The effects of COVID-19 restrictions on physical activity and mental health of children and young adults with physical and/or intellectual disabilities.

BACKGROUND: COVID-19 has caused unprecedented restrictions, significantly affecting the most vulnerable groups in society, such as those with a disability. OBJECTIVE: The aim of the study was to investigate the effects of COVID-19 lockdown restrictions on physical activity and mental health of children and young adults with physical and/or intellectual disabilities. METHODS: The study was a cross-sectional design. Parents/carers completed an electronic survey in the UK between June-July 2020 on behalf of their child. Through Likert scales and free-text questions, the survey asked about physical activity levels and mental health during lockdown compared to before, access to specialist facilities and equipment to aid with physical activity, and the short- and long-term concerns around ongoing lockdown restrictions. RESULTS: Generally, respondents reported negative effects of lockdown restrictions, with 61% reporting a reduction in physical activity levels and over 90% reporting a negative impact on mental health (including poorer behaviour, mood, fitness and social and learning regression). Many respondents cited a lack of access to specialist facilities, therapies and equipment as reasons for this, and raised concerns about the long-term effects of this lack of access on their child's mental health and physical activity levels. CONCLUSIONS: The survey highlights the negative impact of the COVID-19 lockdown on the physical activity levels and mental health of children and young adults with disabilities and highlights the importance of addressing the needs of the disabled community as restrictions are eased.

Variants of the EAAT2 Glutamate Transporter Gene Promoter Are Associated with Cerebral Palsy in Preterm Infants.

Preterm delivery is associated with neurodevelopmental impairment caused by environmental and genetic factors. Dysfunction of the excitatory amino acid transporter 2 (EAAT2) and the resultant impaired glutamate uptake can lead to neurological disorders. In this study, we investigated the role of single nucleotide polymorphisms (SNPs; g.-200C>A and g.-181A>C) in the EAAT2 promoter in susceptibility to brain injury and neurodisability in very preterm infants born at or before 32-week gestation. DNA isolated from newborns' dried blood spots were used for pyrosequencing to detect both SNPs. Association between EAAT2 genotypes and cerebral palsy, cystic periventricular leukomalacia and a low developmental score was then assessed. The two SNPs were concordant in 89.4% of infants resulting in three common genotypes all carrying two C and two A alleles in different combinations. However, in 10.6% of cases, non-concordance was found, generating six additional rare genotypes. The A alleles at both loci appeared to be detrimental and consequently, the risk of developing cerebral palsy increased four- and sixfold for each additional detrimental allele at -200 and -181 bp, respectively. The two SNPs altered the regulation of the EAAT2 promoter activity and glutamate homeostasis. This study highlights the significance of glutamate in the pathogenesis of preterm brain injury and subsequent development of cerebral palsy and neurodevelopmental disabilities. Furthermore, the described EAAT2 SNPs may be an early biomarker of vulnerability to neurodisability and may aid the development of targeted treatment strategies.

Medication reconciliation: a prescription for safer care.

Four national healthcare organizations - Accreditation Canada, the Canadian Institute for Health Information, the Canadian Patient Safety Institute and the Institute for Safe Medication Practices Canada - recently collaborated to better understand and share comprehensive information about medication reconciliation in Canada. This article summarizes the key findings of their joint report titled Medication Reconciliation in Canada: Raising the Bar and profiles innovative approaches and tools for healthcare organizations across Canada.

Medication reconciliation: the priority that isn't.

Medication reconciliation is a crucial step in safe care, but it is often done inconsistently or inadequately, or missed altogether. This can be dangerous and even deadly for patients, and expensive for the system. In this article, the authors discuss the current status of medication reconciliation in Canada, barriers to its implementation and steps healthcare organizations across the country are taking to introduce medication reconciliation. They conclude by outlining ways that provincial and territorial governments could re-energize work on medication reconciliation.

Activating knowledge for patient safety practices: a Canadian academic-policy partnership.

BACKGROUND: Over the past decade, the need for healthcare delivery systems to identify and address patient safety issues has been propelled to the forefront. A Canadian survey, for example, demonstrated patient safety to be a major concern of frontline nurses (Nicklin & McVeety 2002). Three crucial patient safety elements, current knowledge, resources, and context of care have been identified by the World Health Organization (WHO 2009). To develop strategies to respond to the scope and mandate of the WHO report within the Canadian context, a pan-Canadian academic-policy partnership has been established. APPROACH: This newly formed Pan-Canadian Partnership, the Queen's Joanna Briggs Collaboration for Patient Safety (referred throughout as "QJBC" or "the Partnership"), includes the Queen's University School of Nursing, Accreditation Canada, the Canadian Patient Safety Institute (CPSI), the Canadian Institutes of Health Research, and is supported by an active and committed advisory council representing over 10 national organizations representing all sectors of the health continuum, including patients/families advocacy groups, professional associations, and other bodies. This unique partnership is designed to provide timely, focused support from academia to the front line of patient safety. QJBC has adopted an "integrated knowledge translation" approach to identify and respond to patient safety priorities and to ensure active engagement with stakeholders in producing and using available knowledge. Synthesis of evidence and guideline adaptation methodologies are employed to access quantitative and qualitative evidence relevant to pertinent patient safety questions and subsequently, to respond to issues of feasibility, meaningfulness, appropriateness/acceptability, and effectiveness. SUMMARY: This paper describes the conceptual grounding of the Partnership, its proposed methods, and its plan for action. It is hoped that our journey may provide some guidance to others as they develop patient safety models within their own arenas.