Self-directed Support: Personalisation, Choice and Control

Since the late 1990s, there has been a concerted policy drive across social care towards cash based modes of support and strategies to personalise services. Support for this shift was initiated by the disabled peoples’ movement, both in the UK and globally. Policies introducing direct payments in lieu of provided services have been secured gradually as a central plank of the campaign for independent living. Successive governments have promoted a shift towards personalisation as part of a wider focus to develop local care markets and to facilitate enhanced choice and control in service provision. In Scotland, this has been pursued through new legislation for self-directed support. The authors examine some of the key themes and debates emerging from the implementation of this policy. These include a look at the evolution of this concept and its development within the wider personalisation agenda, as well as the changing roles for users, carers, local authorities and service providers. The authors focus on the impact of change for front-line workers and reassess the progress of personalisation across the UK and in Europe during a time of widespread austerity and financial cuts. Written for professional and academic audiences Self-directed Support: Personalisation, Choice & Control will stimulate those wrestling with these themes from policy and professional perspectives and provide essential analysis for those studying health and social policy

Go for It! Supporting people with learning disabilities and / or Autistic Spectrum Disorders in Employment

This study, commissioned to inform The same as you? National Implementation Group, looked at what employment support there is in Scotland for people with learning disabilities and/or autistic spectrum disorders (ASD) and identified good practice. The research surveyed providers of employment support, looked at the literature on best practice, gathered opinions about barriers and key issues, and explored experiences and views of supported employees, their families and employers

Using the TIDieR checklist to standardize the description of a functional strength training intervention for the upper limb after stroke

Background and Purpose: Published reports of intervention in randomized controlled trials are often poorly described. The Template for Intervention Description and Replication (TIDieR) checklist has been recently developed to improve the reporting of interventions. The aim of this article is to describe a therapy intervention used in the stroke rehabilitation trial, "Clinical Efficacy of Functional Strength Training for Upper Limb Motor Recovery Early After Stroke: Neural Correlates and Prognostic Indicators" (FAST-INdICATE), using TIDieR. Methods: The functional strength training intervention used in the FAST-INdICATE trial was described using TIDieR so that intervention can be replicated by both clinicians, who may implement it in practice, and researchers, who may deliver it in future research. The usefulness of TIDieR in the context of a complex stroke rehabilitation intervention was then discussed. Results and Discussion: The TIDieR checklist provided a systematic way of describing a treatment intervention used in a clinical trial of stroke rehabilitation. Clarification is needed regarding several aspects of the TIDieR checklist, including in which section to report about the development of the intervention in pilot studies, results of feasibility studies; overlap between training and procedures for assessing fidelity; and where to publish supplementary material so that it remains in the public domain. Summary: TIDieR is a systematic way of reporting the intervention delivered in a clinical trial of a complex intervention such as stroke rehabilitation. This approach may also have value for standardizing intervention in clinical practice. Video abstract is available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A131)

Effects of Sex and Gender on Adaptation to Space: Musculoskeletal Health

There is considerable variability among individuals in musculoskeletal response to long-duration spaceflight. The specific origin of the individual variability is unknown but is almost certainly influenced by the details of other mission conditions such as individual differences in exercise countermeasures, particularly intensity of exercise, dietary intake, medication use, stress, sleep, psychological profiles, and actual mission task demands. In addition to variations in mission conditions, genetic differences may account for some aspect of individual variability. Generally, this individual variability exceeds the variability between sexes that adds to the complexity of understanding sex differences alone. Research specifically related to sex differences of the musculoskeletal system during unloading is presented and discussed

Theory-based predictors of multiple clinician behaviors in the management of diabetes

Peer reviewedPostprin