Evaluating a New Supported Employment Internship Programme for Autistic Young Adults Without Intellectual Disability

Supported employment initiatives have been shown to increase employment rates for autistic people who want to enter the workforce. Despite the success of supported employment initiatives in increasing employment rates, little is known about the first-hand experiences and views of those involved. In the current study, we examined the experiences and views of autistic young adults without intellectual disability (ID; ‘interns’), employers and parents regarding a previously unevaluated paid internship scheme that offers tailored support for interns and employers before, during, and after the internship, the Employ Autism network. In total, 51 participants (19 interns, 22 employers, ten parents), across eight internships, engaged in semi-structured interviews. Reflexive thematic analysis was used to identify three themes, shared across participant groups: (1) the internship was “an invaluable experience”, (2) the internship helped break down autism-specific barriers to employment, and (3) stakeholder groups had some unmet expectations. Drawing on this multi-informant qualitative evaluation of a novel supported employment scheme, we derive recommendations of best practice for supported employment initiatives for autistic young adults without ID

Sleep and cognition in children with Down Syndrome and Williams Syndrome

This thesis provides a novel contribution to cognitive and developmental psychology by investigating\ud the relationship between sleep, behaviour and cognition in 41 healthy typically developing (TD)\ud children, 22 children with Down syndrome (DS) and 22 with Williams syndrome (WS). In addition,\ud developmental changes in sleep and cognition, and the importance of sleep for consolidation of new\ud memories were assessed in these groups. Finally, the influence of children's sleep and behaviour on\ud their mothers' sleep and wellbeing were examined. The research used a battery of standardised and\ud novel cognitive tasks, objective measures of sleep, and questionnaires.\ud Sleep problems were syndrome-specific, with poor sleep quality and oxyhaemoglobin desaturation\ud occurring more frequently in DS, suggestive of breathing difficulties during sleep, and long sleep\ud latencies in the WS group. TD children performed well on cognitive tasks of short term memory,\ud working memory and sustained attention compared to children with DS and WS, and their\ud performance generally improved with increasing age, which tended not to be the case for the clinical\ud groups. In the TD group, improved sleep quality and higher, less variable oxyhaemoglobin saturation\ud related to better performance on cognitive tasks and fewer behavioural problems. Few associations\ud between sleep, cognition and behaviour were found in the DS and WS groups. TD children and\ud children with WS showed evidence of sleep-dependent memory consolidation for explicitly learnt\ud material on two tasks. Mothers of children with DS had the poorest sleep and most daytime\ud sleepiness, though not related to children's sleep or daytime behaviour.\ud The findings indicate that sleep problems should be assessed and managed in clinical groups.\ud Educational strategies should be implemented to reinforce sleep-related learning gains. Future\ud research could examine whether sleep-dependent learning occurs in relation to specific aspects of\ud sleep architecture in children with DS and WS, as it does in adults and TD children

Evaluating the impact of an online autism training on changing employers’ autism knowledge and commitment to inclusion in the workplace

Employers’ knowledge about autism can be a key barrier to autistic people obtaining employment. The current study evaluated the efficacy of an online autism training program, Understanding Autism in the Workplace, in changing employers’ autism knowledge and commitment to inclusion in the workplace. Employers (N = 129) from 22 organizations in the UK completed the training with an autistic (n = 45) or non-autistic (n = 84) trainer and completed surveys measuring (1) autism knowledge and (2) commitment to inclusion in the workplace (CIW), before and after the training. Results showed that at a group level, autism knowledge and CIW improved from before training to after training for all participants, for both the autistic and non-autistic trainer. This latter result may be attributable to the training being co-designed by autistic people. At an individual level, however, only a minority of participants (both with an autistic and non-autistic trainer) showed a significant increase in autism knowledge (10.1%) and CIW (5.8%), suggesting autism training was more effective for some participants than others. Autism training should not be the sole initiative to address barriers to employment for autistic people but should be part of a broader package of support for employers

Evaluating a new supported employment internship programme for autistic young adults without intellectual disability.

