Background and Aims Previous studies have shown low rates of diagnosis and treatment of hepatitis C virus (HCV) infection in people who inject drugs (PWID). Our aims were to test the effect of a complex intervention [Hepatitis C Awareness Through to Treatment (HepCATT)] in drug and alcohol clinics-primarily, on engagement of HCV-positive PWID with therapy and, secondarily, on testing for HCV, referral to hepatology services and start of HCV treatment. Design and setting A non-randomized pilot study in three specialist addiction clinics in England comparing an intervention year (starting between September 2015 and February 2016) with a baseline year (2014), together with three control clinics.Participants Analysis included all attendees at the intervention and control specialist addiction clinics identified as PWID.Intervention The intervention comprised the placement of a half-time facilitator in each clinic for 12 months with the brief to increase diagnosis of HCV infection within clients at those services and the engagement of diagnosed individuals with an appropriate care pathway. The facilitator undertook various activities, which could include training of key workers, direct interaction with clients, streamlining and support for hepatology appointments and introduction of dried blood-spot testing. Measurements For each clinic and period, we obtained the total number of clients and, as relevant, their status as PWID, tested for HCV, known HCV-positive, engaged with HCV therapy or treated. Findings Compared with baseline, there was strong evidence that engagement with HCV therapy in the intervention year increased (P < 0.001) more in the HepCATT centres than controls, up + 31 percentage points [95% confidence interval (CI) = 19-43] versus À12 (CI = -31 to + 6) and odds ratio (OR) = 9.99 (CI = 4.42-22.6) versus 0.35 (CI = 0.08-1.56). HepCATT centres also had greater increases in HCV testing (OR = 3.06 versus 0.78, P < 0.001), referral to hepatology (OR = 9.60 versus 0.56, P < 0.001) and treatment initiation (OR = 9.5 versus 0.74, P < 0.001). Conclusions Introducing a half-time facilitator into drug and alcohol clinics in England increased engagement of HCV-positive people who inject drugs with hepatitis C virus care pathways, with increased uptake also of testing, referral to hepatology and initiation of treatment.
Flourishing is an indicator of positive mental health and is important for children's development and well-being. We used variables from the National Survey of Children's Health 2016 as indicators of flourishing (difficulty making friends, is bullied, bullies others, shares ideas with family, argues, finishes tasks, does all homework, shows curiosity, stays calm, and cares about doing well in school) to compare differences in parent perceptions of their children with and without autism spectrum disorder (ASD). We anticipate that these findings will help identify intervention targets to support the well-being of individuals with ASD. Children between 6 and 17 years of age, without intellectual disability, brain injury, cerebral palsy, or Down syndrome were included. Total participants were 34,171 controls (male/female = 17,116/17,155) and 812 with ASD (male/female = 668/144). Factor analysis resulted in three-factor structures (social competence, behavioral control, and school motivation) with good model fit (root mean square error of approximation = 0.08, comparative fit index = 0.92, Tucker-Lewis index = 0.89). The multivariate regression model and propensity score with inverse probability of treatment weighting (PS-IPTW) method revealed that children with ASD had lower scores in the social competence and behavioral control factors compared to the control group (all P < 0.05). However, no significant differences were found in the school motivation factor between the two groups (P > 0.05) in both multivariate regression model and PS-IPTW method. Findings suggest that social competence and behavioral control are indicators of flourishing and are important intervention targets to increase flourishing among children with ASD. Autism Res 2019, 12: 952-966. Health 2016 to examine differences in parent perceptions of the indicators of flourishing (difficulty making friends, is bullied, bullies others, shares ideas with family, argues, finishes tasks, does all homework, shows curiosity, stays calm, and cares about doing well in school) between children with and without autism spectrum disorders (ASD). We anticipate that this information will help to identify therapeutic targets to support the well-being of individuals with ASD. Children between 6 and 17 years old, without intellectual disability (ID), brain injury (BI), cerebral palsy (CP), or Down syndrome (DS) were included. From the total (N = 50,212), we excluded children under age 6 (n = 14,494), those who once, but do not currently have ASD (n = 81), and those with ID (n = 432), BI (n = 170), CP (n = 35), and DS (n = 17), resulting in 34,983 records used. Total participants, age 6-17 years, were 34,171 controls (male/female = 17,116/17,155) and 812 with ASD (male/female = 668/144). Factor analysis resulted in the identification of three flourishing categories among the indicator variables (social competence, behavioral control, and school motivation). Children with ASD had lower scores in the social competence and behavioral control factors compared to the cont...
Leisure activity participation is important for health and well-being. This study examined similarities and differences between typically developing children and those with autism spectrum disorders (ASD) from 6 to 17 years old in physical, recreational, social, skill, and jobs/chores activities from a large national database. Findings revealed that children with ASD had significantly lower participation levels than those without ASD between 11 and 17 years old. They suggest an increasing disparity among many types of leisure participation for children and youth with ASD as they age, eventually leading to limited participation in adult activities. They reinforce the importance of intervention at an early age to increase participation in these activities to promote development of skills that contribute to adult competencies.
Importance: Few studies examining the use of peers during interventions have been published, and no systematic review has been conducted to evaluate the available literature. Objective: To examine the effectiveness of social skills interventions incorporating peers for children with attention deficit hyperactivity disorder (ADHD) to improve social interactions. Data Sources: A search of five databases (CINAHL, PubMed, Web of Science, Google Scholar, and PsycINFO) produced 697 articles. Sixty-one were retrieved for full-text review, and 15 articles met inclusion criteria. Study Selection and Data Collection: Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to abstract data. Inclusion criteria: Participants younger than age 18 yr with any ADHD pattern, social skills interventions with peer involvement, outcome measures within the domain of occupational therapy, written in English, and involved a peer as the sole or primary component at some point in the social skills intervention. Exclusion criteria: Studies older than 20 yr or that used participants with comorbidities or multiple conditions. Findings: Interventions incorporating both peer categories were effective for increasing play skills, reducing undesirable social behaviors (e.g., inappropriate verbalizations, dominant behaviors, aggression), and improving communication (e.g., pragmatic language, collaboration, joint participation) and social participation. Improvements were maintained over time, as evidenced by follow-up studies. Conclusions and Relevance: Outcomes of these studies demonstrate moderate evidence that supports the use of social skills interventions incorporating peers for children with ADHD to improve social interactions, supporting their use by occupational therapists and the need for more studies. What This Article Adds: This article provides guidance to occupational therapy practitioners on social skills intervention options for children with ADHD.
Date Presented 04/06/19 Flourishing, an indicator of positive mental health, is important for children’s development and well-being. Behavioral contributors to flourishing, independent of environment, were examined in a large data set of children from age 6 to 17 years. Children with ASD had significantly lower odds of flourishing and demonstrating the behavioral tendencies compared to controls, confirming the early need to address positive emotions and positive affect for these individuals. Primary Author and Speaker: Claudia Hilton Additional Authors and Speakers: Karen Ratcliff, Diane Collins, Joanne Flanagan, Ickpyo Hong
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