POSTED postural care in education - evaluation report

This report describes the evaluation of POSTED (Postural Care in Education) Train the Trainer workshops. The workshops, delivered at Canterbury Christ Church University, Centre for Work Based Learning (2016-2017) are part of the dissemination of original research arising from an NIHR Research for Patient Benefit study. Funding to support the evaluation was available through a Higher Education Innovation Fund award from Canterbury Christ Church University (2016-17). POSTED is a ‘Train the Trainer’ intervention. Children’s occupational therapists and physiotherapists attend a one day POSTED training workshop that equips them to deliver an evidence based training intervention to parents and teachers who manage the postural care needs of children at home and school. The training package builds the knowledge, confidence and skills of parents and carers in postural care. The training has been evaluated and found to be effective in increasing knowledge and confidence and reducing the concerns parents and teachers have about postural care for their child (Hotham et al 2017, Hotham et al 2015)

Modelling treatment, age- and gender-specific recovery in acute injury studies

Background: Acute injury studies often measure physical ability repeatedly over time through scores that have a finite range. This can result in a faster score change at the beginning of the study than towards the end, motivating the investigation of the rate of change. Additionally, the bounds of the score and their dependence on covariates are often of interest. Methods: We argue that transforming bounded data is not satisfactory in some settings. Motivated by the Collaborative Ankle Support Trial (CAST), which investigated different methods of immobilisation for severe ankle sprains, we developed a model under the assumption that the recovery rate at a specific time is proportional to the current score and the remaining score. This model enables a direct interpretation of the covariate effects. We have re-analyzed the CAST data using these improved methods, and explored novel relationships between age, gender and recovery rate. Results: We confirm that using below knee cast is advantageous compared with a tubular bandage in relation with the recovery rate. An age and gender effect on the recovery rate and the maximum achievable score is demonstrated, with older female patients recovering less fast (age-effect: -0.21, 95% confidence interval (CI) [-0.28,- 0.14]; gender effect: -0.06, CI [-0.12,-0.004]) and achieving a lower maximum score (age-effect: -8.07, CI [-11.68,-4.01]; gender-effect: -5.34, CI [-8.18, -2.50]) than younger male patients. Conclusions: Our model is able to accurately model repeated measurements on the original scale, while accounting for the bounded nature of a score. We demonstrate that recovery in acute injury trials can differ substantially by age and gender. Older female patients are less likely to recover well from a sprain

'Lessons learned' from introducing universal strategies designed to support the motor and functional skills of Reception and Year 1 children in a sample of primary schools in South East England

This article describes an evaluation of universal resources designed to support motor development in Reception and Year 1 children. Four schools (Year R - Year 6) in the South East of England, three with high numbers of disadvantaged children participated. Senior leadership influenced take up of the initiative. Health and well-being practitioners and occupational therapy students contributed to ‘roll out’ of the resources with support provided by the authors over 12 weeks. Interview and focus group data from participating staff were gathered alongside examples of schoolwork from pupils. School staff needed access to support when incorporating universal strategies. The initiative contributed to schools working towards Healthy Schools targets. At the end of 12 weeks improvements in children’s sitting position, handwriting and lunch time skills were noted, warranting further exploration of this approach to address the needs of children with poor motor skills at school entry

Parent/carer views on personal health budgets for disabled children who use rehabilitation therapy services

Personalised budgets are promoted as the person centred alternative to generically provided services. Nine parent/carers of children with physical disabilities ( aged 18 years or younger) who accessed at least two rehabilitation services ( physiotherapy, occupational therapy, and speech and language therapy ) were recruited from one region in England. Focus group/interviews explored their views on the proposed introduction of personalised budgets. Parents/ carers viewed a personal health budget with caution and perceived benefits were tempered by experiences of current provision. Concerns were raised about entitlement and how a personal budget would work in practice

Exploring the participation of children with Down Syndrome in Handwriting Without Tears®

Background Children with Down Syndrome typically experience difficulties with attention to task and lack motivation when learning to write. This article provides an evaluation of the HWT® method applied as an intervention to promote handwriting amongst children with Down Syndrome attending mainstream school in The Republic of Ireland. Methods In the absence of standardised measures, a purpose-designed group task participation scale and pre- and post-intervention teacher/parent questionnaire were developed by the first author and used to investigate the participation of 40 children with Down Syndrome in HWT® activities. Results Positive changes in participation in HWT® activities were recorded in group data and in teacher/parent report. Conclusions Hands-on multisensory learning approaches such as HWT® may encourage children with Down Syndrome to participate in activities that promote handwriting skills. Further research and the development of robust measures to evaluate handwriting intervention for this population of children is require

Greater choice and control ? parent carer views on personal health budgets for disabled children who use rehabilitation therapy services.

