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2.
Lancet Child Adolesc Health ; 4(9): 699-708, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32827491

RESUMO

Sexual and reproductive health is an important aspect of human development, but discussions with adolescents and young adults on this topic are often challenging for health-care providers. As a result, many adolescents and young adults do not receive appropriate, comprehensive sexual education, despite recognition from WHO and the UN that access to this education is a human right. Adolescents and young adults with mild to moderate intellectual or developmental disability, or both, are just as likely to be sexually active as are their peers without disability; however, these individuals are less likely to receive comprehensive sexual education. To ensure adequate comprehensive sexual education for adolescents and young adults with intellectual and developmental disabilities, sexual health educators should facilitate conversations about sexual and reproductive health that are non-judgmental and sexually inclusive. Such initiatives should use an educational framework grounded in universal design for learning, including use of multiple media types with clear, concise language and images.


Assuntos
Educação Sexual/métodos , Comportamento Sexual , Saúde Sexual/educação , Adolescente , Deficiências do Desenvolvimento/psicologia , Deficiências do Desenvolvimento/terapia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Deficiência Intelectual/psicologia , Deficiência Intelectual/terapia , Masculino , Medição de Risco , Adulto Jovem
3.
MMWR Morb Mortal Wkly Rep ; 69(34): 1156-1160, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32853187

RESUMO

Clinical guidelines recommend that primary care providers (PCPs) provide guidance and support to ensure a planned transition from pediatric to adult health care for adolescents, beginning at age 12 years (1). However, most adolescents do not receive the recommended health care transition planning (2). This is particularly concerning for adolescents with diagnosed mental, behavioral, and developmental disorders (MBDDs) (3), who account for approximately 20% of U.S. adolescents (4). Childhood MBDDs are linked to increased long-term morbidity and mortality; timely health care transition planning might mitigate adverse outcomes (5,6). CDC analyzed pooled, parent-reported data from the 2016 and 2017 National Survey of Children's Health (NSCH), comparing adolescents, aged 12-17 years, with and without MBDDs on a composite measure and specific indicators of recommended health care transition planning by PCPs. Overall, approximately 15% of adolescents received recommended health care transition planning: 15.8% (95% confidence interval [CI] = 14.1%-17.5%) of adolescents with MBDDs, compared with 14.2% (95% CI = 13.2%-15.3%) of adolescents without MBDDs. Relative to peers without MBDDs and after adjusting for age, adolescents with anxiety were 36% more likely to receive recommended health care transition planning, and those with depression were 69% more likely; adolescents with autism spectrum disorder (ASD) were 35% less likely to receive such transition planning, and those with developmental delay* were 25% less likely. Fewer than 20% of adolescents with MBDDs receiving current treatment met the transition measure. These findings suggest that a minority of adolescents with MBDDs receive recommended transition planning, indicating a potential missed public health opportunity to prevent morbidity and mortality in a population at high risk for health care disengagement (1). Improving access to comprehensive and coordinated programs and services,† as well as increasing provider training concerning adolescents' unique mental and physical health care needs (7), could help increase the number of adolescents benefiting from successful health care transitions (4).


Assuntos
Deficiências do Desenvolvimento/terapia , Transtornos Mentais/terapia , Apoio Social , Transição para Assistência do Adulto/organização & administração , Adolescente , Criança , Deficiências do Desenvolvimento/epidemiologia , Feminino , Pesquisas sobre Serviços de Saúde , Humanos , Masculino , Transtornos Mentais/epidemiologia , Estados Unidos/epidemiologia
4.
Can J Psychiatry ; 65(10): 695-700, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32573397

RESUMO

OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic presents major challenges to places of detention, including secure forensic hospitals. International guidance presents a range of approaches to assist in decreasing the risk of COVID-19 outbreaks as well as responses to manage outbreaks of infection should they occur. METHODS: We conducted a literature search on pandemic or outbreak management in forensic mental health settings, including gray literature sources, from 2000 to April 2020. We describe the evolution of a COVID-19 outbreak in our own facility, and the design, and staffing of a forensic isolation unit. RESULTS: We found a range of useful guidance but no published experience of implementing these approaches. We experienced outbreaks of COVID-19 on two secure forensic units with 13 patients and 10 staff becoming positive. One patient died. The outbreaks lasted for 41 days on each unit from declaration to resolution. We describe the approaches taken to reduction of infection risk, social distancing and changes to the care delivery model. CONCLUSIONS: Forensic secure settings present major challenges as some proposals for pandemic management such as decarceration or early release are not possible, and facilities may present challenges to achieve sustained social distancing. Assertive testing, cohorting, and isolation units are appropriate responses to these challenges.


