bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identifying additional patients with diabetic nephropathy using the UK primary care initiative
Authors: Magee G. M. , Hunter S. J. , Cardwell C. R. , Savage G. , Kee F. , Murphy M. C. , Fogarty D. G. 
Published: August 2010

Diabet. Med. 27, 1372–1378 (2010)AbstractAims  The aim of this study was to use general practice data to estimate the prevalence of diabetic nephropathy within the registered diabetes patients and examine variation in practice prevalence and management performance since introduction of this initiative.Methods  Reported quality indicators from the Northern Ireland General Practice Quality and Outcomes Framework were analysed for diabetes and diabetic nephropathy prevalence and management in the period 2004–2008. Variation in prevalence at practice level was assessed using multiple linear regression adjusting for age, practice size, deprivation and glycaemic control.Results  In 2006–2007, 57 454 (4.1%) adult diabetic patients were registered in the denominator population of 1.4 million compared with 51 923 (3.8%) in 2004–2005 (mean practice range 0.5–7.7%). Diabetic nephropathy prevalence was 15.1 and 11.5%, respectively (8688 and 5955 patients). Documented diabetic nephropathy prevalence showed marked variation across practices (range 0–100%) and was significantly negatively correlated with diabetes list size, albumin creatinine ratio testing rates and renin–angiotensin–aldosterone system blockade use and positively correlated with exception reporting rates. Specifically, for every increase in 100 diabetic patients to a register, documented diabetic nephropathy prevalence reduced by 40% (P = 0.003). On the positive side, median albumin‐creatinine ratio testing rates doubled to 82% compared with figures in the pre‐Framework era.Conclusions  Implementation of the Northern Ireland General Practice Quality and Outcomes Framework has positively benefitted testing for diabetic nephropathy and increased numbers of detected patients in a short space of time. Large variation in diabetic nephropathy prevalence remains and is associated with diabetes registry size, screening and treatment practices, suggesting that understanding this variation may help detect and better manage diabetic nephropathy.
RETAIL SALES DURING THE WAR: B. CHANGES IN GROCERY SALES
Authors: SCHULZ. T. 
Published: August 2010

SummaryWe can now summarize the main findings of our analysis: It seems that during the first eighteen months of the war the number of ‘full’ customers in our sample shops increased by at least 10 per cent. We have reason to assume that during the same period the number of casual customers—which for certain commodities was very large1 —became insignificant. A rough correction for expenditure due to casual custom of the average figures of total turnover for 1938‐39, gives the outlays on all items per ‘full’ customer as approximately 41d. a head a week.2 In January 1941, this outlay was up to about 46d. This, however, represents the average expenditure during a week when it was probably abnormally high (for various reasons, which have been discussed above) and, moreover, most likely accompanied by an exceptional decrease in the expenditure on meat. Hence our data give us little cause to think that as regards the families typical for the customers of our sample shops, money outlay per head on groceries had risen during the first eighteen months of the war. As the price index of all groceries rose by 43 per cent, the cut in real consumption must have amounted to about 30 per cent. Part of this ‘saving’ was, however, represented not by a cut in the actual quantities consumed but by a decline in quality.3The two food groups the prices of which increased most steeply were those of first class protein and of carbohydrate foods. If we subdivide the groceries into two main classes of ‘rationed’ and ‘unrationed’ foods we find the average rate of increase of the prices of ‘unrationed’ foods to have been 1 1/2 times that of the prices of ‘rationed’ foods, for which latter group price control was more comprehensive.
SIZE AND SUCCESS IN RETAIL DISTRIBUTION
Authors: BELLAMY. R. 
Published: August 2010

Summary.1. The Measurement of Success.The problem of measuring success by direct and indirect evidence is discussed. It is proposed to examine the advantages of the large stores and organizations under two broad heads—those which arise from a monopolistic or monopsonistic position, and those which arise from economies of scale.2. Monopolistic and Monopsonistic advantages.Evidence is produced to show that no advantage in respect either of higher prices or higher Percentage Gross Margins is enjoyed by large enterprises. They are, however, undoubtedly able to buy more cheaply.They are also able to afford higher per unit ‘ selling costs ’ (Publicity, Delivery and other services) which should enable them to attract and maintain a greater volume of sales.3. Economics of sale.These higher unit selling costs are possible because the other Operating Expenses of large enterprises are lower. They are lower firstiy because of the rising productivity of labour with size, and secondly because the cost of holding stocks does not increase proportionately with sales.4. Conclusion.Thus the trends towards greater concentration portrayed in our first article are given a basis in the greater profitability of large enterprises. It remains to discuss whether that profitability is achieved at the expense of the consumer.
The law and mental handicap: 1. How law is determined
Authors: Gunn Mike J. 
Published: August 2010