Internships designed for autistic people can help them to find employment, but there is little research about the experiences of those involved with internship schemes. To learn more about a new paid internship scheme in the United Kingdom, the Employ Autism network, we interviewed 19 interns, who were autistic young adults without intellectual disability taking part in one of eight different internships. We also interviewed 22 employers (who worked with the interns), and 10 parents (who supported their children in the internship). The interns, employers and parents told us that the Employ Autism network was a valuable experience that helped the interns become more confident. Also, the parents said it helped the interns become more independent. All the groups said the Employ Autism network removed common barriers to employment, and interns and parents said it would help interns get a job in future. Employers and interns said they understood each other better during the internship, and employers said the internship made them think about how their organisations might have accidentally had barriers in place that could stop autistic people getting employed (barriers that they wanted to address in future). However, all groups said some expectations of the internship were not met. These findings suggest the Employ Autism network is helpful for autistic young adults without intellectual disability and employers, but that there are ways that the internships could be improved in future. We discuss the lessons we can learn from the Employ Autism network that might help others who are thinking about setting up, or getting involved in, similar internship schemes

‘Shall We Send a Panda?’ A Practical Guide to Engaging Schools in Research: Learning from Large-Scale Mental Health Intervention Trials

The substantial time that children and young people spend in schools makes them important sites to trial and embed prevention and early intervention programmes. However, schools are complex settings, and it can be difficult to maintain school engagement in research trials; many projects experience high levels of attrition. This commentary presents learning from two large-scale, mixed-methods mental health intervention trials in English schools. The paper explores the barriers and challenges to engaging schools in promotion or early intervention research and offers detailed recommendations for other researchers

The impact of universal, school based, interventions on help seeking in children and young people:a systematic literature review

Reviews into universal interventions to improve help seeking in young people focus on specific concepts, such as behaviour, do not differentiate between interpersonal and intrapersonal help seeking, and often report on statistical significance, rather than effect size. The aim of this review was to address the gaps highlighted above, to investigate the impact of universal, school-based interventions on help-seeking in children and young people, as well as to explore longer term impact. Four databases were searched. Data were extracted on country of origin, design, participant, school, and intervention characteristics, the help-seeking concept measured (e.g. knowledge, attitude/intention, behaviour), the duration between baseline and each follow-up (if applicable) and effect sizes at each follow-up. Quality assessment of the studies was undertaken using the Effective Public Health Practice Project (EPHPP) quality assessment tool. Overall, 14 different interventions met inclusion criteria. The majority of the studies were rated low in the quality assessment. Three constructs were most frequently reported a) intrapersonal attitudes towards help-seeking, b) interpersonal attitudes towards help-seeking and c) intrapersonal intended help-seeking. Findings around intervention effect were mixed. There was tentative evidence that interventions impacting interpersonal attitudes produced small effect sizes when measured between 3 and 6 months post intervention and that when effect sizes were initially observed intrapersonal attitudes, this remained at 3–6 month follow-up. Further work should pay attention to implementation factors, understanding the core ingredients needed to deliver effective interventions and whether embedding mental health education could help sustain or top up effect sizes from help-seeking interventions.</p

Caffeine gum improves 5 km running performance in recreational runners completing parkrun events.

Purpose The purpose of this study was to determine whether caffeine gum improves the performance of recreational runners completing parkruns (weekly, 5 km, mass participant running events). Methods Thirty-six recreational runners (M = 31, F = 5; age 33.7 ± 10.7 y; BMI 23.1 ± 2.4 kg/m2) capable of running 5 km in < 25 min were recruited to a study at the Sheffield Hallam parkrun, UK. Runners were block randomized into one of three double-blind, placebo-controlled, cross-over intervention trials with caffeine gum as the treatment (n = 6 per intervention trial) or into one of three non-intervention trials that ran concurrently with the intervention trials (n = 6 per non-intervention trial). Changes in conditions across different parkruns were adjusted for using data from the non-intervention trials. Runners in the randomized cross-over intervention trials chewed gum supplying 300 mg of caffeine or a placebo gum for 5 min, starting 30 min before each parkrun. Results Caffeine gum improved 5 km parkrun performance by a mean of 17.28 s (95% CI 4.19, 30.37; P = 0.01). Adjustment for environmental conditions using data from the non-intervention trials attenuated the statistical significance (P = 0.04). Caffeine gum also decreased RPE by 1.21 (95% CI 0.30, 2.13; P = 0·01) units relative to placebo. Conclusions A 300 mg dose of caffeine supplied in chewing gum improved the performance of recreational runners completing 5 km parkruns by an average of 17 s. Trial Registration The study was registered at ClinicalTrials.gov: NCT02473575 before recruitment commenced

