Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.

Introduktion: Höftledsartros är en vanligt förekommande ledsjukdom hos hundar. Där prevalencen ökar med hundarnas ålder. Orsaken till höftledsartros varierar, men särskilt framträdande hos hundar med höftledsartros är höftledsdysplasi, tidigare trauma eller övervikt. Syfte: Syftet med denna litteraturöversikt är att undersöka vilka fysioterapeutiska interventioner som har klinisk relevans för hundar med höftledsartros. Samt vilken effekt dessa har på smärta och funktion. Metod: En litteratursammanställning utfördes för att kunna svara på syftet. För att finna relevanta artiklar utfördes en systematisk sökning i databaserna Web Of Science, Scopus, Journal of the American Veterinary Medical Association och PubMed. Resultat: Sammanlagt inkluderades tio artiklar i denna litteraturöversikt, varav nio stycken var RCT studier och en prospektiv klinisk studie. Dessa artiklar involverar interventioner som hydroterapi, stötvågsbehandling, viktminskning, akupunktur och rörelseträning. Trots relativt korta interventionsperioder kunde goda resultat ses på interventionerna. Där exempelvis enbart viktreduktion som intervention minskade hundarnas VAS och NRS minskade inom 19 veckor. Detta kombinerades även med träning i en studie, vilket bidrog till en förlängd effekt av grundinterventionen. Konklusion: Denna litteraturstudie visar på att vissa fysioterapeutiska interventioner såsom hydroterapi, stötvågsbehandling, viktminskning, akupunktur och rörelseträning förefaller ha en positiv effekt på smärtminskning, ökat rörelseomfång och ökad aktivitet hos hundar med höftledsartros. Mer studier krävs för att fastställa dessa interventioner och även stärka säkerheten för det kliniska arbetet.

Purpose: This study is Phase One of a multi-phase research initiative. The purpose of this study was to examine how well a low-dose, dual oral narrative and expository language intervention delivered in a small group setting improved expressive and receptive oral narrative and expository language in kindergarten, first grade, and second grade students who have been identified as having language disorder or emerging English academic language. Method: We administered a dynamic assessment of language to 325 kindergarten, first, and second grade students from two elementary schools in two school districts. The results of the dynamic assessment identified 61 students who had a language disorder or emerging English academic language. We randomly assigned those 61 students to a treatment or control group; however, 7 students were removed from the study due to incomplete data sets following the posttest phase. Students in the treatment group received small group oral narrative and expository language intervention two times per week over four weeks (eight 20-minute sessions). We administered narrative and expository assessments immediately prior to intervention to all students in the treatment group (n = 27) and the control group (n = 27). Those same measures were administered immediately following intervention to both groups. Results: We conducted a series of one-way analyses of covariance (ANCOVAs), using the pretest narrative retell as a covariate for each of the dependent variables. There were no significant differences between the treatment and control groups for any of the dependent variables. However, trends from means indicate that the treatment group was beginning to perform higher than their control-group peers at the conclusion of this Phase One study, suggesting that significant differences between groups may emerge in later phases. To maximize the efficiency of contextualized language intervention by alternating narrative and expository intervention procedures each week under realistic conditions, it is necessary to ascertain when two 20-minute sessions per week, which is the time that most speech-language pathologists dedicate to language intervention for their students, will yield significant results across both narrative and expository outcomes.