Assuntos
Infecções por Coronavirus/terapia , Deficiências do Desenvolvimento/terapia , Psiquiatria Legal , Hospitais Psiquiátricos , Isolamento de Pacientes , Pneumonia Viral/terapia , Transtornos Psicóticos/terapia , Transtornos Relacionados ao Uso de Substâncias/terapia , Adulto , Idoso , Comorbidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Deficiências do Desenvolvimento/epidemiologia , Feminino , Hospitais Psiquiátricos/organização & administração , Humanos , Masculino , Pessoa de Meia-Idade , Ontário , Pandemias/prevenção & controle , Isolamento de Pacientes/organização & administração , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Transtornos Psicóticos/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
5.
Artigo em Inglês | MEDLINE | ID: mdl-32365607

RESUMO

In the present study, a teacher training program based on behavioral therapy was conducted for high school correspondence course teachers of adolescents aged between 15 and 18 years who showed developmental difficulties. Participating teachers were assigned to either an immediate treatment (IT; n = 13) or delayed treatment control (DTC; n = 17) group to evaluate the effectiveness of the program, which comprised five 90-min sessions with small groups of three to six participants and was conducted over three months. The results showed significant improvement in students' behaviors and social responsiveness and in teachers' confidence among those in the IT group; however, those in the DTC group did not show any such improvement. We discuss the program's feasibility in terms of developing support resources for teachers in Japanese high schools.


Assuntos
Terapia Comportamental , Deficiências do Desenvolvimento/terapia , Capacitação de Professores , Adolescente , Adulto , Feminino , Humanos , Japão , Masculino , Avaliação de Programas e Projetos de Saúde , Professores Escolares , Instituições Acadêmicas , Estudantes , Adulto Jovem
6.
Pediatr Clin North Am ; 67(3): 499-511, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32443989

RESUMO

This article summarizes the literature on prevalence and establishment of severe problem behavior in individuals with intellectual and developmental disabilities, empirical support for applied behavior analysis, and evidence-based behavioral assessment and treatment procedures. Early intervention and prevention approaches and the role of the pediatrician with regard to surveillance, early intervention, and coordination of care are discussed.


Assuntos
Terapia Comportamental/métodos , Deficiências do Desenvolvimento/terapia , Deficiência Intelectual/terapia , Comportamento Problema/psicologia , Criança , Deficiências do Desenvolvimento/psicologia , Humanos , Deficiência Intelectual/psicologia , Fatores de Risco
7.
Pediatrics ; 145(5)2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32327449

RESUMO

As the technical ability for genetic diagnosis continues to improve, an increasing number of diagnoses are made in infancy or as early as the neonatal period. Many of these diagnoses are known to be associated with developmental delay and intellectual disability, features that would not be clinically detectable at the time of diagnosis. Others may be associated with cognitive impairment, but the incidence and severity are yet to be fully described. These neonates and infants with genetic diagnoses therefore represent an emerging group of patients who are at high risk for neurodevelopmental disabilities. Although there are well-established developmental supports for high-risk infants, particularly preterm infants, after discharge from the NICU, programs specifically for infants with genetic diagnoses are rare. And although previous research has demonstrated the positive effect of early developmental interventions on outcomes among preterm infants, the impact of such supports for infants with genetic disorders who may be born term, remains to be understood. We therefore review the literature regarding existing developmental assessment and intervention approaches for children with genetic disorders, evaluating these in the context of current developmental supports postdischarge for preterm infants. Further research into the role of developmental support programs for early assessment and intervention in high-risk neonates diagnosed with rare genetic disorders is needed.


