Active Support Training, Staff Assistance, and Engagement of Individuals With Intellectual and Developmental Disabilities in the United States: Randomized Controlled Trial

2019 ◽  
Vol 124 (2) ◽  
pp. 157-173 ◽  
Author(s):  
Xueqin Qian ◽  
Sheryl A. Larson ◽  
Renáta Tichá ◽  
Roger Stancliffe ◽  
Sandra L. Pettingell

Abstract Two non-U.S. quasi-experimental studies reported Active Support training was associated with increased engagement in individuals with IDD, but no randomized controlled trials (RCTs) exist. We evaluated effects of Active Support training on staff assistance, and social and nonsocial engagement in 75 individuals with intellectual and developmental disabilities (IDD) in U.S. group homes. We detected no significant effects of active support training. Individuals with more skills and less challenging behavior engaged more in nonsocial activities. Younger individuals with more skills living in homes with fewer staff changes were more socially engaged. Factors associated with nonsocial engagement mirrored those reported in Qian, Tichá, Larson, Stancliffe, & Wuorio, (2015). Staffing-related implementation challenges and statistical power limited our ability to detect differences.

Author(s):  
Lorena Gutiérrez-Puertas ◽  
Verónica V. Márquez-Hernández ◽  
Vanesa Gutiérrez-Puertas ◽  
Genoveva Granados-Gámez ◽  
Gabriel Aguilera-Manrique

Introduction: Nursing students establish therapeutic relationships with their patients and as future nursing professionals, they should be trained to be effective communicators. The objective of this systematic review was to know the impact of educational interventions on nursing students to develop their communication skills with patients. Methods: A systematic review of literature was carried out. The following databases were consulted: CINAHL, PubMed (Ovid Medline), SCOPUS and Web of Science. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided this review. As for inclusion criteria, published articles in English from 2000 to 2020 were included. The methodological rigor of the included articles was evaluated with the JBI Critical Appraisal Checklist for Randomized Controlled Trial or Quasi-Experimental Studies. Changes in communication skills with the patient after the implementation of an intervention were analyzed. Results: Of the included studies in this systematic review (N = 19), two studies were randomized controlled trials, others were single group quasi-experimental studies (N = 11) and two group quasi-experimental studies (n = 6). The majority of the studies were carried out in the USA (n = 7). The most frequent educational intervention was simulation (n = 11). As for the improvement of communication skills, 13 of the 19 articles found statistically significant differences in patient-centered communication skills of nursing students. Conclusions: This systematic review provides preliminary evidence of the effectiveness of interventions used to train nursing students in patient-centered communication. Although all the interventions obtained significant results in communication skills, it has not yet been determined which methodology is more effective.


2017 ◽  
Vol 24 (6) ◽  
pp. 1173-1183 ◽  
Author(s):  
Benjamin H Slovis ◽  
Thomas A Nahass ◽  
Hojjat Salmasian ◽  
Gilad Kuperman ◽  
David K Vawdrey

Abstract Objective To systematically review the literature pertaining to asynchronous automated electronic notifications of laboratory results to clinicians. Methods PubMed, Web of Science, and the Cochrane Collaboration were queried for studies pertaining to automated electronic notifications of laboratory results. A title review was performed on the primary results, with a further abstract review and full review to produce the final set of included articles. Results The full review included 34 articles, representing 19 institutions. Of these, 19 reported implementation and design of systems, 11 reported quasi-experimental studies, 3 reported a randomized controlled trial, and 1 was a meta-analysis. Twenty-seven articles included alerts of critical results, while 5 focused on urgent notifications and 2 on elective notifications. There was considerable variability in clinical setting, system implementation, and results presented. Conclusion Several asynchronous automated electronic notification systems for laboratory results have been evaluated, most from >10 years ago. Further research on the effect of notifications on clinicians as well as the use of modern electronic health records and new methods of notification is warranted to determine their effects on workflow and clinical outcomes.


