Validating the Effects of Inclusive Childcare with the Interaction Rating Scale

Abstract This study aimed to validate the effects of inclusion in center-based childcare, focusing on the inclusion of children with disabilities. One hundred thirty-eight 3 to 12-year-olds participated in this study. Participants were required to complete a 5-minute interaction session and were evaluated using the Interaction Rating Scale between Children (IRSC) as an evidence-based practical index of social skills. Significantly higher IRSC self-control scores were observed in interactions between typically developing children and children with disabilities than in normal children pairs. Additionally, behaviors reflecting the IRSC items, "explains his/her opinion logically" and "explains his/her opinion based on the level of competence/ability of the partner" were more frequently observed in interactions involving peers with disabilities than in those involving only typically developing peers. These results suggest that inclusive childcare may be effective in enhancing child social competence, especially self-control and flexibility/adaptability, depending on interaction partners' needs for care

Diminished mental- and physical function and lack of social support are associated with shorter survival in community dwelling older persons of Botswana

<p>Abstract</p> <p>Background</p> <p>Mortality rates for older persons in Botswana have been unavailable and little is known of predictors of mortality in old age. This study may serve as a precursor for more detailed assessments.</p> <p>The objective was to assess diminished function and lack of social support as indicators of short term risk of death.</p> <p>Methods</p> <p>A national population based prospective survey was undertaken in Botswana; twelve rural areas and three urban centers were included.</p> <p>372 community-dwelling persons aged sixty years and over, were included; 265 were followed-up. Sixteen subjects were deceased at follow-up.</p> <p>Subjects were interviewed and clinically assessed at home. Measures of cognitive function, depression and physical function and sociodemographic information were collected. Subjects were followed-up at average 6.8 months after baseline.</p> <p>Results</p> <p>Overall mortality rate was 10.9 per 100 person years. Age-adjusted odds ratios (OR) for death during follow-up were; 4.2 (CI 1.4–12.5) and 3.6 (CI 1.0–12.7) for those with diminished physical- and cognitive function, respectively.</p> <p>Indicators of limited social support; household with only 1 or 2 persons and eating alone, yielded age adjusted ORs of 4.3 (CI 1.5–12.5) and 6.7 (CI 2.2–20), respectively, for death during follow-up.</p> <p>Conclusion</p> <p>Older community dwelling persons with diminished cognitive- or physical function, solitary daily meals and living in a small household have a significantly increased risk of rapid deterioration and death.</p> <p>Health policy should include measures to strengthen informal support and expand formal service provisions to older persons with poor function and limited social networks in order to prevent premature deaths.</p

Attrition and bias in the MRC cognitive function and ageing study: an epidemiological investigation

BACKGROUND: Any hypothesis in longitudinal studies may be affected by attrition and poor response rates. The MRC Cognitive Function and Ageing study (MRC CFAS) is a population based longitudinal study in five centres with identical methodology in England and Wales each recruiting approximately 2,500 individuals. This paper aims to identify potential biases in the two-year follow-up interviews. METHODS: Initial non-response: Those not in the baseline interviews were compared in terms of mortality to those who were in the baseline interviews at the time of the second wave interviews (1993–1996). Longitudinal attrition: Logistic regression analysis was used to examine baseline differences between individuals who took part in the two-year longitudinal wave compared with those who did not. RESULTS: Initial non-response: Individuals who moved away after sampling but before baseline interview were 1.8 times more likely to die by two years (95% Confidence interval(CI) 1.3–2.4) compared to respondents, after adjusting for age. The refusers had a slightly higher, but similar mortality pattern to responders (Odds ratio 1.2, 95%CI 1.1–1.4). Longitudinal attrition: Predictors for drop out due to death were being older, male, having impaired activities of daily living, poor self-perceived health, poor cognitive ability and smoking. Similarly individuals who refused were more likely to have poor cognitive ability, but had less years of full-time education and were more often living in their own home though less likely to be living alone. There was a higher refusal rate in the rural centres. Individuals who moved away or were uncontactable were more likely to be single, smokers, demented or depressed and were less likely to have moved if in warden-controlled accommodation at baseline. CONCLUSIONS: Longitudinal estimation of factors mentioned above could be biased, particularly cognitive ability and estimates of movements from own home to residential homes. However, these differences could also affect other investigations, particularly the estimates of incidence and longitudinal effects of health and psychiatric diseases, where the factors shown here to be associated with attrition are risk factors for the diseases. All longitudinal studies should investigate attrition and this may help with aspects of design and with the analysis of specific hypotheses

Municipal health expectancy in Japan: decreased healthy longevity of older people in socioeconomically disadvantaged areas

BACKGROUND: Little is known about small-area variation in healthy longevity of older people and its socioeconomic correlates. This study aimed to estimate health expectancy at 65 years (HE65) at the municipal level in Japan, and to examine its relation to area socio-demographic conditions. METHODS: HE65 of municipalities (N = 3361) across Japan was estimated by a linear regression formula with life expectancy at 65 years and the prevalence of those certificated as needing nursing care. The relation between HE65 and area socio-demographic indicators was examined using correlation coefficients. RESULTS: The estimated HE65 (years) ranged from 13.13 to 17.39 for men and from 14.84 to 20.53 for women. HE65 was significantly positively correlated with the proportion of elderly and per capita income, and negatively correlated with the percentage of households of a single elderly person, divorce rate, and unemployment rate. These relations were stronger in large municipalities (with a population of more than 100,000) than in small and medium-size municipalities. CONCLUSION: A decrease in healthy longevity of older people was associated with a higher percentage of households of a single elderly person and divorce rate, and lower socioeconomic conditions. This study suggests that older people in urban areas are susceptible to socio-demographic factors, and a social support network for older people living in socioeconomically disadvantaged conditions should be encouraged