Caregiving and quality of life

ABSTRACT

The increase in life expectancy for adults with learning disabilities has extended the caring role for their parents. This study examined the experiences of older parents who provide long-term care for their adult children with learning disabilities and how they conceptualise their quality of life. Data were collected using semi-structured interviews with 27 older parent carers from four London boroughs and were analysed using framework technique. Findings indicate that most parents appraised their quality of life positively and reported benefits, despite the challenges they had to negotiate daily. The benefits from caregiving, more so in later life, were: a connected family from shared caregiving; a sense of belonging; purposeful living; a reciprocal relationship with their adult children; and personal transformations from providing care that improved their quality of life. The challenges that participants regularly encountered were: multiple losses (sleep, career, identity and friends); the added stress of the government’s Personalisation Agenda of caring services; struggles for access to services; searching for a diagnosis; worry about future care and fear of abuse when carers are unable to continue in their role; unhelpful attitudes of health and social care professionals; and a lack of empathy from friends as well as the public towards people with learning disabilities. Caregiving and quality of life are inextricably linked and the difficulties that parents experienced were mainly associated with socio-structural barriers, rather than their children’s disabilities. Importantly, the findings inform the practice of social workers and others who support this unique group of carers by providing new insights into how caring impacts on quality of life over time and how best these parents’ needs can be met. This study makes a specific contribution to understanding the lived realities of older carers and extends current conceptualisations of caregiving and quality of life among older people.     

Using PMCT of Individuals of Known Age to Test the Suchey–Brooks Method of Aging in Victoria,Australia

The estimation of an individual's age at death plays a critical role in the investigation of unidentified human remains. The Suchey–Brooks method, which involves the analysis of degenerative morphological changes in the pubic symphysis, is currently widely used to estimate age in adults. This study tested the applicability of the Suchey–Brooks method on a contemporary adult Australian (Victorian) subpopulation by observing three‐dimensional volume‐rendered postmortem computed tomographic (PMCT) reconstructions of the pubic symphysis of 204 individuals aged 15–100 years. Results showed the method was reliable for females (85% correct allocations) but not for males (67% correct allocations). It is therefore recommended that extreme caution be used when applying the Suchey–Brooks method for estimating age at death of an individual in this subpopulation from PMCT images. The results suggest further investigation into alternate age estimation methods is required.     

Managing children's and adolescents' medical complaints amid parent conflict: Strategies and tools for professionals

Children and adolescents who are having difficulty coping with stress often present with complaints of physical discomfort. Effective treatment approaches exist for many of these issues. Among high-conflict parents, however, children's medical issues can become another canvas for conflict, with parents focused more on blaming one another for the child's distress than on options for assisting the child. Professionals can be drawn into the conflict to such a degree that they overlook essential steps for addressing and managing these issues. The authors present a research-informed model for managing medical and psychophysiological issues amid parental conflict.     

Total Body Mass Estimation from Anthropometric Measurements in Modern Young Adult U.S. Populations with Healthy Body Fat Percentages (NHANES III)

This study presents a method by which to estimate total body mass in modern young adult U.S. populations who self‐identified as non‐Hispanic U.S. White, non‐Hispanic U.S. Black, and Mexican American with anthropometric measurements from the Third National Health and Nutrition Examination Survey (NHANES III) 1988–1994 dataset (N = 2532). Correlations of stature and bi‐iliac breadth with total body mass were stronger among males (r = 0.717–0.774) than among females (r = 0.549–0.661), yet these results were more accurate assessments of total body mass than existing techniques. This study also examined additional anthropometric measurements to estimate total body mass using an information‐theoretic approach demonstrating that some error in the stature–bi‐iliac breadth method is attributed to a nonsupported model with multimodel inference. The limitations of the current total body mass technique are discussed as well as the need for future studies to validate the method.     

Secular Change in Morphological Pelvic Traits used for Sex Estimation

This research evaluates secular change in Phenice's (Am J Phys Anthropol, 30, 1969 and 297) three morphological traits of the pubis, as described by Klales et al. (Am J Phys Anthropol, 149, 2012 and 104): medial aspect of the ischio‐pubic ramus, subpubic contour, and ventral arc. Ordinal scores were collected for these traits and compared between a sample of innominates from the historical Hamann–Todd Collection (n = 170) and modern Bass Donated Collection (n = 129). Using the Freeman–Halton test, significant differences between temporal sample score frequencies were found for all traits in females and for the subpubic contour and ventral arc in males. Despite these findings, classification accuracy using logistic regression between the temporal periods remained low (68.7%). These results suggest that secular changes in trait expression are occurring; however, sex estimation methods using these traits and created with historical samples are still applicable to modern forensic cases. In fact, the secular changes occurring in these traits contribute to better classification accuracy between sexes in modern populations.     

