Disability In Population Research Articles

The Impact of Subjective Socioeconomic Status and Job Satisfaction on Psychological Symptoms of Economically Active People With Disabilities.

This study aimed to investigate the impact of subjective socioeconomic status (SES) and job satisfaction on psychological symptoms of economically active people with disabilities. Data from the Korean Panel Survey of Employment for the Disabled (PSED) from 2016 to 2018 were assessed using a longitudinal analysis. A total of 1591 individuals were included as the study population. To explore the impact of subjective SES and job satisfaction on psychological symptoms, a generalized estimating equation model was applied. People who were dissatisfied with their jobs and perceived themselves to have a low SES were 1.73 times more likely to have stress (95% confidence interval [CI] [1.406, 2.126]). Likewise, people with low job satisfaction and low subjective SES were 3.83 times more likely to have depressive symptoms (95% CI [2.318, 6.339]), and even if subjective SES was high, those dissatisfied with their jobs were 4.24 times more likely to develop depressive symptoms (95% CI [1.736, 10.370]). In conclusion, our findings demonstrated that subjective SES had a greater influence on the psychological health of the economically active disabled population. These results highlight the importance of considering a disabled person's subjective socioeconomic factors and suggest ways to help them achieve a healthier and more fulfilling life.

Disability and Vulnerable Groups Inclusion in COVID-19 Policy and Planning in Sub-Sahara African Countries

Background: The COVID-19 pandemic has caused an excess burden of disease in disabled and vulnerable populations. These populations may face an increased risk of contracting COVID-19, greater demand for services and social support, and reduced access to treatment. Despite various national and international efforts towards disability rights and inclusion, substantial gaps exist between disability rights legislation and its implementation. Aims: To assess the inclusion of people with disability and other vulnerable groups in policy and planning documents related to the COVID-19 pandemic response in sub-Sahara Africa. Methods: We conducted content analysis using the EquiFrame policy analysis tool and assessed commitment to 12 vulnerable groups and 21 core human rights in policy and planning documents related to the COVID-19 pandemic. We included documents on general pandemic response, stakeholder engagement, risk communication, and the COVID-19 vaccine from five sub-Saharan African countries, including Nigeria, South Africa, Ethiopia, Kenya, and Zambia. Results: The study highlights the varying degrees to which countries integrate disability, vulnerable groups, and other core human rights concepts into their COVID-19 health policies and planning documents. Only Kenya mentioned disability in their pandemic response plan. However, all countries have explicitly mentioned disability in their stakeholder engagement plans. Except for Kenya, all countries have included disability in their risk communication plans. Notably, South Africa and Zambia demonstrated extensive disability inclusion in their stakeholder engagement and vaccine plan. Thus, these countries have the potential for comprehensive and inclusive health policymaking. In contrast, Nigeria and Ethiopia lag, therefore highlighting areas of improvement across all policy domains. Conclusion: The findings emphasize the critical importance of not only mentioning disability and other vulnerable groups, but also ensuring the depth and quality of this inclusion. While there are positive strides in certain areas, there remains a consistent need for deeper and broader inclusion across all policy domains. Received: 10 September 2024 | Reviewed: 16 October 2024 | Revised: 03 November 2024 | Accepted: 05 November 2024.

Design of an Inclusive Digital Platform for Training and Distribution of Human Resources in Improving Accessibility and Opportunities for Persons with Disabilities

This study addresses the challenges faced by individuals with disabilities in accessing employment opportunities in Indonesia, focusing on the creation of a digital platform that enhances their employability. The research was conducted at Sentra Budi Perkasa in Palembang City, a center that already utilizes an online training registration system but struggles with effective distribution of resources to its trainees. The primary objective was to develop a web-based platform that facilitates registration and improves access to job vacancies for persons with disabilities capable of using electronic devices. Through a combination of observations, interviews, and literature reviews, this study explored the needs and barriers encountered by this demographic, particularly those affected by conditions such as amputation, stroke, and congenital disorders. The Rapid Application Development (RAD) methodology was employed, ensuring a swift development process and involving users actively to reduce errors and enhance system relevance. The resulting platform not only simplifies the process of finding training and job opportunities for persons with disabilities but also serves as a model for similar initiatives aiming to integrate disabled individuals into the workforce more effectively. This study contributes to the field by providing a practical solution to a significant societal issue and outlining a framework for future enhancements in digital accessibility for disabled populations.

