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Abstract Introduction In 24/7 disability care facilities, patient‐reported experience measures (PREMs) are important to help healthcare professionals understand what matters to care users and to improve the quality of care. However, the successful implementation of a PREM is complex. In a Dutch disability care organization, stakeholders cocreated tailored implementation strategies aimed at improving the use and integration of a qualitative PREM. This study gives insights into the uptake and experiences with these cocreated implementation strategies and the perceived impact of the set of strategies. Methods We performed a prospective process evaluation between February 2020 and February 2021. We collected data in three disability care facilities from 35 care users, 11 professionals, 3 facility managers and 4 organization representatives. Data collection included observations during kick‐offs and learning goal meetings and several attendance checklists. We collected 133 questionnaires (Time 0 and Time 1). We conducted 35 individual semistructured interviews and an online focus group interview. Quantitative data were analysed using descriptive statistics and qualitative data using directed content analysis. Results The exposure to and adoption of strategies was between 76% and 100%. Participants were positive about tailoring the strategies to each facility. Implementation was hindered by challenges in care users' communication and COVID‐19. The perceived impact referred to an improved understanding of the goal and added value of the PREM and better preparation and execution of the PREM. The impact of the set of strategies was mainly experienced on the micro level. Conclusion The uptake of the cocreated implementation strategies was acceptable. The participants valued the tailored approach, which enabled them to focus on facility‐specific learning goals. Stakeholder engagement and co‐created strategies may have strengthened the adoption of and experiences with the implementation. Patient or Public Contribution In this article, we present the process evaluation of implementation strategies for the integrated use of a PREM in disability care. A development group consisting of communication vulnerable care users, trainers and professionals developed the implementation strategies. The disability care organization was responsible for the planning and organization of the implementation process. During the process evaluation the end users, trainers, professionals and managers tailored the implementation strategies to their own settings and needs. Researchers observed this implementation process and interviewed the stakeholders about their experiences and the perceived impact.

Background: A care facility for people with disabilities struggles to obtain financial support for its Parent Education and Support Programme. The programme’s design includes two implementers, an occupational therapist and a community-based worker, increasing its core costs. To enhance the likelihood of donor support, the Facility considered choosing the best-suited implementer for the programme. To help inform this decision, a formal methodological approach to high-level decision-making called multi-criteria decision analysis (MCDA) was utilised. Objective: Through a case study, this paper demonstrates how the MCDA methodology, using the analytical hierarchical process (AHP), was applied in a programme evaluation context. Method: Decision models were constructed using the AHP MCDA method and elicited rater judgments. Raters were drawn from four stakeholder groups: Programme beneficiaries, management, donors, and experts in disability and rehabilitation. This was followed by assigning criteria weights, establishing local priorities for each alternative, and aggregating the judgments. The model was then synthesised, and a sensitivity analysis was conducted. Results: The findings revealed that specific outcomes were attributed to each implementer, and thus, deciding to employ only one implementer would have had serious consequences for the programme’s quality and the achievement of intended outcomes. Conclusion: The results confirmed the usefulness of AHP MCDA for programme design decisions. Contribution: This article contributes by enhancing the understanding of the AHP MCDA methodology. Secondly, it demonstrates the suitability of this methodology for programme designers, evaluators, or non-profit organisations (NPOs) who need to make informed decisions about the design and implementation of interventions.

The evolutionary roots of care for injured, ill, and disabled group members remain unclear. The same can be said about care for dying and dead group members. Accumulating case reports in a variety of nonhuman primates can shed light on these origins. Here we provide a detailed account of interactions of a wild capuchin monkey mother and other group members with a disabled infant before and after its death. Limb disability caused the infant to be in unstable positions when carried, which appeared to increase the frequency of body readjustments by the adults and may have contributed to its death. After death, no adults other than the mother made contact with the corpse, but four immatures approached and touched it. The mother foraged only on flies surrounding the corpse while carrying it, stopped several times to set the corpse down on the branches, and let it finally fall as she leapt between trees. The difficulty of carrying disabled and dead individuals up in the trees may help to explain the scarcity of reports in platyrrhines, and suggests that terrestriality and increasing ease of bipedality may have contributed to the evolution of these behaviors in primates. [ABSTRACT FROM AUTHOR]