A 3D Heterotypic Breast Cancer Model Demonstrates a Role for Mesenchymal Stem Cells in Driving a Proliferative and Invasive Phenotype

Previous indirect 2D co-culture studies have demonstrated that mesenchymal stem cells (MSCs) promote breast cancer (BC) progression through secretion of paracrine factors including growth factors, cytokines and chemokines. In order to investigate this aspect of the tumour microenvironment in a more relevant 3D co-culture model, spheroids incorporating breast cancer cells (BCCs), both cell lines and primary BCCs expanded as patient-derived xenografts, and MSCs were established. MSCs in co-cultures were shown to enhance proliferation of estrogen receptor (ER)/progesterone receptor (PR)-positive BCCs. In addition, co-culture resulted in downregulation of E-cadherin in parallel with upregulation of the epithelial-mesenchymal transition (EMT)-relation transcription factor, SNAIL. Cytoplasmic relocalization of ski-related novel protein N (SnON), a negative regulator of transforming growth factor-beta (TGF-&beta;) signalling, and of &beta;-catenin, involved in a number of pathways including Wnt signalling, was also observed in BCCs in co-cultures in contrast to monocultures. In addition, the &beta;-catenin inhibitor, 3-[[(4-methylphenyl)sulfonyl]amino]-benzoic acid methyl ester (MSAB), mediated reduced growth and invasion in the co-cultures. This study highlights the potential role for SnON as a biomarker for BC invasiveness, and the importance of interactions between TGF-&beta; and Wnt signalling, involving SnON. Such pathways may contribute towards identifying possible targets for therapeutic intervention in BC patients

The importance of sleep: attentional problems in school-aged children with Down syndrome and Williams syndrome

Authors: Anna Ashworth ; Catherine M. Hill ; Annette Karmiloff-Smith ; Dagmara Dimitriou Article URL: http://www.tandfonline.com/doi/full/10.1080/15402002.2014.940107?ai=2gs&mi=3h6sxt&af=R Citation: Behavioral Sleep Medicine Publication Date: Fri, 15 Aug 2014 14:22:59 GM

Nutritional Rehabilitation of HIV-Exposed Infants in Malawi: Results from the Drug Resources Enhancement Against AIDS and Malnutrition Program

Infant malnutrition in sub-Saharan Africa is a public health priority and a challenge in high HIV prevalence areas. The Drug Resources Enhancement Against AIDS and Malnutrition program, with multiple medical centers in Sub-Saharan Africa, developed an innovative intervention for the surveillance and control of malnutrition. In a pilot initiative, 36 HIV-exposed children were evaluated at baseline upon presentation for malnutrition and at six months post- treatment. Parameters included HIV-free survival, nutritional status and change in diet. Food diary data was entered and processed using the Nutrisurvey (WHO) software. At 6 months post-intervention, a significant improvement in anthropometric parameters was noted. Slowing of linear growth was observed in patients with malaria with a mean gain in centimetres of 4.4 ± 1.7 as compared to 5.6 ± 1.7 in children with no malaria, p < 0.048 (CL 95%: −2.32, −0.01). Dietary diversity scores increased from 5.3 ± 1.9 to 6.5 ± 1.3, p < 0.01 at 6 months. A significant increase (+25%, p < 0.02) in the number of children eating fish meals was noted. Our pilot data describes positive outcomes from a rehabilitative nutritional approach based on use of local foods, peer education, anthropometric and clinical monitoring in areas of high food insecurity. The relationship between malaria and linear growth retardation requires further investigation