Factors Influencing Depression in People with Disabilities:Individual and Interpersonal Levels

Abstract Depression is an increasingly important social problem, and this also applies to the disabled, a health-vulnerable group. Although the distribution and influencing factors of depression may be different among the disabled population (young adults vs. the elderly, older adults with disabilities vs. disabilities due to old age), only the high prevalence of depression among the disabled is generally reported. This study seeks to determine the distribution and influencing factors of depression in disabled people according to sociodemographic standards. This study employed data from the 2021 Panel Survey on People with Disabilities (National Unit Survey) to investigate the influence of individual-level factors (health behaviors, health level, environment) and interpersonal-level factors (social network) on depression. Multivariate logistic regression analysis was performed while controlling for demographic sociological factors and disability characteristic factors. The experience of depression was among elderly disabled individuals (age 50+: 40.9%) than younger ones (age 19-49: 36.1%), and in disability with aging (49.3%) versus aging with disabilities (39.2%) (P < 0.05). Chronic diseases, daily living assistance, living environment, and emotional support from family and neighbors affected both young and elderly disabled individuals. Specifically, among the elderly disabled, exercise frequency (aOR=0.78; [CI]0.63-0.97), social network size (aOR=0.87; [CI]0.82-0.93), and social interaction frequency (aOR=0.68; [CI]0.51-0.91) were significant. Disability with aging was influenced by exercise frequency (aOR=0.29; [CI]0.09-0.95) and emotional support (aOR=0.37; [CI]0.17-0.77) from peers. older adults with disabilities were affected by not only individual-level factors (exercise frequency) but also both functional (emotional support) and structural (size of social network, frequency of meetings) aspects of their interpersonal social networks. Key messages • Depression experiences among older adults with disabilities are influenced by both functional and structural social networks. • Developing depression prevention strategies for people with disabilities requires a customized approach that takes into account age-specific characteristics.

Nationwide trends in the suicide mortality among the disabled in Korea from 2006 to 2017

Abstract Aims The disabled are one of the priority populations at risk of suicide, but there has been no study of the factors influencing suicide mortality among the disabled in South Korea. Methods To analyze age-standardized suicide mortality (ICD-10 Codes, X60-84) for each year according to the presence, severity and type of disability, we linked three population datasets (National Health Insurance Claims Database, Disability Registry, and Deaths by Cause). Our dataset covers the entire population of South Korea, extended over a 12-year period from 2006 to 2017. The analyses were stratified by sex, and hazard ratios for suicide were determined by multivariate logistic regression after adjustment for socio-demographic and clinical variables. Results The suicide rate among the disabled was 2.24 times higher than among the non-disabled in 2017. The highest suicide rates were observed among intellectual or mental disabled, and severe disabled. In the disabled group, suicide rates were higher among those with medical benefits, older age (over 70 years), and depressive disorders in both male and female. Conclusions Although the disabled people’s suicide is often seen as an individual problem, it actually affects their families, communities and society. Therefore, government must strive to emphasize the broad view of the disabled population - not just the health of individuals, and track suicide trends and identifying risk and protective factors for suicidal behavior. From this information, suicide prevention strategies for the disabled people should be evaluated to identify the most effective interventions. Financial support: This research was supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education (No. 2022R1I1A3070074, and 2022R1I1A1A01068449), and a grant of Patient-Centered Clinical Research Coordinating Center funded by the Ministry of Health & Welfare, Republic of Korea (No. HC23C016500). Key messages • The suicide rate among the disabled was 2.24 times higher than among the non-disabled in 2017. • In the disabled group, suicide rates were higher among those with medical benefits, older age (over 70 years), and depressive disorders in both male and female.

