Search results

This study aims to understand whether psychotropic prescribing practices for people with intellectual disabilities are in keeping with best practice guidelines.

This service evaluation project was a retrospective analysis of routinely collected data from the care records of all 36 people with intellectual disability discharged from an intellectual disability assessment and treatment unit during the first five years of the Stop Over medicating People with Intellectual Disabilities and/or autistic people (STOMP) initiative. Data were gathered at four time points (pre-admission, discharge, 6- and 12-month follow-up) before being analysed to understand whether psychotropic prescribing differed among people with different clinical characteristics/traits/diagnoses. Changes over time were also explored to ascertain whether and how prescribing altered from admission to discharge, and over the subsequent year of community living.

Most people with intellectual disabilities left the assessment and treatment unit on fewer regular psychotropic medications and at lower doses than at admission. These optimised regimes were still apparent 12 months post-discharge, suggesting effective discharge planning and community care packages. Inpatients with severe intellectual disabilities generally received more anxiolytics and hypnotics, at higher doses. Autistic people tended to receive more psychotropics in total and at higher cumulative doses, a pattern that persisted post discharge. A third of the sample were admitted on regular anti-psychotic medications despite having no corresponding psychotic diagnosis, a proportion that remained relatively stable through discharge and into the community.

This study highlights subsets of the intellectual disability population at particular risk of receiving high doses of psychotropics and a feasible template for providers intending to undertake STOMP-focused evaluations.

The purpose of this paper is to analyse ratings data from the recently developed Learning Disability Needs Assessment Tool (LDNAT) to identify factors associated with specialist intellectual disability (ID) hospital admissions.

Ratings from 1,692 individuals were analysed and the LDNAT items differing significantly between inpatients and non-inpatients were identified. Statistical analyses on total scores derived from these items were used to calculate an optimal cut-off. This LDNAT inpatient index score was also confirmed via an alternative statistical technique.

On average, 18 of the 23 LDNAT item ratings were significantly higher in people with ID assessed as inpatients compared to those rated in community settings. Using the total of these items, the resulting LDNAT inpatient index was analysed. A cut-off score of 22.5 was calculated to be the optimal balance between sensitivity (0.833) and specificity (0.750). This was confirmed by calculating the Youden index (j=0.583). At this level 68 per cent of inpatients and 81 per cent of non-inpatient cases were correctly identified.

Currently there is a national (UK) programme to radically reduce the amount of specialist inpatient care for people ID. This will necessitate early identification of individuals most at risk of admission together with investment in improved, proactive community services if admissions to a diminishing bed-base are to remain manageable.

This study confirms the associations between mental health difficulties, challenging behaviour and specialist hospital admissions for people with ID, extending existing research by translating these findings into a clinically usable risk index.

This purpose of this paper is to discuss the relationship between political independence and operational impartiality in regard to the effectiveness of anti-corruption agencies (ACAs). Against this background of western orthodoxy, it asks whether a non-western country with high levels of corruption (Vietnam being an example) can find another pathway in its efforts to effectively combat corruption.

An exercise in qualitative conceptual clarification and theoretical speculation, drawing upon practical examples.

It is argued that it is important to distinguish between de jure and de facto political independence, and that neither can be fully understood unless they are considered in relationship to other key values, particularly operational impartiality, public accountability, and systemic legitimacy, and in the context of bureaucratic politics. There is little coherent theoretical knowledge available about the relationships among these variables. Such values are central to western notions of “good government” but are much less institutionalised in non-western jurisdictions with high levels of corruption. The question is raised: can such countries, Vietnam being one example, develop effective anti-corruption strategies which because of the nature of their own political system, cannot depend on political independence for its ACAs?

Attention is drawn to some conceptual and putatively theoretical issues relating to the effectiveness of ACAs, and which have received little explicit attention in the relevant academic literature.

The purpose of this paper is to discuss the causes and circumstances of what has become systemic corruption in Vietnam, and the reasons why the moves taken by the regime to combat it have been largely ineffective so far.

The paper offers a commentary based on published secondary sources.

The paper concludes that the immediate prospects for any substantial reduction in the level of corruption in Vietnam appear to be bleak. Endemic corruption, especially in the form of elite rent-seeking, is likely to remain strong. However, the paper sketches two more possible scenarios on anti-corruption prospects in the country for the intermediate future.

The paper relies on secondary sources in providing a macro-level discussion of corruption in Vietnam.

Performance measurements have become a prominent part of government steering of public agencies. At the same time, they are increasingly criticized for creating heavy administrative burdens. The purpose of this paper is to argue that consent on part of the heads of agencies is vital for making performance measurement an efficient tool for not only control but also organizational learning.

The paper reports a survey with a nearly total sample of Swedish Director Generals.

Findings suggest that Director Generals who feel that they are able to influence the goals and indicators of their agencies are significantly more willing to consent to the government’s reporting requirements.

The paper suggests that a more encompassing, interactive and participatory process might increase agency consent with reporting requirements.

While visual arts, drama, dance and music have been used to enhance literacy learning for many decades in preschool and primary classrooms, engaging with mobile learning can also provide many opportunities for young learners to explore and develop language and literacy. The use of mobile devices is of particular interest as technology has an impact on pedagogy and the mobility of digital devices provides many opportunities for engaged and meaningful literacy learning when teamed with the arts. In this chapter, we define the arts and their relationship with literacy learning before exploring a number of resources and practices for integrating their use in early learning settings.

The purpose of this paper is to study the changing relationship between auditing and evaluation. Over the past several years, supreme auditing institutions (SAIs) in a number of advanced democracies have evolved from conventional auditing institutions to becoming increasingly concerned with assisting policy change and administrative reform in the public sector; tasks that are traditionally associated with evaluation. The paper discusses the potential consequences of this development for the SAIs themselves as well as for the audited and reforming institutions and for policy-making.

The paper uses qualitative method and draws on the extensive literature on auditing and evaluation. The analysis has also benefitted from the authors’ recent comparative research on SAIs.

The findings, summarized in six points, are that the growth of auditing in areas previously assigned to evaluators, has led to a shortened time perspective; stronger emphasis on the administration of policies; increased focus on efficiency of the audited entity; greater independence from the evaluated organizations; a shift in receiver of information toward the legislature and/or the public; and improved communication.

Evaluation as a professional and scholarly field has developed theories and advanced methods to assess the effectiveness of public programs. The growth of auditing may thus change the focus and quality of policy evaluation.

The paper speaks to both scholars and practitioners. To the best of the knowledge a similar analysis has not been done before.

The above quotations highlight the adverse consequences of corruption in many countries around the world today. Indeed, the research taboo on corruption, which Gunnar Myrdal identified in 1968, no longer exists, and the silence on the “C” word (corruption) in the World Bank was broken by James Wolfensohn in his famous October 1996 speech, which focused on the negative consequences of the “cancer of corruption” on the World Bank's aid programs.

The city of Newcastle upon Tyne, UK, has become an urban laboratory where numerous nationally prescribed regeneration partnerships and strategies have been “tried‐out” over the last 30 years. This paper unpacks the different and often contradictory spatial scales that such responses have taken, be they area‐based or city‐wide, as well as how “ways of doing” regeneration have been subsequently recast by this range of new partnerships, structures and processes. These developments have subsequently transformed the linkages between both central government and localities, and between local authorities and citizens, especially with regard to issues of trust‐based relationships. This paper will exemplify these changes by highlighting how the Government's flagship community‐centred regeneration partnership collided with an ambitious and far‐reaching local authority‐led city‐wide regeneration strategy. This paper concludes by discussing and how this has implications for managing regeneration partnerships per se in the current urban policy context.