This study examined the efficacy of a multimodal intervention with conduct disordered boys in the middle primary years. The intervention consisted of a behavioural classroom program; a small group, social skills program; and a behavioural parenting program Resource implications of this model were also evaluated. A review of the current literature on conduct disorders showed that these children account for less than 5% of the population, but they have a strong impact on families, teachers, peers, schools and the wider community. About 50% of children with severe, early behavioural problems will continue with these problems, not only throughout their adult lives, but into the next generation. Early intervention appears to offer our best hope of altering this trajectory. Interventions with this population have been largely unsuccessful. At the present time the most promising intervention is behavioural parent training programs. Combining these with child focused social skills programs, and behavioural programs in the school setting, increases their efficacy. This study used a single subject experimental design to examine the effects of this program on four boys with behavioural difficulties. Continuous measures were taken with parent, and teacher daily record charts, and classroom observations. Pre, post and followup measures were taken with the Child Behaviour Checklist. The results of the study were mixed. Some subjects, according to some respondents, improved in home and school behaviours. All three subjects, for whom there was followup data, had improved. The classroom, and parenting programs appeared to be associated with positive changes in child behaviour, the small group was associated with more disruptive behaviour at school.

Problematisk skolfrånvaro är ett omfattande problem som kan få sociala, emotionella och kunskapsmässiga konsekvenser för barn och ungdomar. Forskning visar att multimodala interventioner är effektiva i att öka skolnärvaro, vilka programstrategier inom interventionerna som fungerar i vilka kontexter saknas däremot kunskap om. En realistisk översikt genomfördes därför i syfte att undersöka vilka orsaker till problematisk skolfrånvaro som går att identifiera i tidigare forskning. Vidare var syftet att öka förståelsen för multimodala interventioner genom att specificera vilka programstrategier som leder till ökad skolnärvaro inom vilka kontexter. Efter en systematisk sökprocess inkluderades totalt 124 vetenskapliga artiklar. Resultatet av den realistiska analysen visade att trygghet, attityd, känsloreglering, social kompetens, motivation, föräldraförmåga, föräldrars föreställningar, kommunikation, tillit, familjedynamik, relationen mellan elev och lärare, skolklimat, skolorganisering, normativa föreställningar samt jämlikhet kan generera skolfrånvaro i särskilda kontexter. Inom de multimodala interventionerna identifierades åtta programstrategier som visat sig öka skolnärvaro i vissa kontexter. Mest empiriskt underlag förelåg för de strategier som arbetade med föräldra-förmågan och kommunikationen i elevens omgivning. Resultatet analyserades med hjälp av behavioristisk teori om operant betingning och systemteori. Översiktens slutsatser kan öka förståelsen för orsaker till skolfrånvaro och vägleda yrkesverksamma i vilka programstrategier som bör implementeras under vilka omständigheter. / Problematic school absenteeism is a comprehensive problem associated with social, emotional and cognitive consequences for children and adolescents. Research shows that multimodal interventions are effective in increasing attendance. However, there is a need to refine the contexts in which multimodal interventions are effective. Therefore, a realistic review was carried out in order to identify the causes underlying problematic school absenteeism in previous research. Furthermore, the purpose was to increase the understanding of multimodal interventions by specifying which program strategies lead to increased school attendance in which contexts. Following a systematic search process, a total of 124 articles were included. The results showed that security, attitude, emotion regulation, social skills, motivation, parent self-efficacy, parental beliefs, communication, trust, family dynamics, student-teacher relationship, school climate, school organization, normative ideas and equality can generate school absenteeism in specific contexts. Eight program strategies that generated attendance in different contexts were identified within the multimodal interventions. Most empirical support were found for the strategies related to parent self-efficacy and communication. The result was analyzed using behavioral and systems theory. The conclusions can advance the understanding of causes to absenteeism and guide professionals regarding which program strategies should be implemented under which circumstances.

Spasticity is highly prevalent in neurological conditions involving upper motor neuron lesions (UMNL). Lower limb spasticity is known to impair gait and limit participation in physical activity. Multimodal interventions including botulinum toxin A, orthoses, and physiotherapy have shown longer lasting improvements compared to unimodal interventions. Studies to date, however, have not examined the long term efficacy of this multimodal intervention nor have they examined the impact across a breadth of domains necessary to comprehensively and fully understand its impact. The aim of this study was to investigate the efficacy of a multimodal intervention to treat lower limb spasticity in adults using a longitudinal mixed-methods approach, including a comprehensive set of outcome measures spanning the domains of the International Classification of Functioning, Disability and Health (ICF) model. Seven-teen participants with chronic UMNL were included in the analysis as per inclusion criteria and showed improvements at 6 and 12 months, compared to baseline, within all domains of the ICF model. / Graduate / 0571 / 0382 / 0384 / jazkim@uvic.ca

Spasticity is highly prevalent in neurological conditions involving upper motor neuron lesions (UMNL). Lower limb spasticity is known to impair gait and limit participation in physical activity. Multimodal interventions including botulinum toxin A, orthoses, and physiotherapy have shown longer lasting improvements compared to unimodal interventions. Studies to date, however, have not examined the long term efficacy of this multimodal intervention nor have they examined the impact across a breadth of domains necessary to comprehensively and fully understand its impact. The aim of this study was to investigate the efficacy of a multimodal intervention to treat lower limb spasticity in adults using a longitudinal mixed-methods approach, including a comprehensive set of outcome measures spanning the domains of the International Classification of Functioning, Disability and Health (ICF) model. Seven-teen participants with chronic UMNL were included in the analysis as per inclusion criteria and showed improvements at 6 and 12 months, compared to baseline, within all domains of the ICF model. / Graduate / 2015-04-24 / 0571 / 0382 / 0384 / jazkim@uvic.ca

No description available.

