Background: Knowledge is lacking about dietary habits among people with intellectual disability (ID) living in community residences under new living conditions. Objective: To describe the dietary habits of individuals with ID living in community residences, focusing on intake of food, energy and nutrients as well as meal patterns. Design: Assisted food records and physical activity records over a 3-day observation period for 32 subjects. Results: Great variation was observed in daily energy intake (4.9Á14 MJ) dispersed across several meals, with on average 26% of the energy coming from in-between-meal consumption. Main energy sources were milk products, bread, meat products, buns and cakes. The daily intake of fruit and vegetables (3209221 g) as well as dietary fiber (2199.6 g) was generally low. For four vitamins and two minerals, 19Á34% of subjects showed an intake below average requirement (AR). The physical activity level (PAL) was low for all individuals (1.49 0.1). Conclusion: A regular meal pattern with a relatively high proportion of energy from in-between-meal eating occasions and a low intake of especially fruits were typical of this group of people with ID. However, the total intake of energy and other food items varied a great deal between individuals. Thus, every adult with ID has to be treated as an individual with specific needs. A need for more knowledge about food in general and particularly how fruit and vegetables could be included in cooking as well as encouraged to be eaten as inbetween-meals seems imperative in the new living conditions for adults with ID.
The Swedish Disability Act, LSS, was introduced to guarantee good living conditions for people with severe disabilities. A specific goal was to overcome local variation in support. However, considerable differences still remain between the municipalities. In this study we have identified six characteristics to explain this variation: earlier presence of residential institutions, population density, human capital (age, education, employment, health), local culture, land area and stable left-wing government. The results support a need-responsiveness model of welfare support but also signal accessibility problems and a regional propensity to demand and provide independently of needs. This means that spatial equity is violated. In sum, it still matters where you live.
The food provision for people with intellectual disability (ID) in Sweden is organized within their own households. The aim of this study was to describe how foodwork Á planning for meals, shopping for food and cooking Á is performed in different social contexts in community settings involving people with ID, staff or both. Dietary intake in the main meals in relation to foodwork practice was also studied. Four different foodwork practices could be distinguished. For some participants only one kind of foodwork practice was found, but for most of them two or more different practices. There was a tendency that food items and dishes chosen and used differed depending on what foodwork practice was performed, which, in turn, affected the nutrient intake. More attention needs to be directed to these everyday matters as a means to increase the quality of support in food for people with ID.
The author identified and discusses barriers and facilitators for public action after the occurrence of abuse against an adult with an intellectual disability (ID). Data were collected via a postal survey sent to guardians in one Swedish region with questions about suspected abuse against their wards (n = 978), of whom 392 had an ID (the remaining were affected by dementia or had another physical or mental disability). The rate of abuse was 4.8% (n = 19) among those wards with an ID. A range of abuses were reported, but there were no significant statistical differences attributed by sex of the wards. Facilitating examples for redress in the statutory framework were identified, but it was observed that implementation of redress was often flawed. Three alternative public actions were discussed: (1) victims' refusal to contact the public sector; (2) internal handling by the social services; and (3) reporting to police (but case closed). Findings showed that there were difficulties in understanding that passive respect for integrity and autonomy is not in line with the public ethos that demands actively caring for dependent wards, that offences in residential settings were sometimes handled internally and not reported in accord with the statutory framework, and that the ability of the criminal justice system to compensate for communicative disabilities seemed deficient.
Arend Lijphart's seminal consensus model of democracy does not only try to explain how democracy actually works. It also purports to be a 'kinder, gentler' form of democracy with regard to e.g. unemployment, disability, illness and old age. So far, this conjecture has not been brought to a systematic test which is the purpose of this article. We look into the consequences for one of the areas Lijphart singles out: disability. Does consensus democracy promote a more generous policy towards disabled people than majoritarian democracy? We transfer Lijphart's theory to municipality level. In Sweden, disability care is namely the responsibility for the municipalities, which are comparatively large and independent and with the right to tax their citizens; they are like small nation-states. There is, however, a considerable variation in disability support between them. Some give ten times as much support than others. Is it those governed according to the consensus model? Our approach helps controlling for the variation in political and cultural context and expands the number of observations. The statistical comparison of Swedish municipalities does not, however, lend any confirmation of the famous theory. Instead, there are reasons to doubt that consensus democracy promotes more generous policies. overview of the causes of the regional variation, we find that the clients' propensity to demand support, the ideology of the ruling municipality government and -not very surprisingly -a corresponding variation in needs in the different municipalities turn out to be the best explanations. In the more specific analysis in this article, we focus on Lijphart's explanation and ask the question whether, in fact, consensus municipalities are more generous.One reason why there has been little empirical research on the consequences of consensus democracy is the well-known problem in comparative research of 'cultural dependence': a phenomenon might be due to specific historical events or cultural traditions and the country in question consequently 'unique' and not valid for comparison. Our way out of this problem is to transfer the theory, which has been developed for the nation-state, to municipality level. This is a way to make all units of analysis comparable, since they all belong to the same system. The prerequisite for this operation is, of course, that it is reasonable, and a lengthy part of the article is devoted to justifying this transfer between levels.We begin by introducing the theoretical foundation for consensus democracy and its implication for welfare generosity. We then justify our decision to use Swedish municipalities for the analysis and our division of municipalities according to a consensus-majoritarian scale before presenting our dependent variable: disability care. Finally, we account for the results and conclusions of the study. Our results are negative, however. We find no support for the idea that consensus government would promote more generous policies. Lijphart's theory has been criticized for being biase...
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