A New Approach to Transition Planning for Transitional Aged Youth with Intellectual and Developmental Disabilities

The current study was designed to gain a greater understanding of how transition planning is being done in the Niagara Region, as per the Integrated Transition Protocol, and to examine the barriers to the enactment of this protocol in relation to youth participation and implementation. Further, the study focused on uncovering whether youth were better included in their transition plans since the implementation of the protocol, and on discovering ways to better include youth in the transition process overall. Through a pragmatic qualitative research design informed by the theory of emerging adulthood and by a social model of disability, the perspectives of 14 professionals were explored through questionnaires, focus groups, and individual interviews. From the collected data, the following themes were found: (1) there continue to be barriers that hinder youth participation and the successful implementation of the protocol; (2) professionals feel youth participation is important; however, families continue to play the primary role during the transition process, despite a reported disconnection between the hopes and dreams of the families and the youth; (3) transition planning and practicing meaningful participation need to begin earlier; (4) the transition ends when the protocol ends so there is a gap between children’s services and adult services, and the realities of adult services are unknown to many; (5) there are many benefits to integrated transition planning; (6) we must move past keeping youth “busy and safe” and ensure that they are participating in meaningful activities; and (7) it’s a new process, but the right process. These themes are discussed in terms of their implications for the current transition policy in the Niagara Region and elsewhere in Ontario so that the voices and dreams of youth with developmental disabilities are included and respected during the transition process in hopes of improving their post high school outcomes and overall quality of life

Perceived roles and barriers in caring for the people who are homeless:a survey of UK community pharmacists

Background: Community pharmacists can be an accessible source for advice and support for the people who are homeless, given their utilisation of a variety of currently available services such as dispensing of medicines, drugs and alcohol services. Objective: To determine community pharmacists’ training, experiences and behavioural determinants in counselling and management of homeless population. Setting: UK community pharmacies. Method: A questionnaire based on literature and theoretical domains framework was mailed to randomly sampled community pharmacies in England and Scotland (n = 2000). Data were analysed using descriptive and inferential statistics. Main outcome measures: Pharmacists’ perspectives, pharmacists’ training, pharmacists’ experiences and behavioural determinants. Results: A total of 321 responses (RR 16.1%) were received. Respondents indicated lack of knowledge, skills, intentions as well as contextual factors such as lack of guidelines impacted on their counselling and management of homeless patients. Less than a third (n = 101, 32.2%) indicated that they knew where to refer a homeless patient for social support. Broaching the subject of homelessness was outside their comfort zone (n = 139, 44.3%). Only four (1.2%) respondents could correctly answer all knowledge assessment questions. Conclusions: Community pharmacist identified lack of education, training opportunities and guidelines in counselling and management of homeless patients. Targeting community pharmacists’ knowledge, skills and intention to provide care to the homeless patients may enable addressing health inequality through community pharmacy

A Systematic Review of Evidence for the Clubhouse Model of Psychosocial Rehabilitation

The Clubhouse Model has been in existence for over sixty-five years; however, a review that synthesizes the literature on the model is needed. The current study makes use of the existing research to conduct a systematic review of articles providing a comprehensive understanding of what is known about the Clubhouse Model, to identify the best evidence available, as well as areas that would benefit from further study. Findings are summarized and evidence is classified by outcome domains. Fifty-two articles met the selection criteria of Randomized Clinical Trials (RCT\u27s), quasi-experimental studies, or observational studies for domains of employment (N = 29); quality of life/satisfaction (N = 10); reductions in psychiatric hospitalization(s) (N = 10); social relationships (N = 10); education (N = 3); and health promotion activities (N = 2). RCT results support the efficacy of the Clubhouse Model in promoting employment, reducing hospitalization(s), and improving quality of life. Quasi-experimental and observational studies offer support in education and social domains. The findings from this review indicate that Clubhouses are a promising practice but additional studies using rigorous methods that report the strength of the outcomes are needed to evaluate Clubhouse programs with fidelity to the Clubhouse Model

'If I die, I die, I don't care about my health': perspectives on self-care of people experiencing homelessness.