Brief communication participation in social activities of six individuals with advanced-stage hereditary motor sensory neuropathy with proximal dominant involvement (HMSN-P)

The intractable neurological disease HMSN-P (hereditary motor and sensory neuropathy with proximal dominant involvement) includes four-limb paralysis and resembles amyotrophic lateral sclerosis (ALS). Although the long-term employment and social activities of individuals with severe neurological diseases have increased with improvements in medical/welfare services, those of individuals with HMSN-P have not been reported. We analyzed the long-term outcomes of six individuals with advanced-stage HMSN-P treated in 2018–2023; one exhibited proximal dominant quadriplegia in 2018 and was using an electric wheelchair with full assistance. He had continued to attend Sanshin concerts for 5 years and organized a music festival for the local handicapped population. The other patients similarly exhibited quadriplegia; three were using electric wheelchairs with full assistance, and two were using pushchairs. Four attended music festivals for the handicapped, and all have completed 20–35 years' continuous employment, attended public meetings about HMSN-P, and actively participated in the meetings' discussions.

Performance of the Washington Group questions in measuring blindness and deafness.

The Washington Group Short Set (WGSS) questions are intended to measure the severity of disability and disability status in US federal surveys. We used data from the 2010-2018 National Health Interview Survey to examine the performance of the WGSS visual disability and hearing disability questions in capturing blindness and deafness. We found that the WGSS questions failed to capture 35.7% of blind adults and 43.7% of deaf respondents as having a severe disability, or, per their recommended cut point, as being disabled. Coupled with evidence demonstrating the poor performance of the WGSS questions in estimating the size of the overall disability population, we contend that results from this study necessitate a halt in the use of the WGSS questions to measure disability in US federal surveys.

Association Between Disability and Suicide Mortality in the Spanish Community-Dwelling Adult Population. A Population-Based Follow-Up Study.

To assess the association of disability with suicide mortality, separately for women and men by age group. Information was obtained from a representative national sample of 161,809 community-dwelling adults (≥18years). Participants contributed to follow-up time from baseline interview (2008) until suicide, death by other causes, or 2017. We calculated, by sex, standardized suicide mortality differences (SSMD), comparing persons with and without disabilities standardized to sociodemographic distribution of disability population. 29 women died by suicide during 800,754 person-years follow-up and 97 men during 735,709 person-years. Among women with disabilities, SSMD (95% Confidence interval) per 100,000 person-years at 5years was 54.4 deaths (-17.2 to 126.1) [100.0 (-27.4 to 227.4) in women <65years and -4.8 (-27.3 to 17.7) in women ≥65 years (P homogeneity = 0.11)]. Among men, SSMD increased by 122.2 deaths (4.1 to 240.3) [37.2 (-40.2 to 114.6) in men <65years and 74.7 (-51.8 to 200.5) in men ≥65years (P homogeneity = 0.62)]. Suicide risk was higher in women and men with disability. In women higher risk was only notable for those <65. Men presented similar effects in both age groups. Nevertheless, due to imprecision of estimates, results should be viewed cautiously.

Diaphragmatic Ultrasonography in Sports Performance: A Systematic Review

This paper aims to investigate and analyze the correlation between diaphragmatic parameters through ultrasonography and sports performance in various sports disciplines. This systematic review followed the PRISMA methodology. The search strategy was applied in the Medline database through Ovid, EMBASE, LILACS, the Cochrane Central Register of Controlled Trials, and Open Gray. Clinical trials, cohort, case–control, and cross-sectional studies were included, and animal experiments were excluded. A total of 388 studies were identified. After removing duplicates and screening titles and abstracts, sixteen studies were selected for full review, and six were included in the qualitative analysis. The results demonstrated a positive correlation between diaphragm excursion and thickness during inspiration with the anaerobic power, highlighting their importance in high-intensity performance. Additionally, one study reported a positive correlation between diaphragm thickness and aerobic power, suggesting the need for further research. The impact of inspiratory muscle training in Paralympic athletes was also evaluated, providing valuable insights into diaphragmatic adaptation in disabled populations. Ultrasonography is a feasible tool for evaluating the structure and function of the diaphragm, the main element of the respiratory process during sports practice. Its use could contribute to the evaluation and planning of sports training and be a possible indicator of performance improvement.

