Facilitated Communication: Novel Scientific Evidence or Novel Communication?

I. Introduction II. Admissibility of Testimony from Witnesses Who Require In-Court Assistance to Communicate ... A. Competence of Special Classes of Witnesses ... 1. Witnesses with Physical and Mental Disabilities ... 2. Competence of Children ... B. Admissibility of Testimony from Witnesses Who Communicate with Third-Party Intervention ... 1. Sign Language ... 2. Idiosyncratic Language ... C. Burdens of Proof ... 1. Proving Competency of a Witness ... 2. Proving Qualifications of an Interpreter ... D. Summary of Cases Involving Third-Party Interpreters III. Admissibility of Testimony from Witnesses Whose In-Court Testimony Is Affected by Out-of-Court Procedures … A. Frye v. United States ... B. Courts Applying a Frye Test to Hypnotically Affected Testimony ... C. Courts Holding Frye Inapplicable to Hypnotically Affected Testimony ... D. Constitutional Issues ... E. Summary of Hypnosis Case Law IV. Legal Controversy Surrounding Facilitated Communication V. Application of Precedent to Facilitated Communication ... A. Cases Applying Frye to Testimony Affected by an Out-of-Court Procedure ... B. Cases Not Applying Frye to Testimony Affected by an Out-of-Court Procedure ... 1. Step One: Determining the Qualifications of the Interpreter ... 2. Step Two: Swearing the Interpreter ... 3. Step Three: Assessing Unfair Bias ... 4. Burdens of Proof ... C. The Role of Expert Testimony VI. Conclusio

Supporting active engagement of adults with intellectual disabilities in lifestyle modification interventions: A realist evidence synthesis of what works, for whom, in what context and why.

Background Lifestyle modification interventions for adults with intellectual disabilities have had, to date, mixed effectiveness. This study aimed to understand how lifestyle modification interventions for adults with intellectual disabilities work, for whom they work and in what circumstances. Methods A realist evidence synthesis was conducted that incorporated input from adults with intellectual disabilities and expert researchers. Following the development of an initial programme theory based on key literature and input from people with lived experience and academics working in this field, five major databases (MEDLINE, EMBASE, CINAHL, PsycINFO and ASSIA) and clinical trial repositories were systematically searched. Data from 79 studies were synthesised to develop context, mechanism and outcome configurations (CMOCs). Results The contexts and mechanisms identified related to the ability of adults with intellectual disabilities to actively take part in the intervention, which in turn contributes to what works, for whom and in what circumstances. The included CMOCs related to support involvement, negotiating the balance between autonomy and behaviour change, fostering social connectedness and fun, accessibility and suitability of intervention strategies and delivery and broader behavioural pathways to lifestyle change. It is also essential to work with people with lived experiences when developing and evaluating interventions. Conclusions Future lifestyle interventions research should be participatory in nature, and accessible data collection methods should also be explored as a way of including people with severe and profound intellectual disabilities in research. More emphasis should be given to the broader benefits of lifestyle change, such as opportunities for social interaction and connectedness

A Randomised Control Trial Investigating the Efficacy of the MapMe Intervention on Parental Ability to Correctly Categorise Overweight in Their Child and the Impact on Child BMI Z-Score Change at 1 Year

Research suggests parental ability to recognise when their child has overweight is limited. It is hypothesised that recognition of child overweight/obesity is fundamental to its prevention, acting as a potential barrier to parental action to improve their child’s health-related behaviours and/or help seeking. The purpose of this study was to investigate the efficacy of an intervention (MapMe) to improve parental ability to correctly categorise their child as having overweight one-month post-intervention, and reduce child body mass index (BMI) z-score 12 months post-intervention. MapMe consists of body image scales of known child BMI and information on the consequences of childhood overweight, associated health-related behaviours and sources of support. We conducted a three-arm (paper-based MapMe, web-based MapMe and control) randomised control trial in fifteen English local authority areas with parents/guardians of 4–5- and 10–11-year-old children. Parental categorisation of child weight status was assessed using the question ‘How would you describe your child’s weight at the moment?’ Response options were: underweight, healthy weight, overweight, and very overweight. Child weight status and BMI z-scores were calculated using objectively measured height and weight data and UK90 clinical thresholds. There was no difference in the percentage of parents correctly categorising their child as having overweight/very overweight (n = 264: 41% control, 48% web-based, and 43% paper-based, p = 0.646). BMI z-scores were significantly reduced for the intervention group at 12 months post-intervention compared to controls (n = 338, mean difference in BMI z-score change −0.11 (95% CI −0.202 to −0.020, p = 0.017). MapMe was associated with a decrease in BMI z-score 12 months post-intervention, although there was no direct evidence of improved parental ability to correctly categorise child overweight status. Further work is needed to replicate these findings in a larger sample of children, investigate mechanisms of action, and determine the use of MapMe as a public health initiative