Assuntos
Deficiências do Desenvolvimento/psicologia , Deficiências do Desenvolvimento/terapia , Doenças Genéticas Inatas/psicologia , Doenças Genéticas Inatas/terapia , Deficiências do Desenvolvimento/diagnóstico , Intervenção Educacional Precoce/métodos , Doenças Genéticas Inatas/diagnóstico , Humanos , Recém-Nascido , Recém-Nascido Prematuro/fisiologia , Doenças do Prematuro/diagnóstico , Doenças do Prematuro/psicologia , Doenças do Prematuro/terapia
8.
Medicine (Baltimore) ; 99(15): e19751, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32282736

RESUMO

RATIONALE: This case report expands the mutation and phenotypic spectra of Beaulieu-Boycott-Innes syndrome (BBIS), and will be valuable for mutation-based pre- and post-natal screening of BBIS when conducting a genetic diagnosis. PATIENT CONCERNS: A 4-year old boy from Guilin City, Guangxi Zhuang Autonomous Region, China, was referred to our clinic for clarification of his diagnosis because he showed moderate intellectual disability. DIAGNOSIS: Two novel compound heterozygous mutations of THOC6, c.664T>C (p.Trp222Arg) and c.945+1 G>A were identified in this patient by whole exome sequencing. The two mutations were evaluated as pathogenic and likely pathogenic respectively according to the American College of Medical Genetics guidelines. This is the first case displaying the BBIS phenotype reported in the Chinese population. These two mutations have not been reported previously. INTERVENTIONS: Symptomatic treatment and rehabilitation training for patients. OUTCOMES: The genetic cause of the disease was identified. The family received scientific genetic counseling. LESSONS: BBIS is a rare syndromic autosomal recessive disease with intellectual disability and it is normally difficult for clinicians to recognize it. Whole exome sequencing is an efficient way to identify the gene which causes a particular disease in patients.


Assuntos
Anormalidades Múltiplas/genética , Deficiências do Desenvolvimento/genética , Deficiência Intelectual/genética , Atrofia Muscular/genética , Proteínas de Ligação a RNA/genética , Anormalidades Múltiplas/diagnóstico , Anormalidades Múltiplas/reabilitação , Anormalidades Múltiplas/terapia , Grupo com Ancestrais do Continente Asiático/genética , Pré-Escolar , Deficiências do Desenvolvimento/diagnóstico , Deficiências do Desenvolvimento/reabilitação , Deficiências do Desenvolvimento/terapia , Facies , Aconselhamento Genético/normas , Humanos , Deficiência Intelectual/diagnóstico , Deficiência Intelectual/reabilitação , Deficiência Intelectual/terapia , Masculino , Atrofia Muscular/diagnóstico , Atrofia Muscular/reabilitação , Atrofia Muscular/terapia , Mutação/genética , Fenótipo , Síndrome , Sequenciamento Completo do Exoma/métodos
11.
Sleep Health ; 6(2): 220-231, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32044276

RESUMO

OBJECTIVES: This study explored the feasibility and acceptability of a sleep health education intervention for caregivers of children with developmental disabilities (DD). DESIGN: This mixed-methods pilot study utilized repeated measures and caregiver interviews. SETTING: The intervention occurred in the homes of caregivers who live on the Navajo Nation. PARTICIPANTS: Fifteen caregivers of children with DD aged from birth to 3 years old participated. INTERVENTION: The intervention consisted of three 1-hour home-based sessions. Educational modules were tailored to specific sleep issues of the caregiver and their child(ren), as well as the unique environmental and cultural features of Navajo families. MEASUREMENTS: Quantitative measures included a sleep habits questionnaire, pre- and postmeasures of learning, and the SF-12 HRQoL. Quantitative data were analyzed with frequencies and repeated measures analyses with p .05. Qualitative comments regarding facilitators and detractors to healthy sleep were transcribed verbatim and categorized into themes. RESULTS: Caregiver sleep duration increased by 2 hours (5.8±1.8 to 7.8±1.9, p = .005). Caregivers also reported improved physical (45.0±8.2 to 52.8+8.7 p = .001) and mental HR-QoL (41.8±8.9 to 49.3±10.9, p = .002), and enhanced knowledge of sleep disorders (13.4±4.0 to 20.7±5.6) and healthy sleep habits (15.7±4.1 to 25.4±3.4 each p = .005). Many participants reported better sleep quality in their children with earlier bedtimes and less night waking. CONCLUSIONS: Findings suggest that this tailored sleep education program is a culturally responsive approach to promoting caregiver sleep health and HR-QoL, as well as the sleep health of their children. Caregivers credited improved sleep to the support they received during visits and text messaging.


