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AbstractAs siblings play an increasing role in the lives of people with intellectual and developmental disabilities as a result of the longer lifespan of this population and the aging of their parents, more investigative work in this area is warranted. To lay a foundation for this, the authors reviewed the English‐language literature on siblings of adults with intellectual and developmental disabilities, focusing on three main questions: (1) what are the psychosocial outcomes of having a sibling with an intellectual and developmental disabilities on the sibling without a disability?; (2) what factors relate to the nature of the sibling relationship?; and (3) what factors relate to future planning, including expected and future relationships when parents can no longer provide care? This literature review looked at published work for the period 1970–2008 on adult siblings over 21 years of age that addressed relationships, psychosocial outcomes, and/or involvement in future planning. Twenty‐three relevant studies were identified. Overall, these studies present a mixed, but generally positive picture of the psychosocial outcomes of having a sibling with a disability. They also indicate that siblings tend to have long‐lasting close relationships with their siblings with a disability and anticipate taking on greater supportive roles as both grow older.

Given the longer lives of individuals with disabilities and the increasing likelihood of siblings fulfilling family caregiving roles, it is critical to identify correlates of sibling caregiving. Yet, little research has examined the relation between the severity of the disability and sibling caregiving. The purpose of this study was to understand the relation between the severity of the disability (defined as functional ability and maladaptive behaviors) and sibling caregiving, including advocacy and future planning. Adult siblings of older individuals with disabilities ( N = 141) completed a national survey. Results indicated that individuals with less functional ability were significantly more likely to receive greater sibling caregiving, advocacy, and future planning. There was a nonlinear relation with respect to sibling caregiving and functional ability with individuals with severe disabilities requiring disproportionately greater sibling caregiving. Furthermore, there was a nonlinear relation between maladaptive behaviors and caregiving demands such that siblings of individuals with the greatest asocial behaviors reported significantly greater caregiving demands.

AbstractBackgroundAs individuals with intellectual and developmental disabilities (IDD) grow older, siblings are likely to become caregivers for their brothers and sisters with IDD. Thus, it is important to identify the correlates of sibling caregiving to facilitate transitions to caregiving roles.MethodThis study involved the secondary analysis of a national data set of 429 adult siblings of individuals with IDD.ResultsCurrent sibling caregiving was positively correlated with sibling relationship quality, sibling advocacy and future planning, maladaptive behaviours of individuals with IDD, and family size. Current sibling caregiving was negatively correlated with parent caregiving abilities and functional abilities of individuals with IDD. Further, among siblings who provided care, the level and nature of sibling caregiving were negatively correlated with parent caregiving abilities.ConclusionsThe results identify the correlates of current caregiving among siblings of individuals with IDD. More research is needed to understand current sibling caregiving.

AbstractBackgroundGiven the increasing lifespans of individuals with intellectual and developmental disabilities (IDD), siblings may fulfil multiple caregiving roles simultaneously for their ageing parents, their offspring, and their brother or sister with IDD. Yet, little is known about compound sibling caregivers. The purpose of this study was to compare the perspectives of compound, single and non‐caregiving siblings of adults with IDD.MethodThis study investigated 332 adult siblings of individuals with IDD in the United States via a national web‐based survey. Participants included: 152 non‐caregivers, 94 single caregivers (i.e., caregivers only for their brothers and sisters with IDD), and 86 compound caregivers (i.e., caregivers for their brothers and sisters with IDD and at least one other vulnerable individual).ResultsSingle and compound sibling caregivers (versus non‐caregivers) had more positive relationships and conducted greater advocacy and future planning activities.ConclusionsGiven the potential for compound sibling caregiving, further investigation is warranted.

AbstractBackgroundParents often face many barriers when taking care of their offspring with disabilities. In childhood, support needs vary with families of children with Down syndrome often reporting less caregiving challenges. However, it is unclear whether support needs vary in adulthood. This study compared parents of adults with Down syndrome (DS), autism spectrum disorder (ASD) and cerebral palsy (CP) regarding support needs of their offspring with intellectual and developmental disabilities (IDD) and their families.MethodData were collected via a national survey in the United States with 189 parents of adults with IDD.ResultsAcross the quantitative and qualitative analyses, parents of adults with DS (versus CP and ASD) reported significantly greater recreational, natural supports, more formal services and less future planning barriers.ConclusionThe results indicate that the DS advantage may persist in adulthood regarding support needs. More research is needed to understand different types of support needs.