Introduction: In 24/7 disability care facilities, patient‐reported experience measures (PREMs) are important to help healthcare professionals understand what matters to care users and to improve the quality of care. However, the successful implementation of a PREM is complex. In a Dutch disability care organization, stakeholders cocreated tailored implementation strategies aimed at improving the use and integration of a qualitative PREM. This study gives insights into the uptake and experiences with these cocreated implementation strategies and the perceived impact of the set of strategies. Methods: We performed a prospective process evaluation between February 2020 and February 2021. We collected data in three disability care facilities from 35 care users, 11 professionals, 3 facility managers and 4 organization representatives. Data collection included observations during kick‐offs and learning goal meetings and several attendance checklists. We collected 133 questionnaires (Time 0 and Time 1). We conducted 35 individual semistructured interviews and an online focus group interview. Quantitative data were analysed using descriptive statistics and qualitative data using directed content analysis. Results: The exposure to and adoption of strategies was between 76% and 100%. Participants were positive about tailoring the strategies to each facility. Implementation was hindered by challenges in care users' communication and COVID‐19. The perceived impact referred to an improved understanding of the goal and added value of the PREM and better preparation and execution of the PREM. The impact of the set of strategies was mainly experienced on the micro level. Conclusion: The uptake of the cocreated implementation strategies was acceptable. The participants valued the tailored approach, which enabled them to focus on facility‐specific learning goals. Stakeholder engagement and co‐created strategies may have strengthened the adoption of and experiences with the implementation. Patient or Public Contribution: In this article, we present the process evaluation of implementation strategies for the integrated use of a PREM in disability care. A development group consisting of communication vulnerable care users, trainers and professionals developed the implementation strategies. The disability care organization was responsible for the planning and organization of the implementation process. During the process evaluation the end users, trainers, professionals and managers tailored the implementation strategies to their own settings and needs. Researchers observed this implementation process and interviewed the stakeholders about their experiences and the perceived impact. [ABSTRACT FROM AUTHOR]

Abstract Background Sexual boundary violations (SBV) in healthcare are harmful and exploitative sexual transgressions in the professional–client relationship. Persons with mental health issues or intellectual disabilities, especially those living in residential settings, are especially vulnerable to SBV because they often receive long-term intimate care. Promoting good sexual health and preventing SBV in these care contexts is a moral and practical challenge for healthcare organizations. Methods We carried out a qualitative interview study with 16 Dutch policy advisors, regulators, healthcare professionals and other relevant experts to explore their perspectives on preventing SBV in mental health and disability care organizations. We used inductive thematic analysis to interpret our data. Results We found three main themes on how healthcare organizations can prevent SBV in mental health and disability care: (1) setting rules and regulations, (2) engaging in dialogue about sexuality, and (3) addressing systemic and organizational dimensions. Conclusion Our findings suggest that preventing SBV in mental health and disability care organizations necessitates setting suitable rules and regulations and facilitating dialogue about positive aspects of sexuality and intimacy, as well as about boundaries, and inappropriate behaviors or feelings. Combining both further requires organizational policies and practices that promote transparency and reflection, and focus on creating a safe environment. Our findings will help prevent SBV and promote sexual health in mental health and disability care organizations.

Background: A care facility for people with disabilities struggles to obtain financial support for its Parent Education and Support Programme. The programme's design includes two implementers, an occupational therapist and a community-based worker, increasing its core costs. To enhance the likelihood of donor support, the Facility considered choosing the best-suited implementer for the programme. To help inform this decision, a formal methodological approach to high-level decision-making called multi-criteria decision analysis (MCDA) was utilised. Objective: Through a case study, this paper demonstrates how the MCDA methodology, using the analytical hierarchical process (AHP), was applied in a programme evaluation context. Method: Decision models were constructed using the AHP MCDA method and elicited rater judgments. Raters were drawn from four stakeholder groups: Programme beneficiaries, management, donors, and experts in disability and rehabilitation. This was followed by assigning criteria weights, establishing local priorities for each alternative, and aggregating the judgments. The model was then synthesised, and a sensitivity analysis was conducted. Results: The findings revealed that specific outcomes were attributed to each implementer, and thus, deciding to employ only one implementer would have had serious consequences for the programme's quality and the achievement of intended outcomes. Conclusion: The results confirmed the usefulness of AHP MCDA for programme design decisions. Contribution: This article contributes by enhancing the understanding of the AHP MCDA methodology. Secondly, it demonstrates the suitability of this methodology for programme designers, evaluators, or non-profit organisations (NPOs) who need to make informed decisions about the design and implementation of interventions. [ABSTRACT FROM AUTHOR]