Self-care, which refers to what people do to prevent disease and maintain good health, can alleviate negative health consequences of people experiencing homelessness. The aim of the study was to apply a theoretically informed approach in exploring engagement of people experiencing homelessness in self-care and to identify factors that can be targeted in future health and social care interventions. Qualitative semi-structured interviews were conducted with 28 participants opportunistically recruited from a specialist homelessness healthcare centre of North East Scotland, the United Kingdom (UK). An interview schedule was developed based on the theoretical domains framework (TDF). Interviews were audio-recorded and transcribed verbatim. Six aspects of self-care were explored, including (a) self-awareness of physical and mental health, (b) health literacy, including health seeking behaviour, (c) healthy eating, (d) risk avoidance or mitigation, (v) physical activity and sleep and (e) maintaining personal hygiene. Thematic analysis was conducted by two independent researchers following the Framework Approach. Participants described low engagement in self-care. Most of the barriers to engagement in self-care by participants were related to 'environmental context and resources' domain of TDF. Participants often resorted to stealing or begging for food. Many perceived having low health literacy to interpret health-related information. Visits to churches and charities to get a shower or to obtain free meals were commonplace. Participants expressed pessimism that there was ‘nothing’ they could do to improve their health and described perceived barriers often too big for them to overcome. Alienation, lack of social support and the perception that they had done irreversible damage to their health prevented their involvement in self-care. The theme of ‘social circle’ held examples of both enabler and barriers in participants’ uptake of risky behaviours. Health and social services should work with persons experiencing homelessness in designing and delivering targeted interventions that address contextual barriers, multi-morbidity, health literacy and self-efficacy

Active chiral plasmonics: flexoelectric control of nanoscale chirality

The ability to electrically control the optical properties of metamaterials is an essential capability required for technological innovation. The creation of dynamic electrically tuneable metamaterials in the visible and near IR region are important for a range of imaging and fibre optic technologies. However current approaches require complex nanofabrication processes which are incompatible for low cost device production. Here, we report a novel simple approach for electrical control of optical properties which utilises a flexoelectric dielectric element to electromechanically manipulate the form factor of a chiral nanostructure. By altering the dimensions of the chiral nanostructure, we allow the polarisation properties of light to be electrically controlled. The flexoelectric element is part of a composite metafilm that is templated on to a nanostructured polymer substrate. Since the flexoelectric element does not require in situ high temperature annealing it can be readily combined with polymer‐based substrates produced by high throughput methods. This is not the case for piezoelectric elements, routinely used in microelectromechanical (MEM) devices which require high temperature processing. Consequently, combining amorphous flexoelectric dielectric and low‐cost polymer‐based materials provides a route to the high throughput production of electrically responsive disposable metadevices

Pharmacists' training, experiences and behaviours in managing homeless patients.

Community pharmacists are well-situated to offer proactive and opportunistic support and advice to the homeless. The aim of this research was to investigate pharmacists' training, experiences and behaviours in managing homeless patients. A questionnaire using both open and closed questions was developed, based on existing literature, researcher expertise and the Theoretical Domains Framework (TDF) - a synthesis of behaviour change theory. The TDF outlines fourteen individual domains perceived to influence behaviour, including knowledge, skills, beliefs about capabilities and social influences. The questionnaire was reviewed and piloted with fifty pharmacists, and NHS R&D approval was obtained. The questionnaire was then sent to a random sample of 1,951 community pharmacies in England and Scotland, with two follow-up reminders. Results were analysed using descriptive statistics. 321 responses (response rate 16.5%) were received. The mean (SD) age of respondents was 39 (plus or minus 12) years with a third (n=94, 29.3%) having been qualified as a pharmacist for fewer than five years. Many respondents (n = 187) reported having managed a homeless patient in their pharmacy, with approximately 17% (n=53) saying that this was a daily activity. The majority (n=242, 75.4%) of participants said that homelessness was not included in their undergraduate, postgraduate or continuous professional development (CPD) pharmacy training (n=225, 70.1%). Only a third (n=100, 31.1%) agreed or strongly agreed that they knew to whom they should refer a homeless patient for social support. Approximately 42% (n=137) indicated they would discuss homelessness only if raised by the patient. Only one fifth (n=71, 22.1%) felt comfortable advising homeless patients on how to minimise the impact of homelessness on their medication use, and the vast majority of respondents reported a lack of clear guidelines (n=294, 94.2%). The results of this study suggest lack of appropriate opportunities - at undergraduate, postgraduate and CPD level - for training on how to manage homeless patients. There is a need to develop guidelines that will enable community pharmacists to better support homeless patients in alleviating the impact of homelessness; these guidelines should include advice on the pharmacist's role in supporting homeless medicine management and providing signposting to appropriate social services

Relocating patients from a specialist homeless healthcare centre to general practices: a multi-perspective study.

