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Predictors, costs and characteristics of out of area placement for people with intellectual disability and challenging behaviour 总被引:1,自引:0,他引:1
D. G. Allen K. Lowe K. Moore & S. Brophy 《Journal of intellectual disability research : JIDR》2007,51(6):409-416
Background Out of area placements for people with challenging behaviour represent an expensive and often ineffective strategy for meeting the needs of this service user group. Methods More than 800 agencies and service settings in a large area of South Wales were screened to identify children and adults with challenging behaviour against a number of defined operational criteria. Detailed data on identified individuals and the services they received were collected by interviewing key informants. Univariate and multivariate statistics were employed to identify predictors of out of area placement. Results In total, 1458 people were identified. Full data were available for 901 participants, 97 of whom were placed out of area. Predictors of out of area placement included behaviours resulting in physical injury and exclusion from service settings, a history of formal detention under the mental health act, the presence of mental health problems, a diagnosis of autism and higher total score on the Adaptive Behaviour Scale. Out of area placements were typically of high cost, and associated with only limited evidence of improved service quality. Conclusions Identifying predictors for out of area placement can be used to highlight deficiencies in local services and individuals at increased risk of exclusion from local services. 相似文献
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Maximal static expiratory and inspiratory mouth pressures (PEmax and PImax) and quadriceps femoris muscle strength were measured in 25 patients aged 16-28 years with cystic fibrosis (mean FEV1 46% predicted). Mean (SD) PEmax was 64% (18%) predicted (below 75% predicted in 16 of the 25 patients), and PImax was 64% (24%) predicted (below 75% predicted in 14 patients). Quadriceps muscle strength was 68% (20%) predicted (below 75% predicted in 17 patients). The relatively small reduction in respiratory muscle strength in these patients was unlikely to have contributed appreciably to their respiratory problems. 相似文献
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Kinnison ML; Perler BA; Kaufman SL; Mitchell SE; Kadir S; Williams GM; White RI Jr 《Radiology》1986,160(3):727-730
In situ saphenous vein grafts are being used with increasing frequency for bypass procedures involving the femoral and popliteal arteries. Complications of these procedures include anastomotic stenoses and persistent arteriovenous fistulae that may result in failure of the graft. Balloon angioplasty and embolotherapy with detachable balloons were employed successfully in three or four recent cases of patients with complications from in situ grafts. Tailored angiography is essential for evaluating in situ grafts, and interventional techniques are extremely useful for managing complications. 相似文献
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James M. Brophy 《Canadian Medical Association journal》2005,172(3):361-362
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J M Brophy 《The Canadian journal of cardiology》1992,8(5):495-498
OBJECTIVE: To assess mortality rates from congestive heart failure in Canada from 1970 to 1989. DESIGN: Observational, retrospective design using national population and mortality data. MAIN RESULTS: There is a definite age gradient for deaths from congestive heart failure which, combined with a general ageing of the Canadian population, has lead to an increase in the absolute number of deaths. However, Standardized Mortality Ratios, which account for shifting population distributions, have shown steadily decreasing values for both men and women since 1980. CONCLUSIONS: Recent improvements in cardiology care demonstrated in controlled clinical trials appear also to be present in epidemiological studies. 相似文献