1
|
Kim S, Rochette A, Ahmed S, Archambault PS, Auger C, Battaglini A, Freeman AR, Kehayia E, Kinsella EA, Larney E, Letts L, Nugus P, Raymond MH, Salbach NM, Sinnige D, Snider L, Swaine B, Tousignant-Laflamme Y, Thomas A. Creating synergies among education/research, practice, and policy environments to build capacity for the scholar role in occupational therapy and physiotherapy in the Canadian context. Adv Health Sci Educ Theory Pract 2023:10.1007/s10459-023-10298-9. [PMID: 38015277 DOI: 10.1007/s10459-023-10298-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 10/22/2023] [Indexed: 11/29/2023]
Abstract
Scholarly practice (SP) is considered a key competency of occupational therapy and physiotherapy. To date, the three sectors-education/research, practice, and policy/regulation-that support SP have been working relatively independently. The goals of this project were to (a) understand how representatives of the three sectors conceptualize SP; (b) define each sector's individual and collective roles in supporting SP; (c) identify factors influencing the enactment of SP and the specific needs of how best to support SP; and (d) co-develop goals and strategies to support SP across all sectors. We used interpretive description methodology. Consistent with an integrated knowledge translation approach, partners representing the three sectors across Canada recruited individuals from each sector, developed the content and questions for three focus groups, and collected and analyzed the data. Inspired by the Consolidated Framework for Implementation Research, we developed the questions for the second focus group. We analyzed the data using an inductive thematic analysis method. Thirty-nine participants from the three sectors participated. Themes related to participants' conceptualization of SP included (a) ongoing process, (b) reflective process, (c) broad concept, and (d) collective effort. Themes describing factors influencing and supporting SP were (a) recognition, (b) appropriate conceptualization, (c) social network, (d) accessibility to resources, and (e) forces outside of practitioners' effort. Goals to support SP included (a) further recognizing SP, (b) sustaining SP competency, and (c) ensuring access to information. SP requires collaborative and integrated intersectoral support and further recognition of its importance through the collaboration of multiple stakeholders.
Collapse
Affiliation(s)
- Sungha Kim
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
| | - Annie Rochette
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
| | - Sara Ahmed
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
- Clinical Epidemiology, Center for Outcome Research and Evaluation (CORE), McGill University Health Center Research Institute, Montréal, QC, Canada
| | - Philippe S Archambault
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
| | - Claudine Auger
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
- Institut universitaire sur la réadaptation en déficience physique de Montréal, Montréal, QC, Canada
| | - Alex Battaglini
- Directorate of University Teaching and Research, CISSS de Laval, Laval, QC, Canada
- l'École de Santé Publique de l'Université de Montréal, Montréal, QC, Canada
| | - Andrew R Freeman
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Québec, QC, Canada
- VITAM: Centre de Recherche en Santé Durable, Québec, QC, Canada
| | - Eva Kehayia
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
| | - Elizabeth Anne Kinsella
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
| | - Elinor Larney
- Association of Canadian Occupational Therapy Regulatory Organizations and College of Occupational Therapists of Ontario, Toronto, ON, Canada
| | - Lori Letts
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Peter Nugus
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
| | - Marie-Hélène Raymond
- Institut National d'Excellence en Santé et en Services Sociaux, Montréal, QC, Canada
| | - Nancy M Salbach
- Department of Physical Therapy, Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- The KITE Research Institute, University Health Network, Toronto, ON, Canada
| | - Diana Sinnige
- Canadian Alliance of Physiotherapy Regulators, Toronto, ON, Canada
| | - Laurie Snider
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
| | - Bonnie Swaine
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
- Institut universitaire sur la réadaptation en déficience physique de Montréal, Montréal, QC, Canada
| | - Yannick Tousignant-Laflamme
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Aliki Thomas
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada.
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada.
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada.
| |
Collapse
|
2
|
Elekanachi RU, Shikako K, Snider L, Dahan-Oliel N. A Portrait of the Rights of Children with Disabilities in Nigeria: A Policy Review. Int J Environ Res Public Health 2023; 20:6996. [PMID: 37947554 PMCID: PMC10650762 DOI: 10.3390/ijerph20216996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/30/2023] [Accepted: 10/03/2023] [Indexed: 11/12/2023]
Abstract
Worldwide, 200 million children experience disability, with the vast majority living in low- and middle-income countries. The United Nations Convention on the Rights of the Child (CRC) places great importance on the rights of all children for the opportunities for survival, growth, health, and development. A subsequent document, the UN Convention on the Rights of Persons with Disabilities (CRPD), identifies children with disabilities as rights bearers who should be considered in all policies and programming worldwide. Nigeria, in 1991 and 2010, ratified the CRC and the CRPD, respectively. Nonetheless, knowledge of the extent to which their disability and child-directed policies considers these two key conventions, in ensuring that children and children with disabilities have access to care within their right remains limited. This study examined the extent to which Nigeria's current disability and childhood policies have integrated the two child and disability related conventions from the UN. Using a structured search of databases and Nigerian federal and state government websites, we conducted a policy review to identify their disability and child-related disability policies. We also included the CRC and CRPD reports submitted by the Nigerian government to the United Nations Office of the High Commissioner for Human Rights (OHCHR) (2008 and 2010 cyclical year). A thematic analysis, based on the CRC and CRPD report, identified the following six themes: participation, support systems, awareness raising, factors associated with adherence to the CRC, laws and rights, and services. The review showed that the available Nigerian disability policies were federal, with some state policies which aligned with the CRC and CRPD. Also identified was the lack of disability policies specific to children and their families. We concluded that, to ensure proper inclusion of the rights of all children, including those with disabilities, in Nigeria there is a need for a more optimal uptake of recommendations of the CRC and CRPD as laid out by the UN.
Collapse
Affiliation(s)
- Rose Uzoma Elekanachi
- Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, McGill University, Montreal, QC H3A 0G4, Canada; (K.S.); (L.S.); (N.D.-O.)
| | - Keiko Shikako
- Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, McGill University, Montreal, QC H3A 0G4, Canada; (K.S.); (L.S.); (N.D.-O.)
- Centre for Interdisciplinary Research in Rehabilitation (CRIR)|MAB-Mackay, Montreal, QC H3S 1M9, Canada
| | - Laurie Snider
- Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, McGill University, Montreal, QC H3A 0G4, Canada; (K.S.); (L.S.); (N.D.-O.)
| | - Noemi Dahan-Oliel
- Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, McGill University, Montreal, QC H3A 0G4, Canada; (K.S.); (L.S.); (N.D.-O.)
- Shriners Hospitals for Children, Montreal, QC H4A 0A9, Canada
| |
Collapse
|
3
|
Elfassy C, Wagner L, Higgins J, Montpetit K, Snider L, Dahan-Oliel N. Stakeholder engagement in the development of an upper extremity outcome measure for children with rare musculoskeletal conditions. Res Involv Engagem 2023; 9:64. [PMID: 37553603 PMCID: PMC10408044 DOI: 10.1186/s40900-023-00479-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 07/28/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND Upper extremity (UE) involvement is prevalent in 73% of individuals with arthrogryposis multiplex congenita (AMC), yet no AMC-specific outcome measure exists. When developing a measure specific to a population with a rare musculoskeletal condition, clinicians' and patients' perspectives and involvement is a crucial and necessary step. This study sought to determine the most clinically useful items for an outcome measure of UE function for children with AMC as defined by caregivers and clinicians. METHODS To ensure the perspectives and needs of caregivers of children with AMC and clinicians were considered in the development of the UE measure for AMC, a Nominal Group technique (NGT) with caregivers of children with AMC (phase 1) followed by a three-round survey with clinicians (phase 2) were carried out. RESULTS Phase 1: Eleven individuals participated in the nominal group technique and identified 32 items. The most important items were Picking up an object (n = 11), Eating (n = 10), Reaching mouth (n = 10), Getting out of bed (n = 10). Phase 2: Invitations to participate to an online survey was sent to 47 experts in the field of AMC, 20 participants completed round 1, 15 completed round 2 and 13 completed round 3. Throughout the survey, participants were asked about movement required to screen the UE, essential domains to be included in the measure, establishing a scoring guide and identifying tasks associated with joint motion and position. CONCLUSION A preliminary version of an UE AMC-specific outcome measure was developed with the help of caregivers' perspectives and expert opinions.
Collapse
Affiliation(s)
- Caroline Elfassy
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, Canada.
