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Articles de revues sur le sujet « Capacity and disability – wales »

Auteur : Grafiati

Publié le 25 juillet 2024

Mis à jour le 28 juillet 2024

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1

Shah, Ajit, Chris Heginbotham, Bill Fulford, Natalie Banner, Karen Newbigging, and Mat Kinton. "A Pilot Study of the Early Experience of Consultant Psychiatrists in the Implementation of the Mental Capacity Act 2005: Local Policy and Training, Assessment of Capacity and Determination of Best Interests." International Journal of Mental Health and Capacity Law, no. 19 (September 8, 2014): 149. http://dx.doi.org/10.19164/ijmhcl.v0i19.251.

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<p>The Mental Capacity Act 2005 (MCA) was partially implemented in April 2007 and fully implemented in October 2007 in England and Wales (with the exception of the Deprivation of Liberty Safeguards which were implemented in April 2009). The government estimated that up to 2 million adults in England and Wales may have issues concerning their decision-making capacity (henceforth ‘capacity’), and these will included 840,000 people with dementia, 145,000 people with severe learning disability, 1.2 million people with mild to moderate learning disability and 120,000 people with severe brain injury. Additionally, the prevalence of schizophrenia, mania and serious depression are 1%, 1% and 5% respectively, and some of these individuals may also lack capacity. Moreover, up to 6 million family and unpaid carers are estimated to provide care or treatment for individuals lacking capacity. Furthermore, many other people who do not lack capacity may use aspects of the MCA for future planning.</p>

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Ellem, Kathy, Lesley Chenoweth, and Ruth Edwards. "Choosing the harder road: Naming the challenges for families in person-centred planning." Journal of Intellectual Disabilities 23, no. 3 (2018): 397–412. http://dx.doi.org/10.1177/1744629518784154.

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Person-centred planning (PCP) has underpinned disability service provision in many Western countries for the past 30 years. For many people with an intellectual disability, family members are central to this process and are important allies in facilitating positive change. This article presents findings from an evaluation of a family resourcing and capacity building project in New South Wales (NSW), Australia. Accounts from families show the merits of such work, but family efforts can be undermined by apathy and discrimination to disability from extended family, community and service providers. Asking families to be the primary support in PCP initiatives may potentially ignore the impacts of structural and psycho-emotional disablism on all family members. For families to support people with intellectual disability in PCP, there is a need to acknowledge and respond to the material, cultural and personal challenges for all family members in planning processes.

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Gabbe, Belinda J., Joanna F. Dipnall, John W. Lynch, et al. "Validating injury burden estimates using population birth cohorts and longitudinal cohort studies of injury outcomes: the VIBES-Junior study protocol." BMJ Open 8, no. 8 (2018): e024755. http://dx.doi.org/10.1136/bmjopen-2018-024755.

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IntroductionTraumatic injury is a leading contributor to the global disease burden in children and adolescents, but methods used to estimate burden do not account for differences in patterns of injury and recovery between children and adults. A lack of empirical data on postinjury disability in children has limited capacity to derive valid disability weights and describe the long-term individual and societal impacts of injury in the early part of life. The aim of this study is to establish valid estimates of the burden of non-fatal injury in children and adolescents.Methods and analysisFive longitudinal studies of paediatric injury survivors <18 years at the time of injury (Australia, Canada, UK and USA) and two whole-of-population linked administrative data paediatric studies (Australia and Wales) will be analysed over a 3-year period commencing 2018. Meta-analysis of deidentified patient-level data (n≈2,600) from five injury-specific longitudinal studies (Victorian State Trauma Registry; Victorian Orthopaedic Trauma Outcomes Registry; UK Burden of Injury; British Columbia Children’s Hospital Longitudinal Injury Outcomes; Children’s Health After Injury) and >1 million children from two whole-of-population cohorts (South Australian Early Childhood Data Project and Wales Electronic Cohort for Children). Systematic analysis of pooled injury-specific cohort data using a variety of statistical techniques, and parallel analysis of whole-of-population cohorts, will be used to develop estimated disability weights for years lost due to disability, establish appropriate injury classifications and explore factors influencing recovery.Ethics and disseminationThe project was approved by the Monash University Human Research Ethics Committee project number 12 311. Results of this study will be submitted for publication in internationally peer-reviewed journals. The findings from this project have the capacity to improve the validity of paediatric injury burden measurements in future local and global burden of disease studies.

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Le Gallez, Isabelle, Keith J. B. Rix, Kartina A. Choong, and Helen Dewson. "Sexual rights, mental disorder and intellectual disability: principles and law." BJPsych Advances 24, no. 5 (2018): 334–45. http://dx.doi.org/10.1192/bja.2018.32.

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SUMMARYPeople with mental disorder and intellectual disability have the same rights to sexual expression as other people, albeit that in some cases a lack of capacity may require curtailment of those rights and regard must be had to protecting the vulnerable. Furthermore, the formation or maintenance of sexual relations, or the attainment of sexual fulfilment, may assist in the maintenance or restoration of mental health or well-being. This article demonstrates how the courts in England and Wales, applying statute law and judicial precedent, are largely supportive of the rights of people with mental disorder or intellectual disability to make decisions about sexual expression, sexual relationships and related matters, notwithstanding some societal and staff attitudes that act to prevent them fulfilling their sexual needs and making decisions about sexual and reproductive matters.LEARNING OBJECTIVES•Understand the underlying principles that apply to the exercise of their sexual rights by people with mental disorder or intellectual disability•Understand some of the obstacles to the exercise of sexual rights by people with mental disorder or intellectual disability•Understand the statute and case law that apply to the exercise of sexual rights by people with mental disorder or intellectual disabilityDECLARATION OF INTERESTNone.