Assuntos
Cuidadores/educação , Educação em Saúde , Promoção da Saúde/métodos , Índios Norte-Americanos/educação , Sono , Adulto , Cuidadores/estatística & dados numéricos , Pré-Escolar , Deficiências do Desenvolvimento/terapia , Estudos de Viabilidade , Feminino , Humanos , Índios Norte-Americanos/estatística & dados numéricos , Lactente , Recém-Nascido , Masculino , Projetos Piloto , Avaliação de Programas e Projetos de Saúde , Pesquisa Qualitativa , Inquéritos e Questionários
12.
Curr Psychiatry Rep ; 22(2): 9, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-32008108

RESUMO

PURPOSE OF REVIEW: Although treatment algorithms and parameters for best practice are readily available for all major syndromes of psychiatric impairment, the occurrence of psychiatric syndromes in individuals with intellectual and developmental disability (IDD) invokes serious contextual challenges for interpretation of symptoms, diagnosis, and optimization of treatment, both for clinicians and for the service sectors in which care and support of individuals with IDD are delivered. Recognizing that there exist very few definitive resources for best practice under the circumstance of this form of "dual diagnosis," the Missouri Department of Mental Health convened an expert panel to conduct a focused review and synthesis of the relevant scientific literature from which to develop guidance in the form of decision support to clinicians. This article summarizes the findings for three of the most common and impairing clusters of psychiatric symptoms that co-occur with IDD-aggression, depression, and addictions. RECENT FINDINGS: Individuals with IDD are at high risk for the development of psychiatric symptoms (PS), which often manifest uniquely in IDD and for which evidence for effective intervention is steadily accruing. Interventions that are commonly implemented in the IDD service sector (e.g., functional communication training and positive behavioral support planning) are capable of mitigating severe behavioral impairment, yet rarely invoked when dual diagnosis patients are seen in the psychiatric service sector. Conversely, state-of-the-art interventions for traumatic stress, pharmacotherapy, and psychotherapy have proven capable of improving behavioral impairments in IDD but are typically restricted to the psychiatric service sector, where there exist significant barriers to access for patients with IDD, including limitations imposed by diagnostic eligibility and practitioner experience. Bridging these gaps in knowledge and clinical capacity across the respective IDD and PS service sectors should be of very high priority in strategizing the care and support of IDD patients with serious co-occurring psychiatric conditions.


Assuntos
Deficiências do Desenvolvimento/complicações , Deficiências do Desenvolvimento/diagnóstico , Deficiência Intelectual/complicações , Deficiência Intelectual/diagnóstico , Transtornos Mentais/complicações , Transtornos Mentais/diagnóstico , Deficiências do Desenvolvimento/terapia , Humanos , Deficiência Intelectual/terapia , Transtornos Mentais/terapia
13.
BMJ Open ; 10(1): e034256, 2020 01 26.
Artigo em Inglês | MEDLINE | ID: mdl-31988234