- Clinical Research Department, Shriners Hospital for Children -Canada, 1003 Decarie Boulevard, Montreal, QC, H4A 0A9, Canada.
| | - Lisa Wagner
- Shriners Hospitals for Children, Greenville, USA
| | - Johanne Higgins
- Université de Montréal, École de Réadaptation, Montreal, Canada
| | - Kathleen Montpetit
- Clinical Research Department, Shriners Hospital for Children -Canada, 1003 Decarie Boulevard, Montreal, QC, H4A 0A9, Canada
| | - Laurie Snider
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Noémi Dahan-Oliel
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Clinical Research Department, Shriners Hospital for Children -Canada, 1003 Decarie Boulevard, Montreal, QC, H4A 0A9, Canada
| |
Collapse
|
4
|
Boychuck Z, Andersen J, Bussières A, Fehlings D, Kirton A, Li P, Oskoui M, Rodriguez C, Shevell M, Snider L, Majnemer A. International expert recommendations of clinical features to prompt referral for diagnostic assessment of cerebral palsy. Dev Med Child Neurol 2020; 62:89-96. [PMID: 31025318 DOI: 10.1111/dmcn.14252] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/13/2019] [Indexed: 02/04/2023]
Abstract
AIM To establish international expert recommendations on clinical features to prompt referral for diagnostic assessment of cerebral palsy (CP). METHOD An online Delphi survey was conducted with international experts in early identification and intervention for children with CP, to validate the results obtained in two previous consensus groups with Canadian content experts and knowledge users. We sent two rounds of questionnaires by e-mail. Participants rated their agreement using a 4-point Likert scale, along with optional open-ended questions for additional feedback. Additionally, a panel of experts and knowledge-users reviewed the results of each round and determined the content of subsequent surveys. RESULTS Overall, there was high-level of agreement on: (1) six clinical features that should prompt referral for diagnosis; (2) two 'warning sign' features that warrant monitoring rather than immediate referral for diagnosis; and (3) five referral recommendations to other healthcare professionals to occur simultaneously with referral for diagnosis. INTERPRETATION There was high agreement among international experts, suggesting that the features and referral recommendations proposed for primary care physicians for early detection of CP were broadly generalizable. These results will inform the content of educational tools to improve the early detection of CP in the primary care context. WHAT THIS PAPER ADDS International experts provide strong agreement on clinical features to detect cerebral palsy. Consensus on clinical 'warning signs' to monitor over time. Referral recommendations from primary care to specialized health services are identified.
Collapse
Affiliation(s)
- Zachary Boychuck
- School of Physical and Occupational Therapy, McGill University, Montréal, QC, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada.,Research Institute of the McGill University Health Centre, Montréal, QC, Canada
| | - John Andersen
- Glenrose Rehabilitation Hospital, Edmonton, AB, Canada.,Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - André Bussières
- School of Physical and Occupational Therapy, McGill University, Montréal, QC, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
| | - Darcy Fehlings
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Adam Kirton
- Alberta Children's Hospital, Calgary, AB, Canada
| | - Patricia Li
- Montreal Children's Hospital, Montréal, QC, Canada.,Department of Family Medicine, McGill University, Montréal, QC, Canada
| | | | - Charo Rodriguez
- Department of Family Medicine, McGill University, Montréal, QC, Canada
| | | | - Laurie Snider
- School of Physical and Occupational Therapy, McGill University, Montréal, QC, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada.,Research Institute of the McGill University Health Centre, Montréal, QC, Canada
| | - Annette Majnemer
- School of Physical and Occupational Therapy, McGill University, Montréal, QC, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada.,Research Institute of the McGill University Health Centre, Montréal, QC, Canada
| | | |
Collapse
|
5
|
Abstract
AIM To explore what is currently known regarding participation among children and youth with arthrogryposis multiplex congenita (AMC) using empirical studies, gray literature, and YouTube videos. The secondary objectives included identifying activity types, outcome measures used, interventions provided, and barriers and facilitators to participation. METHOD Empirical studies and gray literature were searched through electronic databases and videos were searched on YouTube. Articles and videos pertaining to participation and youth with AMC were included by two reviewers. Data regarding activity types, location, outcomes measures, interventions, and barriers and facilitators to participation was extracted. Data was critically appraised using specific evaluation criteria. RESULT Eleven empirical studies, six gray literature articles and 71 videos met the inclusion criteria. The most common activity types reported in the empirical studies and YouTube videos were active-physical, social, and skill-based activities. Outcome measures included evaluations and questionnaires, none of which were designed to address participation. Interventions did not target participation although the environments could affect participation. CONCLUSION The paucity of research indicates a need for future studies of participation in this population. Interventions should target participation and address environmental barriers. Videos provide insight for clinicians, youth, and families to help promote participation in the natural environment.
Collapse
Affiliation(s)
- Caroline Elfassy
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada.,Clinical Research Department, Shriners Hospital for Children, Montreal, Canada
| | - Sarah Cachecho
- Clinical Research Department, Shriners Hospital for Children, Montreal, Canada
| | - Laurie Snider
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Noemi Dahan-Oliel
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada.,Clinical Research Department, Shriners Hospital for Children, Montreal, Canada
| |
Collapse
|
6
|
Boychuck Z, Andersen J, Fehlings D, Kirton A, Oskoui M, Shevell M, Majnemer A, Burko B, Dagenais E, Dagenais L, Darsaklis VB, Leduc D, Li P, Shiller M, Snider L, Thibault J, Ahmed S, Bussières A, Rodriguez R, Shikako Thomas K. Current Referral Practices for Diagnosis and Intervention for Children with Cerebral Palsy: A National Environmental Scan. J Pediatr 2020; 216:173-180.e1. [PMID: 31843111 DOI: 10.1016/j.jpeds.2019.09.035] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 08/20/2019] [Accepted: 09/13/2019] [Indexed: 01/29/2023]
Abstract
OBJECTIVES To describe current physician referral practices with respect to age at referral to medical specialists for initial diagnosis of cerebral palsy (CP) and rehabilitation specialists for intervention and to identify factors associated with delayed referral. STUDY DESIGN National environmental scan of 455 children diagnosed with CP who were born in Canada between 2008 and 2011, selected from 4 sites within the Canadian CP Registry (Edmonton, Calgary, Toronto, and Montreal). Two sources of information were used-children's medical charts and the population-based registry, which provided corresponding data for each child. Primary outcomes extracted from the charts were age at referral for diagnostic assessment, age at diagnosis, age at referral for rehabilitation services, and age at initial rehabilitation intervention. Twelve variables were explored as potential predictors. Descriptive statistics, bivariate analyses, and multiple linear regressions were conducted. RESULTS Median age (in months) at referral for diagnostic assessment was 8 (mean: 12.7 ± 14.3), diagnosis 16 (mean: 18.9 ± 12.8), referral for rehabilitation services 10 (mean: 13.4 ± 13.5), and rehabilitation initiation 12 (mean: 15.9 ± 12.9). Lower maternal education, mild severity of motor dysfunction, type of CP, early discharge after birth, and region of residence explained between 20% and 32% of the variance in age at referral for assessment, diagnosis, referral for rehabilitation, and rehabilitation initiation. CONCLUSIONS Findings suggest wide variability exists in the age at which young children with CP are referred to specialists for diagnosis and intervention. User-friendly tools are therefore needed to enhance early detection and referral strategies by primary care practitioners, to ensure early interventions to optimize developmental outcomes and enhance opportunities for neural repair at a younger age.
Collapse
Affiliation(s)
- Zachary Boychuck
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Quebec, Canada; Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - John Andersen
- Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada; Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Darcy Fehlings
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada; Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Adam Kirton
- Department of Pediatrics and Clinical Neurosciences, University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Maryam Oskoui
- Division of Child Neurology, Department of Pediatrics, Montreal Children's Hospital, Montreal, Quebec, Canada
| | - Michael Shevell
- Division of Child Neurology, Department of Pediatrics, Montreal Children's Hospital, Montreal, Quebec, Canada
| | - Annette Majnemer
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Quebec, Canada; Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Boychuck Z, Andersen J, Bussières A, Fehlings D, Kirton A, Li P, Oskoui M, Rodriguez C, Shevell M, Snider L, Majnemer A. Use of consensus methods to determine the early clinical signs of cerebral palsy. Paediatr Child Health 2019; 25:300-307. [PMID: 32765166 DOI: 10.1093/pch/pxz061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 02/04/2019] [Indexed: 11/14/2022] Open
Abstract
Objectives To develop expert-informed content regarding the early motor attributes of cerebral palsy (CP) that should prompt physician referral for diagnostic assessment of CP, as well as concurrent referral recommendations. This content will be used in the creation of knowledge translation (KT) tools for primary care practitioners and parents. Methods Two nominal group processes were conducted with relevant stakeholders, representing Canadian 'content experts' and 'knowledge-users', using an integrated KT approach. Results Six attributes were identified that should prompt referral for diagnosis. If the child demonstrates: Early handedness <12 months; stiffness or tightness in the legs between 6 and 12 months; persistent fisting of the hands >4 months; persistent head-lag >4 months; inability to sit without support >9 months; any asymmetry in posture or movement. Five referral recommendations were agreed upon: Motor intervention specialist (physical therapy and/or occupational therapy) for ALL; speech-language pathology IF there is a communication delay; audiology IF there is parental or healthcare professional concern regarding a communication delay; functional vision specialist (e.g., optometrist or occupational therapist) IF there is a vision concern (e.g., not fixating, following, or tracking); feeding specialist (e.g., occupational therapist, speech-language pathologist) IF there are feeding difficulties (e.g., poor sucking, poor swallowing, choking, and/or not gaining weight). Conclusion Rigorous consensus methods provided the initial evidence necessary to inform the content of tools to assist primary care providers in the early detection of CP. Results will be validated through a Delphi process with international experts, and user-friendly formats of this KT tool will be developed collaboratively with stakeholders.
