Parent/carer views on personal health budgets for disabled children who use rehabilitation therapy services

Personalised budgets are promoted as the person centred alternative to generically provided services. Nine parent/carers of children with physical disabilities ( aged 18 years or younger) who accessed at least two rehabilitation services ( physiotherapy, occupational therapy, and speech and language therapy ) were recruited from one region in England. Focus group/interviews explored their views on the proposed introduction of personalised budgets. Parents/ carers viewed a personal health budget with caution and perceived benefits were tempered by experiences of current provision. Concerns were raised about entitlement and how a personal budget would work in practice

Greater choice and control ? parent carer views on personal health budgets for disabled children who use rehabilitation therapy services.

Aim Personalised budgets have been suggested as the person-centered alternative to generically provided services, where families can exercise greater ‘choice and control’ and decide which services to buy for their disabled child and how to arrange care, taking individual circumstances, preferences and needs into account (NHS England, Patient Participation Team 2014). This poster examines the responses of parents interviewed about the prospect of using a personalised health budget for their children in relation to rehabilitation therapy at a time of significant cut backs in child health services (British Academy of Childhood Disability & British Association for Community Child Health 2014). Method We recruited nine parents and primary carers of children with physical disabilities (aged 18 years or younger) from one region in England who accessed at least two rehabilitation therapy services (physiotherapy, occupational therapy, and speech and language therapy). A focus group / interview guide was developed to explore themes that included parent/carer views on the proposed introduction of personalised budgets and how this might affect care. All focus groups and one-to-one interviews were recorded and transcribed verbatim. The focus group and face-to-face interviews lasted for around 1 hour, telephone interviews were typically shorter (30-45 minutes). Interview data was entered into NVIVO and analysed using ‘framework analysis’ (Pope and Mays 2006). Results Parents/carers viewed the prospect of greater ‘choice and control’ with caution and perceived benefits were tempered by both positive and negative experiences of current provision, alongside concerns about how a personal budget would work in practice. Questions about entitlement and what can and cannot be purchased using a personal budget remain grey areas. Exemptions and limits on what can be included may mean that personal health budgets do not deliver on their promise of greater ‘choice and control for parents/carers. Implications for rehabilitation therapy services are explored

Making a case for universal and targeted children's occupational therapy in the United Kingdom

This article makes the case for increasing the reach and the impact of children’s occupational therapy in the United Kingdom, through inclusion of universal and targeted services alongside specialist provision. It is proposed that achieving a greater balance between these different levels or tiers of provision can promote the health, well-being and participation of all children, including those with additional needs. At a time of austerity, we argue that a broader offer also distributes finite public resources more effectively - potentially reducing pressure on scarce specialist resources. Sustainable options for meeting greater population need are proposed and occupational therapists are encouraged to evaluate the effect of changing the balance of provision to inform future commissioning

On the calibration of the relation between geometric albedo and polarimetric properties for the asteroids

We present a new extensive analysis of the old problem of finding a satisfactory calibration of the relation between the geometric albedo and some measurable polarization properties of the asteroids. To achieve our goals, we use all polarimetric data at our disposal. For the purposes of calibration, we use a limited sample of objects for which we can be confident to know the albedo with good accuracy, according to previous investigations of other authors. We find a new set of updated calibration coefficients for the classical slope - albedo relation, but we generalize our analysis and we consider also alternative possibilities, including the use of other polarimetric parameters, one being proposed here for the first time, and the possibility to exclude from best-fit analyzes the asteroids having low albedos. We also consider a possible parabolic fit of the whole set of data.Comment: Accepted by MNRA

Understanding the support needs of disabled children and their families in East Kent

Objective: Explore the support needs of parents and carers of children with physical disabilities (< 18 years) within a therapy service in the South East of England. Method: Qualitative methods were used including focus groups and interviews with 9 parents/carers of children with a physical disability. Framework analysis approach was used to analyse the data. Results: Data was organised into the following themes. • Parent and carer experiences of using services including direct experience of therapy services • Education • Organisation of services and access to information • Impact of disability on family and carer life • Experiences and views of personalised care. Conclusions: Parents and carers had varied experiences of therapy services. Parents and carers valued close relationships established over time when therapists had knowledge and understanding of their child and family situation. Families experienced most difficulty over the provision of equipment and poor liaison between different parts of the care system added to stress and frustration. Few parents and carers had knowledge or awareness of personal health budgets and were unsure about whether a personal budget would improve their access to or experience of therapy

