538 research outputs found

    Development and implementation of a new service delivery model for children with disabilities : implications for DCD

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    There is a general consensus that new service delivery models are needed for children with developmental coordination disorder (DCD). Emerging principles to guide service delivery include the use of graduated levels of intensity and evidence-based services that focus on function and participation. Interdisciplinary, community-based service delivery models based on best practice principles are needed. In this case report, we propose the Apollo model as an example of an innovative service delivery model for children with DCD. We describe the context that led to the creation of a program for children with DCD, describe the service delivery model and services, and share lessons learned through implementation. The Apollo model has 5 components: first contact, service delivery coordination, community-, group- and individual-interventions. This model guided the development of a streamlined set of services offered to children with DCD, including early-intake to share educational information with families, community interventions, inter-disciplinary and occupational therapy groups and individual interventions. Following implementation of the Apollo model, waiting times decreased and numbers of children receiving services increased, without compromising service quality. Lessons learned are shared to facilitate development of other practice models to support children with DCD

    O(^3P) +CO_2 Collisions at Hyperthermal Energies: Dynamics of Nonreactive Scattering, Oxygen Isotope Exchange, and Oxygen-Atom Abstraction

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    The dynamics of O(^3P) + CO_2 collisions at hyperthermal energies were investigated experimentally and theoretically. Crossed-molecular-beams experiments at Ecoll = 98.8 kcal mol^(–1) were performed with isotopically labeled ^(12)C^(18)O_2 to distinguish products of nonreactive scattering from those of reactive scattering. The following product channels were observed: elastic and inelastic scattering (^(16)O(^3P) + ^(12)C^(18)O^2), isotope exchange (^(18)O + ^(16)O^(12)C^(18)O), and oxygen-atom abstraction (^(18)O^(16)O + ^(12)C^(18)O). Stationary points on the two lowest triplet potential energy surfaces of the O(^3P) + CO_2 system were characterized at the CCSD(T)/aug-cc-pVTZ level of theory and by means of W4 theory, which represents an approximation to the relativistic basis set limit, full-configuration-interaction (FCI) energy. The calculations predict a planar CO_3(C_(2v),^3A″) intermediate that lies 16.3 kcal mol^(–1) (W4 FCI excluding zero point energy) above reactants and is approached by a C_(2v) transition state with energy 24.08 kcal mol^(–1). Quasi-classical trajectory (QCT) calculations with collision energies in the range 23–150 kcal mol^(–1) were performed at the B3LYP/6-311G(d) and BMK/6-311G(d) levels. Both reactive channels observed in the experiment were predicted by these calculations. In the isotope exchange reaction, the experimental center-of-mass (c.m.) angular distribution, T(θ_(c.m.)), of the ^(16)O^(12)C^(18)O products peaked along the initial CO_2 direction (backward relative to the direction of the reagent O atoms), with a smaller isotropic component. The product translational energy distribution, P(E_T), had a relatively low average of E_T = 35 kcal mol^(–1), indicating that the ^(16)O^(12)C^(18)O products were formed with substantial internal energy. The QCT calculations give c.m. P(E_T) and T(θ_(c.m.)) distributions and a relative product yield that agree qualitatively with the experimental results, and the trajectories indicate that exchange occurs through a short-lived CO_3^* intermediate. A low yield for the abstraction reaction was seen in both the experiment and the theory. Experimentally, a fast and weak ^(16)O^(18)O product signal from an abstraction reaction was observed, which could only be detected in the forward direction. A small number of QCT trajectories leading to abstraction were observed to occur primarily via a transient CO_3 intermediate, albeit only at high collision energies (149 kcal mol^(–1)). The oxygen isotope exchange mechanism for CO_2 in collisions with ground state O atoms is a newly discovered pathway through which oxygen isotopes may be cycled in the upper atmosphere, where O(^3P) atoms with hyperthermal translational energies can be generated by photodissociation of O_3 and O_2

    Working with physical therapists to develop and evaluate an evidence-based online module for Developmental Coordination Disorder (DCD): bridging the knowledge-to-practice gap