The immovable veil of black disability: an introduction to Black disability threat theory and its application to the school to prison nexus

ABSTRACT I propose a new theoretical framework that incorporates an intersecting analysis of Blackness and disability: Black disability threat theory. A major contribution of this theory is the notion that being visibly Black and visibly disabled causes moral panic to disabled and nondisabled populations belonging to any racial group including non-disabled Black American persons and disabled White American persons. Additionally, a broader category of intersectional theories has been applied and leveraged to learn more about inequities and how we might resolve them. Being obviously Black and obviously disabled excludes one from belonging to and fully participating in either the disability culture or the Black culture as we are accepted by neither. In society (and schools), these persons – those who wear a veil of both Blackness and disability – are categorized, considered, and treated as the most dangerous of all which typically results in negative life outcomes.

Using Duoethnography to Connect the Disability Justice Principles to Education Research about Disabled Populations on Campus

The terms disability inclusion, disability rights, and disability justice are often used somewhat interchangeably, but have distinct meanings within academe more broadly and academic research contexts. The purpose of this investigation was to explore these concepts in relation to our research and present the way in which we (as education researchers) grappled with what a critical, disability justice-informed research methodology involves. We used a qualitative, duoethnographic research approach as it is both a reflection of social justice and a method to advance it (Sawyer &amp; Norris, 2013). We engaged in virtual, asynchronous and synchronous dialogues in writing and audio formats to reflect, critique, question, and eventually, generate new ideas and ways of moving forward. In the paper, we first consider how the Disability Justice Principles from Sins Invalid (2019) could be connected to our current research practices using two questions about ethical considerations as well as research methodologies and frameworks. We then theorize how education researchers can intentionally incorporate activism throughout each stage of the research process. A Disability Justice-informed education research framework is proposed for use with research about disabled populations in higher education. This framework addresses the relationship between stages of the research process, disability inclusion, and disability justice, which was the ongoing debate throughout our dialogues.

Evolving patterns of COVID-19 mortality in US counties: A longitudinal study of healthcare, socioeconomic, and vaccination associations.

The COVID-19 pandemic emphasized the need for pandemic preparedness strategies to mitigate its impacts, particularly in the United States, which experienced multiple waves with varying policies, population response, and vaccination effects. This study explores the relationships between county-level factors and COVID-19 mortality outcomes in the U.S. from 2020 to 2023, focusing on disparities in healthcare access, vaccination coverage, and socioeconomic characteristics. We conduct multi-variable rolling regression analyses to reveal associations between various factors and COVID-19 mortality outcomes, defined as Case Fatality Rate (CFR) and Overall Mortality to Hospitalization Rate (OMHR), at the U.S. county level. Each analysis examines the association between mortality outcomes and one of the three hierarchical levels of the Social Vulnerability Index (SVI), along with other factors such as access to hospital beds, vaccination coverage, and demographic characteristics. Our results reveal persistent and dynamic correlations between various factors and COVID-19 mortality measures. Access to hospital beds and higher vaccination coverage showed persistent protective effects, while higher Social Vulnerability Index was associated with worse outcomes persistently. Socioeconomic status and vulnerable household characteristics within the SVI consistently associated with elevated mortality. Poverty, lower education, unemployment, housing cost burden, single-parent households, and disability population showed significant associations with Case Fatality Rates during different stages of the pandemic. Vulnerable age groups demonstrated varying associations with mortality measures, with worse outcomes predominantly during the Original strain. Rural-Urban Continuum Code exhibited predominantly positive associations with CFR and OMHR, while it starts with a positive OMHR association during the Original strain. This study reveals longitudinal persistent and dynamic factors associated with two mortality rate measures throughout the pandemic, disproportionately affecting marginalized communities. The findings emphasize the urgency of implementing targeted policies and interventions to address disparities in the fight against future pandemics and the pursuit of improved public health outcomes.