This article is the first in a series, written by Mike Gunn, on the law and its effects upon mentally handicapped people and those who care for them. The series will deal with some common problems faced by handicapped people and will discuss some of the implications of the new legislation.Readers are invited to ask questions, either of a general nature or in regard to a specific problem, which Mr. Gunn will answer either as part of the article series or on the journal's new Legal page which starts in this issue (page 174). All correspondence should be addressed to: The Editors, Mental Handicap Journal, BIMH, Wolverhampton Road, Kidderminster, Worcs DY10 3PP.
Communication and language in mental handicap
Authors: Bell Ian 
Published: August 2010

SUMMARYThis is the second of two articles on the communication and language curriculum for children with severe learning difficulties. The curriculum development model followed is:STEP 1. Specify the underlying philosophy and general aim for educating children who are mentally handicappedSTEP 2. Select the core areas of the curriculumSTEP 3. Specify the aims for each core areaSTEP 4. Divide each core area into component partsSTEP 5. For each component select and sequence the skills the children are to acquireSTEP 6. For each component devise or select a means of assessment and record‐keeping.Steps 1–4 were covered in the previous article. This article deals with Steps 5 and 6. It is suggested that a seventh step should be added:STEP 7. Constantly review and revise the curriculum.
Communication and language in mental handicap 5. DON'T TEACH — INTERVENE
Authors: Bell Ian 
Published: August 2010

SUMMARYThere are reasons for believing it is inappropriate to refer to teaching communication and language skills. This article explains why this is so; argues that “facilitators” can accelerate communication and language acquisition in children with mental handicaps by “intervening” in their environment; and outlines the principles on which intervention should be based.
STAFF IN‐SERVICE TRAINING
Authors: McGinley Patrick , Vickerman Brian A. 
Published: August 2010

SUMMARYA one‐week in‐service staff training course was given on two successive weeks at a residential and day centre for adults with mental handicaps in Ireland; and a year later at a similar centre in England. A total of 44 staff attended. The course included lectures on the philosophy underlying the care and training of people with mental handicaps and a detailed review of behavioural techniques in learning. Course members then applied what they had learned in a series of practical exercises. Course evaluation indicated a significant improvement in members' technical knowledge of training procedures.
WARD SIZE AND COSTS: a study of a large mental handicap hospital
Authors: Johnes Geraint , Haycox Alan 
Published: August 2010

SUMMARYCosts per patient day are explained with reference to the age, dependency, and sex mix of residents, their degree of physical handicap and behavioural disturbance, and ward size. The number of occupied beds is found to be a significant determinant of costs, and becomes increasingly important as the residents become younger or more dependent. In general, a ward in which the majority of residents are young or dependent minimises its costs when 24 beds are occupied; but the least cost size for wards in which all residents are heavily dependent may be less than 10 beds.
Sexual offences involving children: a suggested treatment for adolescents with mild mental handicaps
Authors: Hames Annette 
Published: August 2010

SUMMARYWhilst there is increasing concern about the number of sexual attacks upon young children, and a growing fear of the perpetrators of such offences, there are a few people who occasionally interfere with young children through ignorance and lack of confidence. These people are often adolescents with a mental handicap who associate and play with children much younger than themselves, and then one day find they have done something which they did not realise was illegal.This article describes some techniques which have begun to be used in the treatment of adolescents who are mildly mentally handicapped and who have been convicted of such offences.
The views of parents and carers: 1. Some pleasures, stresses, and strategies
Authors: Swain John , Eagle Paul 
Published: August 2010

Two meetings for parents and carers of people with mental handicaps were held in order to assist in the development of the new Open University course P555 Mental Handicap: Patterns for Living. Parents' and carers' views on a variety of issues were sought and recorded.This is the first of two articles which highlight some of the main points discussed at the meetings and report participants' views in their own words. This article covers the pleasures, stresses, and strategies of caring, and then draws out some general impressions.The meetings seemed to be successful for all concerned. They brought out many factors in the lives of people who have a family member with a mental handicap, and illustrated a wide variety of experiences and views.
Involving parents in teaching reading: a project with nine children with Down's syndrome
Authors: Greene Kay 
Published: August 2010

This project involved parents of nine young children with Down's syndrome, who were all enrolled in St. Michael's House Early Services programme. The parents were given support and guidance by means of fortnightly visits by the home teacher who had worked with their children on other developmental activities since infancy.All the children learned to read some single words, ranging from 10 to 131. The mean for the group was 69 words. Eight children were reading these words in books. The number of completed books read ranged from one to five. The mean for the group was 2.7.There was wide variation within the group on the time taken to learn new words and on fluency in reading. All the parents agreed that the effort involved in teaching their children to read was well worth it.
Assessing the service needs of people with mental handicaps: METHOD USED IN THE JAY PROJECT
Authors: Freedman David 
Published: August 2010