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Wark, Stuart, Catherine MacPhail, Kathy McKay, and Arne Müeller. "Informed consent in a vulnerable population group: supporting individuals aging with intellectual disability to participate in developing their own health and support programs." Australian Health Review 41, no. 4 (2017): 436. http://dx.doi.org/10.1071/ah15235.

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Objective The aim of the present study was to explore the use of complementary consent methodologies to support a potentially vulnerable group of people, namely those aging with intellectual disability, to provide personal input. It was premised on the view that processes to determine capacity for consent, appropriately modified to account for individual capabilities and current circumstances, could facilitate meaningful participation in the development of personal health care plans of people previously excluded from contributing. Methods The present descriptive case study research was undertaken in New South Wales, Australia. A seven-step process for determining capacity for consent was developed, and 10 participants aged between 54 and 73 years with lifelong intellectual disability and health comorbidities were involved. A variety of assistive communication tools was used to support individuals to demonstrate their capacity for giving informed consent. Results After being provided with tailored support mechanisms, seven participants were considered to meet all seven components for determining capacity for consent. Three participants were deemed not to have capacity to give consent regardless of the type of support provided. Conclusions Three critical factors for facilitating personal involvement in decision making for individuals with an intellectual disability were identified: (1) defining consent specifically for the target outcome; (2) outlining the criteria needed for consent to be obtained; and (3) using appropriately modified alternative communication mechanisms as necessary. What is known about the topic? Self-determination is one of the fundamental principles of human rights legislation around the world and, as such, it is considered desirable to have personal input by individuals into the development of their own health care plans. However, this is not always considered feasible if the person comes from a group in the community perceived to be vulnerable to exploitation and viewed as lacking capacity to give informed consent. This results in the use of proxy respondents, who may not accurately represent the desires and life aspirations of the individual. What does this paper add? This paper examines the development and implementation of a targeted program to support individuals aging with lifelong intellectual disability to demonstrate their capacity to provide informed consent. Specifically, it outlines how alternative communications methods, tailored to personal needs and capacity, can assist an individual to both understand and then confirm their understanding of consent in order to participate in developing health care plans. What are the implications for practitioners? People with intellectual disability are now living longer and are increasingly at risk of serious health conditions. The development of long-term health management plans has traditionally not included individuals with more complex needs and moderate intellectual disability, but the present study shows that members of this cohort can successfully understand and consent to participate in health care decision making. By proactively supporting this process, community and healthcare settings may be able to directly facilitate contribution from more individuals, therefore better meeting the goal of person-centred support.

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Kable, Toby J., Angus A. Leahy, Jordan J. Smith, et al. "Time-efficient physical activity intervention for older adolescents with disability: rationale and study protocol for the Burn 2 Learn adapted (B2La) cluster randomised controlled trial." BMJ Open 12, no. 8 (2022): e065321. http://dx.doi.org/10.1136/bmjopen-2022-065321.

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IntroductionPhysical activity declines during adolescence, with the lowest levels of activity observed among those with disability. Schools are ideal settings to address this issue; however, few school-based interventions have been specifically designed for older adolescents with disability. Our aim is to investigate the effects of a school-based physical activity programme, involving high-intensity interval training (HIIT), on physical, mental and cognitive health in older adolescents with disability.Methods and analysisWe will evaluate the Burn 2 Learn adapted (B2La) intervention using a two-arm, parallel group, cluster randomised controlled trial with allocation occurring at the school level (treatment or waitlist control). Secondary schools will be recruited in two cohorts from New South Wales, Australia. We will aim to recruit 300 older adolescents (aged 15–19 years) with disability from 30 secondary schools (10 in cohort 1 and 20 in cohort 2). Schools allocated to the intervention group will deliver two HIIT sessions per week during scheduled specialist support classes. The sessions will include foundational aerobic and muscle strengthening exercises tailored to meet student needs. We will provide teachers with training, resources, and support to facilitate the delivery of the B2La programme. Study outcomes will be assessed at baseline, 6 months (primary endpoint), and 9 months. Our primary outcome is functional capacity assessed using the 6 min walk/push test. Secondary outcomes include physical activity, muscular fitness, body composition, cognitive function, quality of life, physical literacy, and on-task behaviour in the classroom. We will also conduct economic and process evaluations to determine cost-effectiveness, programme acceptability, implementation, adaptability, and sustainability in schools.Ethics and disseminationThis study has received approval from the University of Newcastle (H-2021–0262) and the New South Wales Department of Education (SERAP: 2021257) human research ethics committees. Findings will be published in peer-reviewed journals, and key stakeholders will be provided with a detailed report following the study.Trial registration numberAustralian New Zealand Clinical Trials Registry Number: ACTRN12621000884808.

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Series, Lucy. "On Detaining 300,000 People: the Liberty Protection Safeguards." International Journal of Mental Health and Capacity Law 2019, no. 25 (2020): 82. http://dx.doi.org/10.19164/ijmhcl.v2019i25.952.