Narratives of Personal Health and Sexual Education Experiences of Emerging Adults with Disabilities

Disabled communities’ sexualities have been historically oppressed. Currently in the U.S., public school curricula do not include inclusive sexual education and students with disabilities are often left out of classrooms that discuss any amount of personal health and sexual education (PHSE). Research on the disabled population is filled with samples of non-disabled individuals imposing their opinions on a population that they do not belong to. The purpose of this study was to capture lived experiences of ways emerging adults with disabilities learned about PHSE. Individuals with varied disabilities were intentionally included to add breadth to the research field. The final sample consisted of eight individuals (75% female, 87% White, mean age of 21.5). After conducting narrative interviews and analyses, four story types were generated: (1) “The Self-Guided Journey”, (2) “Experience is the Best Teacher”, (3) “Personal Health Matters More”, and (4) “Two Ears, One Mouth”. Our findings highlighted the lack of formal support and access to adequate, relevant information about sexuality for disabled communities. Informal sources, like families and media, sometimes served as helpful resources for PHSE and disabilities. Individuals’ disability symptoms and personal characteristics need to be considered when crafting universally applicable personal health and sexuality education.

Value for Money Modeling for Scaling up Nature-Based Solutions for Improving Integrated Water Resources Management and Enhanced Water Security in Pakistan

This paper is about the Value for Money (VfM) analysis conducted for the Water Resource Accountability (WRAP) Project, which comprehensively evaluates the project’s economic efficiency, effectiveness, equity, and overall impact. The WRAP implements to undertake demonstrations of Nature-based Solutions (NbS), including Ecosystem-based Adaptation (EbA) interventions that will improve water security and governance, build resilience to climate change of communities at the target sites in Gilgit-Baltistan (GB) and Khyber Pakhtunkhwa (KP), and enable the government and relevant stakeholders to implement and replicate NbS in Pakistan for building climate change resilience. The Paper is based on primary and secondary data collected using a well-structured interview schedule, focus group discussion, and other verified reports. The excel-based model was used for analysis, and a step-by-step and structured framework was used to conduct a VfM assessment. VFM estimates showed a favorable BCR across various interventions, with standout results like the Gabion check weirs and protection bunds (Gabion Bund) intervention achieving an impressive BCR of 3.50. These findings reaffirm the project’s ability to deliver substantial benefits while efficiently utilizing resources, making it a prudent investment in water resource management and natur- based solutions. WRAP’s equity analysis promotes inclusivity and fairness, particularly among vulnerable populations. While the project made significant strides in involving women in water-efficient practices, there is room for enhancing inclusiveness for lower-income and disabled populations. Recommendations emphasize setting specified targets for various populace categories to bolster the project’s social impact further.

119 Addressing inequalities in participation: Developing an inclusive sport and physical activity system across Wales, UK

Abstract Purpose Sport and physical activity participation rates remain low and are particularly apparent in areas of deprivation, among girls and women, those with a disability and minority ethnic populations. In collaboration with Sport Wales (the Welsh Government sponsored body for sport in Wales), this project seeks to facilitate the development of an inclusive sport and physical activity system. Its aim is to identify key organisations and potential leaders where participation in sport and physical activity is low and engage them in finding solutions to these challenges. A specific objective of the project is to use insight and engagement from under-represented groups to drive physical activity and sport participation, amongst children and young people, forwards. Project description The project, undertaken in two phases, was commissioned by Sport Wales. It commenced in September 2023 and is due to finish in late 2024. Phase one includes a social network analysis via an online survey to map the existing sport and physical activity network in Wales. Both a formal and informal distribution strategy for the survey was adopted. The survey seeks to ensure sufficient responses to map the network of key stakeholders and identify previously unknown organisations and individuals. The mapping should enhance our understanding of the current network and identify potential new leaders. Phase two includes the development of a national stakeholder engagement group, made up of the organisations and individuals identified in phase one. This group will act as an advisory group to Sport Wales and produce an engagement plan to inform more effective strategies to target inequalities and under-representation in sport and physical activity participation. A process evaluation is embedded into the project. Conclusions and implications Identifying the organisations and leaders in sport and physical activity in areas where participation is low, and actively engaging them in a leadership group reflects a new approach. It demonstrates a commitment by a national organisation to foster collaboration and seek alternative solutions. The project has the potential to be innovative by developing new ways of working and providing solutions to address ongoing and significant challenges in sport and physical activity participation.

