A study to determine the activities of the nursing assistants in the admission and discharge unit of the patients' control section of one veterans administration hospital, the time required to perform these activities, and the source from which the authority to perform was derived.

Thesis (M.S.)--Boston Universit

An analysis of the effectiveness of University counselling services

It is important to demonstrate replicable evidence of the effectiveness of counselling procedures. The study aimed to contribute to the currently limited evidence base examining the effectiveness of university student counselling in the UK. Information on therapeutic outcome [based on Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) scores] for 305 individuals attending a large UK university counselling service was analysed. Following counselling intervention: there was a statistically significant improvement in CORE-OM scores with 63% of individuals showing a reliable improvement and only 2% showing a reliable deterioration. Of those who began with a score in the clinical range, 49% showed a clinically significant change. These results provide additional evidence for the effectiveness of university counselling interventions. Future research should aim to build on this preliminary research using randomised controlled trial designs

The evaluation of a screening tool for children with an intellectual disability: The Child and Adolescent Intellectual Disability Screening Questionnaire

The study outlines the evaluation of an intellectual disability screening tool, the Child and Adolescent Intellectual Disability Screening Questionnaire (CAIDS-Q), with two age groups. A number of aspects of the reliability and validity of the CAIDS-Q were assessed for these two groups, including inter-rater reliability, convergent and discriminative validity. For both age groups, a significant positive relationship was found between full scale IQ and CAIDS-Q score, indicating convergent validity. Significant differences were found in the CAIDS-Q scores between those with and without an intellectual disability, with the former group scoring significantly lower. The sensitivity and specificity of the CAIDS-Q were above 96.7% and 85.5% respectively for the younger group and 90.9% and 94.9% respectively for the older group. Limitations and implications of the study are discussed

Women's participation in education and training in New Zealand: is the 'learn while you earn' option accessible to all?

Strong education and training systems are viewed as a route to increased labour market participation for groups that have traditionally been excluded from, or marginalised in, the labour market. Engagement in the labour force for such groups has both individual and societal benefits. However, while this emphasis on an increased role for the state in education and training is encouraging, commentators have questioned the ability of 'Third Way' discourse to meet the unique needs of women, given the absence of explicit feminist dialogue in wider discussions on associated policy and practice. Informed by this critique, this article aims to evaluate changes in education and training policy and practice in New Zealand since 1999, in terms of the extent to which it enhances opportunities for women's participation in education and training

Descriptive Study of New Jersey's System for External Foster Care Case Review

Effective October 1, 1978, New Jersey mandated independent review of all out-of-home placements supervised and approved for payment by the Division of Youth and Family Services (DYFS). The law authorized each county's Superior Court Assignment Judges to appoint five-member Child Placement Review Boards who must make recommendations to the judge within 45 days of the child's entry into care; all cases must be reviewed at least annually. Semi-structured telephone interviews with members of 36 Boards and 26 persons from DYFS some two years after review was implemented indicated that the Boards varied greatly in the degree to which they exercised their authority. Boards which assumed an independent role were more likely to (1) require DYFS workers to give testimony on all cases; (2) meet weekly; (3) review at least 12 cases at each meeting; (4) have contact with their judge; and (5) reschedule cases before the next mandated annual review. This latter practice, commonly known as "re-review" or "relist", probably did more to demonstrate the Boards' independent role than formal disagreements with DYFS. Formal disagreements were relatively infrequent, presumably because most children were in the only care arrangement possible. Re-review, on the other hand, recognized the impracticability of immediate return home or adoption but held DYFS accountable for taking timely action to ensure permanence for children. The study described the various ways local DYFS offices prepared for review and local Board-DYFS relationships. The impact of review was considered by eliciting respondents' assessments of review. All 36 Board respondents and all but four DYFS respondents felt that DYFS gave more careful attention to case planning because they knew they would have to report to an outside body. Fourteen Board respondents and 24 DYFS liaisons identified at least one disadvantage. The study concludes with an endorsement for independent review and offers recommendations for strengthening it. The study recommends that further research be undertaken to more rigorously study the effects of review