Collapse
Affiliation(s)
- Zachary Boychuck
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Quebec.,Research Institute-McGill University Health Centre and Montreal Children's Hospital, Montreal, Quebec
| | | | - André Bussières
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Quebec
| | - Darcy Fehlings
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario
| | - Adam Kirton
- Alberta Children's Hospital, Calgary, Alberta
| | - Patricia Li
- Research Institute-McGill University Health Centre and Montreal Children's Hospital, Montreal, Quebec.,Department of Pediatrics, McGill University, Montreal, Quebec.,Department of Family Medicine, McGill University, Montreal, Quebec
| | - Maryam Oskoui
- Departments of Pediatrics and Neurology & Neurosurgery, McGill University, Montreal, Quebec
| | - Charo Rodriguez
- Department of Family Medicine, McGill University, Montreal, Quebec
| | - Michael Shevell
- Departments of Pediatrics and Neurology & Neurosurgery, McGill University, Montreal, Quebec
| | - Laurie Snider
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Quebec.,Research Institute-McGill University Health Centre and Montreal Children's Hospital, Montreal, Quebec
| | - Annette Majnemer
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Quebec.,Research Institute-McGill University Health Centre and Montreal Children's Hospital, Montreal, Quebec
| | | |
Collapse
|
8
|
Elfassy C, Darsaklis VB, Snider L, Gagnon C, Hamdy R, Dahan-Oliel N. Rehabilitation needs of youth with arthrogryposis multiplex congenita: Perspectives from key stakeholders. Disabil Rehabil 2019; 42:2318-2324. [PMID: 30741031 DOI: 10.1080/09638288.2018.1559364] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Background: Arthrogryposis multiplex congenita is a term used to describe congenital contractures in at least two body parts with an overall prevalence of 1 in 3000 live births. It is often caused by lack of fetal movement in utero and presents as contractures of varying severity, which may affect the upper and lower extremities, the spine and jaw. Currently, no practice recommendations exist to inform best clinical practice for arthrogryposis multiplex congenita.Purpose: To identify the needs surrounding rehabilitation as experienced by youth with arthrogryposis multiplex congenita, caregivers, and clinicians and to propose solutions to develop family- and client-centred rehabilitation recommendations.Materials and methods: A modified experience-based co-design methodology was used where qualitative interviews were conducted with key stakeholders.Results: Twenty-seven participants completed the interviews and demographic information was collected where early-active rehabilitation began at birth in most cases and became less frequent through adolescence. Three overarching themes were determined for each stakeholder group.Conclusions: All participants reported that early-active rehabilitation is beneficial as it helps determine future treatments. Transition times and participation need to be at the center of interventions to ensure that the needs of youth with arthrogryposis multiplex congenita are being met. The development a condition-specific outcome-measure and rehabilitation practice recommendations will assist clinicians in addressing the needs of youth with arthrogryposis multiplex congenita.Implications for rehabilitationArthrogryposis multiplex congenita presents in at least two different areas of the body as multiple congenital contractures of varying severity which may affect the upper and lower extremities, spine and jaw.Youth with arthrogryposis multiplex congenita identified participation as an essential component of their life, however caregivers and clinicians did not emphasize this need.Gathering information from different stakeholders is important to ensure varying needs are addressed.Rehabilitation was reported to be beneficial from early childhood to late adolescence by youth, caregivers, and clinicians.Frequency of rehabilitation diminished over time, emphasizing the need for continued follow-up into adolescence.
Collapse
Affiliation(s)
- Caroline Elfassy
- Clinical Research Department, Shriners Hospital for Children, Canada, Montreal, Canada.,Rehabilitation Department, Shriners Hospital for Children - Canada, Montreal, Canada.,School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Vasiliki Betty Darsaklis
- Clinical Research Department, Shriners Hospital for Children, Canada, Montreal, Canada.,Rehabilitation Department, Shriners Hospital for Children - Canada, Montreal, Canada
| | - Laurie Snider
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Cynthia Gagnon
- Centre de Recherche Charles-Le-Moyne, Sherbrooke University, Longueuil, Canada.,Groupe de Recherche Interdisciplinaire sur les Maladies Neuromusculaires (GRIMN), Jonquière, Canada
| | - Reggie Hamdy
- Clinical Research Department, Shriners Hospital for Children, Canada, Montreal, Canada.,Pediatric Orthopedics Department, McGill University, Montreal, Canada
| | - Noemi Dahan-Oliel
- Clinical Research Department, Shriners Hospital for Children, Canada, Montreal, Canada.,Rehabilitation Department, Shriners Hospital for Children - Canada, Montreal, Canada.,School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| |
Collapse
|
9
|
Borges Nery P, Snider L, Camelo JS, Zachary B, Fatima K, Jessica G, Annette M. The Role of Rehabilitation Specialists in Canadian NICUs: A 21st Century Perspective. Phys Occup Ther Pediatr 2019; 39:33-47. [PMID: 30265831 DOI: 10.1080/01942638.2018.1490846] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
UNLABELLED Rehabilitation specialists are an integral part of the team in the neonatal intensive care unit (NICU). New approaches to rehabilitation practice in the NICU have evolved over the past decade that aim to promote child health and development. AIMS The aim of this study was to describe the current roles of the occupational therapist (OT), physical therapist (PT) and speech-language pathologist (SLP) in Canadian NICUs as compared to the roles documented in an earlier national survey conducted 15 years ago. METHODS A telephone survey was conducted across Canadian NICUs and each telephone interview was recorded by a research assistant. In total, 42 questionnaires were completed across 25 health care institutions. RESULTS Eighty percent of the PT, 93.7% of OT and 50% of SLP provided direct services to neonates in the NICU. The results demonstrated that the therapists were involved with case discussion (85.7%), decision-making (97.6%), referrals to other services (97.6%) and discharge planning (97.6%). Splinting (87.5%) and feeding (100%) were most often carried out by OT, whereas chest physiotherapy (65%) and range of motion (100%) were predominantly provided by PT. Changes in the role of rehabilitation specialists over the last decade predominantly included enhanced collaboration with the NICU team, more frequent use of standardized outcome measures and use of interventions supported by evidence. CONCLUSION In comparison with results of the previous survey of rehabilitation practices in Canadian NICUs, rehabilitation specialists now have more dedicated time in the NICU and more frequently use standardized measures and apply interventions that are supported by recent scientific studies.
Collapse
Affiliation(s)
- Pamela Borges Nery
- a Department of Pediatrics , Ribeirão Preto Medical School University of São Paulo , São Paulo , Brazil.,b Centro Universitário Estácio de Ribeirão Preto , Ribeirão Preto , Brazil
| | - Laurie Snider
- c School of Physical & Occupational Therapy , McGill University , Montreal , QC , Canada.,d Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal , Montreal , QC , Canada.,e Research Institute-McGill University Health Centre and Montreal Children?s Hospital , Montreal , QC , Canada
| | - José Simon Camelo
- a Department of Pediatrics , Ribeirão Preto Medical School University of São Paulo , São Paulo , Brazil
| | - Boychuck Zachary
- c School of Physical & Occupational Therapy , McGill University , Montreal , QC , Canada.,d Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal , Montreal , QC , Canada.,e Research Institute-McGill University Health Centre and Montreal Children?s Hospital , Montreal , QC , Canada
| | - Khodary Fatima
- c School of Physical & Occupational Therapy , McGill University , Montreal , QC , Canada
| | - Goldschleger Jessica
- c School of Physical & Occupational Therapy , McGill University , Montreal , QC , Canada
| | - Majnemer Annette
- c School of Physical & Occupational Therapy , McGill University , Montreal , QC , Canada.,d Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal , Montreal , QC , Canada.,e Research Institute-McGill University Health Centre and Montreal Children?s Hospital , Montreal , QC , Canada
| |
Collapse
|
10
|
Hart R, Blakely C, Hart R, Hazell M, Smith L, Snider L, Bisleri G. A STICKY SITUATION: DOES THROMBOCYTOPENIA INCREASE RISK FOR MAJOR ADVERSE EVENTS IN PATIENTS UNDERGOING STENTLESS TISSUE VALVE IMPLANTATION? Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
|
11
|
Snider L, Blakely C, Branscombe P, Campbell D, Hart R, Hazell M, Ryan L, Abunassar J. HEALING A BROKEN HEART - AN IN-DEPTH LOOK AT TAKOTSUBO CARDIOMYOPATHY. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
12
|
de Greef J, Krom Y, den Hamer B, Snider L, Hiramuki Y, van den Akker R, Salvatori D, Tawil R, Blewitt M, Tapscott S, van der Maarel S. Smchd1 haploinsufficiency exacerbates the phenotype of a transgenic FSHD1 mouse model. Neuromuscul Disord 2017. [DOI: 10.1016/j.nmd.2017.06.390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
13
|
Anaby D, Korner-Bitensky N, Steven E, Tremblay S, Snider L, Avery L, Law M. Current Rehabilitation Practices for Children with Cerebral Palsy: Focus and Gaps. Phys Occup Ther Pediatr 2017; 37:1-15. [PMID: 26865220 DOI: 10.3109/01942638.2015.1126880] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIMS To describe the focus of therapy practices in occupational and physical therapy for school-aged children with cerebral palsy, and better understand whether it is congruent with recommended practices. METHODS A Canada-wide Web-based survey was completed by 62 occupational and 61 physical therapists to identify problems, assessments, and treatment interventions for two case-based scenarios. Data were coded using the International Classification of Functioning, Disability and Health (ICF) definitions for "body functions and structure," "activity and participation," and "environment." RESULTS Physical therapists, in comparison to occupational therapists, were more likely to select interventions classed in the "body functions and structure" category (34-42% and 18-20%, respectively). Both professions focused on "activity and participation" (34-61%) when identifying problems, assessing, and intervening; attention, however, was mainly directed towards task-oriented activities such as activities of daily living and mobility. Participation in leisure or community-based activities received less attention (2-15%). The environment received limited attention for problems and assessments (4-25%), though it was an important focus of intervention (19-37%). CONCLUSIONS While body functions and structure are well-addressed, other ICF elements, specifically participation, are poorly integrated into practice. The emerging focus on the environment in therapy intervention, by modifying the context rather than changing aspects of the child, is consistent with current approaches and evidence. Knowledge translation implementation initiatives are recommended to bridge identified gaps.