Early detection and intervention are theorized to facilitate better outcomes in autistic children. However, response to early intervention varies considerably between individuals, some children show significant improvement, while others show minimal response to the intervention. Some pre-treatment individualized characteristics as well as intervention-specific factors were theorized to moderate outcomes, but literature revealed often mixed findings making difficult to understand whether and to what extent these factors facilitate learning during treatment. To parse the heterogeneity of the autistic population, recent studies have also attempted to investigate biological factors related to clinical and behavioral profiles. However, to date it is unknown whether and how biological information can provide insight into the variability of treatment outcomes. With this in mind, we attempted to expand the current knowledge by first investigating whether pre-treatment child’s characteristics and blood leukocyte gene expression patterns could predict developmental trajectories during treatment. Leveraging a cohort of 41 autistic toddlers who received the same early intervention and provided a blood sample, we were able to analyze the effect of starting treatment very early (i.e., <24 months) on treatment trajectories. We also provided for the first-time evidence that both pre-treatment blood leukocyte gene expression patterns and clinical-behavioral characteristics are important for predicting developmental change during intervention, and that pretreatment epigenetic mechanisms such as histone acetylation may be a key biological process that influence how a child respond to early intervention. Lastly, we carried out a mega-analysis of a large international consortium, isolating individual child characteristics and treatment related factors to examine their key role in moderating child developmental trajectories throughout the course of early intervention. The final dataset comprised 645 autistic toddlers who received two types of interventions either Early Start Denver Model (ESDM) or other treatment as usual/community interventions (TAU/COM). This mega-analysis provided strong evidence that individual factors, such as cognitive level and age at treatment start, predict most outcomes, and on-average, ESDM may promote some developmental skills better than COM/TAU. Taken together, these results advance our understanding of “what works, for whom, for what and why” questions, identifying new biological predictors and providing an alternative methodology that can effectively examine the individual variability of treatment outcomes.

Introduktion: Demenssjukdom används som ett paraplybegrepp som innefattar Alzheimers sjukdom, vaskulär demens och demenssjukdom av annan typ. Förekomst av ångest vid diagnostiserad demenssjukdom är vanligt, då demenssjukdom är en dödlig progressiv sjukdom som innebär en nedgång i kognitiva funktioner och skapar begränsningar av möjligheter i livet. Syfte: Syftet med studien var att belysa omvårdnadsinterventioner vid ångest hos personer med demenssjukdom. Metod: Polit och Beck (2021) nio steg användes. Databassökningarna utfördes i CINAHL och PsycInfo, samtliga artiklar är Peer reviewed. Litteraturstudiens resultat är baserad på åtta kvantitativa artiklar och tre kvalitativa artiklar. Resultat: Litteraturstudiens teman är “Musik i rörelse och aktivt deltagande”, “Multimedia, digitala hjälpmedel och fotoböcker ”, “Taktil massage och beröring”, “ Interventioner i omgivningen och nycklar i vardagen”. Samtliga omvårdnadinterventioner i litteraturstudien visar på minskad ångest hos personer med demenssjukdom. Slutsats: Sjuksköterskan är betydelsefull i personcentrerad vård, kollaborativ vård, tillvaratagande av resurser och vårdanpassning. Dessa faktorer är avgörande för hur interventioner implementeras och utfallet. Resultatet visar att interventioner kan användas som nycklar för sjuksköterskan och utgör en kunskap som är en god grund för förbättrad vård för att minska ångest hos personer med demenssjukdom. Interventionerna kan därför appliceras i en vårdplan som individanpassas.

OBJECTIVE: The aim of this literature review was to examine the most current research regarding effective, evidence-based programs for reducing incivility among the healthcare team, particularly nurses. BACKGROUND: Incivility in the work environment is linked to a variety of negative outcomes, including diminished productivity, impaired judgement, and reduced employee retention. Incivility is especially detrimental to the healthcare team because it is correlated with decreased quality of patient care and increased medical errors. Despite regulations and statements made by the Joint Commission and the American Nurses Association to combat this serious problem, incivility continues to plague healthcare. METHODS: CINAHL and MEDLINE databases were reviewed for interventions to reduce incivility or bullying. Articles that evaluated interventions for practicing nurses were included in the review. RESULTS: The majority of studies evaluated training programs based on cognitive theory or cognitive rehearsal training as an intervention for incivility or bullying. Most studies showed positive correlations between the intervention and reducing incivility or bullying in some areas, however, results were inconsistent, most evidence ranked low and most studies shared sub-optimal quality. CONCLUSION: Most current studies towards reducing incivility in the healthcare team are poorly designed for demonstrating causation. More research is required to examine effective, evidence-based solutions for cultivating civility. Research must distinguish independent variables, incorporate teams instead of individuals, and fit into the structure of the work environment that it is serving.