Background: People with profound intellectual and multiple disabilities (PIMD) cannot communicate the need to change their incontinence products. The smart continence care (SCC) product Abena Nova signals caregivers when change is needed. This provides the opportunity for more person-centered care, increased quality of life, and a decreased number of leakages. However, there is a need for evidence of the effectiveness and cost-effectiveness of such technology compared with regular continence care (RCC) for people with PIMD. Objective: This paper presents the research protocol for an effectiveness and cost-effectiveness study with people with PIMD living in long-term care facilities in the Netherlands. Methods: A cluster randomized trial will be conducted in 3 consecutive waves across 6 long-term care providers for people with disabilities and 160 participants with PIMD. Long-term care providers are randomized at a 1:1 ratio, resulting in an intervention group and a group continuing RCC. The intervention group will receive implementation guidance and use SCC for 3 months; the other group will continue their RCC as usual and then switch to SCC. This study consists of three components: effectiveness study, economic evaluation, and process evaluation. The primary outcome will be a change in the number of leakages. The secondary outcomes are quality of life, the difference in the number of changes, the work perception of caregivers, cost-effectiveness, and cost utility. Data collection will occur at T0 (baseline), T1 (6 weeks), T2 (12 weeks), and T3 (9-month follow-up) for the first 2 intervention groups. An intention-to-treat analysis will be performed. The economic evaluation will be conducted alongside the trial from the societal and long-term care provider perspectives. Qualitative data collection through interviews and field notes will complement these quantitative results and provide input for the process evaluation. Results: This research was funded in December 2019 by ZonMw, the Netherlands Organization for Health Research and Development. As of June 2022, we enrolled 118 of the 160 participants. The enrollment of participants will continue in the third and fourth quarters of 2022. Conclusions: This study will provide insights into the effectiveness and cost-effectiveness of SCC for people with PIMD, allowing long-term care providers to make informed decisions about implementing such a technology. This is the first time that such a large-scale study is being conducted for people with PIMD. [ABSTRACT FROM AUTHOR]

Background: Executive functions are essential for independently navigating nearly all of our daily activities. Executive dysfunction often occurs as a result of a neurodevelopmental disorder. Persons with executive dysfunction experience challenges regarding independent execution of daily tasks. Social robots might support persons with executive dysfunction to execute daily tasks and promote their feeling of independence. Objective: This study aimed to study the impact of interacting with social robot Tessa on goal attainment in the execution of daily tasks and perceived independence of persons with executive dysfunction. Methods: In this multiple-case study, 18 participant-caregiver couples were followed up while using Tessa in the home environment for 3 months. Goal attainment on independently performing a self-determined goal was measured by the Goal Attainment Scale, and participant-caregiver couples were interviewed about their experience with their interaction with Tessa and how they perceived Tessa's impact on their independence. Results: In total, 11 (61%) participants reached their goal after 6 weeks and maintained their goal after 3 months. During the study period, 2 participant-caregiver couples withdrew because of mismatch with Tessa. Participants set goals in the following domains: execution of household tasks; intake of food, water, or medication; being ready in time for an appointment; going to bed or getting out of bed on time; personal care; and exercise. Participants perceived that Tessa increased the feeling of independence by generating more structure, stimulation, and self-direction. Participant-caregiver couples reported that the auditive information provided by Tessa was more effective in coping with executive dysfunction compared to their initial approaches using visual information, and the use of Tessa had a positive impact on their relationship. Results: In total, 11 (61%) participants reached their goal after 6 weeks and maintained their goal after 3 months. During the study period, 2 participant-caregiver couples withdrew because of mismatch with Tessa. Participants set goals in the following domains: execution of household tasks; intake of food, water, or medication; being ready in time for an appointment; going to bed or getting out of bed on time; personal care; and exercise. Participants perceived that Tessa increased the feeling of independence by generating more structure, stimulation, and self-direction. Participant-caregiver couples reported that the auditive information provided by Tessa was more effective in coping with executive dysfunction compared to their initial approaches using visual information, and the use of Tessa had a positive impact on their relationship. [ABSTRACT FROM AUTHOR]

Background: Sexual boundary violations (SBV) in healthcare are harmful and exploitative sexual transgressions in the professional-client relationship. Persons with mental health issues or intellectual disabilities, especially those living in residential settings, are especially vulnerable to SBV because they often receive long-term intimate care. Promoting good sexual health and preventing SBV in these care contexts is a moral and practical challenge for healthcare organizations.Methods: We carried out a qualitative interview study with 16 Dutch policy advisors, regulators, healthcare professionals and other relevant experts to explore their perspectives on preventing SBV in mental health and disability care organizations. We used inductive thematic analysis to interpret our data.Results: We found three main themes on how healthcare organizations can prevent SBV in mental health and disability care: (1) setting rules and regulations, (2) engaging in dialogue about sexuality, and (3) addressing systemic and organizational dimensions.Conclusion: Our findings suggest that preventing SBV in mental health and disability care organizations necessitates setting suitable rules and regulations and facilitating dialogue about positive aspects of sexuality and intimacy, as well as about boundaries, and inappropriate behaviors or feelings. Combining both further requires organizational policies and practices that promote transparency and reflection, and focus on creating a safe environment. Our findings will help prevent SBV and promote sexual health in mental health and disability care organizations. [ABSTRACT FROM AUTHOR]

