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Biomedical subjects

A Jahoda

Publications and source records attributed to A Jahoda.

At least 19 recordsLinked to original sources
PubMed2006

Young people with intellectual disabilities attending mainstream and segregated schooling: perceived stigma, social comparison and future aspirations.

BACKGROUND: Mainstream schooling is a key policy in the promotion of social inclusion of young people with learning disabilities. Yet there is limited evidence about the school experience of young people about to leave mainstream as compared with segregated education, and how it impacts on their relative view of self and future aspirations. METHODS: Sixty young people with mild to moderate intellectual disabilities in their final year of secondary school participated in this study. Twenty-eight individuals came from mainstream schools and 32 attended segregated school. They completed a series of self-report measures on perceptions of stigma, social comparison to a more disabled and non-disabled peer and the likelihood involved in attaining their future goals. RESULTS: The majority of participants from both groups reported experiencing stigmatized treatment in the local area where they lived. The mainstream group reported significant additional stigma at school. In terms of social comparisons, both groups compared themselves positively with a more disabled peer and with a non-disabled peer. While the mainstream pupils had more ambitious work-related aspirations, both groups felt it equally likely that they would attain their future goals. Although the participants from segregated schools came from significantly more deprived areas and had lower scores on tests of cognitive functioning, neither of these factors appeared to have an impact on their experience of stigma, social comparisons or future aspirations. CONCLUSIONS: Irrespective of schooling environment, the young people appeared to be able to cope with the threats to their identities and retained a sense of optimism about their future. Nevertheless, negative treatment reported by the children was a serious source of concern and there is a need for schools to promote the emotional well-being of pupils with intellectual disabilities.

Adaptation, Psychological↗
PubMed2005

Knowing you: the interpersonal perceptions of staff towards aggressive individuals with mild to moderate intellectual disabilities in situations of conflict.

OBJECTIVES: Staff attributions concerning challenging behaviour have been found to play a role in determining their responses. The emphasis in the literature has been on staff beliefs about the challenging behaviour itself. However, staff are also likely to be responding to the person engaging in the behaviour. The aim of this study was to explore workers' perceptions of individuals who are frequently aggressive. DESIGN AND METHODS: Thirty-six staff members working with individuals presenting problems of frequent aggression participated in this study. They were interviewed about an incident of aggression involving the person they worked with. The semi-structured interview, based on a Rational Emotive Therapy format, aimed to tap into the emotions aroused in the staff members and interpersonal appraisals that they made at the time of the incident. The responses were content analyzed. RESULTS: The strength of the staff member's emotional reactions were noteworthy. Furthermore, approximately half of the staff members believed that the clients' aggression was directed at them personally. In turn, the majority of staff members described their clients in negative terms, and said that their first impulse had been to confront the clients. CONCLUSIONS: The findings suggest that interpersonal perceptions may have a role in determining staff responses to individuals who behave aggressively. The clinical and theoretical implications of the findings were discussed, alongside directions for future research.

Adult↗
PubMed2004

Coping with social stigma: people with intellectual disabilities moving from institutions and family home.

BACKGROUND: Social stigma and its impact on the life opportunities and emotional well-being of people with intellectual disabilities (IDs) are a subject of both practical and theoretical importance. The disability movement and evolving theories of self, now point to individuals' ability to develop positive identities and to challenge stigmatizing views and social norms. METHOD: This paper presents findings from a phenomenological study of 10 individuals making the transition from their family home to live more independently and 18 individuals moving from a long-stay hospital to live in community housing. It builds on an earlier data set obtained from people living at home with their families and examines: (1) people's awareness of stigma, and (2) their modes of adaptation to stigma. RESULTS: The participants all believed that they faced stigmatized treatment and were aware of the stigma associated with ID. They presented a range of views about self in relation to disability and stigma. These views included regarding themselves as part of a minority group who reject prejudice, and attempts to distance themselves from stigmatizing services and from other individuals with IDs. CONCLUSIONS: The findings are discussed in relation to theories of self and the importance of considering psychosocial factors is stressed in clinical work with people who have IDs.

