The experiences and needs of family carers of people with diabetes at the end of life

ABSTRACT
Diabetes is a common, increasingly prevalent chronic disease. Many people requiring palliative care have diabetes. Diabetes requires lifelong self-care tasks. Family carers frequently perform these tasks when the person with diabetes is no longer able to perform them, but there is a lack of information about carers’ needs to enable them to undertake their new care tasks. The study aimed to collect information from family carers of people with diabetes requiring palliative care about their views and experiences of managing a family member’s diabetes at the end of life and identify their needs to enable them to undertake diabetes care tasks. Data were collected during individual, semistructured interviews with 10 family members caring for a person with diabetes receiving palliative care. The 4 key themes identified were as follows: I didn’t know what to do: it’s a big responsibility; I need education; and it’s important to manage diabetes. Family members/carers feel anxious about their increasing responsibility when caring for their family member’s diabetes and need information and education to help them monitor and interpret blood glucose levels, mange high or low blood glucose levels, and administer glucose-lowering medicines safely and confidently.

On the potential for psychological researchers and psychologists to promote the social inclusion of people with disability: A review

© 2015 Australian Psychological Society. Objective: This paper outlines different approaches to understanding disability and describes ways in which psychological researchers and psychologists can promote the social inclusion of people with disability. Method: Narrative review drawing on writings and research from psychology and disability studies. Results: Five prominent models of disability appear in the literature (moral, medical, social, biopsychosocial, and post-modern), all of which have relevance to the lives of people with disability. Conceptualisations commonly used to understand the experience of disability from a psychological perspective include stigma and psycho-emotional disablism. There is evidence that people with disability wish to have greater involvement in research (e.g., as consultants and partners in research about them, and as participants in mainstream research) and to see research findings translated into practice. Evidence is emerging that can be used to underpin psychologists work with (a) communities (to foster social change and social justice, and to reduce stigma); (b) organisations, such as schools, workplaces, and disability service providers (to help develop inclusive and supportive environments); (c) families (to promote optimism, alternative understandings of disability, and a sense of control, as well as developing behaviour support plans and providing referrals to other sources of practical support); and (d) people with disability (to assist them with the issues they bring to therapy while being mindful of the potential for psycho-emotional disablism to colour the material presented). Conclusion: Psychological researchers and psychologists have significant potential to contribute to the social inclusion of people with disability.

Lipid profile of people with Diabetes mellitus type 2 and periodontal disease

The objective of this study was to evaluate improvement of lipids and periodontal disease in patients with type 2 Diabetes mellitus, by means of the relationship between blood levels of total cholesterol and its fractions, triglycerides and clinical periodontal parameters. Twenty patients, in age-range 18-70 years, were selected and divided into 2 groups: (1) conventional periodontal scaling and root planing + controlled mechanic; (2) conventional periodontal scaling and root planing + controlled mechanical + maintenance therapy. The analyses were performed on day 0, 180 and 720 days, including plaque index, gingival index, probing depth and clinical attachment level, and evaluation of total cholesterol and its fractions, and triglycerides. The 2 groups presented significant reduction in clinical periodontal parameters, however, probing depth did not diminish significantly only in Group 1. There was significant improvement in all blood parameters in both groups. It was concluded that after 720 days of the experiment, there were significant improvements in clinical and blood parameters, in general. The group that received maintenance therapy also showed a more expressive improvement in clinical periodontal parameters, in general, suggesting that this therapy is important and necessary in patients with type 2 Diabetes mellitus and periodontal disease. (C) 2011 Elsevier B.V. All rights reserved.

Crossing the lines and closing the gaps : critical issues in mainstreaming workers with disabilities : an interdisciplinary approach to the medical/vocational rehabilitation process.

Shipping list no.: 89-230-P.

Domestic abuse of adults with disabilities : report to the Illinois General Assembly.

Required by the Domestic Abuse of Disabled Adults Intervention Act ("act"), P.A. 87-658.

Domestic abuse and neglect of adults with disabilities : study and demonstration act PA 84-881 : a report to the General Assembly and the Governor.

