Attitudes towards the sexuality of adults with an intellectual disability: parents, support staff, and a community sample

Attitudes toward the sexuality of adults with intellectual disability were assessed in parents and carers of adults with intellectual disability and in a community sample. An instrument that contained items relating to eight aspects of sexuality (sexual feelings, sex education, masturbation, personal relationships, sexual intercourse, sterilisation, marriage, and parenthood) was developed and found to have good internal consistency and test-retest reliability. Age was associated with attitudes, with those aged 60 and above holding more conservative attitudes. Parents and staff differed in their attitudes, with parents holding more conservative attitudes. This difference was the product of age differences between the groups; nevertheless it may produce some confusion for adults with intellectual disability unless it is addressed appropriately. Both parent and staff groups were less positive about parenthood than about other aspects of sexuality, however the community group did not differ in their views when attitudes towards parenthood were compared with the remaining items Of the scale.

Personal factors, communication and vision predict social participation in older adults

Social isolation is a predictor of morbidity and mortality in older people. Speech pathologists often consider that communication disabilities associated with normal ageing (sensory loss, language and discourse changes) contribute to social isolation. The aims of this study were to describe the functioning of older people using the International Classification of Functioning, Disability and Health (WHO, 2001) as a conceptual framework for language and sensory functioning, communicative activity, and social participation, and to explore the relationship between communication (both at an impairment level and an activity level), social participation and personal factors (demographics and emotional health). In a prospective study, 47 women and 28 men aged 62 to 98 years (mean=74 yrs) completed objective and subjective assessments of functioning and participation, and provided personal information. Assessments were individually conducted in a face- to-face interview situation with the primary researcher, who was a speech pathologist. Assessments revealed the sample had predominantly mild hearing and vision impairments, unimpaired naming ability, frequent involvement in a wide range of communication activities, and variable social network size and social activities participation. Social participation was shown to be associated with vision, communication activities, age, education and emotional health. Naming and hearing impairments were not reliable predictors of social participation. It was concluded that professionals interested in maintaining and improving social participation of older people could well consider these predictors in community-directed interventions. Speech pathologists should therefore promote older people's involvement in everyday communicative activities while also limiting the impact of communication-related impairments, so that social participation is maintained in our ageing population.

Smoking and schizophrenia: is symptom profile related to smoking and which antipsychotic medication is of benefit in reducing cigarette use?

Smoking rate is disproportionately high among patients with schizophrenia, resulting in significant morbidity and mortality. However, cigarette smoking has been reported to have beneficial effects on negative symptoms, extrapyramidal symptoms, cognitive functioning and mood symptoms. Therefore, smoking cessation may worsen disability in schizophrenia. The association between smoking and these key clinical parameters was examined. Additionally, severity of smoking across four different antipsychotic treatment groups was explored. One hundred and forty-six patients with schizophrenia were assessed for smoking using expired carbon monoxide and smoking history. They were administered the Positive and Negative Symptom Scale, The Extrapyramidal Symptom Rating Scale, the Barnes Akathisia Rating Scale, Reitans Trail-making Test (A and B) and General Health Questionnaire-28. There was no difference in the chlorpromazine equivalent dose of any of the medications studied. Atypical agents were associated with significantly lower levels of smoking when compared with typical medications. There was no difference in smoking severity between the individual atypical medications examined. Similarly, there were no significant differences between smoking and non-smoking groups with regard to Positive and Negative Symptom Scale, Extrapyramidal Symptom Rating Scale, Trail-making Test and General Health Questionnaire-28. However, there was a significant difference between these groups with the smoking group demonstrating less akathisia. Smoking is not associated with positive, negative cognitive and mood symptoms in schizophrenia. Smoking is associated with lower levels of antipsychotic induced akathisia. Clinicians should not be discouraged from helping patients stop smoking for fear of worsening symptoms. However, akathisia may emerge upon cessation of smoking. Switching patients from typical to atypical antipsychotics may assist patients with schizophrenia to give up smoking.

Disability's affect: Or, refugees, communication and community

Cultural theorists have given much attention recently to the notion of 'affect', yet such discussions have not seriously, if at all, raised the question of disability. However we would suggest that disability has very strong relationships with affect. In this paper we argue for the importance of rethinking affect and communication from the perspective of a critical, socio-political account of disability. To illustrate this, we look at affect and disability in two important cases of refugees in Australia.