RESUMO

INTRODUCTION: Children born extremely preterm (EP: <28 weeks gestation) and/or extremely low birth weight (ELBW: <1000 g) are at increased risk of motor impairment compared with children born at term. Children with motor impairment have lower rates of physical activity (PA) participation compared with their typically developing peers. PA participation is an important outcome for children with motor impairment, however, there is limited evidence available to support interventions that improve PA participation in this population. The aim of this study is to assess the feasibility, including the recruitment and retention, acceptability and fidelity, of a preschool dance participation intervention for children born EP/EBLW with motor impairment called Dance PaRticipation intervention for Extremely prEterm children with Motor Impairment at prEschool age. METHODS AND ANALYSIS: This feasibility case series trial will recruit EP/ELBW children with motor impairment (n=10) from the Victorian Infant Collaborative Study 2016/2017 cohort, a prospective longitudinal cohort study. Up to 10 community-based dance teachers will be recruited and provided with physiotherapy-led training and support to facilitate the participation of EP/ELBW children in community dance classes. A mixed-methods approach (quantitative and qualitative) will be used to analyse the primary aim, to determine the feasibility of the intervention from the perspectives of families and dance teachers. ETHICS AND DISSEMINATION: This study is approved by the Human Research Ethics Committees of The Royal Children's Hospital and The Royal Women's Hospital, Melbourne. Study outcomes will be disseminated through conference presentations, peer-reviewed publications and social media. TRIAL REGISTRATION NUMBER: ACTRN12619001266156.


Assuntos
Dança , Deficiências do Desenvolvimento/terapia , Exercício Físico , Lactente Extremamente Prematuro/psicologia , Transtornos Motores/terapia , Modalidades de Fisioterapia/educação , Austrália , Desenvolvimento Infantil , Pré-Escolar , Educação não Profissionalizante , Estudos de Viabilidade , Feminino , Humanos , Estudos Longitudinais , Masculino , Destreza Motora , Estudos Prospectivos , Projetos de Pesquisa , Professores Escolares
15.
Curr Opin Psychiatry ; 33(2): 86-91, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31725422

RESUMO

PURPOSE OF REVIEW: People with intellectual and developmental disability (IDD) commonly exhibit behaviors that present challenges to their parents, caregivers, and teachers. Mindfulness-based practices and programs have emerged as a viable alternative to current interventions for such behaviors and the stress faced by their caregivers. This review addresses publications between 2018 and 2019 that examined the effectiveness of mindfulness-based practices and programs for people living with IDD. RECENT FINDINGS: Individuals with IDD can learn mindfulness practices to self-manage their aggressive and destructive behaviors. Individual practices and group-based programs continue to show that mindfulness approaches are effective for this population. Randomized controlled trials indicate that comprehensive mindfulness-based programs (e.g., mindfulness-based stress reduction, MYmind, and mindfulness-based positive behavior support) are effective for enhancing the quality of life of people living with IDD. SUMMARY: Research supports the use of informal mindfulness practices for challenging behaviors of people with IDD. Formal mindfulness-based programs continue to be evaluated for their effectiveness across different populations, cultures, levels of IDD, components of the program, and length of training. The research literature on mindfulness is still in the early stages of development and much work remains.


Assuntos
Deficiências do Desenvolvimento , Deficiência Intelectual , Atenção Plena/métodos , Qualidade de Vida , Autocontrole/psicologia , Deficiências do Desenvolvimento/psicologia , Deficiências do Desenvolvimento/terapia , Humanos , Deficiência Intelectual/psicologia , Deficiência Intelectual/terapia , Comportamento Problema/psicologia
16.
J Pediatr ; 217: 52-58.e1, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31606151

RESUMO

OBJECTIVE: To assess the outcomes in actively managed extremely preterm infants after admission to a neonatal intensive care unit. STUDY DESIGN: Retrospective cohort of 255 infants born at 22-25 weeks of gestation between 2006 and 2015 at a single study institution. Infants were excluded for congenital anomaly, death in delivery room, or parental request for palliation (n = 7). Neurodevelopmental outcomes were analyzed for 169 of 214 survivors (78.9%) at 18-22 months of corrected age. Outcomes were evaluated using the Mann-Whitney U, χ2, or Fisher exact test, where appropriate. In addition, cognitive scores of the Bayley Scales of Infant-Toddler Development (3rd edition) were assessed using generalized estimating equations. RESULTS: Seventy infants born at 22-23 weeks of gestation (22 weeks, n = 20; 23 weeks, n = 50) and 178 infants born at 24-25 weeks of gestation (24 weeks, n = 79; 25 weeks, n = 99 infants) were included. Survival to hospital discharge of those surviving to NICU admission was 78% (55/70; 95% CI, 69%-88%) at 22-23 weeks and 89% (159/178; 95% CI, 84%-93% at 24-25 weeks; P = .02). No or mild neurodevelopmental impairment in surviving infants was 64% (29/45; 95% CI, 50%-77%) at 22-23 weeks and 76% (94/124; 95% CI, 68%-83%; P = .16) at 24-25 weeks. CONCLUSIONS: Although survival was lower in infants born at 22-23 weeks than at 24-25 weeks of gestation, the majority of survivors in both groups had positive outcomes with no or mild neurodevelopmental impairments. Further evaluation of school performance is warranted.


