Not recognized enough: The effects and associations of trauma and intellectual disability in severely mentally ill outpatients

Item does not contain fulltextBackground: Little is known about the association between trauma and intellectual disability in SMI patients. Aim: To establish the prevalence of trauma and its association with intellectual functioning in SMI outpatients. Methods: A cross-sectional study was conducted in two mental health trusts in the Netherlands. We used the Trauma Screening Questionnaire (TSQ) to screen for trauma and PTSD, and the Screener for Intelligence and Learning disabilities (SCIL) for suspected MID/BIF. Chi-square and t-tests were used to test differences in outcome over patient characteristics. Post-hoc analysis was used to investigate gender differences between patients with and without MID/BIF on trauma and sexual trauma. Results: Any trauma was found in 86% of 570 patients and 42% were suspected for PTSD. The SCIL suggested that 40% had Borderline Intellectual Functioning (BIF), half of whom were suspected of having Mild Intellectual Disability (MID). These patients had more traumatic experiences (1.89 in BIF, 1.75 in MID, against 1.41 in SCIL-negative patients). Female MID/BIF patients (61%) had experienced significantly more sexual abuse than male MID/BIF patients (23%). Conclusions: Significantly more SMI outpatients who screened positive for MID/BIF reported having experienced traumatic events than those who screened negative. Rates of all trauma categories were significantly higher in the screen-positive group, who were also more likely to have PTSD. Sexual abuse occurred more in all females but the SCIL positive women are even more often victim. Clinical practice has to pay more attention to all of these issues, especially when they occur together in a single patient.7 p

The interaction between school poverty and agreeableness in predicting educational attainment

This study examined the relation between school poverty and educational attainment of adolescents, and tested whether personality trait agreeableness moderated this link. The sample consisted of 4236 adolescents, whose math abilities were assessed twice, at ages around 13/14 and 15/16. Agreeableness was assessed at age 13. School poverty was measured as the proportion of children eligible for free school meals in the school. The results showed a negative relation between school poverty and educational attainment, however, this negative relation was weaker for adolescents with higher levels of agreeableness. Specifically, in low poverty schools, agreeableness did not predict differences in educational attainment. The results were in line with the diathesis-stress model. This suggests that higher levels of agreeableness can contribute to resilience and better coping with contextual stressors in the school environment.OLD Urban Renewal and Housin

A blind spot? Screening for mild intellectual disability and borderline intellectual functioning in admitted psychiatric patients: Prevalence and associations with coercive measures

Contains fulltext : 169048.pdf (publisher's version ) (Open Access)Background: Failure to detect psychiatric patients' intellectual disabilities may lead to inappropriate treatment and greater use of coercive measures. Aims: In this prospective dynamic cohort study we screened for intellectual disabilities in patients admitted to psychiatric wards, and investigated the use of coercive measures with these patients. Methods: We used the Screener for Intelligence and Learning disabilities (SCIL) to screen patients admitted to two acute psychiatric wards, and assessed patient characteristics and coercive measures during their stay and over the last 5 years. Results: Results on the SCIL suggested that 43.8% of the sample had Mild Intellectual Disability or Borderline Intellectual Functioning (MID/BIF). During their current stay and earlier stays in the previous 5 years, these patients had an increased risk of involuntary admission (OR 2.71; SD 1.28-5.70) and coercive measures (OR 3.95, SD 1.47-10.54). Conclusions: This study suggests that functioning on the level of MID/BIF is very prevalent in admitted psychiatric patients and requires specific attention from mental health care staff.10 p

The association between neighbourhoods and educational achievement, a systematic review and meta-analysis