Plain English summary Exploring care-users experiences is important for decisions to improve quality of care. This applies to care-users in the disability care in particular, as these care-users are highly dependent on their care professional. Instruments that facilitate a dialogue between care-users and care professionals about experiences with care are not always used correctly. Furthermore, it is difficult to translate outcomes into decisions about improving quality of care for the individual care-user and the organisation. In our study, care-users, care professionals, management and researchers developed strategies together to improve the use of care-user experience measures. This study aims to show the impact of all participants, including care-users, professionals, management and researchers, on developing implementation strategies. Additionally, the study aims to show how care-users can participate in developing strategies whilst having problems with communication due to intellectual, developmental and acquired disabilities. We found that care-users gave crucial input to the look and feel, and understandability and relevance of the strategies. The contribution of the professionals had impact on how to use strategies and terminology used in instructions and visuals. Management shared lessons learned and represented the needs on the policy level. Researchers used their analytical skills and facilitated the group process. Care-users were able to collaborate by taking into account their needs and because information was presented to them clearly and attractively.

Abstract Background In implementation science, vast gaps exist between theoretical and practical knowledge. These gaps prevail in the process of getting from problem analysis to selecting implementation strategies while engaging stakeholders including care users. Objective To describe a process of how to get from problem analysis to strategy selection, how to engage stakeholders, and to provide insights into stakeholders’ experiences. Design A qualitative descriptive design. Setting and participants The setting was a care organization providing long‐term care to people with acquired brain injuries who are communication vulnerable. Fourteen stakeholders (care users, professionals and researchers) participated. Data were collected by a document review, five interviews and one focus group. Inductive content analysis and deductive framework analysis were applied. Intervention Stakeholder engagement. Main outcome measures A three‐step process model and stakeholders experiences. Results and conclusion We formulated a three‐step process: (a) reaching consensus and prioritizing barriers; (b) categorizing the prioritized barriers and idealization; and (c) composing strategies. Two subthemes continuously played a role in how stakeholders were engaged during the process: communication supportive strategies and continuous contact. The experiences of stakeholder participation resulted in the following themes: stakeholders and their roles, use of co‐creation methods and communication supportive strategies, building relationships, stimulus of stakeholders to engage, sharing power, empowerment of stakeholders, feeling a shared responsibility and learning from one another. We conclude that the inclusion of communication‐vulnerable care users is possible if meetings are prepared, communication‐friendly presentations and reports are used, and relationship building is prioritized.

Background: Implementation issues often impede the realisation of the potential benefits of technology in disability care organisations for people with disabilities. Therefore, we conducted a longitudinal study to gain insights into the barriers and facilitators to implementation., Methods: From 2019 to 2022, data were collected using questionnaires and interviews during 28 implementation projects in 26 disability care organisations., Results: Barriers and facilitators were identified using 9 themes and 26 subthemes. The main themes identified were finances, disability care organisations, internal collaborations, external collaborations, technology, care staff, project teams, people with disabilities, and context. Most factors mentioned as barriers in one organisation were mentioned as facilitators in others. This suggests that barriers can be resolved to improve implementation., Conclusion: A large number of barriers and facilitators spanning the organisation suggests that the implementation of technology should be considered an organisational reform. Acting upon them is crucial for the successful implementation of technology., (© 2024 The Author(s). Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.)