The purpose of this qualitative case study was to help a second grade student, who struggled with mathematics but excelled in reading, to develop a conceptual understanding of number sense, using a teacher researcher-created intervention. The five-step, one-on-one intervention included the following: (1) use trade books to build mathematical knowledge and vocabulary (2) teacher modeling of concepts, (3) guided practice with manipulatives, (4) review using games and a ?Fact Pack?, and (5) journal writing to explain concepts. The Early Mathematics Assessment-3 (TEMA-3) was used as a pre- and post-test assessment the student?s mathematical knowledge. Other data included transcriptions of audio taped intervention sessions, notes from video-taped intervention sessions, fieldnotes, and artifacts from the classroom and intervention sessions. Data sources were triangulated. On the TEMA-3 Pretest, the student scored at the first grade, fourth month (1.4) level. After 13 Lessons covered in 22 sessions (approximately 11 hours of one-on-one instruction), the student scored at the second grade, second month (2.2) level. She also scored Proficient on the state curriculum test in mathematics. Four aspects of the intervention seem to help the student most in her development of number sense. They included the use of (1) a number line; (2) a number structure, which visually depicted the value of numbers; (3) trade books to provide an anchor for each skill and a memorable context; and (4) journaling. In addition, the data revealed that once the student understood the concept of ten?s and one?s, her ability to count and add extended to include numbers 1 to 100. Recommendations for students who excel in reading and writing, but struggle with mathematics, include the following: the use of trade books and writing may help them better understand mathematics concepts; review of mathematical concepts through enjoyable, meaningful games and the use of a Fact Pack are useful; the use a horizontal number line and number structure, which is consistent with left-to-right directionality of reading and writing, may help students better understand the concepts of more, less, before, and after; and consistent use of vocabulary during instruction may help students better understand number concepts.

The Response to Intervention (RtI) model is an identification model for Specific Learning Disability (SLD), one of the 13 disability categories identified under the Individual with Disabilities Education Act (IDEA) of 2004. The RtI model has been proposed as an alternative model to the discrepancy model (e.g., intelligence quotient-achievement discrepancy model). In the RtI model, students’ responsiveness (e.g., levels of performance and slopes of progress) yields their eligibility for special education. However, to date, research that examined the validity of the RtI model (e.g., examination of intervention responsiveness with students with academic deficits) has been limited in the area of mathematics. The purpose of this study was to examine the responsiveness of elementary-aged students, with and without SLD, to interventions for mathematics calculation. It was hypothesized that students with mathematics deficits would demonstrate progress after receiving an empirically-derived intervention, regardless of their placement in general or special education. It was also hypothesized that students with mathematics deficits would demonstrate satisfaction with intervention procedures and self-efficacy with their progress after receiving an empirically-derived intervention. Students with and without SLD were selected based on specific criteria for this study (e.g., a skill deficit). To examine these hypotheses, for each student, an intervention was selected using an experimental analysis. The effects of the intervention on mathematics calculation were examined using single subject design. Maintenance on instructional materials and generalization from instructional-level to grade-level materials were examined. Social validity (e.g., satisfaction) of interventions and self-efficacy of students were also assessed. The results of the study indicate that empirically-derived interventions were effective in enhancing the calculation skills of students with and without SLD and maintaining their skills during and after the intervention phase. However, the students with and without SLD did not generalize their calculation skills to grade-level materials. The students demonstrated high levels of satisfaction with the interventions at the end of the interventions and enhanced their self-efficacy across the study. The study partially supported the validity of the RtI model in the area of mathematics such that the RtI model may be reliable in identification of students with SLD in mathematics calculation.

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