The Changing View of Physical Recreation for People with Disabilities in the USA: A More Inclusive Perspective?

Historically, people with disabilities have had limited access to physical recreation. However, as society’s view of people with disabilities and their rights has been in transition, so has physical recreation activities for people with disabilities. The purpose of this study is to examine the transition of physical activity for people with disabilities in the United States. A three-fold search process of databases, ancestral, and descendent searches were conducted, yielding sixteen studies for inclusion in this historical literature review. The results show that the earliest physical recreational opportunities for people with disabilities were based in medical response to physical needs. Today, opportunities for physical recreation for people with disabilities include therapeutic and non-therapeutic activities. Nonetheless, there is still a division in how society views recreation for people with disabilities, represented by major recreation organizations holding either medical or sociopolitical views of people with disabilities

The role of the nurse practitioner in rehabilitation of cardiac patients

This thesis is concerned with the role of the nurse in coronary rehabilitation. The primary hypothesis is that a nurse practitioner, trained in coronary medicine and experienced in relevant medical nursing, can intervene independently of team efforts to help rehabilitate the patient who has suffered and survived a myocardial infarction. The term nurse counsellor is used in the study to better represent the actual role of the nurse in intervention which includes assessment, patient and close family counselling for adaptation and rehabilitative efforts, aid in adjustment to social conditions, and reinforcement for psychological recovery. The study is a longitudinal cohort effort which embodies several methods of empirical research. Those methods include the clinical classification of data, assessment, description, and measurement through statistical analyses of variables derived from data. The cohort is comprised of male patients between the ages of 30 and 64 who could be returned to work, and the study takes place in Glasgow, Scotland, through Southern General Hospital. Several prognostic indices are employed together with various assessment tools to include: the Schiller Index, Modified Schiller Index for Paramedics, Norris Prognostic Index Rahe Life Change Unit procedure, Middlesex Hospital Questionnaire, and the Southern General Hospital Outcome Assessment Evaluation. The results focus on the primary emphasis of the research, which was to intervene for secondary prevention and therefore to reduce risk factors among individual patients through counselling and reinforcement of systematic programmes of rehabilitation. The results for the nurse's cohort reflect similar or better success rates compared with published data and parallel studies by team intervention. These results and comparisons are analysed with statistical procedures as well as descriptive information. A case is therefore put forward and supported by the research which endorses the nurse practitioner for coronary rehabilitation intervention. There are several interesting implications as well involving the roles of general practitioners, patient behaviour patterns, family situations and associated problems encountered during the research. The thesis is presented through the Department of Community Medicine, University of Glasgow, and therefore it reports a community medicine approach to rehabilitation. However, the thrust of the work and results are strongly nurse oriented and have the greatest application to the fields of nursing research, nursing theory, nursing education, and specifically coronary nursing specialisation. Every attempt is made to hold to established procedures for intervention, yet the nurse entered this study with the clear idea of caring for patients who had suffered and survived a myocardial infarction. That is to say, the responsibility and commitment to nursing care was foremost in the intervention while research procedures were subordinated to the needs of the patient. With that in mind, there are limitations to the conclusions, limited mainly by small numbers in the cohort (31), yet control groups and parallel studies by team efforts at Southern General Hospital provide much greater numerical qualification. The results and conclusions are specific to outcomes for secondary prevention, including smoking control, weight control, lipid levels control, and exercise programmes. The nurse's role is in part validated by the results, but also in part by qualitative survey data from patients, wives, family, and general practitioners who commented on aspects of the intervention programme and the nurse's performance. Return to work data are provided with case-by-case analysis and risk factor interaction analysis. Specific comments are made. General conclusions are concerned with the future role and feasibility of the nurse practitioner working as a coronary rehabilitation counsellor, and that role is found to be acceptable, feasible, and economic use of health care personnel

Beyond autism and technology: lessons from neurodiverse populations

Purpose – This short paper reports on the sixth seminar in a 7-seminar series entitled, “Innovative Technologies for Autism: Critical Reflections on Digital Bubbles”, funded by the UK Economic and Social Research Council (ESRC). The aim of this particular seminar was to reflect upon the implications from neurodiverse communities for the development of technology for autism. Design/methodology/approach – Presentations from key researchers and parental perspectives are reviewed, highlighting contemporary issues in neurodiverse populations that have important implications for autism. Findings – Whilst there are many conditions associated with autism, most commonly intellectual disability (learning difficulties), this is not reflected in research. In addition, for child-based research, researchers are at least a generation older than participants and have had different digital-childhoods. Involving neurodiverse populations within participatory design sessions can address both of these issues. Understanding the context of the issues that the participatory design sessions address is crucial for developing participatory design principles that extend from one condition to another. This includes understanding when findings based upon verbal populations can be extended to nonverbal populations. Originality/value – This paper offers up-to-date insights into how design principles from one condition extend to different conditions. Universal interaction and neurodiversity HCI are considered. This is important within neurodiverse populations, especially given the high rates of additional conditions that are associated with autism. Whilst the majority of autism research has involved verbal populations, the benefits of technology can extend to non-verbal populations