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<p>The Mental Capacity (Amendment) Act 2019 will introduce a new framework––the Liberty Protection Safeguards (LPS)––for authorising arrangements giving rise to a deprivation of liberty to enable the care and treatment of people who lack capacity to consent to them in England and Wales. The LPS will replace the heavily criticised Mental Capacity Act 2005 deprivation of liberty safeguards (MCA DoLS). The new scheme must provide detention safeguards on an unprecedented scale and across a much more diverse range of settings than traditional detention frameworks linked to mental disability. Accordingly, the LPS are highly flexible, and grant detaining authorities considerable discretion in how they perform this safeguarding function. This review outlines the background to the 2019 amendments to the MCA, and contrasts the LPS with the DoLS. It argues that although the DoLS were in need of reform, the new scheme also fails to deliver adequate detention safeguards, and fails to engage with the pivotal question: what are these safeguards for?</p><p>Keywords: Mental Capacity (Amendment) Act 2019; Mental Capacity Act 2005; deprivation of liberty safeguards; liberty protection safeguards; article 5 European Convention on Human Rights; P v Cheshire West and Chester Council and another; P and Q v Surrey County Council [2014] UKSC 19; [2014] A.C. 896; [2014] H.R.L.R. 13</p>

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Flynn, Eilionóir. "Disability, Deprivation of Liberty and Human Rights Norms: Reconciling European and International Approaches." International Journal of Mental Health and Capacity Law 2016, no. 22 (2017): 76. http://dx.doi.org/10.19164/ijmhcl.v22i2.503.

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<p><span style="font-family: 'Helvetica',sans-serif; font-size: 12pt; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-ansi-language: EN-GB; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;">Persons with disabilities are subject to unique forms of deprivation of liberty, often justified by reference to the need to protect their right to life, right to health, and to protect the human rights of others. This paper examines disability-specific forms of deprivation of liberty, particularly those authorised in mental health and capacity law, in light of their compliance with European and international human rights frameworks. It explores the apparent tension between Article 5 of the European Convention on Human Rights, which permits deprivation of liberty of ‘persons of unsound mind’ in certain circumstances, and Article 14 of the UN Convention on the Rights of Persons with Disabilities, which states that ‘the existence of a disability shall in no case justify a deprivation of liberty.’ The challenges in attempting to comply with both provisions are illustrated through reference to developments in England and Wales. This paper also seeks to offer a way forward for States Parties to both Conventions, in order to protect the rights of persons with disabilities.</span></p>

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Branton, Tim, and Guy Brookes. "Definitions and criteria: the 2007 amendments to the Mental Health Act 1983." Advances in Psychiatric Treatment 16, no. 3 (2010): 161–67. http://dx.doi.org/10.1192/apt.bp.108.006577.

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SummaryThis article deals with the provisions for the lawful detention and compulsory treatment of patients in England and Wales. The 2007 amendments to the Mental Health Act 1983 redefine ‘mental disorder’ and ‘medical treatment’ and remove the classifications required for longer-term detention, abolishing the so-called ‘treatability test’ and introducing a new appropriate-treatment test. ‘Learning disability’ is brought within the definition of mental disorder but only if ‘associated with abnormally aggressive or seriously irresponsible conduct’. The exclusion for promiscuity, other immoral conduct or sexual deviancy is repealed; the exclusion for dependence on alcohol and drugs is retained. The revised definition of ‘medical treatment’ includes psychological treatment and removes the requirement that treatment is under medical supervision. The basic structure of the 1983 Act is retained. Use of the powers is discretionary. The principles of the Mental Capacity Act 2005 are imported into the decision-making framework through the wording of the Mental Health ActCode of Practice.

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Cockett, Norman. "Disability Working Allowance: what was the point?" Benefits: A Journal of Poverty and Social Justice 11, no. 3 (2003): 175–79. http://dx.doi.org/10.51952/vkza9852.

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Disability Working Allowance (DWA) was introduced in 1992 as a benefit to top up the wages of disabled people working 16 hours a week or more. This was the first major attempt, within UK social security policy, to help disabled people take up and remain in paid jobs. The formal evaluation of DWA suggested that the benefit had failed in a number of respects. The purpose of this article is to reflect on what was achieved by introducing DWA. The author looks at the stated objectives and other evidence about what was behind the policy, including the aims of those who lobbied government on ‘partial capacity’. The author was secretary to the Social Security Advisory Committee (SSAC) from 1988 to 1990 and subsequently worked with ministers on the development of DWA. The author aims to give some insight into the policy-making process, while respecting the confidentiality of advice given to ministers.

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Gupta, Jaya, Angela Hassiotis, Ingrid Bohnen, and Yogesh Thakker. "Application of community treatment orders (CTOs) in adults with intellectual disability and mental disorders." Advances in Mental Health and Intellectual Disabilities 9, no. 4 (2015): 196–205. http://dx.doi.org/10.1108/amhid-02-2015-0007.

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Purpose – The purpose of this paper is to explore use of community treatment orders (CTOs) in adults with intellectual disability (ID) and mental health problems across England and Wales. Design/methodology/approach – A web-based exploratory survey was sent to 359 consultants on the database of the Faculty of the Psychiatry of ID, Royal College of Psychiatrists who had declared ID as their main speciality. Socio-demographic details of responding consultants, clinical characteristics of adults with ID on CTO, subjective views of consultants on using CTOs in people with ID were collected and analysed. Findings – In total, 94 consultant questionnaires were returned providing information on 115 patients detained under CTO. More than 75 per cent of the respondents had used CTO in their clinical practice. Patients subject to CTO were generally young, white males with mild ID and living in supported accommodation. CTOs were primarily used in situations of non-engagement (52.2 per cent), non-compliance with medication (47 per cent) or non-compliance with social care supports (49.6 per cent). Practical implications – Responding consultants expressed concerns about encroachment of civil liberties and ethics of using CTOs in people with ID who may lack capacity and stressed that decision to use CTOs needs to be therefore done on individual basis. Originality/value – This is the first national study to examine the practice of applying CTOs in adults with ID and mental disorders. Current practice is based on evidence from research done in adults with normal intelligence. Further research is needed to investigate the utility of CTOs in routine clinical practice in adults with ID and mental disorders.