Background: Against the backdrop of worldwide increases in life expectancy, there is a growing concern about the future of health and social care services in many countries, including Sweden. This is not least due to expected cutbacks in tax revenues and increasing staff shortages in the welfare sector. Challenges such as these have spurred leadership reforms aimed at mobilizing employee engagement and promoting job attractiveness. For instance, distributed leadership, whereby leader responsibilities are distributed and shared among team members, has gained momentum in recent decades. Nevertheless, there is still limited knowledge as to whether and how organizational conditions impact first-line managers’ inclination to distribute influence and control. Objective: This study aims to examine the organizational precursors of two interrelated aspects of distributed leadership among first-line managers in municipal elder- and disability care: collaborative decision-making and the presence (or lack of) a participatory leadership approach. Methods: Utilizing survey data from managers working in the elder- and disability care sectors in the municipality of Gothenburg, Sweden (N = 250), associations between conditions and aspects of distributed leadership were analyzed by means of Confirmatory Factor Analysis (CFA) and Structural Equation Modeling (SEM). Results: Both aspects of distributed leadership were positively and significantly associated with managers’ perceptions of having well-functioning collaborations with their employees (β = 0.277 [0.122–0.432]; β = 0.492 [0.346–0.637]) as well as with the managers’ active participation in development work aimed at, e.g., promoting organizational trust (β = 0.242 [0.039–0.446]; β = 0.251 [0.103–0.398]). No significant associations between distributed leadership and support from senior management or positive collaborations with support functions were observed in the controlled analyses. However, managers’ perceptions of organizational governance deficits were shown to be significantly and positively associated with having a more participatory leadership approach (β = 0.261 [0.032–0.491]). Conclusions: In line with the notion of distributed leadership as a “collective activity”, which is realized in the interaction between managers and their employees, the findings demonstrate that trusting collaborations with responsible and knowledgeable employees play a key role in its practical implementation. Also, distributed leadership, and the work team relations through which it is enabled, are likely to mutually and positively reinforce each other. Additionally, the analyses revealed that managers’ experiences of poor organizational governance appear to promote certain distributed leadership practices. Potentially, this could be because such deficits encourage them to seek support and guidance from their employees, but more research exploring these mechanisms is needed.

Background: The integrated uptake of patient-reported experience measures, using outcomes for the micro, meso and macro level, calls for a successful implementation process which depends on how stakeholders are involved in this process. Currently, the impact of stakeholders on strategies to improve the integrated use is rarely reported, and information about how stakeholders can be engaged, including care-users who are communication vulnerable, is limited. This study illustrates the impact of all stakeholders on developing tailored implementation strategies and provides insights into supportive conditions to involve care-users who are communication vulnerable. Methods: With the use of participatory action research, implementation strategies were co-created by care-users who are communication vulnerable (n = 8), professionals (n = 12), management (n = 6) and researchers (n = 5) over 9 months. Data collection consisted of audiotapes, reports, and researchers' notes. Conventional content analysis was performed. Results: The impact of care-users concerned the strategies' look and feel, understandability and relevance. Professionals influenced impact on how to use strategies and terminology. The impact of management was on showing the gap between policy and practice, and learning from previous improvement failures. Researchers showed impact on analysis, direction of strategy changes and translating academic and development experience into practice. The engagement of care-users who are communication vulnerable was supported, taking into account organisational issues and the presentation of information. Conclusions: The impact of all engaged stakeholders was identified over the different levels strategies focused on. Care-users who are communication vulnerable were valuable engaged in co-creation implementation strategies by equipping them to their needs and routines, which requires adaptation in communication, delimited meetings and a safe group environment. Trial registration: Reviewed by the Medical Ethics Committee of Zuyderland-Zuyd (METCZ20190006). NL7594 registred at https://www.trialregister.nl/. Plain English summary: Exploring care-users experiences is important for decisions to improve quality of care. This applies to care-users in the disability care in particular, as these care-users are highly dependent on their care professional. Instruments that facilitate a dialogue between care-users and care professionals about experiences with care are not always used correctly. Furthermore, it is difficult to translate outcomes into decisions about improving quality of care for the individual care-user and the organisation. In our study, care-users, care professionals, management and researchers developed strategies together to improve the use of care-user experience measures. This study aims to show the impact of all participants, including care-users, professionals, management and researchers, on developing implementation strategies. Additionally, the study aims to show how care-users can participate in developing strategies whilst having problems with communication due to intellectual, developmental and acquired disabilities. We found that care-users gave crucial input to the look and feel, and understandability and relevance of the strategies. The contribution of the professionals had impact on how to use strategies and terminology used in instructions and visuals. Management shared lessons learned and represented the needs on the policy level. Researchers used their analytical skills and facilitated the group process. Care-users were able to collaborate by taking into account their needs and because information was presented to them clearly and attractively. [ABSTRACT FROM AUTHOR]

Thesis. Cerebral palsy (CP) is a group of disorders resulting from damage to the central nervous system in the early stages of its development. The aim of the rehabilitation of persons with CP is to make their dependence on the assistance of others as little as possible and to improve their quality of life, as well as the quality of life of their families. New methods are developed in which new technologies are employed and a holistic approach to the patient, requiring the cooperation of specialists in various fields, is assumed. The most commonly used methods of working with children with cerebral palsy include the NDT-Bobath method and the Vojta method. Apart from them unconventional methods are also employed, including hippotherapy, virtual reality, the sensory integration method, the conductive education method, and the space suit method. Aim of the paper. The aim of the paper is to present the methods employed in increasing the agility of children with cerebral palsy. Focus has been placed on traditional and commonly used methods, as well as the unconventional methods which are currently undergoing evaluation. Results. Thanks to diversifying rehabilitation with new methods and enriching it with the experience of specialists in areas outside medicine patients with cerebral palsy are able to fully benefit from their own potential. Quality of life is improved, independence is increased, and new opportunities are discovered. Some of the newest methods may serve to supplement traditional therapies, others can substitute for them in the future. What is crucial is to focus not only on heightening the physical agility of the patients, but also to make the course of the therapy more attractive, and to work on improving the patients’ functioning in other areas of life, as well, such as social contacts or hobbies.