Assuntos
Doenças do Prematuro/terapia , Unidades de Terapia Intensiva Neonatal , Terapia Intensiva Neonatal/organização & administração , Hemorragia Cerebral Intraventricular/diagnóstico , Deficiências do Desenvolvimento/terapia , Enterocolite Necrosante/terapia , Feminino , Seguimentos , Idade Gestacional , Mortalidade Hospitalar , Humanos , Lactente , Lactente Extremamente Prematuro , Masculino , Transtornos do Neurodesenvolvimento/terapia , Sistema de Registros , Retinopatia da Prematuridade/terapia , Estudos Retrospectivos , Centros de Atenção Terciária , Resultado do Tratamento
17.
J Appl Res Intellect Disabil ; 33(2): 180-192, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31694076

RESUMO

BACKGROUND: Transitioning to adult healthcare systems can be challenging, especially if left unaddressed for adolescents with special healthcare needs (ASHCN), such as those with autism spectrum disorder and attention-deficit/ hyperactivity disorder. While there is evidence of disparities between different demographics regarding general healthcare services, research on healthcare-specific transition planning is lacking. Thus, there is a critical need to continually investigate these disparities. METHOD: Using nationally representative data from the 2016 National Survey for Children's Health, several analyses were conducted to examine doctor-patient interactions and discussions about transitioning to adult health care. Accounting for demographic and diagnostic indicators allowed for the assessment of disparities. RESULTS: Findings revealed significant disparities between age, disability and race relative to various healthcare transition support services. CONCLUSIONS: Findings provide valuable information that can inform the development of training programmes for healthcare providers, influence policy, modify procedures and interventions and highlight the need for increased advocacy for ASHCN.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/terapia , Transtorno do Espectro Autista/terapia , Deficiências do Desenvolvimento/terapia , Disparidades em Assistência à Saúde/estatística & dados numéricos , Deficiência Intelectual/terapia , Relações Médico-Paciente , Transição para Assistência do Adulto/estatística & dados numéricos , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Masculino
18.
J Appl Res Intellect Disabil ; 33(2): 193-203, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31441576

RESUMO

BACKGROUND: Previous evaluations of community PBS teams have not investigated whether behaviour change is both statistically reliable and clinically significant. Few previous studies have reported quality of life (QoL) and social validity outcomes. METHOD: The present authors collected data on 85 people referred to a specialist PBS team. The present authors used a unique set of multiple measures and statistical change metrics to evaluate outcome. RESULTS: Statistically significant improvements in QoL and health-related QoL (HRQoL), with medium to large effect sizes, were demonstrated following PBS input. Mean Behaviour Problems Inventory-Short Form scores reduced from 37.74 (SD = 30.54) at baseline to 12.12 (SD = 12.24) at follow-up, with a large effect size (d = 0.84). Stakeholders reported valuing the process and outcomes of PBS, findings which support the social validity of PBS for people with developmental disabilities. CONCLUSION: This study demonstrates successful PBS outcomes in QoL, HRQoL, challenging behaviour and social validity in a community setting.