Forecasting Informal care needs of the urban-rural older adults in China based on microsimulation model

BackgroundForecasting the intensity, source, and cost of informal care for older adults in China is essential to establish and enhance policy support systems for informal care within the context of East Asian traditional culture that emphasizes filial piety. This study aims to analyze the current situation and influencing factors for the informal care needs and predict the trends of informal care needs for older adults in China from 2020 to 2040.MethodsUsing the CHARLS database from 2015 to 2018, this study first combined a two-part model and a multinomial logit to analyze the influencing factors for the informal care needs of urban-rural older adults in China. Secondly, a multi-state Markov model was constructed to forecast the number of urban-rural older populations in each health state from 2020 to 2040. Finally, based on a microsimulation model, this study predicted the trends of informal care intensity, source, and cost for older adults in urban and rural areas from 2020 to 2040.ResultsIn 2040, the size of the disabled older population in China will expand further. In rural areas, the total number of disabled people in 2040 (39.77 million) is 1.50 times higher than that in 2020; In urban areas, the total number of disabled people in 2040 (56.01 million) is 2.51 times higher than that in 2020. Compared with 2020, older adults population with mild, moderate and severe disability in 2040 would increase by 87.60%, 101.70%, and 115.08%, respectively. In 2040, the number of older adults receiving low-, medium-, and high-intensity care in China will be 38.60 million, 22.89 million, and 41.69 million, respectively, and older people will still rely on informal care provided by spouses and children (from spouses only: 39.26 million, from children only: 36.74 million, from spouses and children only: 16.79 million, other: 10.39 million). The total cost of informal care in 2040 will be 1,086.65 billion yuan, 2.22 times that of 2020 (490.31 billion yuan), which grows faster than the economic growth rate.ConclusionFrom 2020 to 2040, the informal care needs of older people in rural areas will increase first and then decrease due to the demographic structure and rapid urbanization. In contrast, the informal care needs of older people in urban areas will continuously increase from 2020 to 2040, with the growth rate gradually slowing down. This study provides an evidence-based rationale for scientifically measuring the economic value of informal care and reasonably allocating care resources.

Paws for thought: advocating for the disabled population through service dog education in medical school

Service dogs are essential companions for approximately 500,000 disabled individuals in the United States. They provide daily assistance with a diverse range of impairments by performing trained tasks. Despite the studied benefits of owning a service dog, physicians often lack knowledge and education regarding their utility. This widespread ignorance among healthcare providers has left many disabled individuals unaware of the life-changing support service dogs can provide, exacerbating existing healthcare disparities for the disabled community. Integrating service dog education into medical curricula is crucial to enhancing care for disabled patients. By equipping future physicians with this knowledge, the medical community can better advocate for and support disabled patients, ensuring they receive comprehensive and informed care.

2245 Disease trajectories and medical expenditures of older long-term care residents in China: prospective observational study

