Where would you turn for help?:Older adults' awareness of community support services

Previous findings on older adults' awareness of community support services (CSSs) have been inconsistent and marred by acquiescence or over-claiming bias. To address this issue, this study used a series of 12 vignettes to describe common situations faced by older adults for which CSSs might be appropriate. In telephone interviews, 1,152 adults aged 50 years and over were read a series of vignettes and asked if they were able to identify a community organization or agency that they may turn to in that situation. They were also asked about their most important sources of information about CSSs. The findings show that, using a vignette methodology, awareness of CSSs is much lower than previously thought. The most important sources of information about CSSs included information and referral sources, the telephone book, doctors' offices, and word of mouth.

Social determinants of older adults' awareness of community support services in Hamilton, Ontario

Community support services (CSSs) have been developed in Canada and other Western nations to enable persons coping with health or social issues to continue to live in the community. This study addresses the extent to which awareness of CSSs is structured by the social determinants of health. In a telephone interview conducted in February-March 2006, 1152 community-dwelling older adults (response rate 12.4%) from Hamilton, Ontario, Canada were made to read a series of four vignettes and were asked whether they were able to identify a CSS they may turn to in that situation. Across the four vignettes, 40% of participants did name a CSS as a possible source of assistance. Logistic regression was used to determine factors related to awareness of CSSs. Respondents most likely to have awareness of CSS include the middle-aged and higher-income groups. Being knowledgeable about where to look for information about CSSs, having social support and being a member of a club or voluntary organisations are also significant predictors of awareness of CSSs. Study results suggest that efforts be made to improve the level of awareness and access to CSSs among older adults by targeting their social networks as well as their health and social care providers. © 2011 Blackwell Publishing Ltd.

Would older adults turn to community support services for help to maintain their independence?

The purpose of this article is to determine whether middle-aged and older adults would identify community support services (CSSs) as a source of assistance for difficulties with the instrumental activities of daily living (IADLs). Furthermore, we determine factors related to the identification of home health and CSSs. Telephone interviews were conducted with 768 adults aged 50 and older. Respondents were presented with a vignette describing a situation where loss of independence is threatened. They were asked what they would do in that situation. Although less than 20% mentioned CSSs, nearly 50% mentioned either a home health or CSS. Findings suggest those less likely to mention a home health or CSS include men, older adults, and the foreign born. In addition, those with less education, functional health limitations, no social support, and a lack of knowledge of where to find information about CSSs mentioned home health or CSSs less often. © The Author(s) 2010.

Older adults awareness of community health and support services for dementia care

The article examines where older adults seek help in caring for a parent with dementia and the factors associated with their identification of community health and support services as sources of assistance. The authors conducted telephone interviews, using random digit dialing, of 1,152 adults aged 50 and over in the city of Hamilton. Respondents received a vignette that raised issues related to parental dementia. In identifying support sources, over 37 per cent of respondents identified their physician, 33 per cent identified informal support such as family and neighbors, and 31 per cent identified home health services. Only 18 per cent identified community support services. Female participants having higher levels of education were more likely to identify their physician as a source of support. Knowing where to find information about community support services was associated with an increased likelihood of mentioning physicians and home health services as sources of assistance. © 2009 Copyright Canadian Association on Gerontology.

Web Services and Incerta Spiriti: A Game Theoretic Approach to Uncertainty

A web-service is a remote computational facility which is made available for general use by means of the internet. An orchestration is a multi-threaded computation which invokes remote services. In this paper game theory is used to analyse the behaviour of orchestration evaluations when underlying web-services are unreliable. Uncertainty profiles are proposed as a means of defining bounds on the number of service failures that can be expected during an orchestration evaluation. An uncertainty profile describes a strategic situation that can be analyzed using a zero-sum angel-daemon game with two competing players: an angel a whose objective is to minimize damage to an orchestration and a daemon d who acts in a destructive fashion. An uncertainty profile is assessed using the value of its angel daemon game. It is shown that uncertainty profiles form a partial order which is monotonic with respect to assessment.

When care is left to roam: Carers' experiences of grassroots nonprofit services in Ireland

Increasingly countries are turning to nonprofit organisations to provide health and social care, particularly for people with disabilities. Alongside this change, debates continue about how states should manage the relationship with such organisations. Should features of the old-style "welfare" model be retained? Should aspects of the "new public management" model be chosen to measure the impact of the work? Yet others argue that grassroots organisations should form the basis of a service provision system. In the context of these debates, Ireland serves as an interesting case study of the system of care that can emerge when the state operates a "relaxed control" approach. This paper takes the perspectives of users themselves: family carers who are accessing services for a disabled adult child, to examine the effects of this approach on the ground. We show how geography played a central role in shaping these experiences, and discuss how we can learn from the Irish context. Rather than arguing for narrowly defined contractual measures, we conclude by proposing a renewed focus on relationship building with the aim of effective system operation, in the future of care services. © 2010 Elsevier Ltd.