A collaborative approach to develop an intervention to strengthen health visitors’ role in prevention of excess weight gain in children

Background: The high prevalence of childhood obesity is a concern for public health policy and practitioners, leading to a focus on early prevention. UK health visitors (HVs) are well-positioned to prevent excessive weight gain trends in pre-school children but experience barriers to implementing guideline recommended practices. This research engaged with HVs to design an intervention to strengthen their role in prevention of early childhood obesity. Methods: We describe the processes we used to develop a behaviour change intervention and measures to test its feasibility. We conducted a systematic review to identify factors associated with implementation of practices recommended for prevention of early childhood obesity. We carried out interactive workshops with HVs who deliver health visiting services in County Durham, England. Workshop format was informed by the behaviour change wheel framework for developing theory-based interventions and incorporated systematic review evidence. As intended recipients of the intervention, HVs provided their views of what is important and acceptable in the local context. The findings of the workshops were combined in an iterative process to inform the four steps of the Implementation Intervention development framework that was adapted as a practical guide for the development process. Results: Theoretical analysis of the workshop findings revealed HVs' capabilities, opportunities and motivations related to prevention of excess weight in 0-2 year olds. Intervention strategies deemed most likely to support implementation (enablement, education, training, modelling, persuasion) were combined to design an interactive training intervention. Measures to test acceptability, feasibility, and fidelity of delivery of the proposed intervention were identified. Conclusions: An interactive training intervention has been designed, informed by theory, evidence, and expert knowledge of HVs, in an area of health promotion that is currently evolving. This research addresses an important evidence-practice gap in prevention of childhood obesity. The use of a systematic approach to the development process, identification of intervention contents and their hypothesised mechanisms of action provides an opportunity for this research to contribute to the body of literature on designing of implementation interventions using a collaborative approach. Future research should be directed to evaluate the acceptability and feasibility of the intervention

Systematic review of the use of data from national childhood obesity surveillance programmes in primary care: a conceptual synthesis

This study reviewed the use in primary care of national surveillance data for children to determine the data's potential utility to inform policy and practice decisions on how to prevent and treat childhood obesity. We reviewed the 28 countries identified by the World Obesity Federation as having high-quality comparable body mass index data for children. Literature published from any period up to December 2013 was included. Peer review literature was searched using Web of Science (Core Collection, MEDLINE). Grey literature was searched using the Internet by country name, programme name and national health and government websites. We included studies that (i) use national surveillance obesity data in primary care, or (ii) explore practitioner or parent perspectives about the use of such data. The main uses of national surveillance data in primary care were to identify and recruit obese children and their parents to participate in school and general practice-based research and/or interventions, and to inform families of children's measurements. Findings indicate a need for school staff and practitioners to receive additional training and support to sensitively communicate with families. Translation of these findings into policy and practice could help to improve current uses of national child obesity surveillance data in primary care

Tackling reporting issues and variation in behavioural weight management interventions: Design and piloting of the standardized reporting of adult behavioural weight management interventions to aid evaluation (STAR-LITE) template.

In the United Kingdom, the National Institute for Health and Care Excellence make recommendations to guide the local-level selection and implementation of adult behavioural weight management interventions (BWMIs) which lack specificity. The reporting of BWMIs is generally poorly detailed, resulting in difficulties when comparing effectiveness, quality and appropriateness for participants. This non-standardized reporting makes meta-analysis of intervention data impossible, resulting in vague guidance based on weak evidence, reinforcing the urgent need for consistency and detail within BWMI description. STAR-LITE - a 4-section, 119-item standardized adult BWMI reporting template - was developed and tested using a two-phase process. After initial design, the template was piloted using adult behavioural weight management RCTs and currently implemented UK BWMI mapping information to further refine the template and examine current reporting and variance. Overall, reporting quality of weight management RCTs was poor, and large variance across different components of real-world BWMIs was observed. Non-specific guidance and wide variation in adult BWMIs are likely linked to inadequate RCT reporting quality and the inability to perform reliable comparisons of data. Future use of STAR-LITE would facilitate the consistent, detailed reporting of adult BWMIs, supporting their evaluation and comparison, to ultimately inform effective policy and improve weight management practice

