Enhancing staff attitudes, knowledge and skills in supporting the self-determination of adults with intellectual disability in residential settings in Hong Kong: A pretest-posttest comparison group design

Background: The ecological perspective recognizes the critical role that is played by rehabilitation personnel in helping people with intellectual disability (ID) to exercise self-determination, particularly in residential settings. In Hong Kong, the authors developed the first staff training programme of its kind to strengthen the competence of personnel in this area. The purpose of this study was to examine the effectiveness of staff training in enhancing residential staff's attitudes, knowledge and facilitation skills in assisting residents with ID to exercise self-determination. Methods: A pretest-posttest comparison group design was adopted. Thirty-two participants in an experimental group attended a six-session staff training programme. A 34-item self-constructed scale was designed and used for measuring the effectiveness of the staff training. Results: The results showed that the experimental group achieved statistically significant positive changes in all domains, whereas no significant changes were found in the comparison group. Conclusions: The findings provided initial evidence of the effectiveness of staff training that uses an interactional attitude-knowledge-skills model for Chinese rehabilitation personnel. The factors that contributed to its effectiveness were discussed and recommendations for future research were made. © Journal Compilation © 2007 Blackwell Publishing Ltd.postprin

Paralytic shellfish poisoning (PSP) toxin binders for optical biosensor technology: problems and possibilities for the future: a review

This review examines the developments in optical biosensor technology, which uses the phenomenon of surface plasmon resonance, for the detection of paralytic shellfish poisoning (PSP) toxins. Optical biosensor technology measures the competitive biomolecular interaction of a specific biological recognition element or binder with a target toxin immobilised onto a sensor chip surface against toxin in a sample. Different binders such as receptors and antibodies previously employed in functional and immunological assays have been assessed. Highlighted are the difficulties in detecting this range of low molecular weight toxins, with analogues differing at four chemical substitution sites, using a single binder. The complications that arise with the toxicity factors of each toxin relative to the parent compound, saxitoxin, for the measurement of total toxicity relative to the mouse bioassay are also considered. For antibodies, the cross-reactivity profile does not always correlate to toxic potency, but rather to the toxin structure to which it was produced. Restrictions and availability of the toxins makes alternative chemical strategies for the synthesis of protein conjugate derivatives for antibody production a difficult task. However, when two antibodies with different cross-reactivity profiles are employed, with a toxin chip surface generic to both antibodies, it was demonstrated that the cross-reactivity profile of each could be combined into a single-assay format. Difficulties with receptors for optical biosensor analysis of low molecular weight compounds are discussed, as are the potential of alternative non-antibody-based binders for future assay development in this area

The experience of mothers supporting self‐determination of adult sons and daughters with intellectual disability

Background: The right of people with disability to be self‐determining, to live a life of their choosing, is increasingly recognized and promoted. For adults with intellectual disability, support to enable self‐determination may be required. This is often provided by family, yet little is understood about the experience of providing such support. Methods: An interpretative phenomenological analysis (IPA) of eight individual, semi‐structured interviews with mothers was conducted, to understand the meaning given to their experience of supporting self‐determination of their adult son or daughter with intellectual disability. Results: Three superordinate themes were identified: (a) support context; (b) continuum of support roles; and (c) mother's personal concerns. Conclusion: Mothers of adults with intellectual disability experience an ongoing sense of responsibility to balance competing rights and concerns as they support self‐determination. This complex, interdependent relationship results in roles that may facilitate, guide, influence and at times restrict choice and control

Community Adjustment of Young Adults with Mental Retardation: A Developmental Perspective

The community adjustment of young adults with mental retardation remains a crucial issue for all human service providers. No longer does adjustment imply simply the physical integration of persons with disabilities into community settings. Rather, it refers to the adjustment and integration of the whole person into community life. Whether one describes community adjustment as a process, an outcome, a philosophy, or a multidimensional concept (Bachrach, 1981), community adjustment has become synonymous with the term quality-of-life, a quality that depends in large part on one’s happiness and success in socially sanctioned, age-appropriate tasks

Community Adjustment of Young Adults with Mental Retardation: Overcoming Barriers to Inclusion

Movement of persons with mental retardation out of institutions and into community settings is occurring at an ever-increasing pace (Amado, Lakin, & Menke, 1990). State and federal laws have legitimized the basic rights of persons with mental retardation to live, work, and participate in typical community settings. Yet, physical integration is not synonymous with full community inclusion. Numerous barriers remain that serve as obstacles to successful assimilation into community life. For instance, successful social integration depends on attitudinal changes of persons without mental retardation—families, friends, service-delivery professionals, and the general public—toward persons with mental retardation. The way young adults with mental retardation are perceived by others often restricts their opportunities for participation in activities that allow for development of social relationships, enhancement of self-esteem, and enjoyment of life. Removal of such barriers requires that they first be identified. Action plans and strategies can then be developed to remove, or at the least minimize, effects upon the quality-of-life experienced by this segment of the population

Portable Wearable Upper Limb Exoskeletons on Activities of Daily Living and Motor Function After Stroke: A Systematic Review and Meta-Analysis

Aim: To summarise, appraise, and analyse current literature to determine the effectiveness of portable wearable exoskeletons in improving activities of daily living and gross motor function in the upper limb of stroke survivors. Design: Systematic review and meta-analysis. Method: A systematic review of the literature was conducted using four databases to evaluate portable wearable exoskeletons on activities of daily living and gross motor function. Included studies were independently reviewed, and data was extracted and synthesized as per the PRIMSA guidelines. Studies with similar data points were compared with a meta-analysis. Results: Eleven articles, 147 participants, were included in this review. Two studies used the same exoskeleton whereas nine studies used different exoskeletons. The methodological critically appraisal ranged from poor to good. Six studies used elbow exoskeletons and five studies used hand exoskeletons. Meta-analysis showed statistically significant improvements in gross motor function and range of motion for elbow exoskeletons, and positive trends were seen for hand exoskeletons. No significant changes were demonstrated for activities of daily living outcomes. Conclusion: When using portable wearable exoskeletons for post-stroke upper limb rehabilitation can aid the gross motor recovery. However, no significant changes were seen for activities of daily livings. Key Practice Points: Following a stroke, thousands of movement repetitions are needed for recovery. Utilizing an exoskeleton with stroke survivors could allow them to complete their therapy in the comfort of their homes or outside of structured therapy. Clinicians prescribing exoskeletons of the elbow will observe an improvement in gross motor function

Devices used for shoulder subluxation in a stroke population: a systematic review

Aim: This systematic review aims to examine the current literature for the common devices used to manageshoulder subluxation following stroke and whether the effectiveness of these devices is short or long-ter