This article sets out the method used in the Jay Project for assessing the service needs of people with mental handicaps over the major areas of life. Detailed interviews were conducted with the individuals themselves, their close family and/or friends, and the professional workers who knew them well. Available records were also consulted. A summary of the perceptions and opinions of the people interviewed was drawn up and presented under key headings, followed by a list of “service needs” as seen from the point‐of‐view of the service users.The assessments were discussed by the Project's multi‐agency Steering Group where recommendations for action were made, the aims being to try to obtain better services for individuals and to indicate to service planners the degree of service need in a geographical area.The method demonstrated that broad‐based assessments could be produced in a relatively short time. The structure of the Project created a forum for multi‐agency dialogue and helped to foster inter‐agency cooperation.
THE PARTNERS PROJECT: community based recreation for adults with mental handicaps PART 1
Authors: Walsh Patricia Noonan , Coyle Kevin , Lynch Christy 
Published: August 2010

Twelve adults with mental handicaps, who attended day services, were selected randomly and introduced to a range of community based recreational activities with the help of young people from the community who acted as their partners. The activities took the form of a summer project which aimed to offer a variety of recreational experiences to each adult, and to test the benefits of working alongside community helpers.The implications for identifying ways to increase participation levels of individuals and for providing for the carryover of any new levels of activity achieved are discussed. The outcome of the project suggests that a partnership of professional, frontline, and voluntary workers can effectively promote the integration into the community of adults with mental handicaps.
PRIDE AND PREJUDICE? Factors influencing “uptake” of family based respite care services
Authors: Robinson Carol 
Published: August 2010

The research findings described in this article are drawn from a large‐scale evaluative study of one of Britain's largest family based respite care schemes for families with a child who is handicapped (Robinson, 1986). It looks at the evidence which helps to answer the question: “Why don't all families eligible to use this respite service do so?”.The findings suggest that a number of social and demographic characteristics found to influence “uptake” of respite care services in America are equally relevant in Britain, but that a number of other variables are also important. These additional factors are associated with a lack of information about the services on offer, families' past experiences of family based services, and parents' attitudes towards their parenting role.
Integrating adults with mental handicaps into ordinary housing: THE THURLOW CLOSE PROJECT
Authors: Rawlinson Steve 
Published: August 2010

This article portrays the culmination of several years' planning and preparation by a Support and Training Team committed to providing suitable community‐based accommodation for adults with mental handicaps. It is evidence of what can be achieved when several agencies combine in a spirit of partnership to put into practice the concept of community care.An attempt has been made to describe the rehabilitation training provided, starting from the initial assessment at a training unit and ending with the frequency, nature, and provision of follow‐up support once the adults had been re‐housed. It is important to stress the need for continuing collaboration between parents and professionals.
Sex education for pupils with severe learning difficulties: A SURVEY OF PARENT AND STAFF ATTITUDES
Authors: Squire Joan 
Published: August 2010

In April 1987 a survey of parental and staff attitudes was undertaken into the question of providing a personal and social education curriculum at an all‐age day school for pupils with severe learning difficulties.The results show that, while questions of appearance, health, hygiene, and social behaviour were almost unanimously agreed to be relevant, areas of explicitly sexual knowledge and behaviour were not thought to be relevant by the majority of parents. Staff views differed from those of the parents, favouring a much more wide‐ranging approach to the content of such a curriculum.Parents of young pupils were more positive than parents of older pupils in their views of what should be included in the curriculum and in their overall expectations of the pupils.
Challenging behaviour: introducing a preadmission checklist, problem analysis flow chart, and intervention flow chart to guide decision‐making in a multidisciplinary team
Authors: Bridgen Patricia , Todd Margaret 
Published: August 2010

This paper explores one possible approach to caring, in a community setting, for people with mental handicaps who exhibit challenging behaviour. The advantages and disadvantages of a special unit and the flying squad approach are addressed. One model of care which attempts to use both approaches is discussed, with the emphasis on individual case management.The model suggested is underpinned by the philosophy of normalisation which seeks to enable service users to participate in community activities as fully as possible. One method of preventing unnecessary admission to a special unit is explored, and the use of a checklist and flowcharts suggests alternative methods of managing individual service users.
Group Therapy With Offender Patients Who are Mentally Handicapped
Authors: McGinnity Maria , Curran Michael 
Published: August 2010