AbstractBackgroundAs adults with intellectual and developmental disabilities (IDD) have longer lives, parents may remain caregivers into old age. In addition, it is unknown who will fulfil caregiving roles after parents are no longer able to be caregivers. In the current study, we explored the nature (e.g. number of hours of caregiving) and correlates of parental caregiving for their adult offspring with intellectual and developmental disabilities and their future caregiving plans.MethodIn the United States, data were collected from 334 parents of adults with intellectual and developmental disabilities via a national survey.ResultsAltogether, 55% of the sample spent more than 15 hr conducting caregiving per week. Individual characteristics (e.g. maladaptive behaviour and functional abilities) and parent characteristics (e.g. physical proximity of the adult with intellectual and developmental disabilities and caregiving ability) positively correlated with caregiving hours. Notably, 38.58% of participants were unsure who would fulfil caregiving roles.ConclusionImplications for research about caregiving and practice are discussed.

ObjectivesVarious analgesics are frequently prescribed to cancer patients for whom pain contributes to poor physical and emotional health and well-being. We examined changes in trends of analgesic prescribing in over 35,000 cancer patients diagnosed in the Welsh population before and during the COVID-19 pandemic in order to gain insight into the COVID-19 pandemic effects on cancer patients' ability to receive analgesia and their potential ability to control their pain via medications.
ApproachWithin the Secure Anonymised Information Linkage (SAIL) Databank trusted research environment (TRE), patients diagnosed with incident primary breast, lung, colorectal or prostate cancers during 2017–2021 were obtained from Cancer Network Information System Cymru (CaNISC) dataset and patients' prescription records were identified from Welsh Longitudinal General Practitioner (WLGP) dataset before being linked to their oncology e-record. We calculated opioid and non-opioid analgesic items prescribed per patient per year (PPPY) since cancer by clinical and demographic factors including cancer type, stage at diagnosis, diagnosis year, age at diagnosis, sex, comorbidities and patients' socioeconomic status. These factors were included to model the effects of the COVID-19 pandemic on trends in analgesic prescribing for each cancer group.
ResultsWe detected significant differences in the number of analgesic items prescribed PPPY in patients diagnosed before the COVID-19 pandemic (2017–2019) and those during the pandemic (2020–2021), with 1.3 more items PPPY prescribed for the latter group (p<0.001). Differences were accounted for largely by prescriptions for lung cancer patients, having 2.74 more items PPPY prescribed (p<0.001), the highest among the four cancer types evaluated. Patients diagnosed with a late-stage cancer had significantly more items prescribed than patients diagnosed at an early stage (p<0.001), with stage IV patients having 15.7 opioid items PPPY prescribed. For patients diagnosed at stage I, this rate PPPY was 6.7. Significant differences were also identified between patients from different socioeconomic backgrounds (p<0.001), with patients from the most deprived areas prescribed 11.3 items PPPY, 5.8 more than those from the least deprived areas.
ConclusionsThe significant impact of COVID-19 pandemic on pain medication prescribing for cancer patients could be partly related to the impact of COVID-19 lockdowns on presentation, waiting lists and diagnosis timings, and access to healthcare for prescriptions after diagnosis. Explanatory factors revealed by this study can help inform policymakers and provide guidance in improving pain relief for cancer services.

The emergence of SARS-CoV-2 variants complicates efforts to control the COVID-19 pandemic. Increasing genomic surveillance of SARS-CoV-2 is imperative for early detection of emerging variants, to trace the movement of variants, and to monitor effectiveness of countermeasures. Additionally, determining the amount of viable virus present in clinical samples is helpful to better understand the impact these variants have on viral shedding. In this study, we analyzed nasal swab samples collected between March 2020 and early November 2021 from a cohort of United States (U.S.) military personnel and healthcare system beneficiaries stationed worldwide as a part of the Defense Health Agency's (DHA) Global Emerging Infections Surveillance (GEIS) program. SARS-CoV-2 quantitative real time reverse-transcription PCR (qRT-PCR) positive samples were characterized by next-generation sequencing and a subset was analyzed for isolation and quantification of viable virus. Not surprisingly, we found that the Delta variant is the predominant strain circulating among U.S. military personnel beginning in July 2021 and primarily represents cases of vaccine breakthrough infections (VBIs). Among VBIs, we found a 50-fold increase in viable virus in nasal swab samples from Delta variant cases when compared to cases involving other variants. Notably, we found a 40-fold increase in viable virus in nasal swab samples from VBIs involving Delta as compared to unvaccinated personnel infected with other variants prior to the availability of approved vaccines. This study provides important insight about the genomic and virological characterization of SARS-CoV-2 isolates from a unique study population with a global presence.