Röntgenavdelningen har ett blandat flöde av patienter vilket medför att denna är en potentiell smittväg för olika sjukdomar. För att minska risken för smittspridning är det viktigt att de basala hygienrutinerna följs, dock visar studier på att följsamheten till de basala hygienrutinerna är låg. Syfte: Syftet med denna litteraturöversikt var att undersöka hur röntgensjuksköterskans följsamhet till handhygienrutiner kan förbättras. Metod: En integrativ litteraturöversikt där vetenskapliga artiklar har sökts i databaserna PubMed och CINAHL. 15 artiklar har kvalitetsgranskats, kategoriserats, analyserats och slutligen har resultatet sammanställts och en syntes skrivits. Resultat: Olika typer av interventioner, såsom utbildning, information, automatiserade observationssystem och multimodala interventioner kan vara hjälpsamma i arbetet med att förbättra följsamheten till handhygienrutinerna Slutsats: Praktisk och teoretisk utbildning, en engagerad ledning och ett klimat i kombination med god tillgång till handhygienprodukter och påminnelser om att utföra handhygien är viktiga delar i arbetet med att förbättra följsamheten till handhygienrutiner. / The radiology department has a mixed flow of patients which means that it has the potential to become a site for infection transmission. In order to reduce the risk of infection spreading it is important that the basic hand hygiene routines are followed. However, studies show that the compliance with the basic hand hygiene routines is low. Aim: The aim was to examine how the radiographer's adherence to hand hygiene practices can be improved. Method: An integrative literature review where scientific articles were searched in the PubMed and CINAHL databases. 15 articles have been quality reviewed, categorized, analyzed and finally the result has been compiled and a synthesis written. Result: Different types of interventions, such as education, information, automated observation systems and multimodal interventions, can be helpful in improving compliance with hand hygiene routines. Conclusion: Practical and theoretical education, dedicated management and a responsible climate combined with good access to hand hygiene products and reminders to perform hand hygiene are important parts of the work to improve compliance with hand hygiene routines.

Les interventions proactives ou comportementales en classe sont reconnues empiriquement pour leur efficacité à améliorer le comportement ou le rendement scolaire des enfants ayant un TDAH (DuPaul & Eckert, 1997; Hoza, Kaiser, & Hurt, 2008; Pelham & Fabiano, 2008; Zentall, 2005). Or, l’écart entre les interventions probantes et celles retrouvées dans le milieu général de l’éducation souligne l’importance de répliquer les résultats d’études obtenus dans un environnement contrôlé dans un format de livraison réaliste. L’objectif principal de cette thèse est d’élaborer et d’évaluer un programme de consultation individuelle (PCI) fondé sur une démarche de résolution de problème et d’évaluation fonctionnelle, pour soutenir les enseignants du primaire dans la planification et la mise en œuvre cohérente des interventions privilégiées pour aider les enfants ayant un TDAH. D’abord, une recension des principales modalités d’intervention auprès des enfants ayant un TDAH est effectuée afin d’identifier les interventions à inclure lors du développement du programme. Par la suite, des solutions favorisant le transfert des interventions probantes à la classe ordinaire sont détaillées par la proposition du PCI ayant lieu entre un intervenant psychosocial et l’enseignant. Enfin, l’évaluation du PCI auprès de trente-sept paires enfant-enseignant est présentée. Tous les enfants ont un diagnostic de TDAH et prennent une médication (M). Les parents de certains enfants ont participé à un programme d’entraînement aux habiletés parentales (PEHP). L’échantillon final est: M (n = 4), M et PEHP (n = 11), M et PCI (n = 11), M, PEHP et PCI (n = 11). Les résultats confirment l’efficacité du PCI au-delà de M et M + PEHP pour éviter une aggravation des comportements inappropriés et améliorer le rendement scolaire des enfants ayant un TDAH. Par ailleurs, une augmentation de l’utilisation des stratégies efficaces par l’enseignant est observable lorsqu’il a à la fois participé au PCI et reçu une formation continue sur le TDAH en cours d’emploi. Les implications cliniques de l’intervention pour l’enfant ayant un TDAH et son enseignant de classe ordinaire sont discutées. / Classroom management interventions, such as behavior and academic strategies, are well-established interventions for improving social behavior and academic skills of children with ADHD (DuPaul & Eckert, 1997; Hoza, Kaiser, & Hurt, 2008; Pelham & Fabiano, 2008; Zentall, 2005). However, bridging the gap between research and practice raises the question of the practicality of interventions. Therefore, results from controlled studies need to be replicated in regular classrooms with a format that takes into account the practicality of the intervention. The aim of this research is to evaluate the effectiveness of a consultation-based program for teachers (CPT), using a problem-solving approach and a functional assessment to support elementary school teachers in the knowledge of the principles, design and implementation of classroom management evidence-based practices for children with ADHD. First, a review of the literature identifying the main interventions for ADHD children is presented. Then, the consultation-based program for regular class teachers involving solutions in the implementation of these evidence-based strategies in the classroom is detailed. Finally, the evaluation of the CPT implemented with thirty-seven child-teacher pairs is presented. All children were diagnosed as ADHD and received a stimulant medication treatment (M). The parents of some of these children had previously participated in a parent-training program (PTP). The final group composition is: M (n = 4); M + PTP (n = 11), M + CPT (n = 11), M + PTP + CPT (n = 11). Findings confirm the effectiveness of the CPT above and beyond M, and M + PTP to prevent the intensification of inappropriate behaviors and to improve academic performance of ADHD children. Results also indicate that teachers who participated in the CPT and had previous continuing education on ADHD showed a significant improvement of their classroom management strategies. Overall findings offer valuable information for discussing clinical implications for the psychosocial treatment of ADHD children.

No description available.