Evaluation of a computer-assisted cognitive remediation program for young people with psychosis: A pilot study

202101 bcrcVersion of RecordSelf-fundedPublishe

Patient attributes warranting consideration in clinical practice guidelines, health workforce planning and policy

<p>Abstract</p> <p>Background</p> <p>In order for clinical practice guidelines (CPGs) to meet their broad objective of enhancing the quality of care and supporting improved patient outcomes, they must address the needs of diverse patient populations. We set out to explore the patient attributes that are likely to demand a unique approach to the management of chronic disease, and which are crucial if evidence or services planning is to reflect clinic populations. These were incorporated into a new conceptual framework; using diabetes mellitus as an exemplar.</p> <p>Methods</p> <p>The patient attributes that informed the framework were identified from CPGs, the diabetes literature, an expert academic panel, and two cross-disciplinary panels; and agreed upon using a modified nominal group technique.</p> <p>Results</p> <p>Full consensus was reached on twenty-four attributes. These factors fell into one of three themes: (1) type/stage of disease, (2) morbid events, and (3) factors impacting on capacity to self-care. These three themes were incorporated in a convenient way in the workforce evidence-based (WEB) model.</p> <p>Conclusions</p> <p>While biomedical factors are frequently recognised in published clinical practice guidelines, little attention is given to attributes influencing a person's capacity to self-care. Paying explicit attention to predictable threats to effective self-care in clinical practice guidelines, by drawing on the WEB model, may assist in refinements that would address observed disparities in health outcomes across socio-economic groups. The WEB model also provides a framework to inform clinical training, and health services and workforce planning and research; including the assessment of healthcare needs, and the allocation of healthcare resources.</p

Motor ability and weight status are determinants of extra-curricular activity participation in children with developmental coordination disorder

Meeting abstractsBACKGROUND AND PURPOSE: According to the ICF model, participation in everyday activities is integral to child development. This study aimed to: (1) compare the motor performance and pattern of extra-curricular activity participation between children with and without Developmental Coordination Disorder (DCD), and (2) identify the role of motor ability and weight status in activity participation diversity amongst children with DCD. METHODS: 81 children with DCD (63 males, 18 females; mean age: 8.07 ± 1.5 years) and 67 typically developing children (48 males, 19 females; mean age: 8.25 ± 1.6 years) joined the study. Participation patterns (diversity, intensity, companionship, location and enjoyment) were evaluated using Children Assessment of Participation and Enjoyment. Motor ability was evaluated using Movement Assessment Battery for Children-2 (Movement ABC-2). Other factors that may influence participation such as body weight were also measured. Analysis of variance was used to compare the outcome variables between the two groups. Multiple regression analysis was performed to identify the significant determinants of activity participation. RESULTS: Children with DCD participated in fewer activities (p<0.001) and less frequently (p<0.001). No significant difference was found in companionship (p=0.529), location (p=0.773) and enjoyment (p=0.754) between the two groups. The DCD group had significantly poorer motor ability as measured by MABC-2 (p<0.001). A greater proportion of children in the DCD group was in the overweight/obese category than their typically developing peers (p=0.001). Multiple regression analysis revealed that motor ability alone explained 7.6% of the variance in participation diversity (F3,77=2.181, p=0.014) while weight category accounted for another 5.7% of the variance in participation diversity (F3,77=1.640, p=0.033) in children with DCD, after accounting for the effects of age and gender. CONCLUSION: Extra-curricular activity participation in children with DCD is less diverse and intense than typically developing children. Motor impairment and weight status can partly explain this deficit. Interventions aim at improving participation for children with DCD should target on motor proficiency and weight control. Copyright © 2011 Published by Elsevier B.V