Abstract Introduction Global ageing and an increasing disability population impose huge health and economic burdens on societies, and understanding the impact of disability on mortality and medical expenditures among the elderly is vital. Methods This study was based on the government-led long-term care insurance program initiated in July 2017 and followed up to June 2021. Diagnosis and hospitalisation costs were extracted from electronic medical records and medical insurance system. The networks of the disease trajectories were established by combining disease pairs with overlapping diseases. Medical expenditures relating to exact disease were calculated and compared between age groups. Results The 30,003 participants had a mean age of 79.6 ± 11.1 years, with 57.0% females. After a mean follow-up time of 21 ± 16 months, 17,428 (58.1%) death were observed. Diseases with the highest HRs included septic shock (HR 3.59, 95% CI, 3.36–3.84), respiratory failure (HR 3.19, 95% CI, 3.05–3.34), sepsis (HR 2.98, 95% CI, 2.80–3.18), malnutrition (HR 2.38, 95% CI, 2.27–2.48), and decubitus ulcer (HR 2.27, 95% CI, 2.14–2.41). The disease trajectories were initially related to hypertension and diabetes mellitus, while mortality was associated with malnutrition, infectious diseases, and organic failure. In subgroup analysis, participants with older age, those living in nursing institutions, and males had more complex disease trajectories. The medical costs gradually decreased with increasing age, and there was a rapid increasing trend before death for the decedents. Among the diseases of top 30 frequent hospitalisation visits, intracerebral haemorrhage, sepsis, and respiratory failure ranked as the top three total medical costs. Conclusions The study shows that malnutrition and infection-related diseases contribute to death in older disabled and the latter account for part of the highest medical cost, calling for comprehensive strategies for infection prevention and treatment.

Improving training for carers who support individuals with Intellectual Disabilities and Dementia: A service evaluation

Background:Within the Intellectual Disability (ID) population, the prevalence rate of dementia is higher than the general population (Chapman et al., 2018). This signifies a heightened demand on carers to support the transition from routine ID-based care to expert dementia care (Ryan et al., 2014). In line with the National Health Service’s (NHS) long-term plan (2019), it is vital for carers to access regular training to meet individuals’ dementia-related needs.Rationale:The local NHS Community Learning Disability Health Team developed two dementia training packages for paid carers working in residential and supported living facilities. Training package two (TP2) was developed in response to carer feedback obtained from training package one (TP1). This service evaluation aims to investigate the impact of TP2 on participants’ knowledge of dementia and post-diagnostic interventions. Furthermore, this evaluation aims to explore whether the quality of training improved between TP1 and TP2.Methodology:Participants who attended TP2 completed a pre and post knowledge measure; data was analysed using a repeated measures t-test. Quality scores were also completed post TP1 and TP2; this data was analysed using an independent t-test.Results:Participants reported statistically significantly higher dementia knowledge and post-diagnostic support knowledge scores following TP2. Compared with TP1, TP2 had statistically higher post-training quality scores.Discussion:Results from TP2 suggest that this dementia training package is viable and useful. The implications of these findings and wider literature are discussed, in addition to a critical review of the evaluation’s limitations, strengths and recommendations.

Who Counts? Care, Disability, and the Questionnaire in Jesse Ball'sCensus.

In the Biopolitics of Disability, David Mitchell and Sharon Snyder (2015) assert that disabled people are subjected to endless health and government questionnaires that harvest their data in exchange for better care. As disability advocates such as the National Disability Rights Network (2021) have demonstrated, these questionnaires-like the 2020 census-are highly flawed because disabled populations are not asked to shape the questions that will determine government funding and access to medical care. Although data collection is a source of contemporary literary and scholarly interest, few works explore this in the context of disability. However, Jesse Ball's 2018 novel Census examines questionnaires, specifically the census, and illuminates how narratives of disability are warped by the faulty data these objects collect. I argue that the protagonist, a dying father whose son has Down syndrome and requires full-time care, uses what Jack Halberstam calls "queer failure" to create a more equitable census that will make possible the kinds of care disabled populations deserve. Rather than create a perfect, objective questionnaire, the father skews the questions and data to center disability in the story of America, as he moves away from recording everyone's experiences and instead highlights the lives of disabled people, their caretakers, and their systems of care (doctors, neighbors, etc.). I suggest that this "failed" census reveals those networks and systems of interdependency that scholars like Judith Butler (2020) and advocates such as Leah Lakshmi Piepzna-Samarasinha (2018) posit would radically change how care is approached, thus rendering the census as an object of care.