In Demand: Therapeutic Services for Children and Young People Who Have Experienced Sexual Abuse

This paper describes the key findings of an NSPCC study estimating need, in the UK, for therapeutic services for children who have experienced sexual abuse. This is based upon current estimates of the prevalence and impact of sexual abuse towards children and young people against the availability of therapeutic services in the UK. Data were collected on service location, availability, scope and coverage across England, Wales, Northern Ireland and Scotland. Researchers: (1) mapped 508 services; (2) collected data from 195 services via a structured questionnaire; (3) followed up 21 service managers and 11 service commissioners with a semi-structured interview; and (4) carried out two focus groups with young people. Data were collected on service location, availability, scope and coverage The overall level of specialist provision is low, with less than one service available per 10 000 children and young people in the UK. Calculations of need indicate that 57 156 children across the UK in the last year may have been unable to access a service. Findings from services support the view that need outstrips availability; that referral routes are limited, leaving few options for young people who have been raped or seriously sexually assaulted to directly access support; that significant waiting lists mean services must focus on reactive, rather than preventive, work; and that services are less accessible for certain groups, especially sexually abused teenagers, children with disabilities and those from Black, Asian, Minority Ethnic and Refugee backgrounds. Copyright (c) 2012 John Wiley & Sons, Ltd. Key Practitioner Messages Relevant professionals must be adequately trained to talk to children about sexual abuse and to identify those vulnerable in order to identify need. Expert specialist services are well placed to share learning on early help and identification with broader children's service providers. Active steps need to be taken by commissioners in consultation with young people, voluntary sector and adult sexual violence service providers to meet the shortfall at the level of local authorities.

Children’s Views Matter Too! A Pilot Project Assessing Children’s and Adolescents’ Experiences of Clinical Psychology Services

This pilot study explored the experiences and understanding of clinical psychology practices and services of children and adolescents attending clinical psychology outpatient appointments. Fifteen young participants took part in the study. A content analysis indicated that young children and adolescents have an appropriate understanding of the role of the clinical psychologist, with older children commenting on the uniqueness and value of the therapeutic relationship. Attendance was rated as positive and helpful with regards to difficulties across all ages; however, many children were not consulted with at the point of referral and many did not know why they were attending. Implications for assessing children's and adolescents’ experiences of clinical psychology services are discussed.

The influence of the new general ophthalmic services (GOS) contract in optometrist referrals for glaucoma in Scotland

Purpose: To assess the quality of referrals from community optometrists in the northeast of Scotland to the hospital glaucoma service before and after the implementation of the new General Ophthalmic Services (GOS) contract in Scotland. Methods: Retrospective study encompassing two 6-month periods, one before the implementation of the new GOS (Scotland) contract in April 2006 (from June to November 2005), and the other after (from June to November 2006). The community optometrist referral forms and hospital glaucoma service notes were reviewed. Comparisons were performed using the t-test and ?- test. Results: In all, 183 referrals were made during the first 6-month period from June to November 2005, and 120 referrals were made during the second 6-month period from June to November 2006. After the introduction of the new GOS contract, there was a statistically significant increase in true-positive referrals (from 18.0 to 31.7%; P=0.006), decrease in false-positive referrals (from 36.6 to 31.7%; P=0.006), and increase in the number of referrals with information on applanation tonometry (from 11.8 to 50.0%; P=0.000), dilated fundal examination (from 2.2 to 24.2%; P=0.000), and repeat visual fields (from 14.8 to 28.3%; P=0.004) when compared to the first 6-month period. However, only 41.7% of referrals fulfilled the new GOS contract requirements, with information on applanation tonometry the most commonly missing. Conclusions: After the implementation of the new GOS (Scotland) contract in April 2006, there has been an improvement in the quality of the glaucoma referrals from the community optometrists in the northeast of Scotland, with a corresponding reduction in false-positive referrals. Despite the relatively positive effect so far, there is still scope for further improvement. © 2009 Macmillan Publishers Limited All rights reserved.

Reconsidering Resource Rights: The Case for a Basic Right to the Benefits of Life-Sustaining Ecosystem Services

In the presence of anthropogenic climate change, gross environmental degradation, and mass abject poverty, many political theorists currently debate issues such as people's right to water, the right to food, and the distribution of rights to natural resources more generally. However, thus far many theorists either focus (somewhat arbitrarily) only on one particular resource (e.g. water) or they treat all natural resources alike, meaning that many relevant distinctions within the group of natural resources are overlooked. Hence, the paper will start with an analysis of the various forms which natural resources can take and how this might influence one's conception of resource rights. In so doing, the paper argues that we have to carefully distinguish between the actual physical resources people might control and how we distribute these, and the life-sustaining benefits each and every person draws from sustainable and functioning ecosystems. Based on this distinction, the paper will argue for a right to the benefits of life-sustaining ecosystem services as a universal basic right every person has. Further distributive claims with respect to particular physical resources would thus be limited by the requirements of such a basic right.

Effectiveness of Criminal Justice Liaison and Diversion Services for Offenders With Mental Disorders: A Review

Objective: The authors evaluated and synthesised the best-available evidence relating to the effectiveness of CJLD service models with respect to changes in mental health status and/or criminal recidivism.Methods: Research examining the effectiveness of CJLD services when compared to traditional Criminal Justice System (CJS) responses was reviewed and systematically appraised according to Campbell/Cochrane guidelines. Key outcomes included a reduction in offending and post-intervention changes in mental health. Results: Comprehensive searches of published and unpublished literature identified 6571 studies which varied considerably in terms of their methodological approach and overall quality. Ten studies met the inclusion criteria. The synthesised findings indicated that, when compared to traditional CJS outcomes, CJLD services appeared to be effective in terms of identifying MDOs and impacting positively on criminal justice and mental health outcomes.Conclusions: Although the evidence may be deemed to be moderate in terms of methodological rigour, overall, the findings suggest that CJLD services can be beneficial. The effectiveness of services depends upon the model of service delivery, the availability of community services and the engagement of MDOs.The successful implementation of CJLD services requires a clearer recognition of the importance of system of care principles.