Outside the Box: Using a Sibling Training Protocol to Increase Imaginative Play Among Autistic Children

Autistic children seldom develop imaginary play skills. Previous studies have demonstrated the efficacy of therapist and parent training interventions to increase imaginative play among autistic children. However, few studies have utilized a sibling training model, especially when tackling the complexities of pretend play. The purpose of this study is to examine a sibling training program as a supported intervention for increasing imaginative play among autistic children. The results indicated that the sibling training program was effective in increasing the imaginative play of autistic children. This study demonstrates the importance of incorporating typically developing siblings as change agents in behavioral interventions for autistic children

Is Diabetes Treated as an Acute or Chronic Illness in Community Family Practice?

OBJECTIVE — Poor quality of diabetes care has been ascribed to the acute care focus of primary care practice. A better understanding of how time is spent during outpatient visits for diabetes compared with visits for acute conditions and other chronic diseases may facilitate the design of programs to enhance diabetes care. RESEARCH DESIGN AND METHODS — Research nurses directly observed consecu-tive outpatient visits during two separate days in 138 community family physician offices. Time use was categorized into 20 different behaviors using the Davis Observation Code (DOC). Time use was compared for visits for diabetes, other chronic conditions, and acute illnesses during 1,867 visits by patients $40 years of age. RESULTS — Of 20 DOC behavioral categories, 10 exhibited differences among the three groups. Discriminant analysis identified two distinct factors that distinguished visits for chronic disease from visits for acute illness and visits for diabetes from those for other chronic diseases. Compared with visits for other chronic diseases, visits for diabetes devoted a greater proportion of time to nutrition counseling, health education, and feedback on results and less time to chatting. Compared with visits for acute illness, visits for diabetes were longer and involved

How do general practitioners in Denmark promote physical activity?

OBJECTIVE: The primary objective of this study was to quantify the frequency of advice given on type, frequency, duration, and intensity of exercise during physical activity (PA) promoting sessions by general practitioners. Second, to find GP characteristics associated with high quality of PA counselling. DESIGN: A cross-sectional questionnaire survey. SETTING AND SUBJECTS: General practitioners in two Danish municipalities in central Copenhagen, Denmark. RESULTS: 56.3% (223/396) of GPs returned the questionnaire. 95.5% (127/223) of the respondents reported giving advice on PA at least weekly. PA promotion included advice on type of exercise, duration, frequency, and intensity in 80% (interquartile range 60 to 90), 70% (50–80), 70% (50–90), and 60% (40–80) of the consultations, respectively. Length of consultation (minutes) was positively associated with increased chance of advice on type of exercise (OR 1.08; 95% CI 1.02–1.13), frequency (OR 1.09; 95% CI 1.03–1.16), and intensity (OR 1.06; 95% CI 1.01–1.11). Having attended a course on exercise promotion was associated with increased information on frequency (OR 1.94; 95% CI 1.05–3.60) and duration (OR 1.81; 95% CI 1.02–3.21). CONCLUSION: While GPs report frequently providing PA counselling, this often lacks specific advice on how to perform the exercise. GPs who have received training on PA promotion more often report providing advice on duration and frequency of exercise compared with GPs who have not received training on PA promotion