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PubMed2001

Perspectives on legislation relating to the rights and protection of people with dementia in Europe.

This article focuses on the main legal provisions in Europe relating to the protection and rights of people with dementia. The information referred to was obtained in the framework of two EC funded projects, which involved the collection, translation and comparison of relevant legislation, and then the writing of legal recommendations to improve the legal rights and protection of people with dementia. The first project started in 1997 and was completed in 1999. The second project started in 1999 and was completed in November 2000. The article provides an overview of the main features of some of the laws in Europe on a few key issues, i.e. guardianship, coercive measures and bioethical issues. Some of the main differences between the systems in different countries are highlighted. An attempt is made to show how the adequacy and appropriateness of legal provisions differ vastly from one country to the next and also to identify the emergence of a few trends, which seem to reflect a movement towards a greater awareness of the nature of mental incapacity and hence a better provision for the rights and protection of people with dementia.

Bioethics↗
PubMed2000

Smoking reduction activities in a federal program to reduce infant mortality among high risk women.

OBJECTIVES: To determine the smoking cessation/reduction services offered to pregnant women by federally funded Healthy Start projects designed to reduce infant mortality. DESIGN: Information was obtained by questionnaires sent to all Healthy Start projects in 1999. Responses were received from 76 sites. SETTING: The federal government selected the Healthy Start sites on the basis of infant mortality rates that were much in excess of the national average. PATIENTS: The projects served largely minority clients. Most of the women were poor and eligible for Medicaid. MAIN OUTCOME MEASURES: The services that projects offered to pregnant smokers, the priority given the smoking related activities, and whether more should be done. RESULTS: Only 23% of the sites thought that they were doing enough to help pregnant smokers stop or reduce smoking. The sites felt the national office should develop a manual of best practices, provide client materials, and organise workshops. While three quarters of the sites expected home visitors to counsel pregnant smokers, less than half provided training in this area during orientation, but most visitors received on-the-job training. Only 64% of sites gave smoking cessation/reduction activities high priority in comparison to other objectives of home visiting. CONCLUSIONS: Although Healthy Start sites were aware of the importance of smoking cessation/reduction activities for their clients, they offered a limited range of services. These projects, and others with similar objectives serving similar populations, need a better understanding of the time and money such interventions require and greater belief in their effectiveness, along with more funds, staff training and materials, and office systems that promote counselling.

Counseling↗
PubMed2005

Effects of a family literacy program on low-literate children and their parents: findings from an evaluation of the Even Start family literacy program.

A randomized experiment was conducted to test the effectiveness of Even Start, a federally supported family literacy program providing early childhood education, adult education, parenting education, and joint parent-child literacy activities to children and parents from low-literate families. The evaluation of 18 Even Start projects followed 463 families for 2 years and found no statistically significant or educationally important impacts on Even Start families when they were compared with control families on child literacy outcomes, parent literacy outcomes, or parent-child interactions. The study concludes that Even Start projects were able to properly implement family literacy programs, and the observed lack of effectiveness is attributed to a combination of 2 factors: (a) a lack of full participation on the part of families and (b) instructional services that may be ineffective because of the curriculum content or the instructional approach.

Adolescent↗
PubMed2005

A syringe exchange programme in prison as prevention strategy against HIV infection and hepatitis B and C in Berlin, Germany.

In two prisons in Berlin, Germany, provision of sterile injection equipment for injecting drug users (IDUs) started in 1998. To assess the programme's impact, the frequency of injecting drug use and syringe sharing, and the incidence of HIV, HBV, and HCV infection were determined in a follow-up study. Of all IDUs (n=174), 75% continued to inject. After the project start the level of syringe sharing declined from 71% during a 4-month period of previous imprisonment to 11% during the first 4 months of follow-up, and to virtually zero thereafter. Baseline seroprevalences for HIV, HBV, and HCV were 18, 53, and 82%. HIV and HCV seroprevalence at baseline was significantly associated with drug injection in prison prior to the project start. No HIV and HBV seroconversions, but four HCV seroconversions occurred. The provision of syringes for IDUs in appropriate prison settings may contribute to a substantial reduction of syringe sharing. However, the prevention of HCV infection requires additional strategies.

Adult↗
PubMed2003

Development and implementation of a multi-centre information system for paediatric and infant critical care.

BACKGROUND: With no UK collective information system, a need existed to establish an integrated information system for public and private sector hospitals providing paediatric and infant critical care services. A lack of information in the past made it difficult for those procuring, providing and monitoring services to make informed, evidence-based decisions using reliable integrated data. OBJECTIVES: To develop and implement a collective multi-purpose information system for paediatric and infant critical care that was easily adaptable to any UK infant or paediatric critical care setting. Information outputs had to fulfil policy requirements and meet the needs of stakeholders. METHOD: Two minimum datasets, corresponding data definitions, survey forms and a user database were developed through a process of consultation by utilising an information partnership. Design, content, development and implementation issues were identified, discussed and resolved through a co-ordinated collaborative process. RESULTS: Data collection was implemented in all London and Brighton National Health Service (NHS) general and cardio-thoracic paediatric intensive care (PIC) units, several private PIC units and one NHS tertiary referral neonatal unit (NNU) 24 months from project start. CONCLUSIONS: The development of universal integrated information systems for defined settings of care is achievable within reasonable timeframes; however, successful development and implementation requires working within an information partnership to maximise co-ordination, co-operation and collaboration. Those collecting and using data must be identified and involved in all aspects of development from project start. Financial and manpower resources must be well planned. Datasets should be as small as possible in order to make the collection of complete and valid data realistically achievable. When considering service-based information needs, considerable thought should be given to a multi-purpose; multi-use approach based on the most refined minimum dataset possible.

Child↗
PubMed1970

The use of a token system in project Head Start.

The present experiment sought to develop a practical and effective method for teaching the beginning elements of hand-writing in a Head Start program. The method consisted of reinforcing responses to a writing program by giving the children access to a variety of activities normally available in the pre-school classroom. Tokens were presented for correct responses. The children then used the tokens to select reinforcers, such as snacks and access to a variety of play activities. In an experimental evaluation of the token system, it was found that responding was maintained as long as access to the reinforcing activities was contingent upon responding. When reinforcement was no longer contingent upon responding, virtually no responding occurred. Informal observations suggested that the token system had several unanticipated effects: the children's vocabulary and ability to understand instructions improved; a favorable attitude toward school developed; and their ability to play cooperatively with other children increased. It was concluded that the token system is a practical and effective method for teaching beginning writing skills and that it has other desirable, if unanticipated, effects.

Journal Article↗