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Bartlett, Annie, Nadia Somers, Matthew Fiander, and Mari Anne Harty. "Pathways of care of women in secure hospitals: which women go where and why." British Journal of Psychiatry 205, no. 4 (2014): 298–306. http://dx.doi.org/10.1192/bjp.bp.113.137547.

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BackgroundCare pathways for women needing expensive, secure hospital care are poorly understood.AimsTo characterise women in low and medium security hospitals in England and Wales and to compare populations by security and service provider type.MethodCensus data from all specialist commissioning areas. Sociodemographic, clinical, medico-legal, criminological and placement needs data were requested on all women in low and medium secure hospital beds. Parametric tests were used for continuous data and chi-square or Fisher's exact tests for categorical data. Thematic analysis was used for free text data.ResultsThe independent sector is the main service provider. A third of all women (n = 1149) were placed outside their home region despite spare local National Health Service (NHS) capacity. The independent sector provides for women with relatively rare disorders, including intellectual disability. The NHS admits most serious offenders. One in 20 are detained because of self-harm alone.ConclusionsPatient-specific factors (notably the diagnosis of personality disorder) and organisational inadequacy (commissioner and service provider) contribute to placements that compromise rehabilitation. Responses should include local solutions for women whose main risk is self-harm and a national approach to women with highly specialist needs.

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Nogueira, Paula Sacha Frota, Marilia Braga Marques, Janaina Fonseca Victor Coutinho, Juliana Cunha Maia, Maria Josefina da Silva, and Escolástica Rejane Ferreira Moura. "Factors associated with the functional capacity of older adults with leprosy." Revista Brasileira de Enfermagem 70, no. 4 (2017): 711–18. http://dx.doi.org/10.1590/0034-7167-2017-0091.

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ABSTRACT Objective: to investigate the association between socio-demographic and clinical factors and the functional capacity of older adults with leprosy. Method: cross-sectional analytical study conducted in Fortaleza, Ceará, Brazil, with 77 older adult patients with leprosy in a referral service, through interview, medical records and application of the Katz Index and the Lawton and Brody Scale. Results: the mean age was 68.23 years, with prevalence of men, in stable union/married, with mean monthly family income of 2.04 minimum wages, positive bacillary index, clinical dimorphic form and grade zero disability. In the Lawton and Brody scale, independence (58.5%) was predominant and associated to the variables "living arrangement" and "educational attainment". Total independence (87.0%) was predominant in the Katz Index and statistically associated to the variable monthly family income. Conclusion: most of the participants were classified as independent in the instruments used. Furthermore, the instruments pointed to a greater number of associations with socio-demographic and clinical factors not related to leprosy.

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Jayakody, Amanda, Mariko Carey, Jamie Bryant, et al. "Exploring experiences and perceptions of Aboriginal and Torres Strait Islander peoples readmitted to hospital with chronic disease in New South Wales, Australia: a qualitative study." Australian Health Review 45, no. 4 (2021): 411. http://dx.doi.org/10.1071/ah20342.

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ObjectiveThis study explored the experiences and perceptions of unplanned hospital readmissions from the perspective of Aboriginal and Torres Strait Islander peoples with chronic disease. MethodWe conducted semi-structured interviews with Aboriginal and Torres Strait Islander patients readmitted to hospital with chronic disease. Interviews covered perceptions of avoidable readmissions, experiences of health care, medications and carer support. Inductive thematic analysis was used to code and analyse the data. ResultsFifteen patients with multiple chronic diseases were interviewed. Several participants believed their readmission was unavoidable due to their poor health, while others considered their readmission was avoidable due to perceived health professional and system failures. Enablers to chronic disease management included the importance of continuity of care and strong family networks, although a few participants struggled with isolation. Four themes emerged as barriers: poor communication from health professionals; low levels of health literacy and adherence to chronic disease management; poor access to community services; and health risk behaviours. ConclusionsThe participants in our study identified complex and interacting patient-, environmental-, encounter- and organisational-level factors as contributing to chronic disease management and unplanned readmissions. Our findings suggest systemic failures remain in access to basic services and access to culturally appropriate care. Family support and continuity of care were valued by participants. What is known about the topic?Aboriginal and Torres Strait Islander peoples with chronic diseases are more likely to be readmitted to hospital compared with non-Aboriginal people. Unplanned readmissions are associated with high health system costs, as well as poorer quality of life and psychological distress for the patient. What does this paper add?This paper describes the experiences and perceptions of unplanned readmissions by Aboriginal and Torres Strait Islander peoples with chronic disease. Our findings suggest systemic failures exist in access to basic services for a safe and secure living environment, and access to culturally appropriate care that is delivered in a manner which promotes health literacy and self-management capacity. What are the implications for practitioners?Practitioners and policy makers should consider involving family members in discharge planning and other medical care, and funding for Aboriginal and Torres Strait Islander health and community services to enhance transport, care coordination, culturally appropriate disability and housing services, and health promotion.

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Zigmond, A., and A. J. Holland. "Unethical Mental Health Law; History Repeats Itself." International Journal of Mental Health and Capacity Law, no. 3 (September 8, 2014): 50. http://dx.doi.org/10.19164/ijmhcl.v0i3.315.