A study into the effectiveness of a postural care education programme aimed at improving self-efficacy in carers of children with physical disabilities

Background & Aim: Parents and teachers lack knowledge and self-efficacy when providing postural care to physically disabled children. This can act acts as a barrier to the successful implementation of therapy. An intervention was developed to improve knowledge and confidence in providing postural care. The aim is to determine whether this intervention improves parents’ & teachers’ knowledge & confidence. Methods. The intervention includes a 2-hour interactive workshop and follow-up home/school visits delivered in three localities across the South-East. The UKC-PostCarD scale assesses levels of knowledge and confidence in providing postural care was utilised to evaluate the intervention. This will be completed at baseline and after the intervention is completed. Focus groups with participants will provide insight into elements that were effective/ineffective. Interviews with children will provide an end user perspective. Interviews with therapists will consider the feasibility and acceptability of delivery. Analysis: A mixed-design ANOVA 2 (Time: before vs. after) x 3 (Area: Kent, Sussex, Surrey) will be used to determine whether knowledge and confidence improved following the intervention. Framework analysis will be used for the focus group and interview data. Qualitative findings will be fed into the overall evaluation. Findings: Analysis of data will begin in June 2013 and findings will be available in September 2013. Discussion. If shown to improve confidence and knowledge, we hope to make this education programme available regionally and nationally. As more physically disabled children attend mainstream schools this will be a timely and useful resource

Buckling mediated by mobile localized elastic excitations

Experiments reveal that structural transitions in thin sheets are mediated by the passage of transient and stable mobile localized elastic excitations. These ``crumples'' or ``d-cones'' nucleate, propagate, interact, annihilate, and escape. Much of the dynamics occurs on millisecond time scales. Nucleation sites correspond to regions where generators of the ideal unstretched surface converge. Additional stable intermediate states illustrate two forms of quasistatic inter-crumple interaction through ridges or valleys. These interactions create pairs from which extended patterns may be constructed in larger specimens. The onset of localized transient deformation with increasing sheet size is correlated with a characteristic stable crumple size, whose measured scaling with thickness is consistent with prior theory and experiment for localized elastic features in thin sheets. We offer a new theoretical justification of this scaling.Comment: contains link to video

Isolation of an antimicrobial-resistant, biofilm-forming, Klebsiella grimontii isolate from a reusable water bottle

Abstract A reusable water bottle was swabbed as part of the citizen science project ?Swab and Send,? and a Klebsiella grimontii isolate was recovered on chromogenic agar and designated SS141. Whole-genome sequencing of SS141 showed it has the potential to be a human pathogen as it contains the biosynthetic gene cluster for the potent cytotoxin, kleboxymycin, and genes for other virulence factors. The genome also contains the antibiotic-resistant genes, blaOXY-6-4, and a variant of fosA, which is likely to explain the observed resistance to ampicillin, amoxicillin, and fosfomycin. We have also shown that SS141 forms biofilms on both polystyrene and polypropylene surfaces, providing a reasonable explanation for its ability to colonize a reusable water bottle. With the increasing use of reusable water bottles as an alternative to disposables and a strong forecast for growth in this industry over the next decade, this study highlights the need for cleanliness comparable to other reusable culinary items

The languages of peace during the French religious wars

The desirability of peace was a common topos in sixteenth-century political rhetoric, and the duty of the king to uphold the peace for the benefit of his subjects was also a long-established tradition. However, the peculiar circumstances of the French religious wars, and the preferred royal policy of pacification, galvanized impassioned debate among both those who supported and those who opposed confessional coexistence. This article looks at the diverse ways in which peace was viewed during the religious wars through an exploration of language and context. It draws not only on the pronouncements of the crown and its officials, and of poets and jurists, but also on those of local communities and confessional groups. Opinion was not just divided along religious lines; political imperatives, philosophical positions and local conditions all came into play in the arguments deployed. The variegated languages of peace provide a social and cultural dimension for the contested nature of sixteenth-century French politics. However, they could not restore harmony to a war-torn and divided kingdom