Activities of Daily Living↗
PubMed2004

The impact of sildenafil citrate on sexual satisfaction profiles in men with a penile prosthesis in situ.

OBJECTIVE: To assess the efficacy of sildenafil in increasing penile glans tumescence and improving patient satisfaction in men with a penile prosthesis, as this remains a major treatment for erectile dysfunction but a common complaint is the lack of glans engorgement. PATIENTS AND METHODS: To determine whether sildenafil combined with a penile prosthesis improves satisfaction, patients used an implant alone for at least 1 month, after which they completed the International Index of Erectile Function (IIEF) questionnaire. The same patients were then given sildenafil citrate and completed the IIEF questionnaire after using the sildenafil/implant combination. RESULTS: Patients who responded to sildenafil with glans engorgement reported significantly greater satisfaction scores than with an implant alone. CONCLUSION: We currently offer sildenafil citrate after implantation to all men who have a penile prosthesis placed.

Adult↗
PubMed2002

Responses of staff towards people with mild to moderate intellectual disability who behave aggressively: a cognitive emotional analysis.

BACKGROUND: Traditionally, research into interactions between staff and adults with an intellectual disability who engage in challenging behaviour has been carried out within a behavioural paradigm. Recent work has begun to examine cognitive factors. The majority of this research has drawn upon Weiner's attributional model of helping behaviour. Moreover, staff responses have usually been investigated in relation to client vignettes of challenging behaviour. METHOD: The present study involved 38 staff who worked with frequently aggressive clients and its aims were twofold: (1) to compare different methods of examining the cognitive and emotional responses of staff to aggression; namely, descriptive vignettes and real incidents of aggression which staff could recall; and (2) to attempt to replicate previous findings supportive of Weiner's model with a new carer group (day centre staff). RESULTS: When staff responses were compared across the hypothetical and real scenarios, using a series of one-way analyses of variance, it was revealed that staff experienced more negative emotions in response to the real incidents of aggression. The present study produced little evidence in support of Weiner's model. However, it was found that staff perceptions of the aggressive clients were linked to their cognitive and emotional responses to the aggression. CONCLUSION: The theoretical and clinical implications of these findings are considered, and the possible role played by interpersonal attributions in mediating staff responses to aggression is discussed.

Adult↗
PubMed2001

Contingent reinforcement or defending the self? A review of evolving models of aggression in people with mild learning disabilities.

This paper examines the changing approaches to working with people with a moderate to mild learning disability, who are frequently aggressive. Long-held assumptions about the lack of inter-personal understanding and impulsiveness continue to play a central role in clinical assessment and intervention for this group. Yet, there is a lack of controlled studies indicating the influence of such factors in frequent aggression. The dominant behavioural tradition has long encouraged such assumptions, but has focused on people with more severe disabilities where such assumptions are arguably more appropriate. The current review of the literature shows a clear evolution away from a strict behavioural approach towards cognitive-behavioural therapy (CBT) approaches that take account of the heterogeneous psychosocial causes of aggression. We find support for CBT in the child-development literature, which examines inter-personal difficulties from an information-processing perspective. Finally, we argue that much of the literature implicitly utilizes the concept of self, and we suggest that this should be made explicit in a reformulated theory of the 'person', incorporating the self concept and embedding individual cognitive processes and behaviour in a social context.

Aggression↗
PubMed2000

Use of epidermal growth factor and collagen synthesis inhibition as adjuvant to healing of ureteroureteral anastomosis.

