Self-advocacy with retailers by people with complex communication needs

PURPOSE

The researchers aimed to discover what might prevent people with complex communication needs (CCNs) from making complaints if they experienced social exclusion in the retail environment.

METHOD

Qualitative research methods were used to gather data from two groups of participants: adults with CCN and retail customer service staff. Seven adults who used speech-generating devices (SGDs) and who shopped independently were interviewed about their perceptions of retail customer service communication. Nine retail customer service staff were interviewed about their communication with customers with disability. Analysis using grounded theory provided insights into experiences of people with CCN.

RESULT

All participants with CCN had experienced being ignored, patronised and excluded when shopping but faced barriers that prevented them from complaining. Those who did complain exhibited strong self-esteem.

CONCLUSION

Participants with CCN experienced social exclusion because customer complaint mechanisms were inaccessible. Retailers and government agencies monitoring inclusion, as well as speech-language pathologists and disability advocates, place insufficient emphasis on retail communication as a vehicle for social inclusion. The researchers recommend strategies to strengthen self-advocacy by people with CCN and systemic changes to improve accessibility of complaints procedures in the retail sector.

Diversity field officer service: An evaluation of an employer engagement strategy trialled in Geelong, Australia

BACKGROUND: The Australian Government has applied considerable focus to improving the unemployment rate of people with disability through initiatives to build their capacity and job readiness. Far less attention has been paid to addressing the needs of business, especially small- to medium-sized enterprises (SME). OBJECTIVE: We evaluated the Diversity Field Officer Service (DFOS) pilot, which aimed to address that gap through providing direct support to SME to build disability confidence and more inclusive organizations. METHODS: We used a mixed method approach (pre- and post-service surveys along with post-service semi-structured interviews) with representatives from 36 businesses. We used descriptive statistics and thematic analysis to summarise the survey data and interview material, respectively. RESULTS: Confidence in employing people with disability increased, as did the employment of, and intention to employ, people with disability. Many businesses were implementing, or planning to implement, measures to increase the employment of people with disability. DFOS capacity building exercises and activities (e.g., one-to-one conversations to understand the specific needs and challenges of their businesses) were all rated highly. Participants were generally supportive of an ongoing role for DFOS. CONCLUSION: The DFOS holds promise as a strategy to increase the employment of people with disability in SME.

How Do People With Intellectual Disability Engage With and Understand Gambling? A Qualitative Study of Adults in Victoria, Australia

Objective: This study aimed to understand the factors that may influence how and why people with intellectual disability may engage in gambling.

Method: Nineteen people with intellectual disability were recruited from a disability advocacy organization and participated in face to face, semi-structured qualitative interviews. Open ended questions were used to explore participants' gambling participation, recall of, and attitudes toward, different gambling products, understanding of gambling harm, and awareness of responsible gambling messages.

Results: All participants could remember gambling in their lifetime and some participants had recently engaged in gambling. Many participants were aware of different gambling products, and a few participants could describe in detail the technical aspects of electronic gambling machines. Most participants did not specifically recall seeing gambling harm minimization messages, however some described engaging in individual responsibility measures, such as limits and control, as they perceived this reduced the risks of experiencing harm.

Conclusions: People with intellectual disability are engaging with gambling products in a similar way to the general community. Therefore, it is important to understand the different pathways that may lead people with intellectual disability to initiate and continue gambling and to ensure that they are aware of and protected from the potential risk.

Implications for Public Health: Policy makers and practitioners should seek to understand and implement a range of strategies to reduce and prevent the harms associated with particular gambling products and environments for this population sub-group.

Weighing up the risks and benefits of community gambling venues as recreational spaces for people with lifelong disability

BACKGROUND

Community gambling venues (pubs and clubs) are commonly associated with leisure and recreational options in Australian communities. While these venues offer a range of activities and facilities, including social opportunities, sporting facilities, live entertainment, they also contain gambling products that are known to cause significant harm to individuals, their families and communities. Although researchers have explored how adults and children engage with these venues, there is limited understanding about the potential risks and benefits of these venues for people with lifelong disability.