"April 1, 1986."

Overcoming barriers to inclusion of children with disabilities in the local schools : a blueprint for change :executive summary: /

Cover title.

Supportive care needs of people with brain tumours and their carers

Goals of work: The diagnosis and treatment of a brain tumour may result in long-term changes in a patient's functional and social abilities and/or in a greatly reduced life span. A qualitative investigation was conducted to examine the supportive care needs of patients with brain tumour and their carers. Materials and methods: Overall, 18 patients and 18 carers participated in focus groups or telephone interviews, following a structured interview guide to elicit supportive care services of importance to these patients and carers. Main results: Six major themes were identified using the framework analysis method, including needs for information and coping with uncertainty, practical support, support to return to pretreatment responsibilities or prepare for long-term care, support to deal with social isolation and organize respite care, support to overcome stigma/discrimination and support to discuss potentially reduced life expectancy. Conclusions: Five recommendations to improve service delivery include: assignment of a dedicated member of the care team or case manager; proactive dissemination of information, education and psychosocial support; access to objective assessment of neuropsychological functioning; facilitating easier access to welfare payments; and services facilitating communication about difficult illness-related topics. Provision of services along these recommendations could improve supportive care of brain tumour patients and their carers.

Web Interfaces Destined for People with Disabilities

One of the main characteristics of the world that we live in is the access to information and one of the main ways to reach the information is the Internet. Most Internet sites put accessibility problem on a secondary plan. If we try to define this concept (accessibility) we could say that accessibility it’s a way to offer access to information for the people with disabilities. For example blind people can’t navigate on the Internet like usual people. For that reason Internet sites have to put at their disposal ways to make their content known to this people. Accessibility does not refer only at blind people the web accessibility refers to all people who lost their ability to access the Internet sites. The web accessibility includes every disability that stops people with disabilities to access the web sites content like hearing disability, neurological and cognitive. People that have low speed Internet connection or with low performance computers can use the web accessibility.

A qualitative study of the impact of an educational intervention on older parents of adults with disabilities engaged in the phenomenon of future-care planning

This phenomenological study describes the impact of an educational intervention on the day-to-day experiences of older parent caregivers of adults with developmental disabilities who were engaged in the process of future-care planning. Qualitative strategies of individual and focus group interviewing were used with a purposive sample of older caregivers. Participants were members of an existing parent support group. Twenty-three caregivers representing 18 families were queried before and after the education program. The disabilities represented were mental retardation, cerebral palsy and autism. Parents whose children live at or away from home were included. The intervention was conducted on five Saturdays over a two month period; the duration of the study was five months. Findings used typical words of the respondents from their individual and focus group interviews to describe feelings, attitudes and experiences in making future-care plans. Data from verbatim transcriptions and researcher's field notes were coded, analyzed, sorted into themes, and subjected to interpretive analysis. Respondents showed a positive change in attitudes and actions after participating in the education program, regardless of their initial stage in care planning. Fears were replaced by hope and determination; hesitation and ineptitude by feelings of competence and confidence; and procrastination and delay by purposeful actions. Other key findings: use of a planning document greatly aided caregivers; barriers to planning were often intrinsic and amenable to education; residential plans were the most difficult aspect of planning; listening to the experiences of other parent caregivers was helpful; and making burial plans for their offspring was one aspect of planning parents wished to do themselves. ^

Optimization models for selecting bus stops for accessibility improvements for people with disabilities

