Psychiatric morbidity in older people with moderate and severe learning disability (mental retardation). Part I: development and reliability of the patient interview (the PAS-ADD)

This paper describes the development of the PAS-ADD, a semistructured clinical interview for use specifically with patients with learning disabilities, based on items drawn from the PSE. The PAS-ADD includes a number of novel features including: parallel interviewing of patient and informant; a three-tier structure to provide a flexible interview appropriate to the patient's intellectual level; use of a memorable 'anchor event' in the patient's life to improve time focus; and simplified wording, improved organisation and lay out. Inter-rater reliability was investigated using an experimental design in which two raters viewed and re-rated videotaped PAS-ADD interviews which had been conducted by an experienced clinician. Reliability results compared favourably with those obtained in a major study of PSE reliability with a sample drawn from non-learning disabled individuals. Mean kappa for all items was 0.72. Other indexes of reliability were also good. In the current phase of development, the PAS-ADD is to be expanded to include further diagnostic categories, including schizophrenia and autism. The new version will be updated for use with ICD-10 criteria

Corpus to curriculum: Developing word lists for adult learners of Welsh

The launch of a language's first comprehensive general corpus promises a sea-change in teaching and learning resources. Effective transition from corpus to classroom is not necessarily straightforward, though; expert and end-user input is essential for the potential of the corpus resource to be realised. This paper outlines the process by which fit-for-purpose vocabulary lists were derived from the new National Corpus of Contemporary Welsh (Corpws Cenedlaethol Cymraeg Cyfoes – CorCenCC). The immediate purpose in this case was to inform the revision of A1 and A2 level course materials for adult learners. A longer-term aim was to put in place a method by which vocabulary lists for more advanced level learners and learners of different ages could be extracted and developed from the corpus. The new corpus means that for the first time, the Welsh language curriculum is able to use word frequency information; teaching and assessment materials in major languages have been informed by word frequencies for several decades. Raw frequency lists, though, include troublesome content, and can exclude items with high relevance to learners. This paper demonstrates how, by working in partnership, Welsh language curriculum writers, assessors, language experts and corpus linguists can effectively manipulate corpus data into curriculum content. The methods and approaches reported here are replicable for use in other language contexts

Public Health Risks in Urban Slums : Findings of the Qualitative 'Healthy Kitchens Healthy Cities' Study in Kathmandu, Nepal

BACKGROUND: Communities in urban slums face multiple risks to their health. These are shaped by intermediary and structural determinants. Gaining a clear understanding of these determinants is a prerequisite for developing interventions to reduce the health consequences of urban poverty. With 828 million people living in slum conditions, the need to find ways to reduce risks to health has never been greater. In many low income settings, the kitchen is the epicentre of activities and behaviours which either undermine or enhance health. METHODS: We used qualitative methods of semi-structured interviews, observation and participatory workshops in two slum areas in Kathmandu, Nepal to gain women's perspectives on the health risks they faced in and around their kitchens. Twenty one women were interviewed and four participatory workshops with a total of 69 women were held. The women took photographs of their kitchens to trigger discussions. FINDINGS: The main health conditions identified by the women were respiratory disease, gastrointestinal disease and burn injuries. Women clearly understood intermediary (psychosocial, material and behavioural) determinants to these health conditions such as poor ventilation, cooking on open fires, over-crowding, lack of adequate child supervision. Women articulated the stress they experienced and clearly linked this to health conditions such as heart disease and uptake of smoking. They were also able to identify protective factors, particularly social capital. Subsequent analysis highlighted how female headed-households and those with disabilities had to contend with greater risks to health. CONCLUSIONS: Women living in slums are very aware of the intermediary determinants-material, behavioural and psycho-social, that increase their vulnerability to ill health. They are also able to identify protective factors, particularly social capital. It is only by understanding the determinants at all levels, not just the behavioural, that we will be able to identify appropriate interventions

Video streaming in the Wild West

Northern Lakes College in north-central Alberta is the first post-secondary institution in Canada to use the Media on Demand digital video system to stream large video files between dispersed locations (Karlsen). Staff and students at distant locations of Northern Lakes College are now viewing more than 350 videos using video streaming technology. This has been made possible by SuperNet, a high capacity broadband network that connects schools, hospitals, libraries and government offices throughout the province of Alberta (Alberta SuperNet). This article describes the technical process of implementing video streaming at Northern Lakes College from March 2005 until March 2006

Cross-border and domestic surrogacy in the UK context: An exploration of practical and legal decision-making