Background: In implementation science, vast gaps exist between theoretical and practical knowledge. These gaps prevail in the process of getting from problem analysis to selecting implementation strategies while engaging stakeholders including care users. Objective: To describe a process of how to get from problem analysis to strategy selection, how to engage stakeholders, and to provide insights into stakeholders' experiences. Design: A qualitative descriptive design. Setting and participants: The setting was a care organization providing long‐term care to people with acquired brain injuries who are communication vulnerable. Fourteen stakeholders (care users, professionals and researchers) participated. Data were collected by a document review, five interviews and one focus group. Inductive content analysis and deductive framework analysis were applied. Intervention: Stakeholder engagement. Main outcome measures: A three‐step process model and stakeholders experiences. Results and conclusion: We formulated a three‐step process: (a) reaching consensus and prioritizing barriers; (b) categorizing the prioritized barriers and idealization; and (c) composing strategies. Two subthemes continuously played a role in how stakeholders were engaged during the process: communication supportive strategies and continuous contact. The experiences of stakeholder participation resulted in the following themes: stakeholders and their roles, use of co‐creation methods and communication supportive strategies, building relationships, stimulus of stakeholders to engage, sharing power, empowerment of stakeholders, feeling a shared responsibility and learning from one another. We conclude that the inclusion of communication‐vulnerable care users is possible if meetings are prepared, communication‐friendly presentations and reports are used, and relationship building is prioritized. [ABSTRACT FROM AUTHOR]

(1) Background: Climate change is increasing the already frequent diverse extreme weather events (EWE) across geographic locations, directly and indirectly impacting human health. However, current ongoing research fails to address the magnitude of these indirect impacts, including healthcare access. Vulnerable populations such as persons with spinal cord injury (pSCI) face added physiologic burden such as thermoregulation or mobility challenges like closure of public transportation. Our exploratory research assessed commute and transport to healthcare facilities as well as the knowledge, attitudes and behaviors (KAB) of pSCI regarding EWE and climate change when compared to pSCI caregivers (CG) and the general public (GP). (2) Methods: A KAB survey was employed to conduct a cross-sectional assessment of pSCI, CG, and GP in Miami from October through November 2019 using snowball sampling. Descriptive and logistic regression statistical analyses were used. (3) Results: Of 65 eligible survey respondents, 27 (41.5%) were pSCI, 11 (17%) CG, and 27 (41.5%) GP. Overall, pSCI reported EWE, particularly flooding and heavy rain, affecting their daily activities including healthcare appointments, more frequently than CG or GP. The overall models for logistic regression looking at commute to and attendance of healthcare appointments were statistically significant. pSCI self-report being less vulnerable than others, and a large proportion of each group was not fully convinced climate change is happening. (4) Conclusions: This study provided insight to the KAB of 3 population subgroups in Miami, Florida. pSCI are significantly more vulnerable to the effects of regional weather events yet exhibit disproportionate self-perception of their vulnerability. Continued and more comprehensive research is needed to characterize the barriers that vulnerable populations face during weather events.

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This article examines four European countries (Switzerland, Germany, Sweden, and the United Kingdom) with respect to their degree of disability care personalisation. The approach is embedded in a broader theoretical analysis, which in turn is inspired by the notion of bivalent social justice as presented by Nancy Fraser (2003). The theoretical argument is that claims for personal assistance are part of a broader movement toward emancipation. However, it is argued that the specific settings of welfare regimes provide structures that empower or mitigate the possible implementation of personal assistance schemes. The author argues that conservative-corporatist welfare regimes provide less-supportive opportunity structures for policy change pertaining to personal assistance than other welfare regimes. This heuristic argument is developed further by looking more closely at key figures of Sweden, Germany, and the United Kingdom as being ideal-typical welfare regime cases. Furthermore, the case of Switzerland is outlined in an in-depth manner as it seems to have conservative-corporatist characteristics regarding the organisation of disability care while simultaneously being difficult to theorise. It is the aim of this article to serve as a first heuristic undertaking for analysing the low level of disability care personalisation in certain continental European cases.