Assuntos
Serviços Comunitários de Saúde Mental , Deficiências do Desenvolvimento/terapia , Avaliação de Resultados em Cuidados de Saúde , Comportamento Problema , Qualidade de Vida , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
19.
Disabil Health J ; 13(1): 100828, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31422168

RESUMO

BACKGROUND: Few researchers have examined the effects of surf programs on children with disabilities. Due to previous research findings, surfing is being used, as the focus of physical activity intervention due to its numerous health and therapeutic benefits. OBJECTIVE/HYPOTHESIS: The purpose of this study was to explore the effects of an eight-week surfing intervention on various physical fitness measures in 71 children with disabilities such as autism spectrum disorder, down syndrome, global developmental delays, and cerebral palsy. The study also sought to compare the differences in overall fitness levels between the surf therapy group and an unstructured pool playgroup. Researchers predicted significant differences in the surf therapy group. METHODS: The assessment procedure consisted of pre and post physical fitness measures selected from the Brockport Physical Fitness Test in two groups: surfing (n = 71) and an unstructured aquatic program (n = 20). RESULTS: The results demonstrated significant improvements in core strength (p = 0.00), upper body strength (p = 0.00), flexibility (p = 0.01) and cardiorespiratory endurance (p = 0.00) in the surfing group. However, there were no significant differences in overall fitness levels between the surfing and unstructured pool playgroups. Body composition measurements on the surfing group demonstrated a significant reduction in total body fat % (p = 0.016) and fat free mass (p = 0.008) and a significant improvement in bone mineral density (p = 0.004) pre to post surf therapy. CONCLUSIONS: This research demonstrated the effectiveness and physiological benefits of surf therapy for children with selected disabilities.


Assuntos
Crianças com Deficiência , Exercício Físico/fisiologia , Aptidão Física , Esportes para Pessoas com Deficiência/fisiologia , Tecido Adiposo/metabolismo , Adolescente , Transtorno do Espectro Autista/terapia , Composição Corporal , Compartimentos de Líquidos Corporais/metabolismo , Densidade Óssea , Paralisia Cerebral/terapia , Criança , Deficiências do Desenvolvimento/terapia , Síndrome de Down/terapia , Feminino , Humanos , Masculino , Força Muscular , Resistência Física , Aptidão Física/fisiologia , Jogos e Brinquedos , Amplitude de Movimento Articular , Esportes/fisiologia , Resultado do Tratamento , Água
20.
Nutr Clin Pract ; 35(1): 149-156, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31134674

RESUMO

BACKGROUND: Factors associated with gastrostomy placement in adolescents with developmental disabilities (DDs) and cerebral palsy (CP) are poorly investigated. We aimed to develop and validate a machine learning (ML) model for gastrostomy placement in adolescents with DDs and CP. METHODS: We performed a multinational, double-blinded, case-control study including 130 adolescents with severe DD and CP (72 males, 58 females; mean age 16 ± 2 years). Data on etiology, diagnosis, spasticity, epilepsy, clinical history, and functional assessments such as the Eating and Drinking Ability Classification System, Manual Ability Classification System, and Gross Motor Function Classification System were collected between 2005 and 2015. Analysis included Fisher exact test, multiple logistic regressions, and a supervised ML model, named PredictMed, to identify factors associated with gastrostomy placement. "Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis" guidelines were followed. RESULTS: Poor motor function (P < 0.001), trunk muscle tone disorder (P < 0.001), male gender (P < 0.01), epilepsy (P = 0.01), and severe neuromuscular scoliosis (P = 0.04) were factors linked with gastrostomy placement in univariate analysis. Epilepsy (P = 0.03), poor motor function (P = 0.04), and male gender (P = 0.04) were associated with gastrostomy placement in multivariate analysis with 95% accuracy. CONCLUSION: Epilepsy, poor motor function, trunk muscles tone disorder, and male gender were accurate, sensitive, and specific factors associated with gastrostomy need.


Assuntos
Paralisia Cerebral/terapia , Deficiências do Desenvolvimento/terapia , Gastrostomia/métodos , Intubação Gastrointestinal/métodos , Adolescente , Estudos de Casos e Controles , Paralisia Cerebral/cirurgia , Deficiências do Desenvolvimento/cirurgia , Nutrição Enteral/métodos , Feminino , Humanos , Modelos Logísticos , Aprendizado de Máquina , Masculino , Modelos Biológicos , Prognóstico
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