Collapse
Affiliation(s)
- Dana Anaby
- a School of Physical and Occupational Therapy , McGill University , Montréal , Québec , Canada
| | - Nicol Korner-Bitensky
- a School of Physical and Occupational Therapy , McGill University , Montréal , Québec , Canada
| | - Emma Steven
- a School of Physical and Occupational Therapy , McGill University , Montréal , Québec , Canada
| | - Stephanie Tremblay
- a School of Physical and Occupational Therapy , McGill University , Montréal , Québec , Canada
| | - Laurie Snider
- a School of Physical and Occupational Therapy , McGill University , Montréal , Québec , Canada
| | - Lisa Avery
- a School of Physical and Occupational Therapy , McGill University , Montréal , Québec , Canada
| | - Mary Law
- a School of Physical and Occupational Therapy , McGill University , Montréal , Québec , Canada
| |
Collapse
|
14
|
Humphries TW, Snider L, McDougall B. Clinical Evaluation of the Effectiveness of Sensory Integrative and Perceptual Motor Therapy in Improving Sensory Integrative Function in Children with Learning Disabilities. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/153944929301300302] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
After 72 1-hour therapy sessions for 3 hours per week, significantly more subjects, aged 58 to 107 months, receiving sensory integration therapy ( n=35) and perceptual motor training ( n=35) than those receiving no treatment ( n=33) showed improvement in their sensory integrative functioning. The same effect was found for a subgroup of children exhibiting vestibular dysfunction only. Improvement could include an increase of all test scores defining a child's particular dysfunction into the normal range with associated clinical observations indicating no problem, or a reduction in the severity of a child's dysfunction, the number of their dysfunctional systems, or both severity and dysfunctional systems. The groups did not differ in the incidence of any one of these individual types of improvement, but only in their overall improvement represented by the total of all types. Discussion focused on the type and degree of improvement therapists can expect from treatment and problems associated with evaluating outcome.
Collapse
|
15
|
Acquistapace F, Maternini F, Snider L, Bellini O, Moglia P, Capretti P. Endoscopic treatment of superficial colorectal neoplasms. Retrospective analysis of a single center technique and results. G Chir 2016; 36:247-50. [PMID: 26888699 DOI: 10.11138/gchir/2015.36.6.247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Endoscopic Submucosal Dissection (ESD) is a technique developed in Japan for "en bloc" resection of larger superficial neoplasms of the gastrointestinal tract as an alternative to the traditional Endoscopic Mucosal Resection (EMR), with removal of the lesion in multiple fragments ("piecemeal"). ESD offers a lower recurrence rate and allows a more accurate histopathological examination. This procedure is however considered technically difficult and therefore requires an adequate learning curve, it is time consuming with more discomfort for the patient, it has a higher complication rate, it is more expensive. To overcome these disadvantages, in the Western countries a hybrid technique called Circumferential Submucosal Incision - Endoscopic Mucosal Resection (CSI-EMR) has been developed and is especially employed for colonic lesions. This article analyzes retrospectively the results obtained in a single centre by a single operator in the treatment of 23 patients (12 men and 11 women, average age 65,6 years), all suffering from superficial, larger than ≥ 20 mm colorectal neoplasms: 9 were treated with ESD for rectal lesions and 14 were treated with CSI-EMR for colonic lesions. Findings show a technical success rate of 66,6% for ESD and 78,5% for CSI-EM, and a 0% recurrence rate during follow-up, 4,3% bleeding and 13% perforation complications. The histology of the removed lesions showed 13 (56,5%) low grade dysplasia adenomas, 8 (34,7%) high grade dysplasia adenomas, one grade 1 sigmoid colon adenocarcinoma infiltrating the submucosal layer without lymphovascular invasion, with free margins (R0), treated conservatively, and one grade 1 cecum adenocarcinoma, infiltrating the submucosal layer, with lymphovascular invasion and involved excision margin, treated surgically with no residual neoplastic disease in the surgical specimen. These data are in line with the most significant ones in literature, except for the higher complication rate, which the authors ascribe to the "learning curve" and the smaller number of treated patients.
Collapse
|
16
|
Abstract
BACKGROUND Teachers' occupational role and performance can be undermined when working with students with disruptive classroom behaviours. PURPOSE This pilot study aimed to explore the impact of school-based occupational therapy intervention on teachers' classroom management self-efficacy and perceived performance/satisfaction in their management of students with disruptive behaviours. METHOD This pilot study used a multiple-case replication study design. A cohort of regular classroom elementary school teachers (n = 11) participated in a 1-day workshop on sensorimotor strategies for supporting student self-regulation followed by eight individual sessions of Occupational Performance Coaching (OPC). Measurement tools were the Canadian Occupational Performance Measure, Goal Attainment Scaling (GAS), and Teachers' Self-Efficacy Scale-Classroom Management. FINDINGS Improvement in teachers' perception of performance, satisfaction, and classroom management was seen. GAS showed clinically significant improvement. Improvements were sustained at 7 weeks follow-up. IMPLICATIONS Preliminary results support the use of sensorimotor education combined with OPC to enable teachers' occupational performance.
Collapse
|
17
|
Dogba MJ, Dahan-Oliel N, Snider L, Glorieux FH, Durigova M, Palomo T, Cordey M, Bédard MH, Bedos C, Rauch F. Involving Families with Osteogenesis Imperfecta in Health Service Research: Joint Development of the OI/ECE Questionnaire. PLoS One 2016; 11:e0147654. [PMID: 26799959 PMCID: PMC4723157 DOI: 10.1371/journal.pone.0147654] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 01/06/2016] [Indexed: 12/02/2022] Open
Abstract
Background Despite the growing interest in understanding the psycho-social impact of rare genetic diseases, few studies examine this concept and even fewer seek to obtain feedback from families who have lived the experience. The aim of this project was to involve families of children living with osteogenesis imperfecta (OI) in the development of a tool to assess the impact of OI on the lives of patients and their families. Methods This project used an integrated knowledge translation approach in which knowledge users (clinicians and people living with OI and their families) were consulted throughout the four steps of development, that is: content mapping, item generation, tool appraisal and pre-testing of the questionnaires. The International Classification of Functioning and Health was used as a framework for content mapping. Based on a scoping review we selected two validated tools to use as a basis for developing the questionnaire. The final parent self-report version measured six domains: experience of diagnosis; use of health services; use of social and psychological support services; expectations about tertiary specialized centers; and socio-demographic information. Results A total of 27 out of 40 families receiving care at the Shriners Hospital for Children-Canada and invited to participate in the pre-test returned the completed questionnaires. In more than two-thirds of families (69%; n = 18) OI was suspected either at or within the first 3 months after birth. Up to 46% of families consulted between 3 and 5 doctors (46%; n = 12) prior to final diagnosis. The use of services by families varied from 0 to 16 consultations, 0 to 9 exploratory examinations and 1 to 10 types of allied health services. In the 12 months prior to the study, fewer than a quarter of children had been admitted, for treatment, for hospital stays of longer than 8 hours or to an emergency department (24% and 9% respectively). Only 29% of parents received psychological support. Conclusion This joint development process generated a tool, with good psychometric properties, that provides unique insight into the experiences of patients and families with OI, the psycho-social impact of the illness, and their service needs and expectations.