Definitions and factors associated with subthreshold depressive conditions:a systematic review

BACKGROUND: Subthreshold depressive disorders (minor and subthrehold depression) have been defined in a wide range of forms, varying on the number of symptoms and duration required. Disability associated with these conditions has also been reported. Our aim was to review the different definitions and to determine factors associated with these conditions in order to clarify the nosological implications of these disorders. METHODS: A Medline search was conducted of the published literature between January 2001 and September 2011. Bibliographies of the retrieved papers were also analysed. RESULTS: There is a wide heterogeneity in the definition and diagnostic criteria of minor and subthreshold depression. Minor depression was defined according to DSM-IV criteria. Regarding subthreshold depression, also called subclinical depression or subsyndromal symptomatic depression, between 2 and 5 depressive symptoms were required for the diagnosis, and a minimum duration of 2 weeks. Significant impairment associated with subthreshold depressive conditions, as well as comorbidity with other mental disorders, has been described. CONCLUSIONS: Depression as a disorder is better explained as a spectrum rather than as a collection of discrete categories. Minor and subthreshold depression are common conditions and patients falling below the diagnostic threshold experience significant difficulties in functioning and a negative impact on their quality of life. Current diagnostic systems need to reexamine the thresholds for depressive disorders and distinguish them from ordinary feelings of sadness.

Parent emotional functioning, parent responsiveness, and child adjustment

Over the past two decades, interest in the psychological development of children has steadily increased (Beg, Casey, & Saunders, 2007), presumably because statistics describing childhood psychological illness are alarming. Certain parent interaction styles or behaviors are known to influence child adjustment. According to attachment theory, the reason for these findings is that interaction with a caregiver informs an individual’s construction of an internal working model (IWM) of the self in relation to others in the environment. The purpose of this study was to gain a greater understanding of the factors contributing to child adjustment by examining the influence of parents’ emotional functioning and parent responsiveness to children’s bids for interaction. This dissertation tested a multivariate model of attachment-related processes and outcomes with an ethnically diverse sample. Results partially supported the model, in that parent emotional intelligence predicted some aspects of child adjustment. Overall, the study adds to knowledge about how parent characteristics influence child adjustment and provides support for conceptualizing emotional intelligence as a concrete and observable manifestation of the nonconscious attachment IWM.

Food customs of rural and urban Inupiaq elders and their relationships to select nutrition parameters, food insecurity, health, and physical and mental functioning

The Inupiaq Tribe resides north of the Arctic Circle in northwestern Alaska. The people are characterized by their continued dependence on harvested fish, game and plants, known as a subsistence lifestyle (Lee 2000:35-45). Many are suggesting that they leave their historical home and move to urban communities, places believed to be more comfortable as they age. Tribal Elders disagree and have stated, "Elders need to be near the river where they were raised" (Branch 2005:1). The research questions focused on differences that location had on four groups of variables: nutrition parameters, community support, physical functioning and health. A total of 101 Inupiaq Elders ≥ 50 years were surveyed: 52 from two rural villages, and 49 in Anchorage. Location did not influence energy intake or intake of protein; levels of nutrition risk and food insecurity; all had similar rates between the two groups. Both rural and urban Elders reported few limitations of ADLs and IADLs. Self-reported general health scores (SF-12.v2 GH) were also similar by location. Differences were found with rural Elders reporting higher physical functioning summary scores (SF-12.v2 PCS), higher mental health scores (SF-12.v2 MH), higher vitality and less pain even though the rural mean ages were five years older than the urban Elders. Traditional food customs appear to support the overall health and well being of the rural Inupiaq Elders as demonstrated by higher intakes of Native foods, stronger food sharing networks and higher family activity scores than did urban Elders. The rural community appeared to foster continued physical activity. It has been said that when Elders are in the rural setting they are near "people they know" and it is a place "where they can get their Native food" (NRC 2005). These factors appear to be important as Inupiaq Elders age, as rural Inupiaq Elders fared as well or better than Inupiaq Elders in terms of diet, mental and physical health.

Examining Cognitive Processing in Children with an Arithmetic Disability

Currently there is no consensus as to the specific cognitive impairments that characterize mathematical disabilities (MD) or specific subtypes such as an arithmetic disability (AD). The present study sought to address this concern by examining cognitive processes that might undergird AD in children. The present study utilized archival data to conduct two investigations. The first investigation examined the executive functioning and working memory of children with AD. An age-matched achievement-matched design was employed to explore whether children with AD exhibit developmental lags or deficits in these cognitive domains. While children with AD did not exhibit impairments in verbal working memory or colour word inhibition, they did demonstrate impairments in shifting attention, visual-spatial working memory, and quantity inhibition. As children with AD did not perform more poorly than their younger achievement-matched peers on any of these tasks, impairments in specific areas of executive functioning and working memory appeared to reflect a developmental lag rather than a cognitive deficit. The second study examined the phonological processing performance of children with AD compared to children with comorbid disabilities in arithmetic and word recognition (AD/WRD) and to typically achieving (TA) children. Results indicated that, while children with AD did demonstrate impairments on all isolated naming speed tasks, trail making digits, and memory for digits, they did not demonstrate impairments on measures of phonological awareness, nonword repetition, serial processing speed, or serial naming speed. In contrast, children with AD/WRD demonstrated impairments on measures of phonological awareness, phonological short-term memory, isolated naming speed, serial processing speed, and the alphabet a-z task. Overall, results suggested that phonological processing impairments are more prominent in children with a WRD than children with an AD. Together, these studies further our understanding of the nature of the cognitive processes that underlie AD by focusing upon rarely used methods (i.e., age-matched achievement-matched design) and under-examined cognitive domains (i.e., phonological processing).