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    Aims: Developmental Coordination Disorder (DCD) is a chronic condition with potential negative health consequences. Clinicians working with children with DCD need access to tailored, synthesized, evidence-based DCD information; however a knowledge-to-practice gap exists. The aim of this study was to develop and evaluate an evidence-based online DCD module tailored to physical therapists’ (PTs) identified needs. Methods: Guided by the Knowledge to Action framework, we interviewed PTs working with children with DCD (n=9) to identify their information needs. Their recommendations, along with synthesized DCD research evidence, informed module development. PTs (n=50) responded to scaled items and open-ended questions to evaluate module usefulness. Results: The module incorporated important PT DCD content areas including: 1) Identification; 2) Planning Interventions and Goals; 3) Evidence-Based Practice; 4) Management; and, 5) Resources. Case scenarios, clinical applications, interactive media, links to resources, and interactive learning opportunities were also embedded. PTs perceived the module to be comprehensive and useful and provided feedback to improve module navigation. Conclusions: Involving end-users throughout the development and evaluation of an online PT DCD module contributed to its relevance, applicability, and utility. The ongoing clinical use of this module may have the potential to improve the quality of PT DCD services

    “Everything…Fell Apart Once COVID-19 Hit”—Leveraging the COVID-19 Response to Strengthen Public Health Activities toward Ending the HIV Epidemic: A Qualitative Study

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    COVID-19 caused widespread disruption of activities for Ending the HIV Epidemic (EHE). In this study we assessed public health perspectives on leveraging the COVID-19 response to advance the goals of EHE. We conducted a qualitative study with 33 public health partners in the Midwestern and Southern United States from October 2020 to February 2022. Participants were asked how the strategies developed for COVID-19 could be applied to the HIV epidemic. Interviews were recorded, transcribed, and examined using rapid qualitative analysis. Four themes emerged: (1) Rebuilding teams and adapting culture for success in EHE activities; (2) Recognizing and modernizing the role of disease intervention specialists (DIS); (3) Enhanced community awareness of the public health role in disease response and prevention; and (4) Leveraging COVID-19 data systems and infrastructure for EHE activities. The COVID-19 pandemic called attention to the dearth of public health funding and outdated information technology (IT) infrastructure used for HIV activities. It also led to greater public health knowledge, including increased familiarity with partner services and molecular epidemiology of HIV, and opportunities to develop new data systems for surveillance that can be applied to efforts for EHE

    Stakeholder involvement in systematic reviews: a protocol for a systematic review of methods, outcomes and effects

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    Background There is an expectation for stakeholders (including patients, the public, health professionals, and others) to be involved in research. Researchers are increasingly recognising that it is good practice to involve stakeholders in systematic reviews. There is currently a lack of evidence about (A) how to do this and (B) the effects, or impact, of such involvement. We aim to create a map of the evidence relating to stakeholder involvement in systematic reviews, and use this evidence to address the two points above. Methods We will complete a mixed-method synthesis of the evidence, first completing a scoping review to create a broad map of evidence relating to stakeholder involvement in systematic reviews, and secondly completing two contingent syntheses. We will use a stepwise approach to searching; the initial step will include comprehensive searches of electronic databases, including CENTRAL, AMED, Embase, Medline, Cinahl and other databases, supplemented with pre-defined hand-searching and contacting authors. Two reviewers will undertake each review task (i.e., screening, data extraction) using standard systematic review processes. For the scoping review, we will include any paper, regardless of publication status or study design, which investigates, reports or discusses involvement in a systematic review. Included papers will be summarised within structured tables. Criteria for judging the focus and comprehensiveness of the description of methods of involvement will be applied, informing which papers are included within the two contingent syntheses. Synthesis A will detail the methods that have been used to involve stakeholders in systematic reviews. Papers from the scoping review that are judged to provide an adequate description of methods or approaches will be included. Details of the methods of involvement will be extracted from included papers using pre-defined headings, presented in tables and described narratively. Synthesis B will include studies that explore the effect of stakeholder involvement on the quality, relevance or impact of a systematic review, as identified from the scoping review. Study quality will be appraised, data extracted and synthesised within tables. Discussion This review should help researchers select, improve and evaluate methods of involving stakeholders in systematic reviews. Review findings will contribute to Cochrane training resources
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