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<p>The powers enshrined in mental health legislation go directly to fundamental principles central to any caring and democratic society. The tension and dilemma that exists is, on the one hand, the importance of respect for an individual’s right to make decision’s affecting his/her own life to, on the other, the recognition that there are people with mental disabilities that may be vulnerable to abuse and/or neglect and who throughout their lives or at particular times need care and/or treatment, which they may not seek or be able to consent to themselves. In any society it is through case law and statute that an attempt is made to resolve this tension and to ensure that individual rights are not infringed and that those who need care and treatment receive what is in their best interest. Thus a change in such legislation requires the most rigorous of examination and must be judged on the grounds that it a) does not infringe accepted principles such as those of the United Nations Declaration of Human Rights and the European Convention, b) is based on sound ethical principles and does not conflict with the established law of the country, and c) it is practicable and achieves the right balance with respect to the potential tension described above. As practising clinicians (one working in an acute psychiatric service the other in a district learning disability service) we are not in a position expertly to judge the first of these but we believe we can contribute to the second and the third. In this paper we consider specifically the reasons for, and the consequences that follow, the failure on the Government’s part to accept the central importance of decision-making capacity assessment in any new mental health legislation.</p><p>The Green Paper proposals for a new Mental Health Act for England and Wales have now been published. A broad definition of ‘mental disorder’ has been retained, a new system of tribunals is to be established and compulsory treatment in the community would become lawful. However, it rejects the recommendation of the expert committee chaired by Professor Richardson that the assessment of an individual’s decision-making capacity should be a determining factor in the use of compulsory detention. Given this, it does not address the relationship between this legislation and the proposed Mental Incapacity Act. The failure to recognise the central place of decision-making capacity in a modern Mental Health Act is, we believe, a serious omission as it is a reflection of a failure to acknowledge that the basic principle of autonomy is central to such legislation.</p>

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Morrall, Stephen, and Charles Urquhart. "Disability Discrimination." Legal Information Management 3, no. 2 (2003): 76–79. http://dx.doi.org/10.1017/s147266960000181x.

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Disability discrimination law is a fast evolving area of the law in England and Wales. This article sets out the basic concepts of what constitutes a “disability”, what constitutes “discrimination” and some of the factors that tribunals, employees and employers should consider in a disability discrimination dispute.

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Hussain, Rafat, Stuart Wark, and Peta Ryan. "Caregiving, Employment and Social Isolation: Challenges for Rural Carers in Australia." International Journal of Environmental Research and Public Health 15, no. 10 (2018): 2267. http://dx.doi.org/10.3390/ijerph15102267.

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Australia has one of the world’s highest life expectancy rates, and there is a rapidly growing need for informal caregivers to support individuals who are ageing, have chronic illness or a lifelong disability. These informal carers themselves face numerous physical and psychological stressors in attempting to balance the provision of care with their personal life, their work commitments and family responsibilities. However, little is known about the specific challenges facing rural carers and the barriers that limit their capacity to provide ongoing support. A cross-sectional survey composed of open-ended responses and demographic/socioeconomic measures used routinely by the Australian Bureau of Statistics (ABS) and the Australian Institute of Health & Welfare (AIHW) was used with a cohort of 225 rurally-based carers within New South Wales, Australia. Demographic questions specified the respondents’ age, gender, employment, caregiving status, condition of and relationship to the care recipient, postcode, residency status, and distance and frequency travelled to provide care. Open-ended comments sections were provided to allow participants to describe any issues and problems associated with caregiving including employment, travel, residency, carer support groups and any other general information. The results show that most rural carers were middle-aged women supporting a spouse or a child. Unpredictability associated with providing care exacerbated demands on carers’ time, with many reporting significant employment consequences associated with inflexibility and limited job options in rural locations. Specific issues associated with travel requirements to assist with care were reported, as were the impacts of care provision on the respondents’ own personal health. The majority of carers were aware of the social supports available in their local rural community, but did not access them, leaving the carers vulnerable to marginalisation. Problems associated with employment were noted as resulting in financial pressures and associated personal stress and anxiety for the caregivers. While this issue is not necessarily limited to rural areas, it would appear that the lack of opportunity and flexibility evident in rural areas would exacerbate this problem for non-metropolitan residents. The participants also identified specific barriers to the provision of care in rural areas, including the significant impact of travel. Access to support services, such as carer groups, were rarely accessed due to a mix of factors including inaccessibility, poor timing and a lack of anonymity. Financially, there was considerable evidence of hardship, and there is an urgent need for a comprehensive review of government and community-based support to better meet the needs of rural carers.

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Morgan, J., and F. Reid. "Disability Sport Wales Programme: making the connections." British Journal of Sports Medicine 44, Suppl_1 (2010): i78. http://dx.doi.org/10.1136/bjsm.2010.078725.255.

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Fisher, Mick. "The specialist learning disability nurse in Wales." International Journal of Nursing Practice 3, no. 3 (1997): 188–90. http://dx.doi.org/10.1111/j.1440-172x.1997.tb00098.x.

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Cassidy, Simon. "Competence-based education: learning disability nursing in wales." Nursing Standard 27, no. 10 (2012): 42–47. http://dx.doi.org/10.7748/ns.27.10.42.s54.

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Cassidy, Simon. "Competence-based education: learning disability nursing in Wales." Nursing Standard 27, no. 10 (2012): 42–47. http://dx.doi.org/10.7748/ns2012.11.27.10.42.c9399.