2013 ◽  
Vol 51 (6) ◽  
pp. 433-445 ◽  
Author(s):  
David A. Rotholz ◽  
Charles R. Moseley ◽  
Kinsey B. Carlson

Abstract Providing effective behavioral supports to decrease challenging behavior and replace it with appropriate alternative skills is essential to meeting the needs of many individuals with intellectual and developmental disabilities (IDD). It is also necessary for fulfilling the requirements of Medicaid-funded individual support plans and is important for moral, ethical, and societal reasons. Unfortunately, there is no national standard for behavioral support practices or source of information on the status of behavior support policies, practices, and services for adults with IDD at either state or national levels. The collection of comprehensive data on state behavior support definitions, provider qualifications, training, and oversight requirements is a necessary starting point for the development of plans to address needed policy and practice changes. This survey is the first national assessment of state policies and practices regarding the definition and delivery of behavior support services to people with intellectual and developmental disabilities receiving publicly financed supports in the United States.


Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Seamus P Whelton ◽  
Khurram Nasir ◽  
Michael J Blaha ◽  
Daniel S Berman ◽  
Roger S Blumenthal

Introduction: Non-invasive cardiovascular imaging has been proposed as a method to improve risk stratification and motivate improved patient and physician risk factor modification. Despite increasing use of these technologies there remains limited evidence documenting its effect on downstream testing and improvement in risk factor control. Hypothesis: Addition of the EISNER study to a prior meta-analysis will improve statistical power to demonstrate the downstream consequences of non-invasive cardiovascular imaging. Methods: A comprehensive literature search of the MEDLINE database (1966 through July 2011) was conducted. Major inclusion criteria required: 1) randomized controlled trial design, 2) participants with no known history of coronary heart disease or stroke, and 3) comparison of a group provided with results of a non-invasive imaging scan versus those without results. A total of eight trials with 4,084 participants met the inclusion criteria for this analysis. We analyzed the data using a random effects model to allow for heterogeneity. Results: Among imaging groups there was a significant increase in prescribing for statins (RR, 1.15; 95% CI, 1.01–1.32) and a non-significant trend for increased prescription of aspirin (RR, 1.15; 95% CI, 0.97–1.35), ACE/ARB (RR, 1.12; 95% CI, 0.96–1.31), and insulin (RR, 1.54; 95% CI, 0.75–3.18). There was a non-significant trend towards increased smoking cessation (RR, 1.35; 95% CI, 0.88–2.08). For downstream outcomes there was a non-significant increase in coronary angiography (RR, 1.20; 95% CI, 0.92–1.57), but not for revascularization (RR, 0.92; 95% CI, 0.55–1.53). There was no significant effect of imaging on the change in traditional risk factors. Limitations: There remains a limited number of trials in this important area. Therefore, trials included in this analysis use a variety of different imaging modalities and we were not able to pool the results based on appropriate clinical action (intensification at high risk and reduction at low risk). Conclusions: Non-invasive cardiovascular imaging leads to increased statin use, but associations with other downstream treatments and change in risk factors are not statistically significant. Our results highlight the limited amount of data for describing the downstream consequences after CAC testing.


2015 ◽  
Vol 117 (2) ◽  
pp. 1-52
Author(s):  
Dennis J. Barr ◽  
Beth Boulay ◽  
Robert L. Selman ◽  
Rachel Mccormick ◽  
Ethan Lowenstein ◽  
...  

