Using the DBC-P Hyperactivity Index to screen for ADHD in young people with autism and ADHD: a pilot study

This study aimed to (1) determine preliminary validity of the Developmental Behaviour Checklist-Hyperactivity Index (DBC-HI) as a screening measure of combined-type ADHD in autism and ADHD, and (2) compare emotional-behavioural disturbance using the DBC in autism, ADHD and autism + ADHD. Forty-nine age- and PIQ-matched young people [6-18 years; 12 autism, 13 ADHD, 12 autism + ADHD, 12 typically developing] were recruited. Parents completed the Conners-Revised Rating Scale and DBC. The DBC-HI displayed strong internal consistency and good external validity, reliably measuring combined-type ADHD. The DBC-HI distinguished autism from autism + ADHD with fair sensitivity and specificity. Individuals with autism + ADHD exhibited a more severe profile of emotional-behavioural disturbance than autism or ADHD alone. The DBC may be a useful 'all-in-one' screening tool to (1) identify comorbidity and (2) determine the severity of emotional-behavioural disturbance in autism and/or ADHD. © 2014 Elsevier Ltd.

An effective program design to support older workers with intellectual disability to participate individually in community groups

The foreshadowed increase of older people with intellectual disability has become a reality in many developed countries. As these adults age, improved quality of life can be achieved through applications of conjoint policy aims of inclusion and participation. A transition-to-retirement (TTR) program developed for employees of a large multisite disability employment service in Sydney, Australia, used these aims to effect successful partial retirement. The authors describe the program logic of the TTR, detailing its conceptual components as the first step to enabling it to be tested and replicated in other settings. The TTR program has three components: promoting the concept of retirement, laying the groundwork for inclusion of would-be retirees with intellectual disability in the community, and constructing the reality. The third component comprised five stages: planning, locating a group, mapping new routine, recruiting and training mentors, and monitoring and ongoing support. The project's participants were 24 older employees, who replaced 1 day a week of work with membership of a community group and were supported by mentors who facilitated involvement of the participants in their group. Data collected provided information on the implementation of the program, the time and costs expended, and challenges encountered. Key to the model was a coordinator, skilled in generic case management and specific disability interventions (such as active support), who collaborated with others to manage the program. The authors note that by detailing the program logic underpinning the TTR program, they have exposed the hidden work of supporting meaningful inclusion of people with intellectual disability in community groups and added to the limited stock of evidence-informed programs in this area. © 2014 International Association for the Scientific Study of Intellectual and Developmental Disabilities and Wiley Periodicals, Inc.

The lived experience of Australian retirees: 'I'm retired, what do i do now?'

Introduction: The purpose of this qualitative study was to explore the lived experience of retirement in a context where it is not compulsory, and to understand consequent changes in roles, identity and occupational adaptation from the perspective of Australian retirees. Method: Five people aged between 61 and 68 years, who had retired during the previous 18 months, were interviewed. Data analysis included transcription and coding of data, data aggregation and identification of themes. Findings: The themes that emerged from the data analysis were related to time structure and meaningful occupations, ageing and performance capacity, role changes, emotional adjustment to retirement and preparation for retirement. Conclusion: The findings suggest that engagement in meaningful occupations and valued roles, along with the emergence of grandparenting as a significant role, the development of new interests and engagement in retirement planning activities, and support in restructuring the use of time are essential to maintain a positive identity and to adapt successfully to retirement. © The College of Occupational Therapists Ltd.

Understanding the experience of inpatient rehabilitation: insights into patient-centred care from patients and family members

The aim of the study was describe the experiences, needs and preferences of recent inpatients of a rehabilitation centre, and the needs of their families. Data were collected in four focus groups, two with patients (n = 13) who had recently completed inpatient rehabilitation following an illness, injury or elective surgery, and two with family members (n = 11). During the focus groups, two researchers facilitated discussion on any topic that participants considered important to the experience of inpatient rehabilitation; participants were encouraged to describe their care, needs and preferences. The focus group discussions were audio-taped and transcribed verbatim. Field notes were hand recorded. Data were analysed and collated into themes. Six key themes emerged. Participants wanted: interactions with friendly, empathetic staff; regular contact with senior staff and all staff to introduce themselves by name and profession; timely communication of accurate information; and rehabilitation services seven days a week. The physical environment had both positive and negative effects on patient well-being. Patients with complex or atypical circumstances required special attention to ensure their needs were met. In conclusion, patients and families identified six important issues that need to be considered during inpatient rehabilitation.

Narratives of recovery from traumatic injury: issues in the nursing care of patients in rehabilitation

Patients who sustain multiple orthopaedic injuries through trauma frequently undergo lengthy rehabilitation. There is little information available about how patients experience hospital rehabilitation programs. In particular, not much is known about factors that inhibit or facilitate the rehabilitation process. This paper describes a qualitative study that explored the rehabilitation  experiences of thirteen patients who had serious orthopaedic injuries.  In-depth interviews revealed issues about good and bad care, the importance of mateship, getting through the day and living with pain. In addition, participants spoke of the impact that the accident and resulting injuries had on their relationships, their experience of loss, how difficult it was to manage everyday issues and the ways in which the accident changed them. The findings of the study have been set into a framework of therapeutic emplotment, a novel way to view the role of the rehabilitation nurse.

Generic rehabilitation assistants : will rehabilitation nurses take up the challenge?

This paper provides an overview of some of the issues that need to be considered in the context of a declining health workforce. It outlines some of the arguments for and against the introduction of generic health workers and more specifically, for the role of generic rehabilitation - assistant. It is argued that rehabilitation nurses, amongst others, are well placed to take an active role in the development of innovative interdisciplinary models of care that enhance patient outcomes as they transect the continuum of care. Failure to do so will be at the peril of rehabilitation nursing.

Haptic handwriting aid for training and rehabilitation

This paper reports a method of controlling a user's hand through the process of writing. Developed predominantly for enabling users to re-learn the skill of writing after a stroke, the process could also be used for teaching children hand/eye coordination, motor skills, movement and position awareness in writing. Utilising low cost haptic technology and custom control software, the system has the potential to increase writing skills in stroke sufferers in the privacy and comfort of their own home.

Evolutionary multiobjective optimization in engineering management: an empirical study on bridge deck rehabilitation

There exist multiple objectives in engineering management such as minimum cost and maximum service capacity. Although solution methods of multiobjective optimization problems have undergone continual development over the past several decades, the methods available to date are not particularly robust, and none of them performs well on the broad classes. Because genetic algorithms work with a population of points, they can capture a number of solutions simultaneously, and easily incorporate the concept of Pareto optimal set in their optimization process. In this paper, a genetic algorithm is modified to deal with the rehabilitation planning of bridge decks at a network level by minimizing the rehabilitation cost and deterioration degree simultaneously.