Nine Offender patients, who are mentally handicapped and detained in a secure environment were included in a psychotherapy group, which met weekly for sixteen weeks. The patients demonstrated an ability to interact within a group setting and to use the milieu in a therapeutic way. The therapists gained an insight into the dynamics of patient relationships and the subculture of life in a hospital.There was no evidence that running such a group in a secure unit undermined staff authority or caused any deterioration in other staff patient relationships. We would recommend group therapy be included in the range of treatments offered to patients with a mental handicap, including those living in a secure setting.
The Education and Training for Change Programme Part 1: In, But Not Of the Service
Authors: Cole Angela , Ezelle LesleyAnne , de Podesta Sean 
Published: August 2010

This is the first of two papers focusing upon a new approach to staff development provision within Basildon and Thurrock Health Authority's service for people with learning disabilities. The ‘Education and Training for Change’ programme was set up in January 1990 on a contractual basis between the learning disabilities service (the purchaser) and a local HE College (the provider) which has since become a Polytechnic. Both the papers reflect on different aspects of the programme during its first eighteen months of operation, and attempt to draw some preliminary conclusions that may be of interest to other services.This paper addresses the joint nature of the programme and the particular model of provision adopted, where the staff are ‘in, but not of the service’ i.e. sited in, but not employed or managed by the service. Some of the strengths and difficulties of such a model are highlighted, particularly as they apply during a time of organisational change, and the lessons we have drawn from our experiences are explored.
The Role of the Specialist Health Visitor in Aberdeen for People with a Learning Disability
Authors: Milne Kenneth M. 
Published: August 2010

People with learning disabilities living in the community often experience lack of appropriate support to maintain a desirable quality of life. Health and social problems can and do cause those clients unnecessary problems which, in turn, produce stress on their carers. Community health visiting is an acceptable and normal service for all families. Part of the health visitor's role has always been the care and support of people with learning disabilities. It is desirable that health visitors supporting people with learning disabilities acquire specialist expertise but with only a few such clients on their case load, this is often difficult to achieve.This paper describes the role of the specialist health visitor working with clients, carers, teachers in schools for pupils with special needs and other professionals in attempting to facilitate a better quality of life for people with learning disabilities. This holistic approach is present throughout the lifespan of persons with learning disabilities and therefore provides continuity of care and support.
Adolescent inpatient psychiatric admission rates and subsequent one‐year mortality in England: 1998–2004
Authors: James Anthony , Clacey Joe , Seagroatt Valerie , Goldacre Michael 
Published: August 2010

Background:  Adolescence is a time of very rapid change not only in physical but also psychological development. During the teenage years there is a reported rise in the prevalence of psychiatric disorders. The aim of this study was to investigate age‐ and sex‐specific National Health Service (NHS) hospital inpatient admission rates for psychiatric conditions in adolescents in England, and to examine their mortality within one year of discharge.Method:  Using a record‐linked NHS Hospital Episode Statistics (HES) dataset for England, and linked death certificates, age‐ and sex‐specific admission rates and subsequent mortality rates were analysed by single year of age for people aged 10–19 years.Results:  There were similar numbers of admissions for males and females: 29,595 and 28,188 respectively. Admission rates increased substantially with increasing age, from .2 per 1000 population per year aged 10 years to 2.2 per 1000 aged 19 years. There was no appreciable difference in death rates for males and females in the year following discharge – males .23% (based on 68 deaths), females .18% (52 deaths). However, these death rates were significantly higher than those found in the general population of equivalent age: expressed as standardised mortality ratios (SMRs), setting the SMRs for males and females in the general population each as 100, the SMR in the psychiatric population were 518 (95% CI 402–657) for males and 937 (692–1225) for females. The diagnostic groups with the highest mortality were development disorders (SMR 3017, 95% CI 1757–4831), eating disorders (SMR 1103, 443–2272), and affective disorders (SMR 940, 589–1423).Conclusion:  Adolescent psychiatric disorders represent a serious public health issue, with a steep rise in hospital admissions during the teenage years, and a six‐fold increased death rate within one year of discharge compared to the general population of the same age.
Recognition or imposition? Federalism, national minorities, and the Supreme Court of Canada†
Authors: SCHERTZER ROBERT 
Published: August 2010

ABSTRACT. This paper makes two main arguments. First, federalism in Canada, properly conceived, is a system which evolves as a result of struggles over the norms of mutual recognition between territorially based groups. Second, if federalism is to work as a way of accommodating national minorities, the role of the judiciary in adjudicating this relationship must be taken into account, because it plays an integral role in the continuing contestation of the arrangement.I begin with the ‘problem’ of national minorities in the nation‐state system and why federalism is espoused as a solution for alleviating tensions, focusing on Canada. I then turn to review the relevant jurisprudence of the Supreme Court of Canada (SCC) in adjudicating the federal arrangement. Finally, considering this jurisprudence, I reflect on why it is important to account for the role of the Court when promoting federalism to accommodate national minorities. I go on to argue that a dialogical approach to federalism, as opposed to a monological one, is best suited to do this.