BACKGROUND AND PURPOSE: When treating a ureteral narrowing by endopyelotomy or endoureterotomy, the urologist hopes that after the narrowed area is cut, it will heal with a patent lumen. A ureteral stent is usually left in place to provide a framework for healing. In cases of failure, histologic examination shows a predominance of collagen. We evaluated the effects of epidermal growth factor (EGF) and a collagen synthesis inhibitor, halofuginone, as adjuncts to ureteral healing. MATERIALS AND METHODS: Ten female pigs underwent ureteroureteral anastomosis bilaterally, with the left side being stented. They were then randomized to receive EGF (N = 4), halofunginone (N = 3), or saline (control; N = 3). On postoperative day 30, the ureters were examined grossly and histologically. RESULTS: The lumens of the ureters were significantly larger in the animals that received either EGF or funginone than in the control animals. The epithelium was significantly thicker in the animals that received halofunginone than in the controls or animals receiving EGF. The thickness of the smooth muscle and adventitia was similar in the three groups. Stenting improved the results. CONCLUSION: Both EGF and halofuginone show promise as adjuncts to endopyelotomy and endoureterotomy.

Adjuvants, Pharmaceutic↗
PubMed1999

Attribution of intent and role-taking: cognitive factors as mediators of aggression with people who have mental retardation.

An assessment task was devised to explore the attributional style and role-taking ability of 22 aggressive and 22 nonaggressive adults with moderate to mild mental retardation. Aggressive participants showed a hostile bias in their interpretation of others' intentions towards themselves within ambiguous interpersonal situations, although no difference was found across groups within clearly provocative situations. Furthermore, the role-taking ability of the aggressive participants was superior to the nonaggressive group, undermining the focus on global problems of interpersonal understanding as a causal factor of aggression for people with mental retardation.

Adolescent↗
PubMed1998

Facing stress and conflict: a comparison of the predicted responses and self-concepts of aggressive and non-aggressive people with intellectual disability.

The present research consisted of two studies. A total of 44 participants were involved in the first study: 22 individuals with problems of aggression (Ag) and 22 non-aggressive (NAg) individuals. A sentence completion test was used to explore whether there were differences between the two groups' predicted coping responses in stressful situations. While the Ag group provided most aggressive responses, the NAg participants were more assertive. However, gender differences also emerged, with women proving to be less aggressive. A high number of passive answers were given across all the groups, suggesting that background experience could have influenced the participants' sense of efficacy in stressful situations. In the second study, a subsample of the participants were interviewed. The aim was to explore whether particular background experience coloured their perceptions of self and others, in situations of conflict. While nine out of the 10 Ag participants described incidents where they felt treated in a derogatory manner which could be linked to their disability, only two out of the nine NAg participants felt slighted in this fashion. Hence, a vulnerable sense of self could contribute to greater sensitivity in interpersonal situations, increasing the likelihood of an aggressive response. The clinical relevance of this work is discussed, alongside the possibilities for future research in this area.

Adolescent↗
PubMed1997

Transurethral vaporization of the prostate in the treatment of bladder outlet obstruction at two university hospitals.

Transurethral vaporization of the prostate (TVAP) is a new technique for the surgical treatment of men with benign prostatic hyperplasia (BPH). The primary advantage of TVAP appears to be shortened hospitalization and less bleeding than is associated with transurethral resection of the prostate (TURP). Since February 1995, 66 consecutive men with bladder outlet obstruction (47 with persistent voiding symptoms and 19 in complete urinary retention) secondary to prostatic disease underwent TVAP at two university hospitals. TVAP was utilized in all patients regardless of prostate size. The mean length of follow-up was 3.2 months. All 19 men in complete retention were able to void adequately following surgery with a mean postvoid residual volume of 18cc and a mean International Prostate Symptom Score (I-PSS) of 7.5. In the remaining patients, the I-PSS decreased from a mean of 19.6 to 8.4. Pre- and postoperative peak urinary flow rate data were available in 17 men and increased from 9 to 18 cc/s. Limited transurethral resection of prostatic tissue at the completion of TVAP was necessary to adequately relieve bladder outlet obstruction in 18% (12/66) of patients. Hospitalization of < 24 h was needed in 68% (45/66) patients. The urinary catheter was removed within 1 day of surgery in 68% (45/66) of men as well. Seven patients required catheter replacement postoperatively due to difficulty voiding (five men) or bleeding (two men). No patient required blood transfusion. TVAP is effective in relieving bladder outlet obstruction in men with and without urinary retention. The majority of patients require brief or no hospitalization and are able to void adequately within 24 h of surgery. TVAP appears to be less effective in men with large prostate glands, and limited TURP is more frequently needed in these cases. The long-term results of TVAP will require further study.