Collapse
Affiliation(s)
- Maman Joyce Dogba
- Department of Family and Emergency Medicine, Faculty of Medicine, Université Laval, Québec City, Quebec, Canada
- * E-mail:
| | - Noémi Dahan-Oliel
- Office of Clinical Research, Shriners Hospital for Children, Montreal, Quebec, Canada
| | - Laurie Snider
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | | | - Michaela Durigova
- Genetics Unit, Shriners Hospital for Children, Montreal, Quebec, Canada
| | - Telma Palomo
- Genetics Unit, Shriners Hospital for Children, Montreal, Quebec, Canada
| | - Michel Cordey
- Genetics Unit, Shriners Hospital for Children, Montreal, Quebec, Canada
| | | | - Christophe Bedos
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
- Department of Social and Preventive Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Frank Rauch
- Genetics Unit, Shriners Hospital for Children, Montreal, Quebec, Canada
| |
Collapse
|
18
|
Brossard-Racine M, Shevell M, Snider L, Bélanger SA, Julien M, Majnemer A. Persistent Handwriting Difficulties in Children With ADHD After Treatment With Stimulant Medication. J Atten Disord 2015; 19:620-9. [PMID: 23160486 DOI: 10.1177/1087054712461936] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Children with ADHD often present with handwriting difficulties. However, the extent to which motor and attention skills influence performance in this group has not yet been explored. The objective of this study was to examine the factors associated with change in handwriting performance. METHOD This study examines the factors associated with change in handwriting performance of 49 children newly diagnosed with ADHD (mean age = 8.4 [SD=1.3] years) prior to and 3 months following use of a stimulant medication. RESULTS Handwriting legibility and speed improved significantly at follow-up evaluation. However, most of the children with legibility difficulties at baseline continued to demonstrate difficulties when evaluated 3 months after initiation of medication. Change in handwriting legibility was best determined by improvements in visual-motor integration skills (β = 0.07-0.10; p < .001), while the change in speed did not appear to be consistently related to a single factor. CONCLUSION Handwriting difficulties are common in children with ADHD, and medication alone is not sufficient to resolve these challenges.
Collapse
Affiliation(s)
| | - Michael Shevell
- McGill University, Montreal, Quebec, Canada Montreal Children's Hospital, Montreal, Quebec, Canada
| | - Laurie Snider
- McGill University, Montreal, Quebec, Canada Montreal Children's Hospital, Montreal, Quebec, Canada
| | | | - Marilyse Julien
- Centre Hospitalier Universitaire-Sainte-Justine, Montreal, Quebec, Canada
| | - Annette Majnemer
- McGill University, Montreal, Quebec, Canada Montreal Children's Hospital, Montreal, Quebec, Canada
| |
Collapse
|
19
|
Aita M, Goulet C, Oberlander TF, Snider L, Johnston C. A randomized controlled trial of eye shields and earmuffs to reduce pain response of preterm infants. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.jnn.2014.11.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
20
|
Hébert MLJ, Kehayia E, Prelock P, Wood-Dauphinee S, Snider L. Does occupational therapy play a role for communication in children with autism spectrum disorders? Int J Speech Lang Pathol 2014; 16:594-602. [PMID: 24460071 DOI: 10.3109/17549507.2013.876665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study investigates occupational therapy for early communication in children with autism spectrum disorders (ASD). The research explored the role of occupational therapists in supporting children with ASD to become better communicators by considering their inter-professional collaboration with speech-language pathologists. Convenience samples of 21 clinical occupational therapists and speech-language pathologists were recruited to participate in semi-structured audio-recorded focus groups, using a qualitative design. Distinct views included a child-centred focus from speech-language pathologists, whereas occupational therapists spoke of the child through societal viewpoints, which later pointed to occupational therapists' proficiency in enabling skill generalization in ASD. An equal partnership was consistently reported between these clinicians, who identified the same objectives, shared strategies, joint treatments, and ongoing collaboration as the four main facilitators to inter-professional collaboration when treating children with ASD. Three unique roles of occupational therapy comprised developing non-verbal and verbal communication pre-requisites, adapting the setting, educating-partnering-advocating for the child, and providing occupation-based intervention. These three themes meshed with the discipline-specific occupational therapy domains represented in the Person-Environment-Occupation framework. When working in inter-professional collaboration, speech-language pathologists and occupational therapists agree that occupational therapy is indispensable to early intervention in enabling communication in ASD.
Collapse
|
21
|
Abstract
The health-related quality of life of school-aged children with high-functioning autism is poorly understood. The objectives of this study were to compare the health-related quality of life of children with high-functioning autism to that of typically developing peers and to compare child-self and parent-proxy reports of health-related quality of life of children. A cross-sectional study of children with high-functioning autism ( n = 30) and peers ( n = 31) was conducted using the Pediatric Quality of Life Inventory 4.0 Generic Core Scales. Children with high-functioning autism had significantly poorer health-related quality of life than peers whether reported by themselves ( p < .001) or their parents ( p < .001), although disagreement (intra-class coefficient = −.075) between children and parental scores suggested variance in points of view. This study specifically investigated health-related quality of life in children with high-functioning autism as compared to a sample of peers, from the child’s perspective. It strengthens earlier findings that children with high-functioning autism experience poorer health-related quality of life than those without this disorder and points to the importance of clinicians working with families to identify areas in a child’s life that promote or hinder their sense of well-being.
Collapse
|
22
|
Potvin MC, Snider L, Prelock P, Kehayia E, Wood-Dauphinee S. Children's assessment of participation and enjoyment/preference for activities of children: psychometric properties in a population with high-functioning autism. Am J Occup Ther 2013; 67:209-17. [PMID: 23433276 DOI: 10.5014/ajot.2013.006288] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The psychometric properties of assessments must be established for specific populations. The psychometric properties of the Children's Assessment of Participation and Enjoyment/Preference for Activities of Children have been studied only in a sample of children with physical disability. We conducted a study to determine the appropriateness of drawing inferences from this assessment for children with high-functioning autism (HFA). The content validity and test-retest reliability (r > .7) were both found to be adequate for this population. Parents' agreement with most of their children's self-ratings on this assessment provided an estimate of interrater reliability. We also ascertained the feasibility of gathering recreational participation information from children with HFA and found that adaptations to facilitate the self-completion of the tool should be made available. The study findings support the use of this tool to assess recreational participation among children with HFA.
Collapse
Affiliation(s)
- Marie-Christine Potvin
- Center on Disability and Community Inclusion, University of Vermont, Burlington, VT 05405-1757, USA.
| | | | | | | | | |
Collapse
|
23
|
Abstract
Neonatal intensive care unit (NICU) light and noise may be stressful to preterm infants. This research evaluated the physiological stability of 54 infants born at 28- to 32-weeks' gestational age while wearing eye goggles and earmuffs for a 4-hour period in the NICU. Infants were recruited from four NICUs of university-affiliated hospitals and randomized to the intervention-control or control-intervention sequences. Heart rate (HR), heart rate variability (HRV), and oxygen saturation (O2 sat) were collected using the SomtéTM device. Confounding variables such as position and handling were assessed by videotaping infants during the study periods. Results indicated that infants had more stress responses while wearing eye goggles and earmuffs since maximum HR was found to be significantly higher and high-frequency power of HRV significantly lower during the intervention as compared with the control period. Therefore, this intervention is not recommended for the clinical practice.
Collapse
Affiliation(s)
- Marilyn Aita
- University of Montreal, Montreal, Quebec, Canada.
| | | | | | | | | |
Collapse
|
24
|
Brossard-Racine M, Shevell M, Snider L, Bélanger SA, Majnemer A. Motor skills of children newly diagnosed with Attention Deficit Hyperactivity Disorder prior to and following treatment with stimulant medication. Res Dev Disabil 2012; 33:2080-2087. [PMID: 22796639 DOI: 10.1016/j.ridd.2012.06.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Revised: 06/07/2012] [Accepted: 06/07/2012] [Indexed: 06/01/2023]
Abstract
Motor difficulties are common in children with Attention Deficit Hyperactivity Disorder (ADHD). Although preliminary evidence has suggested that methylphenidate can improve the motor skills in children with ADHD and Developmental Coordination Disorder (DCD), the effect of stimulant medication on motor performance in children newly diagnosed with ADHD with or without motor impairment remains unclear. A cohort study of 49 medication-naïve children (39 male; mean age 8.4±1.3 years) with ADHD was conducted. Children were evaluated using the Movement Assessment Battery for Children and the developmental test of visual motor integration at diagnosis and again three months following daily treatment with a stimulant medication. Motor difficulties were highly present at baseline (73.5%) but resolved in a subset after treatment with stimulant medication, suggesting that their motor difficulties may be attributed in part to their attentional problems. Nevertheless, motor impairment persisted in 55.1% of the sample. The severity of the behavioural symptoms was significantly associated with balance skills in children without motor impairments (r(2)=0.30, p<0.01) and with visual motor integration skills in children with persisting motor difficulties (r(2)=0.27, p<0.01). Attentional difficulties negatively affect the motor skills of children with ADHD. Following the use of stimulant medication, an important subset continued to demonstrate motor difficulties. The improvement in behaviour was insufficient to resolve motor problems and these children should therefore be targeted for rehabilitation services.
