 1994.
Article in English | MEDLINE | ID: mdl-7928793

ABSTRACT

We investigated whether variations in alertness among individuals with profound multiple disabilities affected subsequent responsiveness to training programs. Three experiments were conducted involving 5 people. In Experiment 1, results indicated that alertness of 3 individuals increased with provision of skill-acquisition training programs. Results also indicated no predictive relationship between alertness levels prior to training and subsequent responsiveness to training. Experiment 2 replicated results of Experiment 1 with 2 participants from Experiment 1 and an additional participant. Results of Experiment 2 also indicated that the increased alertness levels accompanying provision of training were not a function of the participants simply being in an inactive environment prior to training. Results of Experiment 3 indicated that alertness of an additional participant increased through provision of another training intervention, involving a systematic preference assessment. Responses during the preference assessment appeared to be unrelated to previously existing alertness levels. These findings suggest the need for caution when considering the withholding of scheduled training because an individual appears to be nonalert.


Subject(s)
Arousal , Attention , Disabled Persons/psychology , Education of Intellectually Disabled/methods , Intellectual Disability/psychology , Activities of Daily Living , Adult , Behavior Therapy/methods , Behavior Therapy/standards , Education of Intellectually Disabled/standards , Female , Humans , Observer Variation , Reinforcement, Psychology , Reproducibility of Results , Social Environment , Wakefulness
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