Aged↗
PubMed1992

Living in hospital and hostel: the pattern of interactions of people with learning difficulties.

This study compared interactions between the staff and residents living in hospital wards and in community-based hostels. Twenty-four people with moderate to severe learning difficulties participated in this study. Interactions were categorized according to who was the initiator and recipient, their purpose, attitude of the recipient, duration, and place. It was found that the hospital and hotel residents had virtually no interactions with people outwith the establishment in which they lived. The hostel appeared to offer the residents a sociable environment with more interpersonal interactions and more positive attitudes towards the interactants than the hospital. Interactions in both kinds of setting were very short, thus giving residents little chance to develop communicative skills. It is suggested that a more personal approach, such as joint activities between residents and staff, and living in small groups in ordinary housing, should be the first priorities in the effort to improve the pattern of social interactions of people with moderate to severe learning difficulties.

Activities of Daily Living↗
PubMed1990

Moving out: an opportunity for friendship and broadening social horizons?

The study investigated the changes in social activities and social networks of people with mild learning difficulties who moved from family home and from a long-stay hospital to live more independently in the community. Twenty-five people with a learning difficulty, 12 mothers and 33 members of staff participated in this study based on interviews before and after the move to the community. It was found that people with a learning difficulty participated in more community-based activities after the move but they had very few opportunities to meet non-handicapped people. Their segregation remained a main source of dissatisfaction with their social life.

Adult↗
PubMed1988

Leaving home: the experience of people with a mental handicap.

Open-ended interviews were conducted with 12 people with a mental handicap who had left parental homes in order to live as tenants in community residential hostels. Parents and hostel staff were also interviewed. The nature of life in the family home, and the tenant's role in the move, reasons for leaving home and expectations for the future were explored. It was found that social life, autonomy and opportunities to develop self-help skills had been limited at home. The tenants who had the widest social experience and the greatest use of self-help skills at home were the most active in changing their situation. Tenants hoped to gain more freedom by leaving home, although they were also in agreement with parents and staff about the value of learning new skills.

Activities of Daily Living↗
PubMed1988

Stigma and the self-concept of people with a mild mental handicap.

Twelve people with a mild mental handicap, their mothers and members of staff of Adult Training Centres were interviewed to explore their views on the subjects of stigma and handicap, and to establish the facts about the social life and autonomy of people with a mental handicap. It was found that all participants with a mental handicap were aware of the stigma attached to them. A minority of three conceived of themselves as 'essentially different' from non-handicapped people, while the majority of nine conceived of themselves as 'essentially the same'. In contrast, the majority of mothers viewed their sons and daughters as 'essentially different' from non-handicapped people. These findings do not support the claim of the social constructionist theory of the self that people's self-concepts are primarily determined by the ways in which they are treated by the significant others. Rather, people with a mental handicap are aware of their own agency and clearly express their socio-emotional needs.

Adult↗
PubMedDate not supplied

Laparoscopic surgery for adrenal lesions.

Laparoscopy has become an important tool in the urologist's armamentarium. The optimal utilization of this technology is still in evolution; however, it offers assistance in diagnosis and treatment for a variety of conditions. As experience with laparoscopy increases, more procedures that have traditionally been done with an open surgical approach will be adapted to use with the laparoscope. In this article, we review current applications of laparoscopic adrenalectomy.

Adrenal Gland Diseases↗