The research leading to these results has received funding from the European Research Council under the European Union's Seventh Framework Programme (FP/2007-2013) / ERC Grant Agreement n. 615159 (ERC Consolidator Grant DEPRIVEDHOODS, Socio-spatial inequality, deprived neighbourhoods, and neighbourhood effects). Many studies have examined the effects of neighbourhoods on educational outcomes. The results of these studies are often conflicting, even if the same independent variables (such as poverty, educational climate, social disorganisation, or ethnic composition) are used. A systematic meta-analysis may help to resolve this lack of external validity. We identified 5516 articles from which we selected 88 that met all of the inclusion criteria. Using meta-regression, we found that the relation between neighbourhoods and individual educational outcomes is a function of neighbourhood poverty, the neighbourhood’s educational climate, the proportion of ethnic/migrant groups, and social disorganisation in the neighbourhood. The variance in the findings from different studies can partly be explained by the sampling design and the type of model used in each study. More important is the use of control variables (school, family SES, and parenting variables) in explaining the variation in the strength of neighbourhood effects.OTBArchitecture and The Built Environmen

The role of integration for future urban water systems: Identifying Dutch urban water practitioners' perspectives using Q methodology

Urban water systems are under increased pressure from ongoing developments like climate change, population growth and urbanization. While it is clear that current urban water challenges need a more integrated approach, practitioners disagree on what such an integrated approach means exactly. Integration could therefore be described as a wicked problem, with practitioners having different understandings of integration, as well as the opportunities and challenges they should focus on; e.g., climate adaptation, resource recovery or collective replacement. This lack of consensus challenges decision-making, and thus the implementation of integration. To foster urban water systems integration, this study uses Q methodology to explore the different perspectives that Dutch urban water practitioners have on integration for future urban water systems. Our analysis reveals four salient perspectives: perspective 1 sees coordination as a means to make the system future-proof, perspective 2 focuses on climate adaptation, perspective 3 aims for recovery, and perspective 4 is all about efficiency and being in control. While all perspectives acknowledge that traditional urban water practices need to change, they differ on which sustainability challenges are considered most important and what means should be used. Practitioners need to understand these differences to deal effectively with the wicked nature of integration.Sanitary Engineerin

Towards the integrated management of urban water systems: Conceptualizing integration and its uncertainties

Climate change and urbanization, as well as growing environmental and economic concerns, highlight the limitations of traditional wastewater practices and thereby challenge the management of urban water systems. Both in theory and in practice, it has been widely acknowledged that the challenges of the twenty-first century require solutions that address problems in a more integrated way. Although the demand for integration is obvious, implementation has proved challenging because of the complexity and uncertainty involved. In addition, the urban water literature contains a wide diversity of approaches to integration, each contribution having its own understanding of the term, as well as how to deal with the complexity that comes with it. In this article, we take a first step in supporting both decision-making and decision-makers in urban water systems integration. First, we work towards a more comprehensive perspective on integration in urban water management; one that uses and structures the variety of existing approaches. In so doing, we introduce a typology of urban water systems integration that distinguishes between geographical, physical, informational, and project-based forms. Second, we explore the implications that such integrated solutions bring for decision-makers. They will be faced with additional uncertainty arising (1) at the interfaces of previously unconnected systems and (2) from the social and institutional changes that systems integration requires. Finally, we draft three decision-making challenges that come with integration and provide some possibilities for dealing with them.</p

Neighbourhood effects on migrant and native youth’s educational commitments, an enquiry into personality differences

In the literature examining neighbourhood effects on educational outcomes, the socialisation mechanism is usually investigated by looking at the association between neighbourhood characteristics and educational attainment. The step in between, that adolescents actually internalise educational norms held by residents, is often assumed. We attempt to fill this gap by looking at how the internalisation of educational norms (commitments) is influenced by neighbourhoods’ immigrant concentration. We investigate this process for both migrant and native youth, as both groups might be influenced differently by immigrant concentrations. To test our hypothesis we used longitudinal panel data with five waves (N = 4255), combined with between-within models which control for a large portion of potential selection bias. These models have an advantage over naïve OLS models in that they predict the effect of change in neighbourhood characteristics on change in educational commitment, and therefore offer a more dynamic approach to modelling neighbourhood effects. Our results show that living in neighbourhoods with higher proportions of immigrants increases the educational commitments of migrant youth compared to living in neighbourhoods with lower proportions. Besides, we find that adolescents with a resilient personality experience less influence of the neighbourhood context on educational commitments than do adolescents with non-resilient personalities