Screening with young offenders with an intellectual disability

The research suggests that young offenders with an intellectual disability (ID) may not always be identified within youth justice services. This pilot study assessed some aspects of the validity of a screening tool, the Child and Adolescent Intellectual Disability Screening Questionnaire (CAIDS-Q), in UK forensic settings, using data from 23 individuals. The CAIDS-Q had positive and negative predictive power of 100%. In addition, a significant difference was found in CAIDS-Q scores between those with and without an ID, with the latter group scoring significantly higher, indicating discriminative validity. A significant positive relationship was found between full-scale IQ and CAIDS-Q scores, indicating convergent validity. The pilot study suggested that the CAIDS-Q may represent a valid screening tool to identify those young offenders who are likely to have an ID. Limitations and implications of the pilot are discussed

Screening for offenders with an intellectual disability: The validity of the Learning Disability Screening Questionnaire

The study assessed the validity of an intellectual disability screening tool, the Learning Disability Screening Questionnaire (LDSQ), in three forensic settings: a community intellectual disability forensic service; a forensic in-patient secure unit and a prison, using data for 94 individuals. A significant positive relationship was found between full scale IQ and LDSQ score, indicating convergent validity. Discriminative validity was indicated by, firstly, a significant difference in the LDSQ scores between those with and without an intellectual disability, with those with a diagnosis of intellectual disability, scoring significantly lower. Secondly, a ROC analysis indicated that the sensitivity and specificity of the LDSQ were both above 80%. The screening tool was found to have lower sensitivity in the forensic populations than was obtained in the original community standardisation sample, but had slightly higher specificity. Limitations and implications of the study are discussed

The phenotype of sporadic CJD in the UK between 1993-2004, and a review of the diagnostic criteria and differential diagnosis

BACKGROUND / AIMS Sporadic CJD is a rare but universally fatal neurodegenerative disease of unknown aetiology that occurs worldwide. This study aims to characterise UK sCJD cases between 1993 and 2004 looking for evidence of change over time. Transmission of cattle BSE to humans, with subsequent development of variant CJD, has raised concerns that other novel phenotypes of human prion disease may develop with potentially major public health implications. This study addresses this by reviewing suspect sCJD patients referred before and after the identification of vCJD, by evaluating the phenotype of young onset compared to older onset sCJD and by comparing UK cases with the sCJD databases in France and other predominantly European countries with lower BSE exposure. This study also aims to review the WHO sCJD diagnostic criteria and hence explore the differential diagnosis of sCJD in the UK.METHODS All suspected sCJD cases referred to the NCJDSU between 1993 and 2004 were evaluated by retrospective case note review using the NCJDSU archives. A more detailed analysis of clinical phenotype was performed on patients referred in 1993, 1994, 2003 and 2004, all cases with a negative 14-3-3 result and all patients aged 50 or less at disease onset. MRI, CSF, EEG and pathology results were analysed. UK data were compared with European sCJD data extracted from the EUROCJD database. Suspect sCJD cases that ultimately received an alternative, non CJD diagnosis were reviewed, and the WHO sCJD criteria were evaluated.RESULTS AND CONCLUSIONS There is no evidence to support emergence of a novel, BSE related phenotype of human prion disease. The sCJD demographic data and clinical phenotype are reassuringly similar between 1993/4 and 2003/4, between young and older onset cases and between UK and other European cases. The small number of changes that have been observed can largely be attributed to alterations in data collection and investigation use, plus improved case ascertainment. There is a suggestion that the proportion of PRNP MM cases is decreasing in the UK and France, most likely related to improved identification of atypical presentations. However, continued close observation of PRNP trends is important. The current WHO diagnostic criteria for sCJD are a useful tool, both for research purposes and clinicians in daily practise. Incorporation of CSF 14-3-3 into the Probable sCJD classification has resulted in improved sensitivity of 72% but at the expense of moderate reduction in specificity to 79%. The positive predictive value remains high of 89%. Currently there is insufficient evidence to support inclusion of MRI in the diagnostic criteria.The differential diagnosis of sCJD is wide but Alzheimer's disease is the condition most commonly mistaken for sCJD. However, a significant minority of individuals initially suspected of having CJD never receive a diagnosis, sometimes even after neuropathological studies. Accurate disease surveillance remains a priority, not only to ensure that atypical sCJD presentations are not misdiagnosed, but also to assess putative risk factors for developing sCJD and to identify any novel CJD phenotypes that may emerge in the future