Implementing the Cognitive Orientation to daily Occupational Performance (CO-OP) approach in a group format with children living with motor coordination difficulties.

BACKGROUND/AIM: Children with developmental coordination disorder demonstrate limited participation in daily occupations which negatively impacts on their physical and psycho-social wellbeing. Literature is emerging supporting the use of the Cognitive Orientation to daily Occupational Performance (CO-OP) within a group format. The purpose of this study was to explore the feasibility of the CO-OP approach in a group format for children with motor coordination difficulties. METHODS: A single group mixed-method approach was employed. Four children with motor coordination difficulties between seven-to-nine years of age and their mothers, participated in a CO-OP group intervention once a week over 10 weeks. The study examined performance (perceived and actual) and satisfaction of family-chosen goals, gross and fine motor functioning and parental experience of participating in the intervention. RESULTS: Improvements in performance (perceived) and satisfaction ratings of family-chosen goals bordered on achieving statistical significance. Fine and gross motor functioning and performance (actual) improved, however, the change in performance was variable between participants and among the overarching goals. Semi-structured interviews were thematically analysed. Themes included: formation of the group, moving from disenabling to enabling, belonging and the importance of small successes. CONCLUSIONS: CO-OP offers a feasible intervention approach when delivered in a group format. Parental perceptions are valuable in shaping the delivery of the CO-OP in future studies. More research is needed to support these findings and contribute to evidence-based practice.

Cognitive Orientation to daily Occupational Performance (CO-OP) as group therapy for children living with motor coordination difficulties: An integrated literature review.

BACKGROUND/AIM: Children with Developmental Coordination Disorder (DCD) demonstrate limited participation in daily occupations which negatively impacts their physical and psycho-social wellbeing. The CO-OP approach is strongly supported within the literature as an effective treatment for DCD when delivered as a one-on-one therapy. Group interventions have proven to be effective in increasing self-esteem, decreasing feelings of isolation and are a cost effective way of delivering therapy. The purpose of this review was to explore the evidence for the use of the CO-OP approach in a group format for children with motor coordination difficulties. METHODS: Searches of CINAHL, MEDLINE, Scopus, Proquest, PsycINFO, ERIC and OTDBase, were conducted from 2000 through until September 30, 2015. Articles included were in English, peer reviewed articles, followed principals of CO-OP and were delivered through a group therapy approach. All articles were critically reviewed and thematically analysed. RESULTS: 192 studies were retrieved with a final number of six articles included in the review. Six themes were highlighted: achieving a new level of perceived competence; feeling a sense of belonging; children learning how the condition affected them and strategies to overcome these challenges; careful formation of intervention groups; the value of following the CO-OP protocols; and the significance of parental involvement. CONCLUSION: The findings of this review suggest that the CO-OP approach, when administered in a group format, has the potential to benefit children living with motor coordination difficulties in both physical and psycho-social domains. More research is required to confirm these findings and contribute to evidence-based practice.

Determination of Heavy Metals in a Variety of Cannabis and Cannabis-Derived Products, First Action 2021.03.

BACKGROUND: The legalization of medicinal or recreational marijuana across many states in the United States and other countries has driven demand for cannabis, hemp, and related products. OBJECTIVE: In the absence of federal regulations to ensure the product quality and safety of these products, each state issues its own guidance and sets its own regulations. Like food and pharmaceuticals, cannabis testing should include the analysis of heavy metals, which may be toxic if ingested or inhaled. METHODS: Based on established methods for the preparation and multi-elemental analysis of plant materials, a range of cannabis and cannabis-related products were prepared for analysis using microwave-assisted acid digestion followed by testing with inductively coupled plasma-mass spectrometry (ICP-MS). The sample preparation procedure was validated by measuring arsenic (As), cadmium (Cd), mercury (Hg), and lead (Pb) in four plant-based certified reference materials (CRMs). RESULTS: The mean ICP-MS results for As, Cd, Hg, and Pb were in good agreement (85-110%) with the certified concentrations. The accuracy and precision of the ICP-MS method for the determination of As, Cd, Hg, and Pb, as well as other elements, were tested by spiking the various cannabis samples at different concentration levels and determining the spike recoveries. The spike recoveries for As, Cd, Hg, and Pb in all spiked samples met the AOAC Standard Method Performance Requirements (SMPR®) for Determination of Heavy Metals in a Variety of Cannabis and Cannabis-Derived Products (SMPR 2020.001) of 60-115% for low-level spike and 80-115% for mid- and high-level spikes. CONCLUSION: Microwave-assisted acid digestion and ICP-MS are suitable for trace metal preparation and analysis of cannabis, as well as related products, as shown by the results of this method. The repeatability and recovery results for As, Cd, Hg, and Pb met the method requirement criteria in the AOAC SMPR 2020.001. This method can be used for all stages of production to ensure safety with respect to toxic metals. HIGHLIGHTS: A wide range of cannabis and hemp samples, from raw materials to finished products, are within scope for analysis using the microwave-assisted acid digestion/ICP-MS method.

Framework for Improving Governance and Quality of Rural Oncology Outreach Services.

PURPOSE: Rural outreach is a common method for delivering oncology services closer to rural residents; however, there is no clear service framework for supporting its quality and governance. This work aimed to develop an agreed framework for improving the governance and quality of a rural oncology outreach service. METHODS: A Six Sigma and participatory action approach was used. Key clinicians and managers identified project goals and scope, participated in several rounds of interviews and medical record audits, and discussed findings to reach consensus about a framework for quality outreach service delivery from one regional cancer center supporting two rural hospital sites (5-chair nurse-led oncology units). RESULTS: Themes included strong investment by stakeholders in maintaining the outreach service for its importance for rural populations. The referral, treatment, and clinical governance processes were implicitly understood between stakeholders but not well documented. Medical record audits of treated patients identified important gaps in clinical information at rural sites. Through reflection and discussion, consensus was reached about a framework for quality service delivery. The participatory action planning cycle involving sites in regular discussions fostered information sharing, strong engagement, and uptake of the final framework. CONCLUSION: The framework was applied to a memorandum of understanding for planning, governance, and outcomes monitoring and provides a basis for developing new and benchmarking existing oncology outreach services.