Background/Context Billions of dollars are spent annually on professional development (PD) for educators, yet few randomized controlled trials (RCT) have demonstrated the ultimate impact PD has on student learning. Further, while policymakers and others speak to the role schools should play in developing students’ civic awareness, RCTs of PD designed to foster civic learning are rare. This randomized controlled trial contributes to the knowledge base on the effectiveness of PD designed to integrate civic learning, ethical reflection, and historical thinking skills into high school humanities courses. Focus of Study The study examined the impact of a PD intervention in two areas: (a) teacher self-efficacy, burnout, and professional engagement and satisfaction; and (b) the academic, civic, social, and ethical competencies of 9th and 10th grade students in the teachers’ classes. Population/Participants/Subjects The study involved 113 teachers and 1,371 9th and 10th grade students in 60 high schools from eight metropolitan regions in the United States. Intervention/Program/Practice The intervention, Facing History and Ourselves, provides PD through a five-day seminar, curricular materials, and follow-up coaching and workshops to help teachers develop their capacities to implement an interdisciplinary historical case study unit using student-centered pedagogy. Research Design The study used a school-level, randomized, experimental design to investigate impacts of the intervention for teachers and their 9th and 10th grade students. Findings/Results Intervention teachers showed significantly greater self-efficacy in all eight assessed domains, more positive perceptions of professional support, satisfaction and growth, and greater personal accomplishment. Intervention students demonstrated stronger skills for analyzing evidence, agency, and cause and effect on a historical understanding performance measure; greater self-reported civic efficacy and tolerance for others with different views; and more positive perceptions of the classroom climate and the opportunities afforded for engaging with civic matters. Fidelity analysis found these causal effects despite the fact that roughly half of the intervention teachers did not fully implement the program. Conclusions/Recommendations Educators need evidence-based approaches for teaching complex social, civic, and political issues enabling students of diverse mindsets and backgrounds to engage constructively with one another while obtaining necessary skills and knowledge. These findings provide empirical support for a professional development approach that engages teachers in fostering academic and civic competencies critical to both participation in a democracy and success in college and career.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ihab Hassan Abdel Fattah ◽  
Mohamed Mahmoud Abdel Allim ◽  
MortadaElsayed Ahmed ◽  
Yasmeen Ahmed Mohamed Taha

Abstract Background Preterm delivery with its associated morbidity and mortality still represents one of the major unsolved problems in Obstetrics. In PPROM, there is an increased incidence of preterm delivery which represents a life threatening situation. It has been calculated that the mean duration of PROM pregnancies is 37 weeks, so premature birth defined as delivery before 37 week of gestation, is the leading cause of perinatal mortality and short and long term fetal morbidity. Obviously, preterm deliveries represent a problem because of the severe neonatal complications that often occur afterwards. These complications are worse for the smaller newborn with earlier gestational age. These complications include respiratory distress syndrome, intraventricular hemorrhage, sepsis and necrotizing enterocolitis. Objective The present study aims to investigate the effect of 17-OH progesterone on primegravida and the possible change in the premature delivery rates and other pregnancy outcomes and complications regarding its use. Methods The current research is a randomized controlled study was conducted at Obstetric outpatient clinic of Ain Shams University Maternity Hospital and involved 80 pregnant admitted to assess the efficacy of intramuscular progesterone compared to placebo therapy in decreasing the rate of preterm birth in women with PPROM pregnancy, selected on basis being with age between 18-35 years, carrying Singleton pregnancy, at gestational age between24-34 weeks. Results The present study provides no evidence that 17OHP-C is beneficial in women with PROM. Although the trial turned out to be underpowered for the primary outcome, it had reasonable statistical power for the prespecified secondary outcomes, which allowed us to conclude that 17OHP-C does not prolong pregnancy or reduce perinatal morbidity after PROM. Preterm PROM is a frequently encountered obstetric diagnosis, with improved neonatal outcomes when an uninfected mother is able to continue her pregnancy for a longer duration to reach a more advanced gestational age. Conclusion Compared placebo with intramuscular 17-OHPC in women with prelabour rupture of membranes. Pregnancy is associated with lower percentage of preterm labour, fewer NICU admissions in 17 OHPC.


Author(s):  
Irang Kim ◽  
Sarah Dababnah

As the United States grows more racially and ethnically diverse, Koreans have become one of the largest ethnic minority populations. We conducted this qualitative study to explore the perspectives of Korean immigrant parents about their child’s future and the factors that shape those perspectives. We used modified grounded theory methods. Twenty Korean immigrant parents of children and adults with intellectual and developmental disabilities participated in the study. Four themes emerged: navigating complicated and limited service systems, maintaining safety and relationships through work and higher education, ongoing parental care at home, and the need for culturally relevant adult services. We discuss implications for culturally responsive practice and inclusive research.


Sign in / Sign up

Export Citation Format

Share Document