Best Outcomes for Indian Children

The Wisconsin Department of Children and Families and the Midwest Child Welfare Implementation Center are collaborating with Wisconsin\u27s tribes and county child welfare agencies to improve outcomes for Indian children by systemically implementing the Wisconsin Indian Child Welfare Act (WICWA).This groundbreaking coUaboration wiU increase practitioners\u27 understanding ofthe requirements of WICWA and the need for those requirements, enhance communication and coordination between all stakeholders responsible for the welfare of Indian children in Wisconsin; it is designed to effect the systemic integration of the philosophical underpinnings of WICWA. In December 2009, Governor James Doyle signed the Wisconsin Indian Child Welfare Act, signaling the end ofa historic collaborative effort to enact the law and marking the beginning ofa new initiative to effectively implement it. Like the work that led to enactment ofthe statute, the work required to effectuate it requires the involvement of stakeholders with very diverse views and interests. However, this group has a common goal to which aU members are committed: to achieve better outcomes for Indian children in Wisconsin. The Midwest Child Welfare Implementation Center, a member of the Training and Technical Assistance network ofthe Children\u27s Bureau, is privileged to assist the 11 tribes, the state of Wisconsin, and its project partners in a four-year implementation project toward the achievement ofthat goal. This article describes the early years ofthat journey and the plan for its current segment, which is in progress

The impact of, and views on, school food intervention and policy in young people aged 11-18 years in Europe: a mixed methods systematic review

Understanding the social and environmental influencers of eating behaviours has the potential to improve health outcomes for young people. This review aims to explore the effectiveness of school nutrition interventions and the perceptions of young people experiencing a nutrition focused intervention or change in school food policy. A comprehensive systematic search identified studies published between 1 December 2007 to 20 February 2020. Twenty‐seven studies were included: 22 quantitative studies of nutrition related outcomes and five qualitative studies reporting views and perceptions of young people (combined sample of 22,138 participants, mean ages 12–18 years). The primary outcome was nutrition knowledge/dietary behaviours, with secondary outcomes exploring body mass index (BMI) and wellbeing. Due to the heterogeneity of studies, a narrative results description is presented. The findings demonstrate that school nutrition programmes can be effective in reducing sugar, sugar sweetened beverages (SSB) and saturated fat and increasing fruit and vegetable (FV) intake. The lived experiences of young people in a school context provide valuable insights that should be considered in the development of effective school food policy and interventions. This review affirms the significant role that schools can play in supporting good nutrition in all young people and provides opportunities to inform the school food agenda

A qualitative study of the experiences of individuals who did not complete the NHS Low Calorie Diet Programme Pilot

Background: Attrition remains a significant public health challenge as individuals who do not complete programmes are likely to have poorer programme outcomes. On calorie- restricted diets, including the NHS Low Calorie Diet (LCD) Programme pilot, approximately 50% of people are discharged prematurely, and thus do not complete the programme. Reducing attrition therefore has the potential to improve programme efficacy, impact and cost-effectiveness. Methods: Ten semi-structured interviews were conducted with purposively sampled individuals who did not complete the NHS LCD programme. Interviews explored service user experiences of the programme and experiences of being discharged. Interview data were analysed thematically. Results: Four core themes were identified: 1) the pre- programme struggles of service users and their route to LCD; 2) a positive and impactful programme; 3) life gets in the way; and 4) a perceived lack of support from the provider. These findings show that individuals had pre-programme struggles and a series of life events that constrained their good intentions, and whilst they were positive about the programme, they were critical of the support they received from providers to deal with their life circumstances. Conclusions: Policy makers and providers can act proportionately to ensure that programmes, such as the NHS LCD Programme pilot, recognise the circumstances and context of people’s lives, and take a more person-centred approach

A Layman's guide to SUSY GUTs

The determination of the most straightforward evidence for the existence of the Superworld requires a guide for non-experts (especially experimental physicists) for them to make their own judgement on the value of such predictions. For this purpose we review the most basic results of Super-Grand unification in a simple and clear way. We focus the attention on two specific models and their predictions. These two models represent an example of a direct comparison between a traditional unified-theory and a string-inspired approach to the solution of the many open problems of the Standard Model. We emphasize that viable models must satisfy {\em all} available experimental constraints and be as simple as theoretically possible. The two well defined supergravity models, $SU(5)$ and $SU(5)\times U(1)$, can be described in terms of only a few parameters (five and three respectively) instead of the more than twenty needed in the MSSM model, \ie, the Minimal Supersymmetric extension of the Standard Model. A case of special interest is the strict no-scale $SU(5)\times U(1)$ supergravity where all predictions depend on only one parameter (plus the top-quark mass). A general consequence of these analyses is that supersymmetric particles can be at the verge of discovery, lurking around the corner at present and near future facilities. This review should help anyone distinguish between well motivated predictions and predictions based on arbitrary choices of parameters in undefined models.Comment: 25 pages, Latex, 11 figures (not included), CERN-TH.7077/93, CTP-TAMU-65/93. A complete ps file (1.31MB) with embedded figures is available by request from [email protected]