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Jones, Melanie K., Paul L. Latreille, and Peter J. Sloane. "Disability, Gender and the Labour Market in Wales." Regional Studies 40, no. 8 (2006): 823–45. http://dx.doi.org/10.1080/00343400600984999.

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Cashin, Andrew, Tony Butler, Michael Levy, and Emily Potter. "Intellectual disability in the New South Wales inmate population." International Journal of Prisoner Health 2, no. 2 (2006): 115–20. http://dx.doi.org/10.1080/17449200600935752.

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Matthews, David R. "Learning disability consent and capacity." Learning Disability Practice 6, no. 2 (2003): 26–27. http://dx.doi.org/10.7748/ldp.6.2.26.s19.

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Green, Samantha, Rachel Potter, and Mariёlle Wilcox. "Providing advice and consultation in learning disability teams." Clinical Psychology Forum 1, no. 249 (2013): 23–26. http://dx.doi.org/10.53841/bpscpf.2013.1.249.23.

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Consultancy is an increasingly important skill for clinical psychologists to develop. This paper describes the use and evaluation of ‘advice and consultation’ sessions within a South East Wales learning disabilities service.

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Marshall, Kim. "Disability Discrimination and Higher Education in England and Wales and Australia Compared." International Journal of Discrimination and the Law 6, no. 4 (2005): 289–324. http://dx.doi.org/10.1177/135822910500600403.

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In its original form the provisions of the UK Disability Discrimination Act 1995 (DDA) contained little of practical help to students with disabilities. This situation was rectified when the Special Educational Needs and Disabilities Act (SENDA) was passed in 2001 becoming the new Part 4 of the DDA. From 2002 legal duties not to discriminate against students with disabilities came into effect. In the Commonwealth of Australia a very different attitude towards disability discrimination has been demonstrated by having legislation to combat disability discrimination in place since 1992, which included specific provisions on education from the outset. The purpose of this article is to examine the approach taken in both jurisdictions towards the use of the anti-discrimination statutes and consider the effectiveness of the legislation in preventing discrimination on the ground of disability in higher education. The paper will examine points of similarity and divergence in the respective systems regarding the application of anti-disability discrimination laws to higher education as well as look to the longer established jurisprudence of the Australian courts for potential guidance that may be helpful to the nascent Part 4 of the DDA and the types of issues that may arise.

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Jones, Melanie K., Paul L. Latreille, and Peter J. Sloane. "The Role of Disability in Labour Market Outcomes in Wales." Welsh Economic Review 16, no. 2 (2004): 39. http://dx.doi.org/10.18573/j.2004.10342.

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McMillan, Ian. "The future looks bright, learning disability nurses in Wales told." Learning Disability Practice 7, no. 7 (2004): 6. http://dx.doi.org/10.7748/ldp.7.7.6.s8.

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Bebbington, A. C. "The expectation of life without disability in England and Wales." Social Science & Medicine 27, no. 4 (1988): 321–26. http://dx.doi.org/10.1016/0277-9536(88)90265-1.

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Jones, Melanie K., and Paul L. Latreille. "Disability, Health and the Labour Market: Evidence from the Welsh Health Survey." Local Economy: The Journal of the Local Economy Policy Unit 24, no. 3 (2009): 192–210. http://dx.doi.org/10.1080/02690940802645539.

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This study uses data from the Welsh Health Survey to examine issues of disability/health measurement and its impact on labour market outcomes. The data suggest that self-reported disability, general health and summary composite measures of physical and mental health are broadly consistent both in measurement and predictions for labour market outcomes. This consistency in measurement is also demonstrated at the local level but the employment disadvantage associated with disability is found to vary considerably within Wales.

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Randolph, David Charles. "Functional capacity evaluation and disability management." Journal of Back and Musculoskeletal Rehabilitation 7, no. 3 (1996): 181–86. http://dx.doi.org/10.3233/bmr-1996-7309.

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Biggs, Herbert C., and Donald P. Dingsdag. "The Challenging Environments of Injury Management in Construction and Coalmining in New South Wales." Australian Journal of Rehabilitation Counselling 9, no. 1 (2003): 40–51. http://dx.doi.org/10.1017/s1323892200000491.

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Workers' compensation and disability management in the hazardous occupations of mining and construction are ongoing concerns for employers, employees, insurers and governments. Rising insurance costs, options of self-insurance models, highly competitive tendering, legislative rigidities, and escalating costs of compensation, have contributed to industry practices for injured workers that are driven by cost containment strategies rather than benchmarked disability management processes. In this article a critical review of legislation, industry practices, and published reports is undertaken with a view to oudining the adequacy of current and planned services and practices to meet the needs of injured workers in both sectors. Attention is also given to industrial practices that contra-indicate quality disability management processes. The authors detail a number of industrial and organisational operating environments, which have arisen from legislative frameworks, financial constraints, and outdated disability management practices. They comment on the more recendy introduced legislation and offer comment on its potential to drive benchmark changes in the building and coalmining sectors. Finally, suggestions are provided for more contemporary approaches to the insurance framework and return to work facilitation for injured workers.

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Andrushko, A. "Establishing the fact of labor relations in court." Uzhhorod National University Herald. Series: Law 3, no. 75 (2023): 84–87. http://dx.doi.org/10.24144/2307-3322.2022.75.3.14.