Aim Personalised budgets have been suggested as the person-centered alternative to generically provided services, where families can exercise greater ‘choice and control’ and decide which services to buy for their disabled child and how to arrange care, taking individual circumstances, preferences and needs into account (NHS England, Patient Participation Team 2014). This poster examines the responses of parents interviewed about the prospect of using a personalised health budget for their children in relation to rehabilitation therapy at a time of significant cut backs in child health services (British Academy of Childhood Disability & British Association for Community Child Health 2014). Method We recruited nine parents and primary carers of children with physical disabilities (aged 18 years or younger) from one region in England who accessed at least two rehabilitation therapy services (physiotherapy, occupational therapy, and speech and language therapy). A focus group / interview guide was developed to explore themes that included parent/carer views on the proposed introduction of personalised budgets and how this might affect care. All focus groups and one-to-one interviews were recorded and transcribed verbatim. The focus group and face-to-face interviews lasted for around 1 hour, telephone interviews were typically shorter (30-45 minutes). Interview data was entered into NVIVO and analysed using ‘framework analysis’ (Pope and Mays 2006). Results Parents/carers viewed the prospect of greater ‘choice and control’ with caution and perceived benefits were tempered by both positive and negative experiences of current provision, alongside concerns about how a personal budget would work in practice. Questions about entitlement and what can and cannot be purchased using a personal budget remain grey areas. Exemptions and limits on what can be included may mean that personal health budgets do not deliver on their promise of greater ‘choice and control for parents/carers. Implications for rehabilitation therapy services are explored

Writing readiness and children with Down Syndrome in an Irish context

There is a dearth of studies investigating writing readiness in children with Down Syndrome (DS) and limited information on appropriate interventions. This article reports on a study conducted in the Republic of Ireland. An uncontrolled pretest-posttest design was implemented using writing readiness measures specifically adapted/developed from the literature to collect data on the writing readiness skills of 28 school-aged children with DS attending mainstream schools in the Republic of Ireland. Teacher/parent perspectives were also gathered during focus groups. The children presented with complex needs in relation to posture, pencil grasp, copying basic shapes, name/letter copying. Teacher and parent reports highlighted the need for collaborative intervention with occupational therapy. Findings from the study supports the need for targeted early collaborative syndrome-specific intervention to support the development of writing readiness in children with DS as an important part of school readiness. Intervention should include adopting a broader emergent literacy approach, teacher education regarding writing readiness and parental involvement in intervention

Identifying studies for systematic reviews - An example from medical imaging

Objectives: To determine if published figures on the proportion of articles included in systematic reviews and identified in electronic databases are applicable to an example from medical imaging. Methods: A systematic review was performed. Additionally, sensitivity and precision of a MEDLINE search were compared with values from three published searches, each customized for a specific field. Results: All articles included in the systematic review were in electronic databases. The MEDLINE search had low precision compared with searches in other fields. Conclusions: in a specific area of medical imaging, electronic databases, including MEDLINE, are reliable sources of articles

The Making of the Early Modern British Fairy Tradition

ABSTRACTThis review is intended to examine the development of representations of elves and fairies in British culture between the twelfth and the seventeenth centuries. It will argue that a very clear two-stage evolution in those representations can be found in literary sources, from an inchoate range found in different kinds of text, with no apparent collective identity, to a coherent sense of a kingdom, to which the common word ‘fairy’ could be applied, to an intense interest in, and discussion of, the nature of fairies. The first development occurred in the late middle ages, and the second after the Reformation, and both were pan-British phenomena. These literary changes were, moreover, paralleled at each stage, and perhaps responsible for, changes in perception in culture at large. The alterations in representations of these non-human beings, with no clear status in Christian theology, may have wider implications for an understanding of late medieval and early modern cultural history.</jats:p