Collapse
Affiliation(s)
- Marie Brossard-Racine
- Advanced Pediatric Brain Imaging Research Laboratory, Diagnostic Imaging and Radiology/Fetal and Transitional Medicine, Children's National Medical Center, Washington, DC, USA
| | | | | | | | | |
Collapse
|
25
|
Snider L. Measurement of educational attainment in school-aged children born preterm. Dev Med Child Neurol 2012; 54:490. [PMID: 22458416 DOI: 10.1111/j.1469-8749.2012.04292.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Laurie Snider
- McGill University - Physical & Occupational Therapy, Montreal, Quebec, Canada
| |
Collapse
|
26
|
Brossard-Racine M, Majnemer A, Shevell M, Snider L, Bélanger SA. Handwriting capacity in children newly diagnosed with Attention Deficit Hyperactivity Disorder. Res Dev Disabil 2011; 32:2927-2934. [PMID: 21640552 DOI: 10.1016/j.ridd.2011.05.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2011] [Accepted: 05/04/2011] [Indexed: 05/30/2023]
Abstract
UNLABELLED Preliminary evidence suggests that children with Attention Deficit Hyperactivity Disorder (ADHD) may exhibit handwriting difficulties. However, the exact nature of these difficulties and the extent to which they may relate to motor or behavioural difficulties remains unclear. The aim of this study was to describe handwriting capacity in children newly diagnosed with ADHD and identify predictors of performance. Forty medication-naïve children with ADHD (mean age 8.1 years) were evaluated with the Evaluation Tool of Children's Handwriting-Manuscript, the Movement Assessment Battery for Children (M-ABC), the Developmental Test of Visual Motor Integration (VMI) and the Conner Global Index. An important subset (85.0%) exhibited manual dexterity difficulties. Handwriting performance was extremely variable in terms of speed and legibility. VMI was the most important predictor of legibility. Upper extremity coordination, as measured by the M-ABC ball skills subtest, was also a good predictor of word legibility. CONCLUSION Poor handwriting legibility and slow writing speed were common in children newly diagnosed with ADHD and were associated with motor abilities. Future studies are needed to determine whether interventions, including stimulant medications, can improve handwriting performance and related motor functioning.
Collapse
|
27
|
Lemmers R, van der Vliet P, Sacconi S, Camano P, Snider L, Geng L, van Ommen G, Padberg G, Miller D, Tapscott S, Frants R, van der Maarel S. O.19 Facioscapulohumeral muscular dystrophy: Muscle running out of control. Neuromuscul Disord 2011. [DOI: 10.1016/j.nmd.2011.06.1113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
28
|
Abstract
AIM To examine the evidence of the effectiveness of different feeding interventions for children with cerebral palsy. METHODS A search of 12 electronic databases identified all relevant studies. For each study, the quality of the methods was assessed according to the study design. A total of 33 articles were retrieved, and 21 studies were included in the final analysis. RESULTS Feeding interventions were separated into five main categories: oral sensorimotor facilitation, food consistency, positioning, oral appliances, and adaptive equipment. Five studies were randomized controlled trials. Outcomes were mainly reported on feeding safety and efficiency. One study documented positive results in height and weight change. Nineteen of the 21 studies presented positive outcomes in eating efficiency and/or safety. INTERPRETATION Feeding interventions demonstrate potential benefits for children with cerebral palsy. However, the current level of evidence is poor, and empirical data are lacking. Methodologically, rigorous studies are required particularly investigating multimodal approaches.
Collapse
Affiliation(s)
- Laurie Snider
- Montreal Children's Hospital, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
| | | | | |
Collapse
|
29
|
Abstract
OBJECTIVE The evidence for using virtual reality (VR) with children with cerebral palsy (CP) was examined. METHODS A search of 13 electronic databases identified all types of studies examining VR as an intervention for children with CP. The most recent article included was published in October 2008. For each study, the quality of the methods was assessed using the appropriate scale. A total of 19 articles were retrieved. Thirteen studies from 11 articles were included in the final analysis. RESULTS Outcomes documented brain reorganization/plasticity, motor capacity, visual-perceptual skills, social participation and personal factors. Two studies were randomized controlled trials. These reported conflicting results regarding motor outcomes. Twelve of the 13 studies presented positive outcomes in at least one domain. CONCLUSIONS VR has potential benefits for children with CP. However, the current level of evidence is poor and empirical data is lacking. Future methodologically rigorous studies are required.
Collapse
Affiliation(s)
- Laurie Snider
- McGill University, School of Physical & Occupational Therapy, Montreal, Canada.
| | | | | |
Collapse
|
30
|
|
31
|
Young NL, Varni JW, Snider L, McCormick A, Sawatzky B, Scott M, King G, Hetherington R, Sears E, Nicholas D. The Internet is valid and reliable for child-report: An example using the Activities Scale for Kids (ASK) and the Pediatric Quality of Life Inventory (PedsQL). J Clin Epidemiol 2009; 62:314-20. [PMID: 18834710 DOI: 10.1016/j.jclinepi.2008.06.011] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2007] [Revised: 05/28/2008] [Accepted: 06/27/2008] [Indexed: 01/19/2023]
Affiliation(s)
- Nancy L Young
- School of Rural and Northern Health, Laurentian University, Sudbury, Ontario, Canada.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Piazzi L, Zancanella L, Chilovi F, Merighi A, De Vitis I, Feliciangeli G, Borgheresi P, Snider L, Grassi SA, Manfrini C, Orzes N, Bianco MA, Cugia L, Lenoci N, Castagnini A. Diagnostic value of endoscopic markers for celiac disease in adults: a multicentre prospective Italian study. MINERVA GASTROENTERO 2008; 54:335-346. [PMID: 19047974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
AIM Some endoscopic features of duodenal mucosa are marker of mucosal injury, the most common cause being celiac disease (CD). The aim of this study was to prospectively assess the diagnostic value of the endoscopic markers for the diagnosis of CD in the adult population undergoing routine upper endoscopy. METHODS This was a prospective multicenter study conducted at 37 Italian endoscopic centers. A total of 509 consecutive patients submitted to routine upper endoscopy who presented one or more of following endoscopic markers were included: 1) mucosal mosaic pattern in the bulb and/or descending duodenum (DD); 2) nodularity in the bulb and/or DD; 3) scalloping of Kerkring's folds; 4) reduction in the number or absence of folds in the DD. 4 biopsies samples were taken from descending duodenum. In patients with histological findings consistent with CD, according to Oberhuber classification, sierologic test (EMA, tTGA) were performed for confirm the diagnosis. RESULTS At endoscopy, 249 patients showed an isolated marker; 260 subjects showed a coexistence of more than one marker; 369 patients (72.5%) presented mucosal lesions at histological examination and in 347 of these patients the diagnosis of CD was confirmed by serologic markers (94.0%). For 10 patients the diagnosis remained uncertain because of negative sierology and exclusion of other other cause of mucosal lesions. The diagnosis of CD was made in 61.3% patients who showed the mosaic pattern, in 65.7% of patients with nodular mucosa, in 64.4% of patients with scalloping of folds, in 40.2% of patients with reduction of folds, and in 61.5% of patients with loss of folds and in 83.6% of patients who showed the coexistence of more than one marker. The endoscopic markers overall had a PPV of 68% for the diagnosis of CD; the markers that singularly have demonstrated a higher correlation with CD are: mosaic mucosa of DD (PPV 65.0%), nodular mucosa of the bulb and DD (PPV 75.5%), and scalloping of folds (PPV 64.4%). CONCLUSION The study confirms the important role of endoscopy in the diagnostic process of CD not only for the bioptic sampling in patients with clinical suspicion of CD, but especially for the opportunity to evaluate alterations of the duodenal mucosa suggestive of CD in the general population and, consequently, to identify those patients who should undergo a duodenal biopsy.
Collapse
Affiliation(s)
- L Piazzi
- Divisione di Gastroenterologia, Ospedale Centrale di Bolzano, Bolzano, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Abstract
Attention deficit hyperactivity disorder (ADHD) is the most common neurobehavioral condition of childhood. Consequences are multifaceted and include activity limitations in daily-living skills, academic challenges, diminished socialization skills, and motor difficulties. Poor handwriting performance is an example of an affected life skill that has been anecdotally observed by educators and clinicians for this population and can negatively impact academic performance and self-esteem. To guide health and educational service delivery needs, the authors reviewed the evidence in the literature on handwriting difficulties in children with ADHD. Existing evidence would suggest that children with ADHD have impaired handwriting performance, characterized by illegible written material and/or inappropriate speed of execution compared to children without ADHD. Studies with larger sample sizes using standardized measures of handwriting performance are needed to evaluate the prevalence of the problem and to better understand the nature of handwriting difficulties and their impact in this population.