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In the field of labor law, the establishment of the fact of labor relations in court is investigated. It is emphasized that the importance of establishing the fact of labor relations lies in the fact that, in its presence, grounds are created for the employee to exercise labor rights, in particular to wages, guarantee, compensation and other social benefits, including benefits related to temporary disability, unfortunate accident at work or occupational disease, etc. Attention is drawn to the fact that in establishing the fact of labor relations, it should be taken into account that between an individual and a business entity, relations regarding the performance of work can arise both on the basis of an employment contract and on the basis of a civil law contract, at the same time, this depends on the nature of work. The theoretical research is conducted taking into account the optimization of labor legislation, that is, finding the best option, finding the optimal model for establishing the fact of labor relations, taking into account the martial law and adapting labor legislation to the standards of the European Union. It is emphasized that in order to avoid disputes about establishing the fact of labor relations, the employer, having a choice to enter into a civil or labor contract, must clearly delimit the scope of application of these contracts and compare it with the work for which the employee is hired. The actions of employers regarding providing employment contracts with the content of a civil law contract, failure to formalize labor relations with an employee who performed work without concluding an employment contract, hinder the realization of the employee's right to work, guaranteed by the Constitution of Ukraine and the Labor Code of Ukraine, as well as the right to social protection in case of unemployment, in case of temporary loss of working capacity, in the event of an accident at work or as a result of an occupational disease, the right to rest, annual paid vacations, the right to healthy and safe working conditions, the right to join trade unions, etc.

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Fernando, Shelanah A., Anne E. Duggan, Owen F. Dent, and Maeve C. Eikli. "Colonoscopy capacity in selected New South Wales hospitals." Medical Journal of Australia 187, no. 4 (2007): 249–50. http://dx.doi.org/10.5694/j.1326-5377.2007.tb01218.x.

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Jameson, SS, UK Amarasuriya, H. Vint, and MR Reed. "The Mental Capacity Act 2005: Relevance for the Surgeon." Bulletin of the Royal College of Surgeons of England 91, no. 5 (2009): 176–79. http://dx.doi.org/10.1308/147363509x436586.

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Patients who lack the capacity to make decisions regarding surgical treatment are complex to manage. In the past, under common law in England and Wales, these patients underwent emergency surgery if in the patient's 'best interests,' as decided by the surgical team. Surgeons in England and Wales now need to understand the changes introduced in October 2007 by the Mental Capacity Act 2005 (MCA).

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Ravindran, Subahari, Jennie Brentnall, and John Gilroy. "Conceptualising disability: A critical comparison between Indigenous people in Australia and New South Wales disability service agencies." Australian Journal of Social Issues 52, no. 4 (2017): 367–87. http://dx.doi.org/10.1002/ajs4.25.

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Nothdurft, John, and Hilary Astor. "Laughing in the Dark—Anti— Discrimination Law and Physical Disability in New South Wales." Journal of Industrial Relations 28, no. 3 (1986): 336–52. http://dx.doi.org/10.1177/002218568602800302.

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Legislation in New South Wales proscribes discrimination, both direct and indirect, against people with disabilities. The coverage of the legislation is wide and includes dis crimination in all aspects of employment and the provision of education, accommo dation, goods and services, and in registered clubs. The procedures that must be followed by a person with a disability to establish that discrimination has taken place have, however, caused problems. This paper reviews the New South Wales legislation and its operation, particularly in relation to equal employment opportunity programmes and people with physical disabilities. It concludes with reconunendations for refining the law and the methods by which it is implemented.

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Corrigan, Lisa M. "The Right to Maim: Debility, Capacity, Disability." QED: A Journal in GLBTQ Worldmaking 6, no. 3 (2019): 255–57. http://dx.doi.org/10.14321/qed.6.3.0255.

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Sheehi, Stephen. "The Right to Maim: Debility, Capacity, Disability." Journal of Middle East Women's Studies 16, no. 1 (2020): 72–76. http://dx.doi.org/10.1215/15525864-8016547.

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Kinkaid, Eden. "The right to maim: debility, capacity, disability." Gender, Place & Culture 25, no. 6 (2018): 936–37. http://dx.doi.org/10.1080/0966369x.2018.1449139.

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Pransky, Glenn. "Clinical Update: Functional Capacity Evaluations and Disability." Guides Newsletter 3, no. 2 (1998): 4–5. http://dx.doi.org/10.1001/amaguidesnewsletters.1998.marapr02.

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Abstract According to the AMA Guides to the Evaluation of Permanent Impairment, a functional capacity evaluation (FCE) measures an individual's physical abilities via a set of activities in a structured setting and provides objective data about the relationship between an impairment and maximal ability to perform work activities. A key distinction between FCEs and self-reported activities of daily living is that the former involve direct observation by professional evaluators. Numerous devices can quantify the physical function of a specific part of the musculoskeletal system but do not address the performance of whole body tasks in the workplace, and these devices have not been shown to predict accurately the ability to perform all but the simplest job tasks. Information about reliability has been proposed as a way to identify magnification and malingering, but variability due to pain and poor comprehension of instructions may cause variations in assessments. Structured work capacity evaluations involve a set of activities but likely underestimate the individual's ability to do jobs that involve complex or varying activities. Job simulations involve direct observation of an individual performing actual job tasks, require a skilled and experienced evaluator, and raise questions about expense, time, objectivity and validity of results, and interpretation of results in terms of the ability to perform specific jobs. To understand the barriers to return to work, examiners must supplement FCEs with information regarding workplace environment, accommodations, and demotivators.

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Harding, Katharine E., Mark Wardle, Robert Carruthers, et al. "Socioeconomic status and disability progression in multiple sclerosis." Neurology 92, no. 13 (2019): e1497-e1506. http://dx.doi.org/10.1212/wnl.0000000000007190.