At present, with the continuous development of the trend of population aging worldwide, more elderly people are increasingly facing serious life disorders caused by physical and mental disability. In this study, the common symptoms and the nursing practice related to diseases of the disabled elderly are reviewed with reference to the basic concepts of disability care and the current situation of domestic and foreign research, which is expected to provide the basis for the construction of a new model of disability nursing.

Supplemental digital content is available in the text. Background: People with disabilities (PWDs) experience significant health disparities. The complex experience of disability requires that nurses are adequately and deliberately prepared to care for PWDs. However, there are no recognized nursing competencies to direct education and care. Purpose: The purpose of this study was to develop a set of nursing competencies to better prepare prelincensure nursing students to provide competent care to PWDs. Methods: A 2-round Delphi survey was administered to experts in the field of disabilities (n = 47, n = 35). Quantitative and qualitative methods were used to analyze data. Results: Three major themes emerged: unique knowledge, volume and repetition, and distinct disability culture. Competencies were reduced with a focus on 4 dimensions: environment and care, communication, culture, and referral. Conclusions: The 12 new competencies can serve as the foundation for the inclusion of disability content in nursing curricula. [ABSTRACT FROM AUTHOR]

Thesis. Cerebral palsy (CP) is a group of disorders resulting from damage to the central nervous system in the early stages of its development. The aim of the rehabilitation of persons with CP is to make their dependence on the assistance of others as little as possible and to improve their quality of life, as well as the quality of life of their families. New methods are developed in which new technologies are employed and a holistic approach to the patient, requiring the cooperation of specialists in various fields, is assumed. The most commonly used methods of working with children with cerebral palsy include the NDT-Bobath method and the Vojta method. Apart from them unconventional methods are also employed, including hippotherapy, virtual reality, the sensory integration method, the conductive education method, and the space suit method. Aim of the paper. The aim of the paper is to present the methods employed in increasing the agility of children with cerebral palsy. Focus has been placed on traditional and commonly used methods, as well as the unconventional methods which are currently undergoing evaluation. Results. Thanks to diversifying rehabilitation with new methods and enriching it with the experience of specialists in areas outside medicine patients with cerebral palsy are able to fully benefit from their own potential. Quality of life is improved, independence is increased, and new opportunities are discovered. Some of the newest methods may serve to supplement traditional therapies, others can substitute for them in the future. What is crucial is to focus not only on heightening the physical agility of the patients, but also to make the course of the therapy more attractive, and to work on improving the patients' functioning in other areas of life, as well, such as social contacts or hobbies. [ABSTRACT FROM AUTHOR]

Disability reform in Australia centres on a National Disability Insurance Scheme (NDIS), which aims to provide lifelong, individualised support based on the principle of 'reasonable and necessary' care. As a universal rights-based scheme it represents a historical shift in allocation principles in Australia's disability policy. Nonetheless, attention will be on determining who receives what care given the diversity of personal and family contexts. The aim of this paper is to discuss the operational complexities of a principle of reasonable and necessary care with reference to the findings of a three-year study on the experiences and perspectives of disability care of 25 adults with acquired disability, their 22 nominated family members and 18 service providers. Evidence from this study suggests enacting the principle of reasonable and necessary care and support will be problematic, in particular as it relates to personalising the level and scope of services, balancing formal and informal care, and principles of equity. The paper contributes to the literature about allocation principles in social policy and the challenges of implementation. Further, it provides an empirically informed discussion of some of the specific policy implementation challenges concerning the NDIS. [ABSTRACT FROM AUTHOR]

We report the physical and behavioral development of one severely disabled female infant chimpanzee ( Pan troglodytes schweinfurthii) of the well-habituated M group in the Mahale Mountains National Park. We documented interactions between the infant and its mother and with other group members. Congenital disabilities occur in many primate species, including chimpanzees. However, there have been only a few case studies of congenitally disabled chimpanzee infants and no reports examining how a chimpanzee mother copes with such a disabled infant in the wild. The observed infant exhibited symptoms resembling Down syndrome, similar to those reported previously for a captive chimpanzee. The mother did not allow nonrelatives to take care of the infant even though she had been previously relatively tolerant of allomothering by nonrelatives. The mother's compensatory care for her infant's disabilities and allomothering of the infant by its sister might have helped it to survive for 23 months in the wild. Other group members did not show any aversive or fearful reactions to the disabled infant. [ABSTRACT FROM AUTHOR]