Background: - The relocation of formerly homeless patients eligible to transfer from a specialist homeless healthcare centre (SHHC) to mainstream general practices is key to patient integration in the local community. Failure to transition patients conferring eligibility for relocation may also negatively impact on SHHC service delivery. Aim: - To explore barriers and facilitators of relocation from the perspectives of formerly homeless patients and healthcare staff involved in their care. Design and setting: - Qualitative semi-structured face-to-face and telephone interviews conducted in the north east of Scotland. Method: - Participants were patients and healthcare staff including GPs, nurses, substance misuse workers, administrative, and local community pharmacy staff recruited from one SHHC, two mainstream general practices, and four community pharmacies. Interview schedules based on the 14 domains of the Theoretical Domains Framework (TDF) were drafted. Transcripts of the interviews were analysed by two independent researchers using a framework approach. Results: - Seventeen patients and 19 staff participated. Key barriers and facilitators aligned to TDF domains included: beliefs about consequences regarding relocation; patient intention to relocate; environmental context and resources in relation to the care of the patients and assessing patient eligibility; patient skills in relation to integration; social and professional role and identity of staff and patients; and emotional attachment to the SHHC. Conclusion: - Implementation of services, which promote relocation and integration, may optimise patient relocation from SHHCs to mainstream general practices. These include peer support networks for patients, better information provision on the relocation process, and supporting patients in the journey of identifying and adjusting to mainstream practices

Life on Mars: Evidence from Martian Meteorites

New data on martian meteorite 84001 as well as new experimental studies show that thermal or shock decomposition of carbonate, the leading alternative non-biologic explanation for the unusual nanophase magnetite found in this meteorite, cannot explain the chemistry of the actual martian magnetites. This leaves the biogenic explanation as the only remaining viable hypothesis for the origin of these unique magnetites. Additional data from two other martian meteorites show a suite of biomorphs which are nearly identical between meteorites recovered from two widely different terrestrial environments (Egyptian Nile bottomlands and Antarctic ice sheets). This similarity argues against terrestrial processes as the cause of these biomorphs and supports an origin on Mars for these features

Southern GEMS groups II: HI distribution, mass functions and HI deficient galaxies

We investigate the neutral hydrogen (HI) content of sixteen groups for which we have multi-wavelength data including X-ray observations. Wide-field imaging of the groups was obtained with the 20-cm multibeam system on the 64-m Parkes telescope. We have detected ten previously uncatalogued HI sources, one of which has no visible optical counterpart. We examine the HI properties of the groups, compared to their X-ray characteristics, finding that those groups with a higher X-ray temperature and luminosity contain less HI per galaxy. The HI content of a group depends on its morphological make-up, with those groups dominated by early-type galaxies containing the least total HI. We determined the expected HI for the spiral galaxies in the groups, and found that a number of the galaxies were HI deficient. The HI deficient spirals were found both in groups with and without a hot intra-group medium. The HI deficient galaxies were not necessarily found at the centre of the groups, however, we did find that two thirds of HI deficient galaxies were found within about 1 Mpc from the group centre, indicating that the group environment is affecting the gas-loss from these galaxies. We determined the HI mass function for a composite sample of 15 groups, and found that it is significantly flatter than the field HI mass function. We also find a lack of high HI-mass galaxies in groups. One possible cause of this effect is the tidal stripping of HI gas from spiral galaxies as they are pre-processed in groups.Comment: accepted for publication in MNRAS, 26 pages, 13 Figures, 2 Appendice

Music and HCI

Music is an evolutionarily deep-rooted, abstract, real-time, complex, non-verbal, social activity. Consequently, interaction design in music can be a valuable source of challenges and new ideas for HCI. This workshop will reflect on the latest research in Music and HCI (Music Interaction for short), with the aim of strengthening the dialogue between the Music Interaction community and the wider HCI community. We will explore recent ideas from Music Interaction that may contribute new perspectives to general HCI practice, and conversely, recent HCI research in non-musical domains with implications for Music Interaction. We will also identify any concerns of Music Interaction that may require unique approaches. Contributors engaged in research in any area of Music Interaction or HCI who would like to contribute to a sustained widening of the dialogue between the distinctive concerns of the Music Interaction community and the wider HCI community will be welcome