National Evaluation of the Capacity Building Programme in English Local Government: Evaluation of the National Programmes: Annex 2: Evaluation of the National Programmes

The report is one of a series of outputs from the national evaluation of the CBP, being undertaken by a team of researchers at the Policy Research Institute (PRI) at Leeds Metropolitan University and the Cities Research Unit at the University of West of England. The Capacity Building Programme for local government was launched in 2003 as a joint Department for Communities and Local Government (DCLG) / Local Government Association (LGA) initiative to support capacity building and improvement activities within local authorities in England. The evaluation of the Capacity Building Programme has been underway since late 2004. A scoping phase was conducted until May 2005, including a short evaluation of the Pilot Programmes. The main phase of the evaluation commenced in September 2005 and encompassed four main phases (see Section 1.3: p10)

Ritualised eating in young people with Obsessive Compulsive Disorder:clinical characteristics and treatment outcomes

Ritualised eating can present as a symptom of Obsessive Compulsive Disorder (OCD) and in some extreme cases can lead to restricted eating causing low-weight. Little is known about the prevalence and clinical significance of ritualised eating in paediatric OCD populations. Participants were 397 patients referred to a specialist OCD clinic. The prevalence, demographic and clinical characteristics as well as treatment outcomes were compared for young people who endorsed ritualised eating on a structured measure (N=101) and those who did not (N=296). Ritualised eating was common with 25% exhibiting this symptom. There were no significant differences in demographic or treatment outcomes between those who did and did not have ritualised eating symptom. However, ritualised eaters had more severe OCD and greater functional impairment. Cognitive Behavioural Therapy (CBT) outcomes for an underweight sub-group (N=10) were compared to a matched healthy weight group (N=10). CBT outcomes were significantly worse in the underweight group. Treatment implications for this group are discussed.</p

Paediatric Obsessive-Compulsive Disorder and Depressive Symptoms: Clinical Correlates and CBT Treatment Outcomes

Depression frequently co-occurs with paediatric obsessive-compulsive disorder (OCD), yet the clinical correlates and impact of depression on CBT outcomes remain unclear. The prevalence and clinical correlates of depression were examined in a paediatric specialist OCD-clinic sample (N = 295; Mean = 15 [7 – 18] years, 42 % female), using both dimensional (Beck Depression Inventory-youth; n = 261) and diagnostic (Development and Wellbeing Assessment; n = 127) measures of depression. The impact of depressive symptoms and suspected disorders on post-treatment OCD severity was examined in a sub-sample who received CBT, with or without SSRI medication (N = 100). Fifty-one per-cent of patients reported moderately or extremely elevated depressive symptoms and 26 % (95 % CI: 18 – 34) met criteria for a suspected depressive disorder. Depressive symptoms and depressive disorders were associated with worse OCD symptom severity and global functioning prior to CBT. Individuals with depression were more likely to be female, have had a psychiatric inpatient admission and less likely to be attending school (ps &lt; 0.01). OCD and depressive symptom severity significantly decreased after CBT. Depressive symptoms and depressive disorders predicted worse post-treatment OCD severity (βs = 0.19 and 0.26, ps &lt; 0.05) but became non-significant when controlling for pre-treatment OCD severity (βs = 0.05 and 0.13, ns). Depression is common in paediatric OCD and is associated with more severe OCD and poorer functioning. However, depression severity decreases over the course of CBT for OCD and is not independently associated with worse outcomes, supporting the recommendation for treatment as usual in the presence of depressive symptoms.</p

ACURÁCIA DE TESTES FUNCIONAIS NA IDENTIFICAÇÃO DA PRÉ-ATIVAÇÃO DE MÚSCULOS LOMBOPÉLVICOS

RESUMO Introdução: Ajustes antecipatórios (pré-ativação) dos músculos profundos do tronco aumentam a estabilidade lombopélvica. Estudos prévios demonstram que indivíduos assintomáticos podem apresentar atrasos no início de ativação muscular e alterações físico-funcionais. No entanto, não foram encontrados estudos que tenham verificado se testes físico-funcionais (TFF) são capazes de identificar alteração no início de ativação dos músculos estabilizadores lombopélvicos. Objetivo : Verificar os níveis de sensibilidade, especificidade e acurácia de um conjunto de testes de avaliação da capacidade física funcional para detectar alterações na pré-ativação dos músculos transverso do abdome/oblíquo interno (TrA/OI) e multífido lombar (ML) durante o teste de movimento rápido de flexão do ombro (TMRFO). Método : Participaram do estudo 27 voluntários assintomáticos para dor lombar, com média de idade de 23,8 anos (desvio padrão: 2,2), e que foram submetidos aos TFF e TMRFO para determinação do início da ativação dos músculos profundos do tronco por meio da eletromiografia de superfície. Foi verificada sensibilidade e especificidade e análise da acurácia através da curva ROC (Receiver Operating Characteristic) e teste de qui-quadrado para comparações entre porcentagens (p < 0,05) . Resultados : A "pré-ativação" foi a condição que ocorreu com maior frequência no grupo como um todo, bem como em ambos os gêneros, com exceção do TrA/OI no gênero feminino (&#967;2 = 0,28/P = 0,58). Entre todos os TFF aplicados, o de enrolamento repetitivo do tronco apresentou maior valor de sensibilidade, especificidade e área sob a curva ROC (0,75; 0,73; 0,74, respectivamente) . Conclusão : Entre os TFF avaliados, o de enrolamento repetitivo do tronco mostrou níveis aceitáveis de acurácia para identificar alterações na ativação da musculatura estabilizadora lombopélvica em voluntários assintomáticos para dor lombar. Assim, o teste de enrolamento repetitivo do tronco pode ser utilizado na clínica para predizer alterações na ativação dos músculos profundos do tronco