Bus stops are key links in the journeys of transit patrons with disabilities. Inaccessible bus stops prevent people with disabilities from using fixed-route bus services, thus limiting their mobility. The Americans with Disabilities Act (ADA) of 1990 prescribes the minimum requirements for bus stop accessibility by riders with disabilities. Due to limited budgets, transit agencies can only select a limited number of bus stop locations for ADA improvements annually. These locations should preferably be selected such that they maximize the overall benefits to patrons with disabilities. In addition, transit agencies may also choose to implement the universal design paradigm, which involves higher design standards than current ADA requirements and can provide amenities that are useful for all riders, like shelters and lighting. Many factors can affect the decision to improve a bus stop, including rider-based aspects like the number of riders with disabilities, total ridership, customer complaints, accidents, deployment costs, as well as locational aspects like the location of employment centers, schools, shopping areas, and so on. These interlacing factors make it difficult to identify optimum improvement locations without the aid of an optimization model. This dissertation proposes two integer programming models to help identify a priority list of bus stops for accessibility improvements. The first is a binary integer programming model designed to identify bus stops that need improvements to meet the minimum ADA requirements. The second involves a multi-objective nonlinear mixed integer programming model that attempts to achieve an optimal compromise among the two accessibility design standards. Geographic Information System (GIS) techniques were used extensively to both prepare the model input and examine the model output. An analytic hierarchy process (AHP) was applied to combine all of the factors affecting the benefits to patrons with disabilities. An extensive sensitivity analysis was performed to assess the reasonableness of the model outputs in response to changes in model constraints. Based on a case study using data from Broward County Transit (BCT) in Florida, the models were found to produce a list of bus stops that upon close examination were determined to be highly logical. Compared to traditional approaches using staff experience, requests from elected officials, customer complaints, etc., these optimization models offer a more objective and efficient platform on which to make bus stop improvement suggestions.

Categorical Differences in Scores of Students with Disabilities on the Florida Comprehensive Assessment Test

Students with disabilities participate in statewide assessments as required by federal law, and the success of schools is contingent on this group making Adequate Yearly Progress. This report on research includes the findings of differences between disability categories scoring proficient on the FCAT from the years 2005 through 2010.

TEACHERS’ ATTITUDES TOWARD INCLUSION OF CHILDREN WITH DISABILITIES IN RURAL EL SALVADOR

The attitude of school teachers toward inclusion of children with disabilities is an important factor in the successful implementation of a national inclusion program. With the universal pressure to provide education for all and international recognition of the importance of meeting the needs of diverse populations, inclusive education has become important to governments around the world. El Salvador’s Ministry of Education seeks to establish inclusion as an integral part of their struggle to meet the needs of children across the country, but this is a difficult process, especially for a country with limited resources which still struggles to meet international expectations of educational access and quality. Teacher attitude is an important factor in the success of inclusion programs and can be investigated in relation to various factors which may affect teachers’ classroom practice. While these factors have been investigated in multiple countries, there is a need for more knowledge of the present situation in developing countries and especially in schools across the rural areas of El Salvador to meet the needs of the diverse learners in that country. My research was a mixed methods case study of the rural schools of one municipality, using a published survey and interviews with teachers to investigate their attitudes regarding inclusion. This research was the first investigation of teachers’ attitudes toward inclusion in rural El Salvador and explored the needs and challenges which exist in creating inclusive schools across this country. The findings of this study revealed the following important themes. Some children with disabilities are not in school and those with mild disabilities are not always getting needed services. Teachers agreed with the philosophy of inclusion, but believed that some children with disabilities would receive a better education in special schools. They were not concerned about classroom management. Teachers desired more training on disability and inclusion. They believed that a lack of resources, including materials and personnel, was a major barrier to inclusion. Teachers’ attitudes were consistent regardless of family and professional experience with disability or amount of inclusion training. They were concerned about the role of family support for children with disabilities.

A longitudinal analysis of disproportionality in statewide exclusionary discipline of students with disabilities

The study examined the state-by-state changes in the rates of exclusionary discipline of students with disabilities compared to their non-disabled peers. Historically, students with disabilities have been excluded at rates that are out of proportion with their population. This study used state discipline to investigate the current status of disproportional exclusion of students with disabilities and if there are any regional trends in the discipline of students receiving special education services. Results indicate that in both the 2009-2010 and 2011-2012 school years, there were significant differences between the rates at which students with and without disabilities were disciplined. Students with disabilities were suspended at higher rates during both school years and expelled at higher rates during the 2011-2012 school year. Results also suggest that rates of suspensions and expulsions continue to be high, particularly for students with disabilities. Findings may help states and schools develop policies that promote fair discipline of students with disabilities.