Disability in the Digital Age: Reconfiguring Access, Inclusion and Equality

There is an abundance of research that examines disability and technology in the context of computers and the Internet, however few have examined disability and mobile devices. Also largely absent from existing literature are the voices of disabled people themselves. This dissertation draws upon science and technology studies (STS) and disability studies to address these gaps by conducting in-depth qualitative research that examines disabled people’s experiences using smartphones and tablets. At its core, this dissertation aims to provide insight on the following: 1) an understanding of how disability is perceived in the digital age and the subjective meanings of access, inclusion and equality; 2) the ways in which mobile devices impact the lived experience of disability; and 3) how perspectives in disability studies and STS can be applied to understand the relationship between the body, disability and technology. The empirical contribution of this research draws from participant diaries and interviews with disabled people, as well as from open-ended questionnaires completed by mobile app developers. The concept of ‘subjectivities of disability’ is introduced to refer to the uniquely personal and individual experience of disability. Findings reveal that mobile device use amongst disabled people redefines their subjectivities of disability through socio-technical interactions whereby disabled people use their devices in ways that are integrated into their everyday lives and positively shapes how they view themselves in relation to their experience of disability. The responses from app developers reveal that there is a place for disability in the mobile market and that disabled people play a key role in making apps accessible. The data suggests that mobile devices facilitate access, inclusion and equality by integrating the body in ways that recognize and accommodate diversity. The results furthermore make it clear that the interaction between disabled people and mobile devices takes on an embodied and social characteristic. This research concludes that both on an individual level and collectively, disabled people are engaging with digital artifacts in ways that promote agency and independence as well as reshaping how disability is experienced and perceived in the digital age.

Isotope and fatty acid trends along continental shelf depth gradients: Inshore versus offshore hydrological influences on benthic trophic functioning

Anthropogenic activities and land-based inputs into the sea may influence the trophic structure and functioning of coastal and continental shelf ecosystems, despite the numerous opportunities and services the latter offer to humans and wildlife. In addition, hydrological structures and physical dynamics potentially influence the sources of organic matter (e.g., terrestrial versus marine, or fresh material versus detrital material) entering marine food webs. Understanding the significance of the processes that influence marine food webs and ecosystems (e.g., terrestrial inputs, physical dynamics) is crucially important because trophic dynamics are a vital part of ecosystem integrity. This can be achieved by identifying organic matter sources that enter food webs along inshore–offshore transects. We hypothesised that regional hydrological structures over wide continental shelves directly control the benthic trophic functioning across the shelf. We investigated this issue along two transects in the northern ecosystem of the Bay of Biscay (north-eastern Atlantic). Carbon and nitrogen stable isotope analysis (SIA) and fatty acid analysis (FAA) were conducted on different complementary ecosystem compartments that include suspended particulate organic matter (POM), sedimentary organic matter (SOM), and benthic consumers such as bivalves, large crustaceans and demersal fish. Samples were collected from inshore shallow waters (at ∼1 m in depth) to more than 200 m in depth on the offshore shelf break. Results indicated strong discrepancies in stable isotope (SI) and fatty acid (FA) compositions in the sampled compartments between inshore and offshore areas, although nitrogen SI (δ15N) and FA trends were similar along both transects. Offshore the influence of a permanently stratified area (described previously as a “cold pool”) was evident in both transects. The influence of this hydrological structure on benthic trophic functioning (i.e., on the food sources available for consumers) was especially apparent across the northern transect, due to unusual carbon isotope compositions (δ13C) in the compartments. At stations under the cold pool, SI and FA organism compositions indicated benthic trophic functioning based on a microbial food web, including a significant contribution of heterotrophic planktonic organisms and/or of SOM, notably in stations under the cold pool. On the contrary, inshore and shelf break areas were characterised by a microalgae-based food web (at least in part for the shelf break area, due to slope current and upwelling that can favour fresh primary production sinking on site). SIA and FAA were relevant and complementary tools, and consumers better medium- to long-term system integrators than POM samples, for depicting the trophic functioning and dynamics along inshore–offshore transects over continental shelves.