Collapse
Affiliation(s)
- Marie Brossard Racine
- School of Physical and Occupational Therapy McGill University, McGill University Health Centre, Montreal, QC, Canada
| | | | | | | |
Collapse
|
34
|
Saleh MN, Korner-Bitensky N, Snider L, Malouin F, Mazer B, Kennedy E, Roy MA. Actual vs. best practices for young children with cerebral palsy: a survey of paediatric occupational therapists and physical therapists in Quebec, Canada. Dev Neurorehabil 2008; 11:60-80. [PMID: 17943507 DOI: 10.1080/17518420701544230] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
RATIONALE Cerebral palsy (CP) constitutes a substantial portion of paediatric rehabilitation, yet little is known regarding actual occupational therapy (OT) and physical therapy (PT) practices. This study describes OT and PT practices for young children with CP in Quebec, Canada. METHODS This was a cross-sectional survey. All eligible, consenting paediatric occupational therapists (OTs) and physical therapists (PTs) were interviewed using a structured telephone interview based on vignettes of two typical children with CP at two age points--18 months and 4 years. Reported practices were grouped according to the International Classification of Functioning, Disability and Health (ICF). RESULTS 91.9% of PTs (n=62; 83.8% participation rate) and 67.1% of OTs (n=85; 91.4% participation rate) reported using at least one standardized paediatric assessment. OT and PT interventions focused primarily on impairments and primary function (such as gait function and activities of daily living). Both professions gave little attention to interventions related to play and recreation/leisure. Clinicians reported the need for more training and education specific to CP and to the use of research findings in clinical practice. CONCLUSION Wide variations and gaps were identified in clinicians' responses suggesting the need for a basic standard of OT and PT management as well as strategies to encourage knowledge dissemination regarding current best practice.
Collapse
Affiliation(s)
- M N Saleh
- School of Physical & Occupational Therapy, Faculty of Medicine, McGill University and Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Montreal, Quebec, Canada.
| | | | | | | | | | | | | |
Collapse
|
35
|
Snider L, Korner-Bitensky N, Kammann C, Warner S, Saleh M. Horseback riding as therapy for children with cerebral palsy: is there evidence of its effectiveness? Phys Occup Ther Pediatr 2007; 27:5-23. [PMID: 17442652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
A systematic review of the literature on horseback riding therapy as an intervention for children with cerebral palsy (CP) was carried out. The terms horse, riding, hippotherapy, horseback riding therapy, equine movement therapy, and cerebral palsy were searched in electronic databases and hand searched. Retrieved articles were rated for methodological quality using PEDro scoring to assess the internal validity of randomized trials and the Newcastle Ottawa Quality Assessment Scale to assess cohort studies. PICO questioning (Population, Intervention, Comparison, and Outcomes) was used to identify questions of interest to clinicians for outcomes within the context of the International Classification of Functioning, Disability and Health. Levels of evidence were then accorded each PICO question. There is Level 2a evidence that hippotherapy is effective for treating muscle symmetry in the trunk and hip and that therapeutic horseback riding is effective for improved gross motor function when compared with regular therapy or time on a waiting list. No studies addressed participation outcomes.
Collapse
Affiliation(s)
- Laurie Snider
- , School of Physical and Occupational Therapy, 3654 Promenade Sir William Osler, Montreal, Quebec, Canada.
| | | | | | | | | |
Collapse
|
36
|
Johnston CC, Filion F, Snider L, Limperopoulos C, Majnemer A, Pelausa E, Cake H, Stone S, Sherrard A, Boyer K. How much sucrose is too much sucrose? Pediatrics 2007; 119:226. [PMID: 17200300 DOI: 10.1542/peds.2006-3001] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
37
|
Snider L, Tremblay S, Limperopoulos C, Majnemer A, Filion F, Johnston C. Construct validity of the Neurobehavioral Assessment of Preterm Infants. Phys Occup Ther Pediatr 2005; 25:81-95. [PMID: 16120557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
In this nonrandomized, prospective cohort study, the construct validity of the Neurobehavioral Assessment of the Preterm Infant (NAPI) was examined by comparing it with measures of neonatal physiological status. A cohort of preterm infants (n = 37) was tested repetitively at 32 and 36 weeks post-conceptional age (PCA) to determine whether there was a correlation between physiological status and NAPI scores at these ages. We anticipated fair, clinically significant correlations (r = 0.25-0.50) between physiological and neurobehavioral status. This was found using Pearson Product Moment correlational analysis between components of the neurobehavioral performance repertoire at 32 weeks PCA, the degree of medical intervention and the early biological risks that contribute to developmental status. The finding was less marked at 36 weeks PCA when the subjects were physiologically more stable.
Collapse
Affiliation(s)
- Laurie Snider
- School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir William Osler, Montreal, Quebec, H3G 1Y5, Canada.
| | | | | | | | | | | |
Collapse
|
38
|
Abstract
Neonatal neurobehavioral assessments describe a newborn's spontaneous behavioural repertoire and observable responses to environmental stimuli. Infant developmental assessments document the range of developmental skills that emerge and develop over the first years of life. This review highlights two neonatal assessments (Einstein Neonatal Neurobehavioral Assessment Scale, Neurobehavioral Assessment of the Preterm Infant) and two infant assessments (Alberta Infant Motor Scale, Test of Infant Motor Performance). A general description of these tests is followed by their content and psychometric properties. These standardized tests of neurologic integrity are useful in characterizing current developmental status and in monitoring change in performance over time.
Collapse
Affiliation(s)
- Annette Majnemer
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | | |
Collapse
|
39
|
August-Dalfen S, Snider L. A multimedia case based approach to the study of office ergonomics. Work 2003; 20:3-11. [PMID: 12631997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
Multimedia technology has the capacity to provide students with an interactive approach to problem based learning and to bridge the gap between theoretical knowledge and clinical practice. The present paper describes the design and development of the program ErgoROM, a CD which presents a case study to assist occupational therapy students in their studies of office ergonomics. A pilot study showed that overall, 91% of respondents rated the ErgoROM as either "Excellent" or "Very Good". Additionally they reported that ErgoROM had a positive impact on active learning and critical thinking.
Collapse
Affiliation(s)
- Sharon August-Dalfen
- Laboratory for Innovations in Rehabilitation Technology, University of Haifa, Israel.
| | | |
Collapse
|
40
|
Abstract
INTRODUCTION The survival rate of infants born prematurely and hospitalized in Neonatal Intensive Care Units (NICUs) has increased due to improvement of the technology in obstetrics and neona tology that allows saving preterm infants at earlier gestational ages. Preterm infants are hospitalized in a care environment which is quite different from the maternal womb. Therefore the application of developmental care in NICUs is critical to promote the development of preterm infants while they are hospitalized. AIM This concept analysis contributes to the body of knowledge in developmental care and clarifies its understanding as well as its involvement in neonatal practice and research. METHODS Using the method of concept analysis of Walker and Avant, this article identifies the definitions and uses of the concept of developmental care, exposes its main attributes and introduces a model case representing the acknowledged attributes. The antecedents of the concept and consequences of the application of developmental care are discussed. CONCLUSION This concept analysis provides guidelines for nurses and health professionals to establish a 'developmental care' environment which is conducive for preterm infants. Moreover, it suggests conceptual and operational foundations of developmental care for clinicians and researchers in the neonatal field.
Collapse
Affiliation(s)
- Marilyn Aita
- School of Nursing, McGill University, Montreal, Quebec, Canada.
| | | |
Collapse
|
41
|
Johnston CC, Filion F, Snider L, Majnemer A, Limperopoulos C, Walker CD, Veilleux A, Pelausa E, Cake H, Stone S, Sherrard A, Boyer K. Routine sucrose analgesia during the first week of life in neonates younger than 31 weeks' postconceptional age. Pediatrics 2002; 110:523-8. [PMID: 12205254 DOI: 10.1542/peds.110.3.523] [Citation(s) in RCA: 174] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To determine the efficacy of sucrose analgesia for procedural pain during the first week of life in preterm neonates in neonatal intensive care units on enhancing later clinical outcomes. METHODS A total of 107 preterm neonates who were born at <31 weeks' postconceptional age (PCA) entered this double-blind, randomized, controlled trial within 48 hours of birth at 3 level III university-affiliated neonatal intensive care units in Canada, and 103 completed the study. Sucrose (0.1 mL of 24%) or sterile water was administered orally up to 3 times, 2 minutes apart, for every invasive procedure during a 7-day period. Motor development and vigor, and alertness and orientation components of the Neurobehavioral Assessment of the Preterm Infant were measured at 32, 36, and 40 weeks' PCA; Score for Neonatal Acute Physiology was measured on the last day of intervention; and Neuro-Biological Risk Score (NBRS) was measured at 2 weeks of age and at discharge. Primary analyses of covariance were applied for each outcome to compare group differences followed by secondary analyses using standard linear regression within each group to determine predictors of outcomes. RESULTS Although there were no differences between the groups on any outcomes, there were significant dose-related effects within each group. In the sucrose group only, higher number of doses of sucrose predicted lower scores on motor development and vigor, and alertness and orientation at 36 weeks', lower motor development and vigor at 40 weeks', and higher NBRS at 2 weeks' postnatal age. Higher number of invasive procedures was predictive of higher NBRS both times in the water group. CONCLUSIONS Repeated use of sucrose analgesia in infants <31 weeks' PCA may put infants at risk for poorer neurobehavioral development and physiologic outcomes. Additional study is needed to determine the most appropriate age and duration of sucrose analgesia in preterm infants.