超滤管在陈旧生物检材中的应用

目的探讨millipore超滤管滤过方法对陈旧生物检材DNA分型检验的应用价值。方法将23份陈旧血样分别剪取同样合适大小的血片3组,标为A、B、C组,磁珠法提取DNA,分别用80μL、80μL、20μL洗脱液洗脱得到模板DNA,其中A、C组模板直接扩增,B组用millipore超滤管滤过浓缩后扩增。PCR产物用AB3130x L基因分析仪检测,Gene Mapper ID V3.2软件进行自动分型。所得实验数据用SPSS软件分析处理。结果 A组没有1例样本扩出全部STR基因座,B组有18例样本扩出全部STR基因座,C组有11个样本扩出全部STR基因座。结论应用millipore超滤管滤过方法可以明显提高陈旧生物检材的DNA分型成功率。     

mRNA在体液斑迹鉴定与组织来源推断中的应用

体液斑迹鉴定及其组织来源推断一直是法医学研究的重要方向之一,其传统的检验方法存在诸如假阳性率高、检材易破坏等缺陷,亟需更高效的确证实验。高度分化的体细胞表达特异的m RNA分子,可推断其来源:外周血、月经血、精液、唾液、阴道分泌物、接触斑等,且灵敏度、特异度及保存时间相对较为理想,是未来用于体液斑迹鉴别的理想遗传标记。本文对m RNA在体液斑迹鉴定和组织来源推断方面的应用及其前景进行综述。     

母血浆中胎儿游离核酸与无创性产前亲子鉴定

近年来,涉及胎儿亲权鉴定的案例逐渐增多。传统胎儿产前亲权鉴定常需有创性取样,故存在一定的风险。母血浆中胎儿游离核酸的发现,给无创性产前亲权鉴定带来了新的契机。本文主要就母血浆中胎儿游离核酸及其在无创性产前亲权鉴定中的应用价值和前景进行简要介绍。     

51个常染色体STR基因座在ITO法判断全同胞中的应用

目的探讨ITO法和判别函数法在全同胞鉴定中的应用价值。方法根据342对全同胞和3 900对无关个体的19、21、39、51个常染色STR基因座的分型结果,采用ITO法计算全同胞关系指数(FSI)。用SPSS软件Fisher判别分析法,分别建立lg FSI全同胞-无关个体的判别函数。结果每组全同胞对和无关个体对的lg FSI符合正态分布,具有显著性差异。在19、21、39、51个STR基因座,全同胞组判别函数分别为L同胞=1.666 6×lg FSI-5.208 0,L同胞=1.643 9×lg FSI-5.512 0,L同胞=1.569 4×lg FSI-8.076 4,L同胞=1.480 7×lg FSI-9.860 9;无关个体组分别为L无关=-1.346 1×lg FSI-3.638 5,L无关=-1.330 9×lg FSI-3.851 7,L无关=-1.319 2×lg FSI-5.910 2,L无关=-1.273 8×lg FSI-7.477 6。平均错判率分别为:1.361 9%、1.228 5%、0.438 6%和0.146 2%。结论 ITO判别函数法在全同胞-无关个体鉴定中具有很高的应用价值,且检测基因座越多,系统效能越高,并能降低错判风险。     

120例强奸案法医学回顾分析

强奸案的证据通常应具备暴力证据和性交证据,机械性损伤、使用药物和生物检材等是构成暴力证据和性交证据的重要组成部分。由于加害人实施强奸时手段的不同以及个体性行为的差异,损伤的类型、形态、部位及生物检材的种类、遗留部位、遗留客体也会呈现不同特征。如果不仔细地检查和提取,就会使这些物证灭失。本文通过对120例强奸案件的分析,总结了案件中损伤、药物、生物检材的发现、提取和检验的相关信息与技术细节问题,同时结合案情对案件发生的时段、地点、环境、区域、作案手段与方法、嫌疑人和受害人的职业特点等进行了讨论,希望对法医学鉴定工作和民警办理案件有所帮助。