Integrative treatment in persons with intellectual disability and mental health problems.

Contains fulltext : 53317.pdf (publisher's version ) (Closed access)BACKGROUND: Clinical experience has proven thus far that a monodisciplinary treatment approach to behavioural and psychiatric problems in persons with intellectual disability (ID), such as psychotropic medication or behaviour modification programmes, has yielded limited success. It is clear that the complexity of behavioural and psychiatric problems in this population calls for a treatment approach from different perspectives. METHODS: A multidimensional treatment approach to the persons with ID who suffer from behaviour problems and psychiatric disorders is described. RESULTS: Four dimensions - biological, psychological, social and developmental - are represented as well in an integrative diagnosis as in an integrative treatment, embodied by cooperation of different professionals, such as a psychiatrist, psychologist, pedagogues, social worker, nurse and, where possible, the person's caretakers. The developmental dimension receives a salient attention of assessors. By introducing the developmental dimension in diagnostics and treatment, the bio-psycho-social dimensions are set in a new context, more appropriate for persons with ID. CONCLUSION: The integrative treatment should not be primarily directed towards the symptoms of the disorder but towards restoring a person's mental well-being. The disorder is combated through treatment of the underlying processes that have led to its onset. Different treatment methods from different perspectives may be applied. Strategy and methodological procedures of an integrative treatment are discussed by way of case presentations

Durability assessment of the Alaçatı tuff (Izmir) in western Turkey

Ala double dagger atA +/- tuff has been used extensively as a source of building stone for outdoor and indoor decorations since the historical times in and around the tourist town of Ala double dagger atA +/- (western Turkey). The use of the Alacati tuff in buildings has been made compulsory by the Ala double dagger atA +/- municipality, for preserving the historical appearance of the buildings, after 2005 in Ala double dagger atA +/-. It has been noticed that, evident deteriorations developed in tuff surfaces of the stone buildings and garden walls within 5-6 years of their emplacement. Durability properties of the Ala double dagger atA +/- tuff are evaluated by determining the mineralogical, chemical, and physico-mechanical properties of the fresh tuff samples obtained from the only operative quarry in the area. Ageing tests such as Na2SO4 and MgSO4 salt crystallization, freezing-thawing, and wetting-drying were conducted on the fresh tuff samples to assess their durability. Additionally, the durability of the tuff is also evaluated by determining its average pore diameter, saturation coefficient, wet-to-dry strength ratio, static rock and slake-durability indices. Fresh Ala double dagger atA +/- tuff has high porosity and low unit weight and strengths and are classified to be very poor to moderately durable stone based on the test results of different durability assessment methods. Mineralogical and geochemical analyses have also been carried out on the deteriorated tuff samples collected from the surfaces of the stone buildings to determine the effect of weathering on tuff and the test results have been compared with those of the fresh tuff samples. There is no major difference observed between the mineralogy and chemistry of the fresh and weathered tuff samples thus, it has been concluded that physical weathering has been dominant in the area in deterioration of tuff