Collapse
|
42
|
|
43
|
Olson JM, Asakura A, Snider L, Hawkes R, Strand A, Stoeck J, Hallahan A, Pritchard J, Tapscott SJ. NeuroD2 is necessary for development and survival of central nervous system neurons. Dev Biol 2001; 234:174-87. [PMID: 11356028 DOI: 10.1006/dbio.2001.0245] [Citation(s) in RCA: 115] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
NeuroD2 is sufficient to induce cell cycle arrest and neurogenic differentiation in nonneuronal cells. To determine whether this bHLH transcription factor was necessary for normal brain development, we used homologous recombination to replace the neuroD2 coding region with a beta-galactosidase reporter gene. The neuroD2 gene expressed the reporter in a subset of neurons in the central nervous system, including in neurons of the neocortex and hippocampus and cerebellum. NeuroD2(-/-) mice showed normal development until about day P14, when they began exhibiting ataxia and failure to thrive. Brain areas that expressed neuroD2 were smaller than normal and showed higher rates of apoptosis. Cerebella of neuroD2-null mice expressed reduced levels of genes encoding proteins that support cerebellar granule cell survival, including brain-derived neurotrophic factor (BDNF). Decreased levels of BDNF and higher rates of apoptosis in cerebellar granule cells of neuroD2(-/-) mice indicate that neuroD2 is necessary for the survival of specific populations of central nervous system neurons in addition to its known effects on cell cycle regulation and neuronal differentiation.
Collapse
Affiliation(s)
- J M Olson
- Clinical Research and Human Biology Divisions and Program in Developmental Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Abstract
A subgroup of patients with childhood-onset obsessive-compulsive disorder (OCD) has been identified who share a common clinical course characterized by dramatic symptom exacerbations following Group A beta-hemolytic streptococcal (GABHS) infections. The term PANDAS has been applied to the subgroup, to indicate the postulated etiology of their symptoms: Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections. Five clinical characteristics define the PANDAS subgroup: presence of OCD and/or tic disorder, prepubertal symptom onset, sudden onset or abrupt exacerbations (sawtooth course), association with neurological abnormalities (presence of adventitious movements or motoric hyperactivity during exacerbations), and temporal association between symptom exacerbations and GABHS infections. Post-streptococcal symptom exacerbations are typically quite dramatic, with patients reporting that their symptoms "...came on overnight" or "...appeared all of a sudden a few days after I had a sore throat." The post-streptococcal inflammatory nature of the neuropsychiatric symptoms provides novel opportunities for treatment and prevention, including immunomodulatory therapies such as therapeutic plasma exchange (TPE) and intravenous immunoglobulin (IVIG). A recently completed placebo-controlled trial revealed that both IVIG and TPE were effective in reducing neuropsychiatric symptom severity (40% to 55% reductions, respectively) for a group of severely ill children with OCD and/or tic disorders. Further research is required to determine why the treatments are helpful, as well as to ascertain whether or not antibiotic prophylaxis can help prevent post-streptococcal symptom exacerbations.
Collapse
Affiliation(s)
- S E Swedo
- Pediatrics and Developmental Neuropsychiatry, the National Institute of Mental Health, Bethesda, MD, USA
| | | | | | | | | |
Collapse
|
45
|
Snider L. Infection control in the care of older adults. Nurs Older People 2001; 13:37. [PMID: 12008246 DOI: 10.7748/nop.13.3.37.s29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
46
|
Affiliation(s)
- H L Leonard
- Department of Psychiatry, Brown University School of Medicine, Providence, Rhode Island, USA
| | | | | | | | | | | |
Collapse
|
47
|
Abstract
We have determined that I-mfa, an inhibitor of several basic helix-loop-helix (bHLH) proteins, and XIC, a Xenopus ortholog of human I-mf domain-containing protein that shares a highly conserved cysteine-rich C-terminal domain with I-mfa, inhibit the activity and DNA binding of the HMG box transcription factor XTcf3. Ectopic expression of I-mfa or XIC in early Xenopus embryos inhibited dorsal axis specification, the expression of the Tcf3/beta-catenin-regulated genes siamois and Xnr3, and the ability of beta-catenin to activate reporter constructs driven by Lef/Tcf binding sites. I-mfa domain proteins can regulate both the Wnt signaling pathway and a subset of bHLH proteins, possibly coordinating the activities of these two critical developmental pathways.
Collapse
Affiliation(s)
- L Snider
- Fred Hutchinson Cancer Research Center, University of Washington Medical Center, Seattle, Washington 98109
| | | | | | | | | | | |
Collapse
|
48
|
Klesert TR, Cho DH, Clark JI, Maylie J, Adelman J, Snider L, Yuen EC, Soriano P, Tapscott SJ. Mice deficient in Six5 develop cataracts: implications for myotonic dystrophy. Nat Genet 2000; 25:105-9. [PMID: 10802667 DOI: 10.1038/75490] [Citation(s) in RCA: 192] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Expansion of a CTG trinucleotide repeat in the 3' UTR of the gene DMPK at the DM1 locus on chromosome 19 causes myotonic dystrophy, a dominantly inherited disease characterized by skeletal muscle dystrophy and myotonia, cataracts and cardiac conduction defects. Targeted deletion of Dm15, the mouse orthologue of human DMPK, produced mice with a mild myopathy and cardiac conduction abnormalities, but without other features of myotonic dystrophy, such as myotonia and cataracts. We, and others, have demonstrated that repeat expansion decreases expression of the adjacent gene SIX5 (refs 7,8), which encodes a homeodomain transcription factor. To determine whether SIX5 deficiency contributes to the myotonic dystrophy phenotype, we disrupted mouse Six5 by replacing the first exon with a beta-galactosidase reporter. Six5-mutant mice showed reporter expression in multiple tissues, including the developing lens. Homozygous mutant mice had no apparent abnormalities of skeletal muscle function, but developed lenticular opacities at a higher rate than controls. Our results suggest that SIX5 deficiency contributes to the cataract phenotype in myotonic dystrophy, and that myotonic dystrophy represents a multigenic disorder.
Collapse
Affiliation(s)
- T R Klesert
- Program in Developmental Biology and Divisions of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Abstract
The bHLH-repressor protein I-mfa binds to MyoD family members, inhibits their activity, and blocks their nuclear import and binding to DNA. In situ hybridization analysis demonstrated that mouse I-mfa was highly expressed in extraembryonic lineages, in the sclerotome, and subsequently within mesenchymal precursors of the axial and appendicular skeleton, before chondrogenesis occurs. Targeted deletion of I-mfa in a C57Bl/6 background resulted in embryonic lethality around E10.5, associated with a placental defect and a markedly reduced number of trophoblast giant cells. Overexpression of I-mfa in rat trophoblast (Rcho-1) stem cells induced differentiation into trophoblast giant cells. I-mfa interacted with the bHLH protein Mash2, a negative regulator of trophoblast giant cell formation, and inhibited its transcriptional activity in cell culture. In contrast, I-mfa did not interfere with the activity of the bHLH protein Hand1, a positive regulator of giant cell differentiation. Interestingly, I-mfa-null embryos on a 129/Sv background had no placental defect, generally survived to adulthood, and exhibited delayed caudal neural tube closure and skeletal patterning defects that included fusions of ribs, vertebral bodies and abnormal formation of spinous processes. Our results indicate that I-mfa plays an important role in trophoblast and chondrogenic differentiation by negatively regulating a subset of lineage-restricted bHLH proteins.
Collapse
Affiliation(s)
- N Kraut
- Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N., A3-025, PO Box 19024, Seattle, WA 98109-1024, USA.
| | | | | | | | | |
Collapse
|
50
|
Humphries TW, Snider L, McDougall B. Therapists' consistency in following their treatment plans for sensory integrative and perceptual-motor therapy. Am J Occup Ther 1997; 51:104-12. [PMID: 9124267 DOI: 10.5014/ajot.51.2.104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES Treatment integrity is concerned with whether treatment conditions as provided are consistent with specifications for the treatment. Therapists' consistency in following their treatment plans that called for the use of sensory integrative and perceptual-motor techniques was evaluated. METHOD Three occupational therapists were rated on their consistency in 46 sessions each of sensory integrative and perceptual-motor therapy. Ratings were made both earlier (1 month) and later (4 months) in treatment. Consistency was rated with a five-point scale for 10 categories of the treatment plans. RESULTS Overall consistency did not differ significantly (86% for sensory integrative techniques and 79% for perceptual-motor techniques). Perceptual-motor activities showed less consistency early in treatment but approached the level for sensory integrative techniques by later treatment sessions. Consistency differed significantly among therapists for sensory integrative activities that addressed tactile defensiveness and perceptual-motor activities associated with fine coordination and dexterity. CONCLUSION Despite the less structured, more child-centered nature of sensory integrative techniques, consistency in using these techniques was as high as that found for more scripted, program-centered, perceptual-motor techniques. Therapists reported that gaining the interest and attention of some children with the more structured perceptual-motor activities was more difficult early in treatment but could be achieved with time. Differences in consistency among therapists require verification with a larger sample.
Collapse
Affiliation(s)
- T W Humphries
- Department of Paediatrics, Ontario Institute for Studies in Education, University of Toronto, Canada
| | | | | |
Collapse
|