METHODS

Semi structured interviews were conducted with nineteen people aged 20-70 years with lifelong disability (includes in this context intellectual disability, autism spectrum disorder, ADHD, and learning disability), predominately intellectual disability. The interviews occurred in a large Australian city and explored interviewees' experiences and attitudes towards pubs and clubs. Using a range of visual prompts (if needed), participants were asked to describe their engagement in different activities offered within the venue. Interviews were audio-recorded and transcribed, with a thematic analysis used to identify themes across the group.

RESULTS

Most participants attended venues with family, friends, and supporters, with a few attending on their own. Participants described socialising in the venue, going for reduced price meals, and attended for a range of activities including recreational activities, live entertainment and sport. Some participants also valued being a member of venues, and the interactions with staff members. While participants were cautious about the consumption of alcohol, most had gambled, particularly on electronic gambling machines (EGMs, pokies, or slots). Some participants stated that they had experienced problems with gambling.

CONCLUSIONS

While many people with lifelong disability have positive experiences in pubs and clubs, some are vulnerable to the harms associated with risky products such as gambling within the venue. While it is important to acknowledge the positives associated with recreational facilities and encourage engagement in leisure activities for people with lifelong disability, further consideration is needed to ensure people are informed and protected from the harms associated with gambling and other products that are provided within these spaces.

Communication access in the retail environment for people with complex communication needs

Purpose: To identify what facilitates retail communication access for people with complex communication needs, and the impact of communication in this context on social inclusion.Materials and method: Seven adults with lifelong or acquired complex communication needs who used augmentative and alternative communication devices (AAC) and nine retailers participated in interviews to determine factors that contributed to communication access and inclusion. Interview data were analysed using the grounded theory method within an ecological model of social inclusion.Results: Retail participants did not differentiate between disabilities and their lack of understanding of complex communication needs was a barrier to inclusion. Participants with complex communication needs had received little preparation from speech-language pathologists on how to use AAC effectively when shopping. Communication access was achieved predominantly through participants' individual self-advocacy.Conclusions: Organisational and systemic measures are needed to better inform retailers about their responsibilities toward people who use AAC. Business prioritisation of communication access, government programs that differentiate and support people with lesser-known disabilities such as complex communication needs, and speech-language pathology support to use AAC in the retail environment is likely to improve communication access and social inclusion.Implications for rehabilitationThere is an urgent need to consider.Social policy that differentiates people with complex communication needs and contributes to public awareness of their communication needs.Directly-delivered training for retailers on adjustments for communication access for people with CCN.Support from local disability advocates, speech-language pathologists and disability services for self-advocacy with retailers by people with CCN.Early training aimed at all stakeholders by speech-language therapists in the use of speech generating devices when retail shopping.

The emergence of decreased susceptibility to vancomycin in Staphylococcus epidermidis

BACKGROUND

Coagulase-negative staphylococci (CNS) are the major cause of nosocomial bloodstream infection. Emergence of vancomycin resistance among CNS is a serious public health concern, because CNS usually are multidrug-resistant, and glycopeptide antibiotics, among which only vancomycin is available in the United States, are the only remaining effective therapy. In this report, we describe the first bloodstream infection in the United States associated with a Staphylococcus epidermidis strain with decreased susceptibility to vancomycin.

METHODS

We reviewed the hospital's microbiology records for all CNS strains, reviewed the patient's medical and laboratory records, and obtained all available CNS isolates with decreased susceptibility to vancomycin. Blood cultures were processed and CNS isolates identified by using standard methods; antimicrobial susceptibility was determined by using minimum inhibitory concentration (MIC) and disk-diffusion methods. Nares cultures were obtained from exposed healthcare workers (HCWs) to identify possible colonization by CNS with decreased susceptibility to vancomycin.

RESULTS

The bloodstream infection by an S. epidermidis strain with decreased susceptibility to vancomycin occurred in a 49-year-old woman with carcinoma. She had two blood cultures positive for CNS; both isolates were S. epidermidis. Although susceptible to vancomycin by the disk-diffusion method (16-17 mm), the isolates were intermediate by MIC (8-6 microg/mL). The patient had received an extended course of vancomycin therapy; she died of her underlying disease. No HCW was colonized by CNS with decreased susceptibility to vancomycin.

CONCLUSIONS

This is the first report in the United States of bloodstream infection due to S. epidermidis with decreased susceptibility to vancomycin. Contact precautions likely played a role in preventing nosocomial transmission of this strain, and disk-diffusion methods may be inadequate to detect CNS with decreased susceptibility to vancomycin.