In a poll of 714 US physicians, it was revealed that only 40.7% felt very confident in their ability to provide the same quality of care, overall, to patients with disabilities (PWDs) compared with patients without disabilities. It was also found that only 56.5% strongly agreed that they welcomed PWDs into their practice as healthcare providers. This suggests a systemic issue of inequity in medicine, which affects both physicians and patients. If this problem is not corrected, our healthcare system will continue to lack in providing adequate care to PWDs. A key component of this issue is that the lack of confident care for PWDs appears to be a result of insufficient exposure to PWDs during the formative years in medical schools. Although medical students are taught extensive clinical skills and bedside manners, there appears to be little mention of how to make adaptations to basic patient encounters to accommodate PWDs. Further, the lack of representation of PWDs in the medical community results in minimal experience among trainees and the perpetuation of unjust biases in the healthcare system. Changes to the medical field must start with shaping future physicians and filling the void in medical education. As a solution, we at Florida State University (FSU) College of Medicine (COM) propose a program called the Disability Advocacy and Awareness Program (DAAP). Two interactive sessions were designed, and students were offered an immersive experience in which they were not only provided with information through well-crafted presentations but also encouraged to engage in direct interactions with PWDs and a myriad of assistive devices. We believe a great deal of the program's success stemmed from the two-phase interactive model that allowed students to undergo a truly immersive experience that a textbook cannot endow. Although we cannot expect every provider to be an expert on all disabilities, all physicians should have an understanding of how a disability may impact a patient's life and medical care. Improved knowledge and awareness surrounding disability and the barriers faced by the PWD population will provide insights that will allow for the most equitable, patient-centered care for the disabled community., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Morelli et al.)

This article discusses the entanglement of implementing welfare technology in disability care, and draws on ethnographic observations from a pilot project involving 30 disabled citizens from three different boroughs in Denmark. The disabled citizens suffered from diseases such as multiple sclerosis and cerebral paralysis. The article follows four care assistants and four citizens through a period of 10 months, focusing particularly on the experiences and struggle of two citizens. Against this background, the article takes up a number of conflicting values and criteria practiced by diverse interested groups: 1. employee retrenchment, 2. citizen independence and 3. workforce flexibility. The main argument is that the housing institution studied has turned into a battlefield, where professional values of authentic care meet a strong governmental discourse of modernization of the public sector. The study demonstrates that the implementation of welfare technology in disability care is highly fragile, which is predominantly due to the delicate body-technology assembly, and takes place in agony.

This article discusses the entanglement of implementing welfare technology in disability care, and draws on ethnographic observations from a pilot project involving 30 disabled citizens from three different boroughs in Denmark. The disabled citizens suffered from diseases such as multiple sclerosis and cerebral paralysis. The article follows four care assistants and four citizens through a period of 10 months, focusing particularly on the experiences and struggle of two citizens. Against this background, the article takes up a number of conflicting values and criteria practiced by diverse interested groups: 1. employee retrenchment, 2. citizen independence and 3. workforce flexibility. The main argument is that the housing institution studied has turned into a battlefield, where professional values of authentic care meet a strong governmental discourse of modernization of the public sector. The study demonstrates that the implementation of welfare technology in disability care is highly fragile, which is predominantly due to the delicate body-technology assembly, and takes place in agony. Theoretically, the article articulates a sociomaterial approach to the balancing of incoherent agendas and goals in institutions based on Orlikowsky (2010, 2007), Akrich (2000) and Law and Moser (1999, 2003). [ABSTRACT FROM AUTHOR]

All levels of government in Australia (national, state and territory, municipal) are increasingly contracting with charitable and other not-for-profit organisations (and, at times, for-profit businesses) for the delivery of public services. While estimates vary about the extent of such arrangements, recent statistics suggest they are a large and growing phenomena. The shift to 'purchase of service' contracting and other forms of 'managed markets' has been partly motivated by a desire to improve the efficiency and effectiveness of service delivery. However, there are some criticisms of the approach, arguing that it leads to a range of problems for not-for-profit organisations, including being burdened by excessive regulation, movement away from their core purpose (so-called 'mission drift'), and a weakening of the connections with the community they serve. This article examines the prevalence of the contracting arrangements and some of the main reasons why they have come about. It also considers the main gains and challenges resulting from such arrangements, in particular for public sector management. The article draws on recent work by the Productivity Commission ('the Commission') including the 2010 study of the contribution of the not-for-profit sector (PC 2010); the 2011 inquiry on disability care and support (PC 2011a); and the 2011 inquiry on caring for older Australians (PC 2011b). It also draws more broadly on a range of other Commission work, including recent reports on government services produced for the Council of Australian Governments (SCRGSP 2011a, 2011b). [ABSTRACT FROM AUTHOR]