The everyday lives of children with disabilities are not well understood, with few studies exploring how participation in everyday life is conceptualized and given meaning. The overall aims of this study were, first, to explore parental views of their children’s participation and, second, to identify barriers and facilitators in relation to participation in everyday activities. A qualitative research strategy was adopted, whereby parents of children with Down syndrome (DS) aged 6–12 years were selected using purposive sampling. Five interviews with seven participants were audio-recorded and analysed using a framework approach whereby the overall research aims guided the analysis. Analysis of the data identified two main themes and seven sub-themes. The first theme was the value of participation. Parents reported that through participation in activities, their children developed skills that in turn enhanced their well-being and sense of belonging. The second theme was barriers and facilitators of participation, which included four subthemes: child factors, attitudes and views of others, modifications to the environment and logistical issues. Findings also illustrate how the child and his/her physical, social and attitudinal environments are inherently intertwined, with parents identifying the influence of several interacting factors on their child’s participation in everyday activities. This study supports the view that while frameworks like the ICF have an important role in understanding disability, they need to be supplemented with personal experiences of children and others in their lives. Speech and language therapists need to consider activities and participation both from the perspective of factors within children themselves and also from the point of view of barriers and facilitators in the children’s environment.
Our evidence supports the wider use of diamorphine administration by nasal drops in children, as it shows that adequate plasma levels of morphine are usually achieved. However, we demonstrated significantly attenuated and delayed peak plasma morphine levels with lower levels at 1 h with intranasal compared with intravenous diamorphine.
Introduction: Beaumont Hospital is committed to delivering on the objectives of the National Clinical Programme for Older People (NCPOP) and the Integrated Care Programme for Older Persons. The clinical needs of older people presenting to the Emergency Department (ED) are substantially different to those of younger adults. Many older people present with acute or sub-acute illnesses, which may be accompanied by functional and/or cognitive deterioration. Additionally, these patients often have complex social care needs. Evidence confirms that Emergency Department overcrowding is associated with increased mortality, increased length of stay, patient harm and reduced staff morale and therefore, hospital admissions for frail older people should be avoiding where at all possible. Prior to September, 2015, Beaumont Hospital (BH) provided an on-call Health and Social Care Professions (HSCP) service to the ED which focused only on facilitating patient discharge. The team comprised Occupational functioning at a high level of independence and could be sustained at home with access to the right supports and intervention. Conclusion and Discussion: In line with best available evidence and practice, the FIT Team undertook to provide early intervention for frail adults with the intention of ensuring they receive the right care, at the right time, in the right place. Early results are extremely positive and the team continues to work closely with the Clinical Strategy and Programmes Directorate to help inform the development of frail older persons' services nationally.
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