The Relationship Between the Design of the Built Environment and the Ability to Egress of Individuals with Disabilities

Recent catastrophic events have brought into focus the importance of planning for the evacuation needs of all persons, regardless of their diverse physical and mental abilities. While these efforts are primarily concerned with the activities before and after a crisis, there is also a renewed interest in evaluating how effectively the built environment accommodates the needs of all individuals during a crisis. This discussion focuses on the current body of knowledge concerning the relationship between the design of the built environment, the collective egress behavior of complex decentralized groups of individuals, and the ability of individuals with disabilities to effectively egress from the built environment during emergency events

Communication Between Health Care Providers and At-Risk Mothers: Perceptions and Practices

Background This study examined knowledge, attitudes and opinions regarding alcohol, tobacco, and other drug (ATOD) use during pregnancy among women enrolled in drug treatment centers. It also assessed the educational and screening practices of health care professionals who care for women of child-bearing age in Utah. Methods The assessment of ATOD use was based on a convenience sample of women who were enrolled in drug treatment centers in Utah. The sample (n = 60) was surveyed by trained research team members. The assessment of screening practices of physicians and other medical professionals (n = 350) who deal with women’s obstetric and gynecological conditions was conducted via an online survey. An in-depth interview with seven of the professionals was also conducted. Results Most women surveyed (72%) reported that they would follow the advice of their health care provider regarding the use of alcohol, tobacco and other drugs (ATOD). Other sources of information (e.g. TV, Internet and radio) were less trusted. The women also indicated that a major barrier to disclosing an ATOD use was fear of negative consequences, both legal and social. Analysis of data from the professionals surveyed indicated that while most do some screening, there is a significant difference in ATOD screening practices for pregnant women and for women who are of childbearing age but not pregnant. Further, while nearly all professionals reported educating women who came to their clinic, fewer than 35% indicated using written educational materials. Lack of time was indicated as the primary barrier to proper screening and education of women in health care clinics. Conclusion Women who have been enrolled in treatment centers for ATOD addictions are fearful of the negative legal and social repercussions as a result of their ATOD use and hence do not consistently seek prenatal care. However, when information is given, most women are willing to comply with the recommendations of their health care providers. Providers are also very interested in quality patient care, but indicate that lack of time does not allow adequate one-on-one time with each patient. Screening and educational practices are performed in most offices, but both the timing of the screening and approach to patient education may not be sufficient to ensure optimal outcomes

High burden of complicated skin and soft tissue infections in the Indigenous population of Central Australia due to dominant Panton Valentine leucocidin clones ST93-MRSA and CC121-MSSA

BACKGROUND: Superficial skin and soft tissue infections (SSTIs) are common among the Indigenous population of the desert regions of Central Australia. However, the overall burden of disease and molecular epidemiology of Staphylococcus aureus complicated SSTIs has yet to be described in this unique population. METHODS: Alice Springs Hospital (ASH) admission data was interrogated to establish the population incidence of SSTIs. A prospective observational study was conducted on a subset of S. aureus complicated SSTIs (carbuncles and furuncles requiring surgical intervention) presenting during a one month period to further characterize the clinical and molecular epidemiology. High resolution melting analysis was used for clonal complex discrimination. Real-time polymerase chain reaction identifying the lukF component of the Panton Valentine leucocidin (pvl) gene determined pvl status. Clinical and outcome data was obtained from the ASH medical and Northern Territory shared electronic health records. RESULTS: SSTIs represented 2.1% of ASH admissions during 2014. 82.6% occurred in Indigenous patients (n = 382) with an estimated incidence of 18.9 per 1, 000 people years compared to the non-Indigenous population of 2.9 per 1000, with an incident rate ratio of 6.6 (95% confidence interval 5.1-8.5). Clinical and molecular analysis was performed on 50 isolates from 47 patients. Community-associated methicillin-resistant S. aureus (CA-MRSA) predominated (57% of isolates). The high burden of SSTIs is partly explained by the prevalence of pvl positive strains of S. aureus (90% isolates) for both CA-MRSA and methicillin-susceptible S. aureus (MSSA). ST93-MRSA and CC121-MSSA were the most prevalent clones. SSTIs due to ST93-MRSA were more likely to require further debridement (p = 0.039), however they also more frequently received inactive antimicrobial therapy (p < 0.001). CONCLUSIONS: ST93-MRSA and CC121-MSSA are the dominant causes of carbuncles and furuncles in Central Australia. Both of these virulent clones harbor pvl but the impact on clinical outcomes remains uncertain. The high prevalence of CA-MRSA supports empiric vancomycin use in this population when antimicrobial therapy is indicated. Prompt surgical intervention remains the cornerstone of treatment

Double Umbilical Cord Blood Transplantation in High-Risk Hematological Patients: A Phase II Study Focusing on the Mechanism of Graft Predominance

Immunobiology of allogeneic stem cell transplantation and immunotherapy of hematological disease