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ObjectiveTo examine the association between socioeconomic status (SES) and disability outcomes and progression in multiple sclerosis (MS).MethodsHealth administrative and MS clinical data were linked for 2 cohorts of patients with MS in British Columbia (Canada) and South East Wales (UK). SES was measured at MS symptom onset (±3 years) based on neighborhood-level average income. The association between SES at MS onset and sustained and confirmed Expanded Disability Status Scale (EDSS) 6.0 and 4.0 and onset of secondary progression of MS (SPMS) were assessed using Cox proportional hazards models. EDSS scores were also examined via linear regression, using generalized estimating equations (GEE) with an exchangeable working correlation. Models were adjusted for onset age, sex, initial disease course, and disease-modifying drug exposure. Random effect models (meta-analysis) were used to combine results from the 2 cohorts.ResultsA total of 3,113 patients with MS were included (2,069 from Canada; 1,044 from Wales). A higher SES was associated with a lower hazard of reaching EDSS 6.0 (adjusted hazard ratio [aHR] 0.90, 95% confidence interval [CI] 0.89–0.91), EDSS 4.0 (aHR 0.93, 0.88–0.98), and SPMS (aHR 0.94, 0.88–0.99). The direction of findings was similar when all EDSS scores were included (GEE: β = −0.13, −0.18 to −0.08).ConclusionsLower neighborhood-level SES was associated with a higher risk of disability progression. Reasons for this association are likely to be complex but could include factors amenable to modification, such as lifestyle or comorbidity. Our findings are relevant for planning and development of MS services.

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HERISSONE-KELLY, PETER. "Capacity and Consent in England and Wales: The Mental Capacity Act under Scrutiny." Cambridge Quarterly of Healthcare Ethics 19, no. 3 (2010): 344–52. http://dx.doi.org/10.1017/s0963180110000125.

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The Mental Capacity Act 2005 came into force in England and Wales in 2007. Its primary purpose is to provide “a statutory framework to empower and protect people who may lack capacity to make some decisions for themselves.” Examples of such people are those with dementia, learning disabilities, mental health problems, and so on. The Act also gives those who currently have capacity a legal framework within which they can make arrangements for a time when they may come to lack it. Toward this end, it allows for them to make advance decisions (in effect, refusals of consent to certain forms of treatment) or to appoint proxy decision makers with lasting powers of attorney.

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Sakellariou, Dikaios, Sally Anstey, Sarah Gaze, et al. "Barriers to accessing cancer services for adults with physical disabilities in England and Wales: an interview-based study." BMJ Open 9, no. 6 (2019): e027555. http://dx.doi.org/10.1136/bmjopen-2018-027555.

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ObjectivesThe aim of this study was to explore the barriers to accessing cancer services faced by adults with pre-existing physical disabilities.DesignCross-sectional, exploratory qualitative study. Data were collected by semistructured interviews and analysed thematically.SettingParticipants were recruited through statutory and third sector organisations in England and Wales between October 2017 and October 2018.Participants18 people with a diagnosis of cancer and a pre-existing physical disability.ResultsThe findings illustrate that people with physical disabilities in England and Wales face a variety of barriers to accessing cancer services. The overall theme that emerged was that participants experienced a lack of attitudinal and institutional preparation both from healthcare professionals and healthcare facilities. This overall theme is illustrated through three subthemes: lack of acknowledgment of disability, unseeing disability and physical inaccessibility.ConclusionsAs the population ages and increasing numbers of people live with cancer and disability, it is important to develop knowledge to respond to the needs of this population. The mere existence of services does not guarantee their usability. Services need to be relevant, flexible, and accessible and offered in a respectful manner. It is important that healthcare professionals work towards inclusive healthcare provision, enabling the utilisation of services by all. Necessary steps to be taken include better communication between the various professionals and across the different teams involved in patients’ care, raising awareness of how physical disability can affect or interact with cancer-related treatment and creating more accessible physical environments.

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Weise, Janelle C., Preeyaporn Srasuebkul, and Julian N. Trollor. "Potentially preventable hospitalisations of people with intellectual disability in New South Wales." Medical Journal of Australia 215, no. 1 (2021): 31–36. http://dx.doi.org/10.5694/mja2.51088.

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Wel, Karel L., Lydia Kleinjan, and Marleen J. Leeuw. "Potentially preventable hospitalisations of people with intellectual disability in New South Wales." Medical Journal of Australia 216, no. 3 (2022): 160. http://dx.doi.org/10.5694/mja2.51389.

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Weise, Janelle C., Preeyaporn Srasuebkul, and Julian N. Trollor. "Potentially preventable hospitalisations of people with intellectual disability in New South Wales." Medical Journal of Australia 216, no. 3 (2022): 161. http://dx.doi.org/10.5694/mja2.51390.

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Curtis, Ben, and Steven Thompson. "Disability and the Family in South Wales Coalfield Society, c.1920–1939." Family & Community History 20, no. 1 (2017): 25–44. http://dx.doi.org/10.1080/14631180.2017.1316030.

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Williams, Ann K. "Defining and diagnosing intellectual disability in New South Wales 1898 to 1923." Journal of Intellectual & Developmental Disability 21, no. 4 (1996): 253–71. http://dx.doi.org/10.1080/13668259600033191.

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Lymer, S., L. Brown, M. Yap, and A. Harding. "2001 Regional Disability Estimates for New South Wales, Australia, Using Spatial Microsimulation." Applied Spatial Analysis and Policy 1, no. 2 (2008): 99–116. http://dx.doi.org/10.1007/s12061-008-9006-4.

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