The present study aimed to explore UK intending parent’s reasons for cross-border and domestic surrogacy, their preparations for the birth and the practical and legal challenges faced after the birth. An online survey was completed by 203 participants, of which 132 had a child had born through surrogacy, 33 were in the process of surrogacy and 38 were planning a surrogacy arrangement. The most common reason for pursuing surrogacy in the UK was wanting a relationship with the surrogate (43%, 17) and for the USA it was having a better legal framework (97%, 60). Parents returning to the UK from countries other than USA experienced greater delay and difficulties in obtaining the necessary documents for their return. This study highlights the disparities in parents’ experiences of undergoing surrogacy in different countries, the frustrations some face in obtaining legal parenthood and the feelings of stress and anxiety this may cause. Whilst this is the first study comparing the experiences of people from the UK having surrogacy in different countries, the representativeness of the sample is unknown. The findings are important in identifying future directions for research, including assessing the impact of these early decisions and experiences for later parental wellbeing and children’s welfare

Parents' relationship with their surrogate in cross-border and domestic surrogacy arrangements: comparisons by sexual orientation and location.

OBJECTIVE: To study heterosexual and gay couples' relationship with their surrogate and their disclosure decisions when the surrogacy arrangement was completed domestically compared with internationally. DESIGN: Cross-sectional study. SETTING: Not applicable. PATIENT(S): Participants were 40 gay couples and 76 heterosexual couples who had domestic surrogacy in the United Kingdom (UK) (n = 38) or international surrogacy in the United States (n = 58) or Asia (20). Most (75%) of the children were aged <4 years. INTERVENTION(S): Online surveys containing open-ended and multiple-choice questions. MAIN OUTCOME MEASURE(S): Experiences of finding a surrogate, relationship with the surrogate, and disclosure to the child were examined among UK parents who had undergone surrogacy in the UK, United States, or India/Thailand. RESULT(S): Parents who had surrogacy in the UK and United States felt very involved in the pregnancy compared with those who had surrogacy in Asia. Couples whose surrogacy was completed in Asia were less likely to want contact with their surrogate after the birth and were also less likely to have any current contact with the surrogate. Parents who had surrogacy in the UK and United States described positive relationships with their surrogate. Gay couples intended to tell their child about surrogacy more than heterosexual couples. CONCLUSION(S): The specific country where couples conducted their surrogacy arrangement (i.e. United States, UK, or Thailand/India) was associated with how involved they were in the pregnancy and their contact with the surrogate over time. Limitations of the study include use of survey methodology and that the representativeness of the sample is not known.Wellcome Trus

Poker machine playing and problem gambling amongst members of Sydney registered clubs: second report

This is the second report of a three stage project examining the gaming machine playing behaviour of members of certain Sydney registered clubs. This report compares the social, demographic, cultural and linguistic characteristics of a random sample of gaming machine playing members of some of the largest registered clubs in Sydney. Further, it compares the characteristics of these members with profiles of people with gambling problems as identified in previous research. The other reports from this project are Evaluating the Current and Future Adequacy of Services for Problem Gamblers in Sydney and Socio-Demographic Characteristics of Resident Populations Supporting Poker Machine Playing in Sydney’s Registered Clubs

Socio-demographic characteristics of resident populations supporting poker machine playing in Sydney registered clubs: first report

This is the first report of a three stage project examining the gaming machine playing behaviour of certain Sydney registered club members of different social, demographic, cultural and linguistic backgrounds. This initial report provides the background to subsequent survey and interview work. From secondary research, it identifies the socio-demographic features of adult resident populations in Sydney local areas that have high concentrations of registered clubs and high levels of gaming machine expenditures per capita. The other reports from this project are Poker Machine Playing and Problem Gambling Amongst Members of Sydney’s Registered Clubs and Evaluating the Current and Future Adequacy of Services for Problem Gamblers in Sydney

Validity of the schizophrenia diagnosis of the Psychiatric Assessment Schedule for Adults with Developmental Disability (PASS-ADD)

Background: first rank symptoms are central to the diagnosis of schizophrenia, but their complexity makes it difficult to validly detect them in people with learning disability. This report investigates ability of PAS-ADD to detect schizophrenia, validated against expert clinical opinion. Method: the sample consisted of 98 patients with learning disabilities and a key informant for each sample member. Clinical opinions of the referring psychiatrists were sought using a symptom checklist. Reportage of remission, and the number of core schizophrenia symptoms identified, were used to estimate level of symptom activity at time of interview. Results: the proportion of schizophrenia cases detected by PAS-ADD increases with the number of active core symptoms identified by the referrer. Where two or more core symptoms were indicated, PAS-ADD detected 71% cases. The most frequently fulfilled criterion was third-person auditory hallucinations. Six schizophrenia diagnoses disagreed with the clinician, four of which were referred as being hypomania. Overall symptom frequency detected by PAS-ADD was positively correlated with IQ. Conclusions: results suggest there may be scope for modifying the ICD-10 diagnostic algorithm for use with learning disability, particularly in relation to the delusions and negative symptoms criteria